Refining circumstances of mortality categories (COMCAT): a verbal autopsy model connecting circumstances of deaths with outcomes for public health decision-making

D’Ambruoso, Lucia; Price, Jessica; Cowan, E. E.; Goosen, Gerhard; Fottrell, Edward; Herbst, Kobus; Merwe, Maria van der; Sigudla, Jerry; Davies, Justine; Kahn, Kathleen

doi:10.1080/16549716.2021.2000091

Cited by 6 publications

(5 citation statements)

References 59 publications

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“…On water, repeated and prolonged periods without piped water documented, as were unreliable and unavailable infrastructure, inadequate service delivery, unregulated sources, empty reservoirs, and poor supply exacerbated by droughts [ 67 ]. We supplemented community intelligence with statistical data on the extent of the burden and its social and circumstantial drivers [ 70 , 71 ].…”

Section: Resultsmentioning

confidence: 99%

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Realising radical potential: building community power in primary health care through Participatory Action Research

Mabetha,

Ojewola,

van der Merwe

et al. 2023

Int J Equity Health

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Background While community participation is an established pro-equity approach in Primary Health Care (PHC), it can take many forms, and the central category of power is under-theorised. The objectives were to (a) conduct theory-informed analysis of community power-building in PHC in a setting of structural deprivation and (b) develop practical guidance to support participation as a sustainable PHC component. Methods Stakeholders representing rural communities, government departments and non-governmental organisations engaged through a participatory action research (PAR) process in a rural sub-district in South Africa. Three reiterative cycles of evidence generation, analysis, action, and reflection were progressed. Local health concerns were raised and framed by community stakeholders, who generated new data and evidence with researchers. Dialogue was then initiated between communities and the authorities, with local action plans coproduced, implemented, and monitored. Throughout, efforts were made to shift and share power, and to adapt the process to improve practical, local relevance. We analysed participant and researcher reflections, project documents, and other project data using power-building and power-limiting frameworks. Results Co-constructing evidence among community stakeholders in safe spaces for dialogue and cooperative action-learning built collective capabilities. The authorities embraced the platform as a space to safely engage with communities and the process was taken up in the district health system. Responding to COVID-19, the process was collectively re-designed to include a training package for community health workers (CHWs) in rapid PAR. New skills and competencies, new community and facility-based alliances and explicit recognition of CHW roles, value, and contribution at higher levels of the system were reported following the adaptations. The process was subsequently scaled across the sub-district. Conclusions Community power-building in rural PHC was multidimensional, non-linear, and deeply relational. Collective mindsets and capabilities for joint action and learning were built through a pragmatic, cooperative, adaptive process, creating spaces where people could produce and use evidence to make decisions. Impacts were seen in demand for implementation outside the study setting. We offer a practice framework to expand community power in PHC: (1) prioritising community capability-building, (2) navigating social and institutional contexts, and (3) developing and sustaining authentic learning spaces.

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Section: Resultsmentioning

confidence: 99%

“…The elements outlined above—pilot work [ 65 ], Cycle 1 community-based process [ 66 – 68 ], multisectoral engagement [ 69 ], VA [ 70 , 71 ], reflective/adaptive element [ 72 ], Cycle 2 redesign [ 73 , 74 ] and Cycle 3 CHW training [ 75 ]—are reported elsewhere.…”

Section: Methodsmentioning

confidence: 99%

Realising radical potential: building community power in primary health care through Participatory Action Research

Mabetha,

Ojewola,

van der Merwe

et al. 2023

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Global statistics show that about half of annual deaths pass without formal medical certification leaving crucial causes of death information outside any form of useful application for policy making and public health program monitoring [19][20][21][22][23]. While this issue is broadly associated with low-and middle-income countries (LMICs) due to insufficient investment in civil registration and vital statistics (CRVS) systems [23], higher income countries are also prone to misclassification of crucial international classification of disease (ICD) information [24].…”

Section: Introductionmentioning

confidence: 99%

Dying to make a care policy: Community perception of causes of deaths using standardized verbal autopsy method: Saudi type 2 diabetes mellitus register data

Alyazidi

Shakely

Petzold

et al. 2023

Preprint

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Diabetes mellitus (DM) is a serious global health issue which significantly impacts public health and socioeconomic development. Exploring how the community perceives the causes of deaths and their associated risk factors is crucial for public health. This study combines verbal autopsy (VA) with the Type 2 Diabetes Mellitus (T2DM) register to explore community perceptions of causes of death and associated influential factors in the western region of Saudi Arabia. 302 VA interviews were conducted with relatives or caregivers of deceased who died between 2017 and 2021 based on T2DM medical register from Alnoor Specialist Hospital in Makkah city, Saudi Arabia. Cause-specific mortality fractions (CSMFs) obtained from the VA using the InterVA-5 model were utilized to assess community perception. We used a multivariable logistic regression model to determine factors influencing community perceptions of causes of death. Lin's CCC with 95% CI was used to analyze the concordance for the CSMFs from verbal autopsy causes of death (VACoD) as a presumed reference standard and family-reported causes of death (FRCoD). The outcomes of this study demonstrate a generally broad spectrum of community perceived mortalities, with some critical misconceptions based on the type of death and the deceased's background and characteristics, with an overall CCC of 0.60 (95% CI: 0.20-1.00; p=003). The study findings demonstrate that community perception is weak if the deceased was male compared to female (aOR: 0.52; 95% CI: 0.26 –1.03) and if the deceased was >=80 years compared to 34–59 years (aOR: 0.48; 95% CI: 0.16-1.38), but it significantly improves among married compared to single (aOR: 2.13; 95% CI: 1.02 –4.42). The Saudi community perception of causes of death with reported type 2 diabetes was relatively plausible but varied substantially based on the type of death, sex, age >=80 years, and other vital events like marital status. Higher or lower community perception is attributed to how people may perceive risk factors associated with the causes of death, which can guide public health planning and interventional programs. The study findings further emphasize the need to employ robust and standardized VA methods within the routine medical services for a systemized assessment of families' reported causes of death.

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“…Global statistics show that about half of annual deaths pass without formal medical certification leaving crucial causes of death information outside any form of useful application for policy making and public health program monitoring [23][24][25][26][27]. While this issue is broadly associated with low-and middle-income countries (LMICs) due to insufficient investment in civil registration and vital statistics (CRVS) systems [27], higher income countries are also prone to misclassification of crucial international classification of disease (ICD) information [28].…”

Section: Introductionmentioning

confidence: 99%

Community perception of causes of death using verbal autopsy for diabetes mellitus in Saudi Arabia

Alyazidi,

Shakely,

Petzold

et al. 2023

PLOS Glob Public Health

View full text Add to dashboard Cite

Diabetes mellitus is a serious global health issue which significantly impacts public health and socioeconomic development. Exploring how the community perceives the causes of death and their associated risk factors is crucial for public health. This study combines verbal autopsy (VA) with the Type 2 Diabetes Mellitus (T2DM) register to explore community perceptions of causes of death and associated influential factors in Makkah province, Saudi Arabia. 302 VA interviews were conducted with relatives or caregivers of deceased who died between 2018 and 2021 based on T2DM medical register from Alnoor Specialist Hospital in Makkah City, Saudi Arabia. Cause-specific mortality fractions (CSMFs) obtained from the VA using the InterVA-5 model were utilized to assess community perception. We used a multivariable logistic regression model to determine factors influencing community perceptions of causes of death. Lin’s CCC with 95% CI was used to analyze the concordance for the CSMFs from verbal autopsy causes of death (VACoD) as a presumed reference standard and family-reported causes of death (FRCoD). The outcomes of this study demonstrate a generally broad spectrum of community perceived mortalities, with some critical misconceptions based on the type of death and other vital events like marital status, with an overall CCC of 0.60 (95% CI: 0.20–1.00; p = 003). The study findings demonstrate that community perception is weak if the deceased was male compared to female (aOR: 0.52; 95% CI: 0.26–1.03) and if the deceased was > = 80 years compared to 34–59 years (aOR: 0.48; 95% CI: 0.16–1.38), but it significantly improves among married compared to single (aOR: 2.13; 95% CI: 1.02–4.42). Exploring community perception of causes of death is crucial as it provides valuable insights into the community’s understanding, beliefs, and concerns regarding mortality. Higher or lower community perception is attributed to how people may perceive risk factors associated with the causes of death, which can guide public health planning and interventional programs. The study findings further emphasize the need to employ robust and standardized VA methods within the routine medical services for a systemized assessment of families’ reported causes of death.

show abstract

Refining circumstances of mortality categories (COMCAT): a verbal autopsy model connecting circumstances of deaths with outcomes for public health decision-making

Cited by 6 publications

References 59 publications

Realising radical potential: building community power in primary health care through Participatory Action Research

Realising radical potential: building community power in primary health care through Participatory Action Research

Dying to make a care policy: Community perception of causes of deaths using standardized verbal autopsy method: Saudi type 2 diabetes mellitus register data

Community perception of causes of death using verbal autopsy for diabetes mellitus in Saudi Arabia

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