Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
Abstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data i...
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-021-12180-y |
| _version_ | 1818918866022039552 |
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| author | Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez |
| author_facet | Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez |
| author_sort | Matthew Reeve |
| collection | DOAJ |
| description | Abstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data in such contexts are often of limited use for policy and planning. Verbal autopsies (VAs) are a cost-effective way of generating reliable COD information in populations lacking comprehensive MCCOD coverage, but this method has not previously been applied in the Solomon Islands. This study describes the establishment of a VA system to estimate the cause specific mortality fractions (CSMFs) for community deaths that are not medically certified in the Solomon Islands. Methods Automated VA methods (SmartVA) were introduced into the Solomon Islands in 2016. Trained data collectors (nurses) conducted VAs on eligible deaths to December 2020 using electronic tablet devices and VA responses were analysed using the Tariff 2.0 automated diagnostic algorithm. CSMFs were generated for both non-inpatient deaths in hospitals (i.e. ‘dead on/by arrival’) and community deaths. Results VA was applied to 914 adolescent-and-adult deaths with a median (IQR) age of 62 (45–75) years, 61% of whom were males. A specific COD could be diagnosed for more than 85% of deaths. The leading causes of death for both sexes combined were: ischemic heart disease (16.3%), stroke (13.5%), diabetes (8.1%), pneumonia (5.7%) and chronic-respiratory disease (4.8%). Stroke was the top-ranked cause for females, and ischaemic heart disease the leading cause for males. The CSMFs from the VAs were similar to Global Burden of Disease (GBD) estimates. Overall, non-communicable diseases (NCDs) accounted for 73% of adult deaths; communicable, maternal and nutritional conditions 15%, and injuries 12%. Six of the ten leading causes reported for facility deaths in the Solomon Islands were also identified as leading causes of community deaths based on the VA diagnoses. Conclusions NCDs are the leading cause of adult deaths in the Solomon Islands. Automated VA methods are an effective means of generating reliable COD information for community deaths in the Solomon Islands and should be routinely incorporated into the national mortality surveillance system. |
| first_indexed | 2024-12-20T00:56:46Z |
| format | Article |
| id | doaj.art-9ac43f87a0cb480e8e88c1fa78b5e2aa |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-20T00:56:46Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-9ac43f87a0cb480e8e88c1fa78b5e2aa2022-12-21T19:59:05ZengBMCBMC Public Health1471-24582021-11-0121111010.1186/s12889-021-12180-yGenerating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon IslandsMatthew Reeve0Hafizur Chowdhury1Pasyodun Koralage Buddhika Mahesh2Gregory Jilini3Rooney Jagilly4Baakai Kamoriki5Rodley Ruskin6Deirdre McLaughlin7Alan D. Lopez8Bloomberg Philanthropies Data for Health Initiative, University of MelbourneBloomberg Philanthropies Data for Health Initiative, University of MelbourneBloomberg Philanthropies Data for Health Initiative, University of MelbourneMinistry of Health & Medical ServicesMinistry of Health & Medical ServicesMinistry of Health & Medical ServicesMinistry of Health & Medical ServicesBloomberg Philanthropies Data for Health Initiative, University of MelbourneUniversity of WashingtonAbstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data in such contexts are often of limited use for policy and planning. Verbal autopsies (VAs) are a cost-effective way of generating reliable COD information in populations lacking comprehensive MCCOD coverage, but this method has not previously been applied in the Solomon Islands. This study describes the establishment of a VA system to estimate the cause specific mortality fractions (CSMFs) for community deaths that are not medically certified in the Solomon Islands. Methods Automated VA methods (SmartVA) were introduced into the Solomon Islands in 2016. Trained data collectors (nurses) conducted VAs on eligible deaths to December 2020 using electronic tablet devices and VA responses were analysed using the Tariff 2.0 automated diagnostic algorithm. CSMFs were generated for both non-inpatient deaths in hospitals (i.e. ‘dead on/by arrival’) and community deaths. Results VA was applied to 914 adolescent-and-adult deaths with a median (IQR) age of 62 (45–75) years, 61% of whom were males. A specific COD could be diagnosed for more than 85% of deaths. The leading causes of death for both sexes combined were: ischemic heart disease (16.3%), stroke (13.5%), diabetes (8.1%), pneumonia (5.7%) and chronic-respiratory disease (4.8%). Stroke was the top-ranked cause for females, and ischaemic heart disease the leading cause for males. The CSMFs from the VAs were similar to Global Burden of Disease (GBD) estimates. Overall, non-communicable diseases (NCDs) accounted for 73% of adult deaths; communicable, maternal and nutritional conditions 15%, and injuries 12%. Six of the ten leading causes reported for facility deaths in the Solomon Islands were also identified as leading causes of community deaths based on the VA diagnoses. Conclusions NCDs are the leading cause of adult deaths in the Solomon Islands. Automated VA methods are an effective means of generating reliable COD information for community deaths in the Solomon Islands and should be routinely incorporated into the national mortality surveillance system.https://doi.org/10.1186/s12889-021-12180-yVerbal autopsySolomon IslandsCivil registration and vital statisticsSmartVATariff methodCauses of death |
| spellingShingle | Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands BMC Public Health Verbal autopsy Solomon Islands Civil registration and vital statistics SmartVA Tariff method Causes of death |
| title | Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands |
| title_full | Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands |
| title_fullStr | Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands |
| title_full_unstemmed | Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands |
| title_short | Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands |
| title_sort | generating cause of death information to inform health policy implementation of an automated verbal autopsy system in the solomon islands |
| topic | Verbal autopsy Solomon Islands Civil registration and vital statistics SmartVA Tariff method Causes of death |
| url | https://doi.org/10.1186/s12889-021-12180-y |
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