Title: Verbal Autopsy: Effective Tool to Evaluate ‘Before the Encounter’ causes of Neonatal Deaths
Authors: Pragathi Kamath, Sushant Mane
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.11
Abstract
Introduction
In 2018 about 2.5 million newborns died before the first month of life with average worldwide rate of 18 per 1000 livebirths(1). Prevention of child death remains a major challenge before mankind. Neonatal mortality a major cause of under 5 mortality and remains most difficult to prevent completely and is integral part of Third Sustainable Developmental Goal(2). These goals envision reducing the neonatal mortality equal to or less than12 per 1000 livebirths by the year 2030(2). Neonatal mortality rate is an important factor in various health and socioeconomic indices(3). Vast burden of the neonatal mortality is born by economically poor countries especially in South Asia (including India), Sub-Saharan Africa. Though these regiions have made significant strides in the reduction of neonatal mortality, still they have to cover a vast grounds before their figures are anywhere near North America and Western Europe(4).
In India, neonatal mortality was 23 per 1000 live births. This places India below some Saharan and Sub Saharan countries like Kenya and Libya. In India, many neonatal deaths occur at home and are seldom medically certified(5). Apart from the medical causes, socio-economico-cultural causes are also important in Indian settings. While clinical records can identify medical causes of Neonatal mortality, ‘before the encounter’ causes play an equally important and potentially preventable factors.
We at a tertiary care centre in Western Maharashtra, used ‘Verbal Autopsy’ method, to analyse ‘before the encounter’ issues contributing to the neonatal mortality. We utilized ‘Verbal Autopsy Questionnaire’ which is a structured question series prepared by Maharashtra State Family Welfare Bureau with their prior permission(6). This questionnaire encompasses various clinical and socio economic points for death audit.
References
- Neonatal mortality [Internet]. UNICEF DATA. [cited 2019 Sep 22]. Available from: https://data.unicef.org/topic/child-survival/neonatal-mortality/
- Hug L, Alexander M, You D, Alkema L. National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health. 2019 Jun 1;7(6):e710–20.
- Yu VY. Global, regional and national perinatal and neonatal mortality. J Perinat Med. 2003;31(5):376–9.
- Mortality rate, neonatal (per 1,000 live births) | Data [Internet]. [cited 2019 Sep 22]. Available from: https://data.worldbank.org/indicator/SH.DYN.NMRT
- Causes of neonatal and child mortality in India: nationally representative mortality survey. Lancet. 2010 Nov 27;376 (9755):1853–60.
- Infant and Child Death Audit- Interviewer’s Reference Manual, Verbal Autopsy Questionnaire for 0-5 years, NRHM MAHARASHTRA 2010. NRHM MAHARASHTRA; 2010.
- Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, et al. State of newborn health in India. J Perinatol. 2016 Dec;36(Suppl 3):S3–8.
- Fonseca SC, Flores PVG, Camargo KR, Pinheiro RS, Coeli CM. Maternal education and age: inequalities in neonatal death. Rev Saúde Pública [Internet]. 2017 Nov 7 [cited 2019 Oct 14];51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676700/
- Pilkington H, Blondel B, Drewniak N, Zeitlin J. Where does distance matter? Distance to the closest maternity unit and risk of foetal and neonatal mortality in France. Eur J Public Health. 2014 Dec;24(6):904–9.
- Fotso Jc, Cleland J, Mberu B, Mutua M, Elungata P. Birth Spacing And Child Mortality: An Analysis Of Prospective Data From The Nairobi Urban Health And Demographic Surveillance System. J Biosoc Sci. 2013 Nov;45(6):779–98.