Examples - Validation Studies

Specific objectives
• To recode and analyze VA forms from Navrongo HDSS centre of the INDEPTH Network in Ghana for the period between 2007 and 2011
• To describe the cause of death structure for the five-year period using consistent methods over time in the Navrongo HDSS site in Ghana
• To compare causes of death among VA forms (previously coded vs. recode) to assess level of inter-coder variability
• To investigate causes of death among key age groups: neonatal, children 1-11 months, children under 5 year old, 5-15 years and over 15 years
• To disseminate the results on the causes of deaths among the international global health community

One of the most valuable metrics in population health is cause-specific mortality rates. The rates and numbers of people who die, where, at what age, and from what, is a crucial input into policy debates, planning interventions, and prioritizing research for new health technologies. Accurate determination of cause of death in many developing countries is a major problem facing evaluation of programmes and interventions with mortality as one of the major endpoints. This is largely due to the fact that most deaths in low and middle income countries occur outside health facilities – they are not certified – and many different data sources and diagnostic approaches must be used to build a comprehensive picture of causes of death in different populations.

Verbal autopsy conducted on deaths has proven to be one of the reliable methods of compiling cause of death data to support programs and policies in the absence of National Vital Registration Systems.  Using longitudinal (2007-2011) VA data from the Navrongo Health and Demographic Surveillance System (NHDSS), this study seeks to provide reliable information on cause of death structure that will help improve estimates on cause specific mortality at national level in Ghana. This information will feed into the PMI impact evaluation which will be conducted next year.  Seven doctors who have been working in the district and have been coding the VA forms were trained on death certification and coding using ICD 10 codes and the Sample Vital Registration with Verbal Autopsy (SAVVY) methods. Previously coded VA forms were then recoded using the SAVVY methods, resulting in  each VA form having two separate codes for cause of death – one assigned in the previous coding and the second assigned in the SAVVY coding. Data entry and management was done using Microsoft Visual FoxPro software.