PLoS ONE
Volume 6, Issue 9, 2011

Economic feasibility of a new method to estimate mortality in crisis-affected and resource-poor settings (Article) (Open Access)

Roberts B.* , Morgan O.W. , Sultani M.G. , Nyasulu P. , Rwebangila S. , Sondorp E. , Chandramohan D. , Checchi F.
  • a Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • b United States Centers for Disease Control and Prevention, Atlanta, GA, United States
  • c Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • d Médecins Sans Frontières France, Malawi Programme, Chiradzulu, Malawi
  • e United Nations High Commissioner for Refugees, Tanzania Office, Kigoma, Tanzania
  • f Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • g Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • h Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

Abstract

Introduction: Mortality data provide essential evidence on the health status of populations in crisis-affected and resource-poor settings and to guide and assess relief operations. Retrospective surveys are commonly used to collect mortality data in such populations, but require substantial resources and have important methodological limitations. We evaluated the feasibility of an alternative method for rapidly quantifying mortality (the informant method). The study objective was to assess the economic feasibility of the informant method. Methods: The informant method captures deaths through an exhaustive search for all deaths occurring in a population over a defined and recent recall period, using key community informants and next-of-kin of decedents. Between July and October 2008, we implemented and evaluated the informant method in: Kabul, Afghanistan; Mae La camp for Karen refugees, Thai-Burma border; Chiradzulu District, Malawi; and Lugufu and Mtabila refugee camps, Tanzania. We documented the time and cost inputs for the informant method in each site, and compared these with projections for hypothetical retrospective mortality surveys implemented in the same site with a 6 month recall period and with a 30 day recall period. Findings: The informant method was estimated to require an average of 29% less time inputs and 33% less monetary inputs across all four study sites when compared with retrospective surveys with a 6 month recall period, and 88% less time inputs and 86% less monetary inputs when compared with retrospective surveys with a 1 month recall period. Verbal autopsy questionnaires were feasible and efficient, constituting only 4% of total person-time for the informant method's implementation in Chiradzulu District. Conclusions: The informant method requires fewer resources and incurs less respondent burden. The method's generally impressive feasibility and the near real-time mortality data it provides warrant further work to develop the method given the importance of mortality measurement in such settings. © 2011 Roberts et al.

Author Keywords

[No Keywords available]

Index Keywords

information processing Afghanistan refugee health care planning economics methodology survival rate Thailand Population Surveillance human community economic aspect controlled study Health Resources Feasibility Studies intermethod comparison autopsy Humans questionnaire Myanmar Article feasibility study Retrospective Studies Questionnaires Tanzania retrospective study cause of death Malawi mortality Data Collection documentation health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-80052891297&doi=10.1371%2fjournal.pone.0025175&partnerID=40&md5=8cfc2dba3ba1cba4fd0ecafb5596af94
DOI: 10.1371/journal.pone.0025175
ISSN: 19326203
Cited by: 3
Original Language: English