Verbal autopsies better track deaths
autopsies, as well as cancer registries and other programs intended to help developing countries gather accurate data about the health of their citizens.
“With more and better data on causes of death, more countries can save more lives,” Michael Bloomberg, the philanthropy’s founder, said in a statement.
The work is badly needed, experts say.
An estimated 60 million people in the world will die this year, and half will have no death certificates or other records describing what killed them. Most will be in low- and middleincome countries, particularly in Africa and parts of Asia.
That means the common understanding of overall disease too. It requires specially trained technicians, and samples have to be taken and shipped for analysis within 24 hours after a person’s death.
Verbal autopsies “are much better to do that than do nothing, which is the only alternative” in some countries, said Peter Byass, a researcher at Sweden’s Umea University and an expert on the interviews.
The New York-based organization Vital Strategies began working with the Rwandan government in 2015 to develop a verbal autopsy program, using Bloomberg and other funding. The project trained government health workers — who already provide health and hospice care in homes — to conduct the interviews.
About 2,700 verbal autopsies have been done in nine small pockets of the country. That’s not enough to provide a good look at national death trends, but the government is planning to scale up the work in coming years to achieve a representative sample.
At first, neighbors sometimes perceived the questions as intrusive. But over time, most people have come to accept them.
“When we explain to them why we do this, in the end they will understand and answer our questions,” said Janvier Ngabonziza, who conducts the interviews in a rural area called Rwamagana.
The verbal autopsy of Sandrine Umwungeri was conducted by Leonie Mfitumukiza, who had met her mother through her job as a community health worker. After allowing several months for the family to rest and grieve, she had come to ask about Umwungeri’s illness.
Afterward, Mfitumukiza said she believes Umwungeri died of diabetes, not malaria. But she noted her job that day was to gather information, not to draw any conclusion.
Janvier Ngabonziza, right, interviews Lyiza Uwimbabazi about her sister who died recently in Rwamagana, Rwanda.
Alphonsine Umurerwa, reflects after talking about her late daughter Sandrine Umwungeri during a verbal autopsy.