Verbal autopsy in health policy and systems: a literature review

Thomas, Lisa-Marie; D’Ambruoso, Lucia; Balabanova, Dina

doi:10.1136/bmjgh-2017-000639

Cited by 78 publications

(77 citation statements)

References 42 publications

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“…Hence, facility level IDSR reports may not be sufficiently timely to pick up the outbreaks from community. The strengthened community level surveillance and verbal autopsy to detect unusual deaths can be a good approach to detect lower level health events and provide timely response [30]. By the fact of traditional medicine health seeking behaviour among villagers in Malawi, it is also important to understand how these behaviours may delayed the outbreak detection.…”

Section: Discussionmentioning

confidence: 99%

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert

Kagoli

Kaasbøll

et al. 2018

PLoS ONE

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ObjectiveThe recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon global efforts to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening.MethodsThis was a mixed-method research study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2) during October 2014 to September 2016. Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and 7 key informants of the IDSR system implementation and administration at district and national levels.FindingsThe current IDSR system showed relatively good completeness (73.1%) but poor timeliness (40.2%) of total expected monthly reports nationwide and zero weekly reports during the study period. Major implementation gaps were lack of weekly report and trainings. The challenges of IDSR implementation revealed through qualitative data included case identification, compiling reports for timely submission and inadequate resources.ConclusionsThe differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.

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Section: Discussionmentioning

confidence: 99%

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert

Kagoli

Kaasbøll

et al. 2018

PLoS ONE

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“…Facility level IDSR reports may not be sufficiently timely to pick up the outbreaks from community. The strengthened community level surveillance and verbal autopsy to detect unusual deaths can be a good approach to detect lower level health events and provide timely response [26]. In Malawi, a pilot study conducted in Lilongwe District in Central Region showed that mobile technologies had good opportunities to improve timeliness of HMIS reports [27].…”

Section: Discussionmentioning

confidence: 99%

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation Gaps and Challenges for Timely Alert

Kagoli

Kaasbøll

et al. 2018

Preprint

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Objective: The emerging and recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon efforts from globe to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening.Methods: This was a mixed-method observational study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2). Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and key informants of the IDSR system implementation and administration at district and national levels.Findings: The current IDSR system showed relatively good completeness (76.4%) but poor timeliness (41.5%) of total expected monthly reports nationwide and zero weekly reports. The challenges of IDSR implementation revealed through qualitative data included lack of supervision, inadequate resources for training and difficulty to implement weekly report due to overwhelming paperwork at frontline health services.Conclusions: The differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.

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“…The procedure adopted in community epidemiology over the years with the same criteria for all events, independently of the underlying or suspected cause and/or disease, involves formal reporting such as a "verbal autopsy." The collective context-oriented interpretation of this technique of event qualification is increasingly recognized [18]. Training promoters to collect, report, judge, and verify cases, basing their narratives on facts, in regular dialog with a professional provides strong backing for their responsibility and accuracy in pursuing what is most likely and plausible and/ or needs confirmation.…”

Section: Lowmentioning

confidence: 99%

Long-Term Outcomes of a Cohort of Hypertensive Subjects in Rural Ecuador

Moreira¹,

Figueroa²,

Anselmi³

et al. 2019

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Background: In contrast with the abundance of global epidemiological descriptive data on cardiovascular diseases and their risk factors, information on the outcomes of real populations prospectively followed up in their life and care settings is much rarer, especially in low-income countries. Objectives: This study sought to evaluate the feasibility and the overall results of a hypertension control program, based mainly on a network of community nonprofessional health promoters, in the poor rural region of Borbon (Ecuador). Methods: This is a prospective cohort study describing the results of a program of hypertension diagnosis, treatment and follow-up from 2004 to 2015 in the area, carried out mainly by the health promoters. Results: The number of hypertensive patients identified and followed over the years increased from 1,024 in 2004 to 1,733 in 2015. The percentage of patients with no visits during a year was reduced to <10%, whereas the proportion of hypertensive subjects attending all 4 scheduled annual checks approached and, in some years, exceeded 50%. From 2004 to 2015, the proportion of patients at high or very high cardiovascular risk progressively decreased from 26.6% in 2004 to 17.5% in 2015 (p for trend <0.01), whereas the proportion of hypertensive patients at low or very low risk increased from 30.4% in 2004 to 45.0% in 2015 (p for trend <0.01). Conclusions: In a poor, disadvantaged area, a strategy of control mainly based on the involvement and responsibility of community health promoters (with health professionals as supporters more than direct actors) can achieve adequate follow-up of the population of hypertensive patients and improve their global cardiovascular risk level.

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Verbal autopsy in health policy and systems: a literature review

Cited by 78 publications

References 42 publications

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation Gaps and Challenges for Timely Alert

Long-Term Outcomes of a Cohort of Hypertensive Subjects in Rural Ecuador

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