Table 4 Key recommendations for verbal autopsy practice

Rationale for verbal autopsy processes

1. Collect verbal autopsy data from a wider range of respondents and sources, including community informants, health care workers, hospital and police records

It is ethical to use alternative methods of data collection when these methods minimize risks and provide data of similar quality

Condolences and compensation

2. Compensate VA respondents for time spent in interview and issue bereaved with a culturally appropriate token of condolence

To demonstrate respect for local community bereavement practices

Data sharing and use

3. Use verbal autopsy data locally

4. Integrate VA with CRVS to facilitate issuance of death certificates and strengthen mortality statistics

To ensure a fair balance of benefits and burdens among VA stakeholders

Interviewer recruitment

5. Consider diversity, including in terms of gender, age and religion, field experience and cultural competency when recruiting interviewers

Conducting VA interview presents significant emotional and social challenges. Interviewers draw on experience, cultural knowledge and bonding social capital to address these challenges

Interviewer training

6. Provide training on bereavement counselling

Counselling skills will enable interviewer to comfort distressed respondents

Interviewer support

7. Ethics reflection sessions and implementation of agreed action points

8. Establish a moral distress consultation service

Address interviewers’ emotional distress and strengthen ethics practice through group discussions and one-on-one conversations with ethicists and mental health experts