Journal
HEALTH AFFAIRS
Volume 36, Issue 11, Pages 1887-1895Publisher
PROJECT HOPE
DOI: 10.1377/hlthaff.2017.0635
Keywords
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Funding
- National Institutes of Health
- Bill & Melinda Gates Foundation
- Disease Control Priorities Network
- Connaught Global Challenge Fund of the University of Toronto
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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.
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