Fabulous new health data for Mozambique: INCAM study uses verbal autopsy to provide information on causes of death

A new report, "Mortality in Mozambique: Results from a 2007-2008 Post-Census Mortality Survey", provides valuable data on mortality and causes of death in Mozambique. The underlying survey, known in Portuguese as Inquérito Sobre Causas de Mortalidade (INCAM), was conducted by the National Institute of Statistics in collaboration with the Ministry of Health in Mozambique. The study followed up deaths reported in the 2007 census with a country-wide verbal autopsy survey. It is representative on the national and provincial level and includes information on area of residence, age group, sex and other characteristics, such as the use of health services prior to death.

Verbal autopsy is an innovative method to determine the cause of death of a deceased where the causes of death had not previously been established (e.g. by a physician or coroner in a death certificate). In those cases, a trained interviewer administers a standardized questionnaire to someone familiar with a deceased person which covers his or her symptoms, known diagnoses, demographic characteristics etc. Often, the questions are then analyzed by two physicians to determine the cause of death; a third physician is consulted if the two disagree. Lately, innovative algorithms have been developed that use machine learning or other methods to analyze the cause of death. These machine learning tools now even outperform physicians (disclosure: the cited paper was published by my employer, IHME).

The INCAM survey is particularly valuable because Mozamibique does not have a complete civil registration system, and cause of death information had not been available on a nationally representative level.