Understanding Causes of Mortality Among Mothers and Children in Ethiopia Using Verbal Autopsy Interviews
MetadataShow full item record
CitationMuleta, Hemen. 2020. Understanding Causes of Mortality Among Mothers and Children in Ethiopia Using Verbal Autopsy Interviews. Doctoral dissertation, Harvard Medical School.
AbstractPurpose: A top priority of the Ethiopian health system remains to reduce the maternal and under 5 mortality rates. In general, Ethiopia currently does not have a vital event registration system to document deaths since most deaths occur at home and anatomical autopsies are not routinely performed. Given the need for evidence driven interventions, the BIRHAN Maternal and Child Health Morbidity and Mortality Surveillance Program was established to understand the causes of maternal and childhood mortality and morbidity in Ethiopia. The WHO Verbal Autopsy Questionnaire was utilized to understand causes of mortality.
Methods: The 2016 WHO Verbal Autopsy Questionnaire was translated into the local language of Amharic and used to interview caregivers following a culturally appropriate four to six weeks bereavement period after a death. In this study, the following definitions were applied: stillbirth as a fetus greater than 28 weeks’ gestation, neonates as age zero to 28 days, and children as four weeks to two years. In order to determine causes of death, we used InterVA-5, a software system developed at the Umeå Centre for Global Health Research in Sweden which utilizes Bayesian probabilistic modeling to produce the likelihood of a cause of death based on responses from the WHO VA Questionnaire.
Results: A total of 105 VA interviews were completed corresponding to 25 stillbirths, 54 neonates, 21 childhood, and five maternal mortalities. The average age at death was 6.4 days for neonates and six months for children between four weeks to two years of age. The major cause of mortality among neonates was birth asphyxia while infectious causes were most common in children. Among maternal deaths, both pregnancy related hemorrhage and infectious causes were reported. Overall, circumstances at all three stages of the Three Delay Model were also reported.
Conclusions:Understanding the causes of mortality among neonates, mothers, and children by utilizing the InterVA-5 software provides critical information to help with the development of maternal and child interventions in Ethiopia.
Citable link to this pagehttps://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37364970