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Health Aff (Millwood). 2017 Nov;36(11):1887-1895. doi: 10.1377/hlthaff.2017.0635.

Nationwide Mortality Studies To Quantify Causes Of Death: Relevant Lessons From India's Million Death Study.

Author information

1
Mireille Gomes is a scientist at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto, in Ontario.
2
Rehana Begum is director of operations at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto.
3
Prabha Sati is associate director for program outreach at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto.
4
Rajesh Dikshit is a professor of epidemiology at the Tata Memorial Centre, in Mumbai, India.
5
Prakash C. Gupta is managing director of the Healis Sekhsaria Institute for Public Health, in Mumbai.
6
Rajesh Kumar is dean (academic) of the Post Graduate Institute of Medical Education and Research, in Chandigarh, India.
7
Jay Sheth is an associate professor in the Department of Community Medicine at Ahmedabad Municipal Corporation's Medical Education Trust Medical College, in Ahmedabad, India.
8
Asad Habib is a project manager and senior software systems developer at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto.
9
Prabhat Jha ( prabhat.jha@utoronto.ca ) is director of the Centre for Global Health Research, St. Michael's Hospital and University of Toronto, and a professor of global health and epidemiology, also at the University of Toronto.

Abstract

Progress toward the United Nations 2030 Sustainable Development Goals requires improved information on mortality and causes of death. However, causes of many of the fifty million annual deaths in low- and middle-income countries remain unknown, as most of the deaths occur at home without medical attention. In 2001 India began the Million Death Study in 1.3 million nationally representative households. Nonmedical staff conduct verbal autopsies, which are structured interviews including a half-page narrative in local language of the family's story of the symptoms and events leading to death. Two physicians independently assess each death to arrive at an underlying cause of death. The study has thus far yielded information that substantially altered previous estimates of cause-specific mortality and risk factors in India. Similar robust studies are feasible at low cost in other low- and middle-income countries, particularly if they adopt electronic data management and ensure high quality of fieldwork and physician coding. Nationwide mortality studies enable the quantification of avoidable premature mortality and key risk factors for disease, and provide a practicable method to monitor progress toward the Sustainable Development Goals.

KEYWORDS:

causes of death; civil registration and vital statistics; mortality; sample registration system; verbal autopsy

PMID:
29137507
DOI:
10.1377/hlthaff.2017.0635
[Indexed for MEDLINE]

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