title: A qualitative inquiry into the application of verbal autopsy for a mortality surveillance system in a rural community of southern India.
abstract: The aim of this investigation was to identify operational and ethical issues encountered in the application of verbal autopsy (VA) in a rural community in south India. A qualitative study involving semi-structured interviews was conducted with 183 bereaved caregivers in rural Andhra Pradesh, India. Simple descriptive analysis was undertaken. Only 16% of adult deaths and 27% of child deaths occurred in healthcare settings. Healthcare utilization for the terminal illness was reported in two thirds of medical (non-injury) causes of death. Supporting medical evidence was available in <10% of cases to supplement the interpretation of verbal autopsies. About 14% of bereaved caregivers refused to give written consent but provided oral consent. Additional ethical concerns included inability to ensure privacy in 15% of interviews and unsolicited information from unauthorized neighbours in 5% of cases. Such methodological, logistical and ethical issues operate to impact on the quality of VAs. Consideration of these issues would strengthen ongoing efforts in the harmonization of VA procedures.
authors.affiliation: St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India. premkmony@gmail.com
authors.forename: Prem K
authors.initials: PK
authors.lastname: Mony
authors.forename: Mario
authors.initials: M
authors.lastname: Vaz
mesh_terms: D001344:Autopsy / Q000941:ethics / Q000379:methods*; D002423:Cause of Death; D005260:Female; D006117:Grief; D006801:Humans; D007194:India; D008297:Male; D009026:Mortality; D036301:Qualitative Research; D012424:Rural Population / Q000706:statistics & numerical data*; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors