Improving Cause of Death Information for Infant Deaths by Application of Verbal Autopsy Tool in India

To see the usefulness of verbal autopsy and in assessing the cause of deaths among infants and identify gaps in reporting system in 4 PHCs in India.

The study incorporated all the infant deaths, which occurred in a one-year period from 2nd Jan 2004 to 1st Jan 2005 in Yavatmal district (rural India).This data was compared with the corresponding district data and the gaps in reporting were identified site-wise.

Among the 4 health centers under reporting was more than 50% in 2 health centers. The IMR was found to be 59 per 1000 live births in contrast to 38 per 1000, given by the district authorities. Medical certification of cause of death was done in only 12% of deaths. Of all the 90 infant deaths studied, majority (73%) were delivered at home and were attended by unskilled personnel (72%). There were 63% deaths which occurred in the early neonatal period, 13% in late neonatal period and 23% in post neonatal period. In early neonatal period 47% were contributed by both Prematurity and LBW. In post neonatal period mostly infectious causes like ARI contributed for 35% followed by CNS infections (12%).

It was seen that the verbal autopsy can be used for two purposes. Firstly, it can help to give information for the health planners to prioritize health services based on the mortality pattern of an area. Secondly the VA can be used for collecting information for action at the local level.