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Incorporating verbal autopsy into the civil registration and vital statistics system

Verbal autopsy within the civil registration and vital statistics sequence of events

This section provides simplified sequences of events that precede and follow the collection of VAs. It is assumed that:

  • There is a process for the notification of deaths in addition to family notification and registration
  • There is an organisation or agency that will take responsibility for the collection of VAs. 

VAs are generally collected when deaths occur in the community or in health facilities where there is no physician to certify COD. A typical sequence for the conduct and use of a VA in a country’s CRVS system might be as follows:

  1. A death occurs and a key community informant assists the family to report the death
  2. The family notifies the local authority
  3. The local authority then assigns a registration number and registers the death in the system. Data are entered on a tablet for transfer to central server; the local authority then provides a death certificate and/or burial permit to the family
  4. All data are transmitted to a central server and stored in the CRVS database
  5. The central server sends a notification to the nearest health facility to conduct a VA
  6. The health facility receives this notification on the tablet with the contact details prepopulated in the VA questionnaire
  7. The interviewer collects the data for the VA on the tablet
  8. VA results are uploaded onto a computer or onto the cloud and linked to the CRVS record
  9. COD data are transmitted to the registrar (in some cases); the registrar records the COD in the register using the registration number for linkage 
  10. The distribution of CODs is reviewed for plausibility and processes are corrected as necessary.

If such systems are not in place, they will need to be developed in parallel with the development of processes for the management of VA data.

Sources (see PDFs below).

Read more

Jha P et al (2005). Prospective study of one million deaths in India: rationale, design, and validation results. PLoS ONE.

Joshi R et al (2015). How much does a verbal autopsy based mortality surveillance system cost in rural India? PLoS ONE.

Liu S et al (2016). An integrated national mortality surveillance system for death registration and mortality surveillance, China. Bulletin of the World Health Organization.

Mahapatra P (2010). An overview of the sample registration system in rural India. Prince Mahidol Award Conference and Global Health Information Forum.

Pratiwi ED et al (2013). Development of an Indonesian sample registration system: a longitudinal study. The Lancet.

Sampling Strategies for National CRVS-Verbal Autopsy Planning: A Guidance Document for D4H Countries.

Integrating community-based verbal autopsy into CRVS: System-level considerations
Integrating community-based verbal autopsy into CRVS: System-level considerations

This document provides recommendations for integrating VA processes into CRVS, which involves consideration of system-wide integration issues.

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Authors: de Savigny D, Riley I, Chandramohan D, Odhiambo F, Nichols E, Notzon S, AbouZahr C, Mitra R, Cobos Munoz D, Firth S, Maire N, Sankoh O, Bronson G, Setel P, Byass P, Jakob P, Boerma T, Lopez AD

Publication date: January 2017

Resource type: CRVS peer-reviewed publication

Related resources: Summary: Integrating verbal autopsy into CRVS systems

Source: Global Health Action

Summary: Integrating verbal autopsy into CRVS systems thumbnail
Summary: Integrating verbal autopsies into CRVS systems

This document details how to sustainably integrate verbal autopsy into CRVS systems.

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Publication date: April 2018

Resource type: CRVS best-practice and advocacy

Related resources: Integrating community-based verbal autopsy into CRVS: System-level considerations

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