Peer-reviewed article
A verbal and social autopsy study to improve estimates of mortality determinants in Pakistan: study design and methods.
Chauhadry IA, Soofi SB, Habib MA, Rizvi A, Khan A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper describes a national study in Pakistan that uses verbal and social autopsy (VASA) methodology to understand why children, adolescents, and pregnant women die. VASA combines medical investigation of cause of death with examination of social and care-seeking factors. The study was conducted using Pakistan's National Nutrition Survey sampling frame and aimed to identify preventable deaths to guide public health policy. The research examined deaths occurring both in and outside healthcare facilities across multiple age groups.
Key points
- VASA methodology combines symptom-based identification of cause of death with structured assessment of social and care-seeking factors
- The study examined stillbirths, neonatal, post-neonatal, child, adolescent, and maternal deaths
- Routine civil registration in Pakistan does not capture causes or social determinants for most deaths
- The research aimed to integrate sociocultural and systemic factors into mortality analysis
- Findings were intended to guide public health interventions and inform the integration of VASA into national surveys
Limitations
This paper describes study design and methods only; it does not present findings or results from the VASA study itself. The document cannot tell us whether the VASA approach successfully identified preventable causes of death or what specific interventions should be prioritized.
Abstract
Background Reducing newborn, child, adolescent, and maternal mortality is a global priority, yet Pakistan continues to bear a high burden of preventable deaths. Routine civil registration does not capture causes or social determinants for most of these deaths. The verbal and social autopsy (VASA) methodology fills this gap by combining symptom-based identification of the cause of death with structured assessment of social and care-seeking factors. Here we describe the methodological framework of a national VASA study conducted using the Pakistan National Nutrition Survey 2018 sampling frame, designed to estimate cause-specific mortality and social determinants of stillbirths and neonatal, post-neonatal, adolescent, and maternal deaths. Methods We used the sampling frame of the Pakistan National Nutrition Survey 2018 and employed VASA techniques to identify biological causes and social determinants of stillbirths, neonatal, child, adolescent, and maternal deaths. By utilising adapted VASA tools and rigorous analytical methods, we sought to bridge the gap between health systems and mortality data by examining deaths that occurred in and outside of healthcare facilities. Our aim was to provide insights into preventable deaths to guide public health interventions and policymaking, such as integrating VASA into the national survey and building the capacity of community-level healthcare workers to conduct VASA. Conclusions This study provides a vital contribution to improving health outcomes and reducing mortality in low- and middle-income countries by integrating sociocultural and systemic factors into mortality analysis. Keywords verbal and social autopsy, cause of death, VASA methodology, Pakistan.