In the paper, Philip Setel, a research professor of epidemiology in University of North Carolina’s School of Public Health, says that over the past 30 years there has been a persistent failure to establish, support and sustain civil registries and to ensure that causes of death are accurately known in the world’s poorest countries.

“In sub-Saharan Africa fewer than ten countries have routine vital statistics systems that produce usable data, and mortality data is reported from only four,” Setel said. “Reliable data on levels of adult death – let alone causes of death – simply do not exist for most countries in Africa and Asia, where a large majority of deaths occur at home.”

Until civil registration systems can be rebuilt, Setel said, other cost-effective interim measures must be taken. National authorities in Mozambique, for example, are conducting Sample Vital Registration with Verbal Autopsy, or “SAVVY”. It can provide an ongoing source of data on mortality and causes of death for countries in which they have never previously existed. The SAVVY methods also can be used with other data collection activities.

Mozambique’s 2007 national census collected information on deaths within the last twelve months. Workers trained through SAVVY are currently are conducting a “verbal autopsy,” contacting people in these households, asking about signs and symptoms the deceased displayed before death with the hope that a reasonable cause of death can be determined.

When the survey is complete, Mozambique will know, for example, how many AIDS, malaria and maternal deaths occurred in the last year. This information will not only become the basis of national mortality statistics to be reported internationally, but will be used in benchmarking health Millennium Development Goals.; Source: University of North Carolina at Chapel Hill