Investigation of causes of death in the rural landless people of Guntur District

Accurate recording of cause of death is necessary for a correct data base and future planning. Verbal autopsy is a recognized scientific method for verifying cause of deaths. The District Rural Development Agency (DRDA) insurance scheme for rural landless people depends on their field staff (Bima Mithra) to register occurring deaths and the causes.

To verify cause of deaths among rural landless insured under DRDA scheme.

The DRDA, Guntur district entrusted the NRI Medical College, Department of Community Medicine, to verify the cause of death of insured landless members during the years 2010 to 2012. The deaths covered 128 men and 25 women from 8 Mandals in 38 panchayats in 43 villages. Using a pretested questionnaire, the next of kin was interviewed for events leading to the death.

80% of the interviewed persons were closely related to the deceased. Verbal autopsy showed predominance of Lifestyle diseases (52%) followed by infectious diseases (35%) and accidental deaths (12%). Acute Myocardial Infarction is the most predominant cause of death followed by viral fevers, pulmonary Tuberculosis, HIV/AIDS and Cerebral stroke. Only 30% of the diagnosis made by the field staff of DRDA concurred with that of the investigating team.

Grass root workers involved in obtaining cause of death information should be adequately trained in methods like verbal autopsy. The study showed that non infectious, non communicable and lifestyle related diseases are predominant. Comprehensive insurance programmes for rural poor should include preventive and promotive measures to protect life.