Using Verbal Autopsy to Determine Cause of Stillbirths and Early Neonatal Deaths within the NICHD Global Network: Work in Progress

Abstract

Imtiaz Jehan, MBBS, MSc, Assistant Professor, Department of CHS
Omrana Pasha, MBBS, MSPH, Assistant Professor, Departments of CHS and Family Medicine.

Globally eight million neonatal deaths and stillbirths occur each year; 98 percent in the developing world. The majority of these deaths occur at home, without vital registration. Vital registration systems that include cause of death (COD) are available for less than 3 per cent of all neonatal deaths. Understanding COD is essential in developing strategies to reduce mortality.

Perinatal Verbal Autopsy (VA) is a technique used to ascribe probable COD, based on an interview with the primary caregiver where health registration systems are weak. A systematic description of signs, symptoms and circumstances preceding death is recorded and a Physician Panel assigns COD. VA has been used extensively to assess population cause-specific childhood and maternal deaths where no registry or death certificates are available.

The National Institute of Child Health & Human Development (NICHD) Global Network (GN) for Women's and Children's Health Research, a multi-site, international research network, provides a unique infrastructure to implement an expanded perinatal verbal autopsy study, using the FIRST BREATH trial, an ongoing study of neonatal resuscitation training in rural community settings within Global Network sites in Central Africa, Asia and Latin America.

This study proposes to use a validated VA questionnaire to determine COD of stillbirths and early neonatal deaths to expand the usefulness of perinatal verbal autopsy methodology by assessing whether the FIRST BREATH Community Coordinator (a non-physician health worker) can assign COD with a high level of concordance to the Physician Panel, and, whether the birth attendant can provide as reliable perinatal information as the mother during the VA interview.

Current Status

Data collection completed. Paper writing and analysis are under way.