How ‘Verbal Autopsies’ Are Helping Reduce Infant Mortality Rates Globally

Take India for example: The country’s estimated 2017 infant mortality rate is 47th worldwide — higher than Iraq’s. In absolute terms, the numbers are staggering. At a time when the United Nations has set a goal of reducing child deaths by half, India accounted for a fifth of child deaths between the years of 2000 and 2015.

During the latter half of that span, mortality rates actually declined. But researchers who set about trying to explain the drop, which would have seen 10 million more perish at the year 2000 rate, have uncovered a remarkable story.

It goes back to 1998 when the Center for Global Health research began tracking the problem through what it termed its Million Death Study. Since 2001, India’s Registrar General oversaw the use of its research methods in over a million homes spread across more than 7,000 different parts of the country.

Here’s where the social science comes in. The method involves utilizing 900 surveyors who conduct “verbal autopsies” of infant and child deaths in the home — deaths whose causes wouldn’t otherwise be known.

These innovative reports, stretching over several pages and conducted every six months, provided a standardized set of illness symptoms and a family narrative of the child’s death. Then, they went out — anonymously — to pairs of 400 total physicians. Each group of two reached a determination about the cause of death.

What the researchers found is that the 2005 tipping point in mortality rates correlated with a National Health Mission effort to ramp up surgical and medical care in rural areas, including vaccine administration and reproductive care.

There’s still massive room for improvement. The study’s authors suggest that India’s wealth, rapid development, and access to state-of-the-art medical infrastructure could have saved as many as 20 million additional lives. But the path forward has been revealed by the Center for Global Health’s careful, thoughtful reliance on the intimate research verbal autopsies help provide.