Evaluating the use of verbal autopsy methods for producing cause of death estimates in Uganda

Over the past 60 years, Africa has demonstrated a small evidence-based shift from one demographic and epidemiological regime to another as compared to other regions. This is partly because cause-of-death determination in Sub-Saharan Africa (including Uganda) remain very poor due to the lack of effective civil registration vital systems. World Health Organization recommends use of verbal autopsy (VA) in the absence of a comprehensive, vital registration systems and it can be embedded within Health and Demographic Surveillance Systems (HDSS). There is an ongoing debate on the best method for assigning cause of death from VA interviews. My PhD project will evaluate the different methods used to assign cause of death from VA interviews and then estimate cause-specific mortality in Uganda. It stipulates that the cause specific mortality profile of the country has changed over time, and it differs by age, gender, and region. To achieve this, my project will be divided into four major studies. In study 1, I will estimate the adult cause specific mortality rates in Rakai, Uganda based on Physician reviews of the verbal autopsy interview data. Study 2 will evaluate the performance of the different methods used in assigning underlying cause of death from verbal autopsy interviews. In study 3, I will estimate and examine the cause specific mortality rates of the three Ugandan sites by age, sex and calendar year, while study 4 will estimate cause specific mortality rates of Masaka, based on VA interview data in the narratives section.

I will use data collected in VA interviews conducted in three HDSS within the country. I will use advanced quantitative analysis methods to achieve the above objectives. It is expected that the findings of this study will contribute to the existing literature and debate on cause specific mortality clearly showing how the epidemiological transition has evolved over the years.