Reliable data on the levels and causes of mortality are cornerstones for building a solid evidence base for health policy, planning, monitoring and evaluation. The main objective of VA is to describe the causes of death at the community level or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. In settings where the majority of deaths occur at home and where civil registration systems do not function, there is little chance that deaths occurring away from health facilities will be recorded and the cause of death certified. As a partial solution to this problem, VA has become a primary source of information about causes of death in populations lacking vital registration and medical certification.
VA has become an essential public health tool for obtaining a reasonable direct estimation of the cause structure of mortality at population level, although it may not be an accurate method for attributing causes of death at the individual level.
Verbal autopsy is a method used to ascertain the cause of a death based on an interview with next of kin or other caregivers. The interview is done using a standardized questionnaire that elicits information on signs, symptoms, medical history and circumstances preceding death. The cause of death, or the sequence of causes that led to death, are assigned based on the data collected using the VA questionnaire and any other available information. Rules and guidelines, algorithms or computer programs, may assist in interpreting the information collected using the VA questionnaire to determine the cause of death. A standard VA instrument comprises a VA questionnaire, a list of causes of death or mortality classification system, and sets of diagnostic criteria (either expert or data derived algorithms) for assigning causes of death. The VA process consists of several steps, and many factors can influence the cause specific mortality fractions estimated through this process.