Improving the Policy Utility of Cause of Death Statistics in Sri Lanka: An Empirical Investigation of Causes of Out-of-Hospital Deaths Using Automated Verbal Autopsy Methods
| Autor: | Manoj Dissanayake, Deirdre McLaughlin, Palitha Karunapema, Alan D. Lopez, Roshan Hewapathirana, Vindya Kumarapeli, Rangana Wadugedara, Pasyodun Koralage Buddhika Mahesh, Chamika H. Senanayake, Sunil de Alwis, Sridharan Sathasivam, Lene Mikkelsen, Rajitha Jayasuriya, Saman Gamage, Kapila Jayaratne, Ajith Tennakoon |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
verbal autopsy health care facilities manpower and services Psychological intervention Public policy Context (language use) causes of death 030204 cardiovascular system & hematology cause specific mortality fractions Global Burden of Disease 03 medical and health sciences 0302 clinical medicine Environmental health Cause of Death parasitic diseases medicine Humans 030212 general & internal medicine Stroke Cause of death Sri Lanka Original Research business.industry Public health Public Health Environmental and Occupational Health medicine.disease Verbal autopsy home deaths Hospitals SmartVA out-of-hospital deaths Autopsy Public Health Public aspects of medicine RA1-1270 Sri lanka business geographic locations |
| Zdroj: | Frontiers in Public Health Frontiers in Public Health, Vol 9 (2021) |
| ISSN: | 2296-2565 |
| Popis: | Background: Setting public health policies and effectively monitoring the impact of health interventions requires accurate, timely and complete cause of death (CoD) data for populations. In Sri Lanka, almost half of all deaths occur outside hospitals, with questionable diagnostic accuracy, thus limiting their information content for policy.Objectives: To ascertain whether SmartVA is applicable in improving the specificity of cause of death data for out-of-hospital deaths in Sri Lanka, and hence enhance the value of these routinely collected data for informing public policy debates.Methods: SmartVA was applied to 2610 VAs collected between January 2017 and March 2019 in 22 health-unit-areas clustered in six districts. Around 350 community-health-workers and 50 supervisory-staffs were trained. The resulting distribution of Cause-Specific-Mortality-Fractions (CSMFs) was compared to data from the Registrar-General's-Department (RGD) for out-of-hospital deaths for the same areas, and to the Global-Burden-of-Disease (GBD) estimates for Sri Lanka.Results: Using SmartVA, for only 15% of deaths could a specific-cause not be assigned, compared with around 40% of out-of-hospital deaths currently assigned garbage codes with “very high” or “high” severity. Stroke (M: 31.6%, F: 35.4%), Ischaemic Heart Disease (M: 13.5%, F: 13.0%) and Chronic Respiratory Diseases (M: 15.4%, F: 10.8%) were identified as the three leading causes of home deaths, consistent with the ranking of GBD-Study for Sri Lanka for all deaths, but with a notably higher CSMF for stroke.Conclusions: SmartVA showed greater diagnostic specificity, applicability, acceptability in the Sri Lankan context. Policy formulation in Sri Lanka would benefit substantially with national-wide implementation of VAs. |
| Databáze: | OpenAIRE |
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