SAVVY Improves Data Collection in Zambia
For the first time, the Zambian government may be able to obtain reliable, detailed information about causes of death and other key health indicators in its populace thanks to the SAVVY verbal autopsy tools, developed by MEASURE Evaluation.
Working with a team of researchers, the Zambian government conducted a pilot study in four of the country’s nine provinces, using the sample vital registration with verbal autopsy (SAVVY) methodology, examining deaths occurring in 2009-2010. The study concluded that expanding SAVVY methodology to the national level appeared feasible, and the Zambian government is interested in doing so. The complete results of the study, published in the August issue of Population Health Metrics, are available here.
“This study shows the potential for improving coverage, availability, and accessibility of accurate and reliable demographic and mortality indicators in Zambia, that are otherwise not available anywhere else,” says MEASURE Evaluation’s Robert Mswia, one of the study’s authors. “The SAVVY system provides the opportunity toward improving the civil and vital registration systems in Zambia, which are currently fragmented and not fully functional.”
The pilot test found a mortality rate of 17.2 per 1,000 person years among the four provinces, a rate comparable to that in neighboring countries. Specific causes of death were also roughly similar, with HIV/AIDS the leading cause of death (27 percent of total deaths), followed by malaria (10 percent), accidents and injuries (8 percent), circulatory diseases (7 percent), and malnutrition (6 percent).
The pilot report also obtained data on the types of health centers, if any, the deceased visited between final illness onset and death, as well as their demographic information.
Simple information like a person’s cause of death, demographic characteristics, and where he or she went to receive treatment are vital to creating and maintaining effective health systems. However, obtaining this data can be difficult in many developing countries. In Zambia, there are shortages of health workers, financial resources are limited, and 49 percent of the population dies at home, often without a physician present.
SAVVY methodology allows trained interviewers (typically health workers living near the deceased person) to visit a person’s next of kin or caregiver and obtain information about the death. Trained physicians can then review and verify the completed questionnaires. The compiled data, once analyzed, can then be used to identify gaps in the quality of and access to care, strengthen health systems, and provide better care.
Mswia says that the study also has implications for expanded use of SAVVY in sub-Saharan Africa. “Hopefully more countries with poor vital registration systems will see the potential for SAVVY as intermediate step toward creating fully and well-functioning vital events registration systems,” says Mswia.
The verbal autopsy methods used by SAVVY follow recommendations by the World Health Organization, and countries such as Brazil, Mozambique, Ghana, Tanzania and Kenya have also implemented SAVVY-based studies. More information about SAVVY, as well as the complete toolkit, are available on MEASURE Evaluation’s website.