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.
