Use of standard verbal autopsies to improve the mortality data capacity of civil registration and vital statistics systems in low- and middle-income countries: Analysis of key issues

BACKGROUNDMultidimensional issues confront the use of standard verbal autopsies (SVAs), such as the WHO's verbal autopsy standards and the Population Health Metrics Research Consortium's gold standard verbal autopsy, to improve the mortality data performance of civil registration and vital statistics (CRVS) systems in low-and middle-income countries (LMICs). OBJECTIVESThis paper attempts an inclusive analysis of these issues and their implications for policies intending to integrate routine SVAs into CRVS systems to enhance mortality data coverage in LMICs. METHODOLOGYIssues were identified from the verbal autopsy and CRVS literature, official documents, and the authors' field experiences with the Nigerian CRVS system.These were analysed using a problem (key issues) analysis methodology. RESULTSTwo classes of issues were shown to impinge on the use of SVAs within CRVS systems.One class is generic to SVAs (technical complexity, cost, and standardization issues) and