%0 Journal Article
%T Opportunities and challenges for verbal autopsy in the national Death Registration System in Sri Lanka: past and future
%A Samath D Dharmaratne
%A Rajitha L Jayasuriya
%A Buddhipani Y Perera
%A EM Gunesekera
%A A Sathasivayyar
%J Population Health Metrics
%D 2011
%I BioMed Central
%R 10.1186/1478-7954-9-21
%X In Sri Lanka, once a death occurs, it has to be registered before the deceased can be cremated or buried. For deaths that occur outside hospitals, the relatives of the deceased notify the Death Registrar (DR). The majority of these notifications will not have a medically-determined COD, and the Death Registrar determines this by interviewing the relatives regarding events preceding the death.For deaths that occur in hospitals, a COD is declared by the medical officer who attended the deceased by filing a Death Declaration Form (DDF). Except for "sudden deaths," the COD for three out of four deaths that occur outside a hospital is given by the Death Registrar. Sudden deaths (which are a small proportion of total deaths) that occur outside a hospital are attended by an Inquirer into sudden death or by a court of law. The majority of the Death Registrars are lay people with minimal or no training in how to decide on the probable COD. Deaths that occur outside a hospital, in the majority of instances, do not have a death declaration made by a medical officer (A.Sathasivayyar. Assistant Registrar General of Sri Lanka. 3-11-2010 - personal communication).Several studies conducted in Sri Lanka [1,4], have highlighted the biases that are present in the DRS. They point out that only 30% to 40% of the registered deaths occur in a government hospital and that 80% of the registration and certification of deaths is done by nonmedical registrars. A study carried out in 1996 to assess the quality and coverage of death certification found that 15.5% of the medical officers misclassified the underlying cause of death. The study also found that the use of ill-defined terms (e.g., cardiovascular arrest) was frequent (76.4%), as was the use of abbreviations leading to misclassification (26.4%) [1].The Verbal Autopsy Questionnaire (VAQ), introduced into Sri Lanka in 2006, has several important limitations: only a limited number of diseases are included that encompass very broad categori
%U http://www.pophealthmetrics.com/content/9/1/21