Technical guidance to D4H staff for the introduction of verbal autopsy into civil registration and vital statistics systems

Accurate cause of death (COD) information is fundamental to good public health practice. The principal sources of information are medical certificates of COD for deaths in hospitals and verbal autopsies for non-hospital deaths. A verbal autopsy (VA) is a process whereby relatives of the deceased respond to questions about the medical history and terminal illness of the decedent (i.e. the illness that led directly to death). These two sources of COD data are complementary. Medical certification and VA should each be linked to the notification and registration of deaths through a country’s civil registration and vital statistics (CRVS) system. In general terms, medical certification will provide a more detailed and legally recognised account of COD; VAs will be more representative of patterns of mortality at the population level. The principal purpose of a VA is to describe the cause composition of mortality through the estimation of cause specific mortality fractions (CSMFs) in a population.