TY - JOUR
T1 - Social autopsy for maternal and child deaths
T2 - A comprehensive literature review to examine the concept and the development of the method
AU - Kalter, Henry D.
AU - Salgado, Rene
AU - Babille, Marzio
AU - Koffi, Alain K.
AU - Black, Robert E.
N1 - Funding Information:
The authors thank Save the Children for permission to present the data in Figure 2, which were collected by Save the Children in Guinea, and Eric Swedberg of Save the Children for his leadership in conducting the Pathway Analysis study at the Guinea project site. We also acknowledge the contributions of dozens of NGO project staff and health workers in Bolivia, Guinea, and India to the social autopsy studies that we participated in and led in those countries; and of the many Government of India MOHFW officials and health workers and UNICEF health officers and fieldworkers who helped bring the MAPEDIR program to life in order to overcome death. Most of all, we acknowledge the contributions of the thousands of family members of deceased children and women who gave of their time and energy to participate in the verbal/social autopsy inquiries of the deaths of their loved one, to increase our understanding so that we might increase theirs. Support for the Bolivia and Guinea VASA studies as well as for development of the Pathway Analysis format was provided by the United States Agency for International Development through The BASICS Project. Support for updating the Pathway Analysis questionnaire and conducting integrated VASA studies in sub-Saharan Africa was provided by the Child Health Epidemiology Reference Group through a grant from the Bill & Melinda Gates Foundation to the US Fund for UNICEF. The conceptualization, piloting and scaling up of MAPEDIR were funded by UNICEF as part of the UNICEF-assisted Country Programme in India.
PY - 2011/8/5
Y1 - 2011/8/5
N2 - "Social autopsy" refers to an interview process aimed at identifying social, behavioral, and health systems contributors to maternal and child deaths. It is often combined with a verbal autopsy interview to establish the biological cause of death. Two complementary purposes of social autopsy include providing population-level data to health care programmers and policymakers to utilize in developing more effective strategies for delivering maternal and child health care technologies, and increasing awareness of maternal and child death as preventable problems in order to empower communities to participate and engage health programs to increase their responsiveness and accountability. Through a comprehensive review of the literature, this paper examines the concept and development of social autopsy, focusing on the contributions of the Pathway Analysis format for child deaths and the Maternal and Perinatal Death Inquiry and Response program in India to social autopsy's success in meeting key objectives. The Pathway Analysis social autopsy format, based on the Pathway to Survival model designed to support the Integrated Management of Childhood Illness approach, was developed from 1995 to 2001 and has been utilized in studies in Asia, Africa, and Latin America. Adoption of the Pathway model has enriched the data gathered on care seeking for child illnesses and supported the development of demand- and supply-side interventions. The instrument has recently been updated to improve the assessment of neonatal deaths and is soon to be utilized in large-scale population-representative verbal/social autopsy studies in several African countries. Maternal death audit, starting with confidential inquiries into maternal deaths in Britain more than 50 years ago, is a long-accepted strategy for reducing maternal mortality. More recently, maternal social autopsy studies that supported health programming have been conducted in several developing countries. From 2005 to 2009, 10 high-mortality states in India conducted community-based maternal verbal/social autopsies with participatory data sharing with communities and health programs that resulted in the implementation of numerous data-driven maternal health interventions. Social autopsy is a powerful tool with the demonstrated ability to raise awareness, provide evidence in the form of actionable data and increase motivation at all levels to take appropriate and effective actions. Further development of the methodology along with standardized instruments and supporting tools are needed to promote its wide-scale adoption and use.
AB - "Social autopsy" refers to an interview process aimed at identifying social, behavioral, and health systems contributors to maternal and child deaths. It is often combined with a verbal autopsy interview to establish the biological cause of death. Two complementary purposes of social autopsy include providing population-level data to health care programmers and policymakers to utilize in developing more effective strategies for delivering maternal and child health care technologies, and increasing awareness of maternal and child death as preventable problems in order to empower communities to participate and engage health programs to increase their responsiveness and accountability. Through a comprehensive review of the literature, this paper examines the concept and development of social autopsy, focusing on the contributions of the Pathway Analysis format for child deaths and the Maternal and Perinatal Death Inquiry and Response program in India to social autopsy's success in meeting key objectives. The Pathway Analysis social autopsy format, based on the Pathway to Survival model designed to support the Integrated Management of Childhood Illness approach, was developed from 1995 to 2001 and has been utilized in studies in Asia, Africa, and Latin America. Adoption of the Pathway model has enriched the data gathered on care seeking for child illnesses and supported the development of demand- and supply-side interventions. The instrument has recently been updated to improve the assessment of neonatal deaths and is soon to be utilized in large-scale population-representative verbal/social autopsy studies in several African countries. Maternal death audit, starting with confidential inquiries into maternal deaths in Britain more than 50 years ago, is a long-accepted strategy for reducing maternal mortality. More recently, maternal social autopsy studies that supported health programming have been conducted in several developing countries. From 2005 to 2009, 10 high-mortality states in India conducted community-based maternal verbal/social autopsies with participatory data sharing with communities and health programs that resulted in the implementation of numerous data-driven maternal health interventions. Social autopsy is a powerful tool with the demonstrated ability to raise awareness, provide evidence in the form of actionable data and increase motivation at all levels to take appropriate and effective actions. Further development of the methodology along with standardized instruments and supporting tools are needed to promote its wide-scale adoption and use.
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U2 - 10.1186/1478-7954-9-45
DO - 10.1186/1478-7954-9-45
M3 - Review article
C2 - 21819605
AN - SCOPUS:79961122036
SN - 1478-7954
VL - 9
JO - Population Health Metrics
JF - Population Health Metrics
M1 - 45
ER -