Afghanistan Mortality Survey 2010 - Measure DHS

CAUSE OF DEATH 8One of the main objectives of the Afghanistan Mortality Survey (AMS) 2010 is to ascertain thecause of death. Information on cause of death is essential for policy makers to assess the needs of healthsystems and to set priorities for interventions. Ideally such data would be generated from a vital statisticssystem. However, this system is not functioning well in Afghanistan, as no death certificate is issued inmost cases and reliable data on cause of death are not available.To address this information gap, the AMS included collection of data on cause of death throughinterviews with the relatives of the deceased. These “verbal autopsies” are generally not as accurate asmedical certification of the cause of death but can be useful in identifying the probable cause of death inbroad groupings.The verbal autopsy (VA) questionnaire and manual used in the AMS 2010 were adapted fromSAmple Vital registration with Verbal autopsy (SAVVY). SAVVY is a library of best practice methodsfor improving the quality of vital statistics where high coverage of civil registration and good cause ofdeath data are not available. SAVVY is not a substitute for universal civil registration. Its componentscan, however, fill short- to medium-term needs for critical information on births, deaths, and cause ofdeath at the population level. The Verbal Autopsy instrument administered in the AMS 2010 usedinternational standards for verbal autopsy forms, death certification and ICD coding proceduresdeveloped in collaboration with WHO, the Health Metrics Network, and other stakeholders. The purposeof the VA was to describe the cause structure of mortality at the community or population level where nobetter alternative sources exist. VA is not intended to diagnose cause of death at the individual level.While VA has some limitations, the shortcomings of the tool are known and quantifiable.Interviewers visited households where deaths occurred and interviewed relatives or caregiversusing VA forms. Once completed, these forms were used to determine probable causes of death. Thisinformation can be used at many levels of the health system for planning, reporting, monitoring,evaluating, and priority setting.8.1 SOURCE OF DATADuring the household interview, questions were asked about deaths among usual residents of thehousehold since 21 March 2005 (1 Hammal 1384), a date that was five years before the start of the AMSdata collection. Probing questions were included to elicit early infant deaths and stillbirths. For eachdeath, the name, age at death and sex of the deceased were recorded. Following the household interview,the Verbal Autopsy (VA) questionnaire was administered to a caregiver or family member of thedeceased. One of three separate verbal autopsy questionnaires was used, depending on the age at death:1. Form 1 for deaths to children aged 0-28 days (neonatal)2. Form 2 for deaths to children aged 29 days-11 years (post neonatal and child)3. Form 3 for deaths to adults aged 12 years and above (adult).Key informants, that is, person(s) identified as present at the time of death, were interviewed toensure accurate information surrounding the circumstances that lead to the death of the deceased.Cause of Death | 135