This document discusses the history and development of lay reporting systems for collecting health data in communities. Some key points: - Lay reporting was first proposed by WHO in 1956 to aid reporting of morbidity and mortality where medical certification was not available. Various consultations and field trials were held from the 1970s onwards to develop standardized classification lists. - India began utilizing lay reporting through the PHC network in the late 1970s to collect data on causes of death, treatment, and health service usage to aid planning. Verbal autopsy methods were also developed to ascertain probable causes of deaths. - Over time, recommendations aimed to improve simplicity, usefulness of data, training of lay reporters, and ensuring reporting supported primary healthcare evaluation and

1. DR. RAGHAVENDRA HUCHCHANNAVAR
Junior Resident, Deptt. of Community
Medicine,
PGIMS, Rohtak

2. CONTENTS
• Definition
• Time-line
• Feasibility and utility of lay reporting
• The Caveats
• Improvement and expansion of lay reporting
• Verbal autopsy
• Mortality reporting in India
• Community based MDR
• Morbidity reporting
• Recent developments

3. DEFINITION
• Lay report: The information provided (by a lay reporter) to monitor the
health situation in the community and to plan and manage the health
activities.
• Lay reporter: A person of sufficient maturity and intelligence to operate
a lay report and in a position to become aware of illness and death
occurring within his/her sphere of influence. He/she can be a local
government official, a health worker, a school teacher, community
worker, social worker or a house-wife with the appropriate education.
• While selecting the reporting personnel, one should take into their
official status in the community and responsibility in respect for defined
portions of the geographical area.
• Lay reporting system: Is a set of procedures for collecting, processing,
summarizing, analyzing and utilizing the data being gathered by the lay
or paramedical personnel.

4. TIME-LINE
• 1956: Lay reporting was for the first time proposed as a WHO
objective, mainly to aid for reporting morbidity and mortality.
• 1971: A consultation held, which considered problems inherent in
using the International Classification of Diseases (ICD) as a base for
lay reporting of diseases.
• 1973: Another consultation for development of the symptom and
disease classification lists, particularly in relation to the lay
reporting of maternal and infant deaths.

5. TIME-LINE
• 1975: A working party of the International Conference on the 9th
revision of ICD, recommended WHO:
1. Become increasingly involved in the attempts made by the
various developing countries for collection of morbidity and
mortality statistics through lay or paramedical personnel;
2. Organize meetings at regional level for facilitating exchange of
experiences between the countries currently facing this problem
so as to design suitable classification lists with due
consideration to national differences in terminology;
3. Assist countries in their endeavour to establish or expand the
system of collection of morbidity and mortality data through lay
or paramedical personnel.

6. TIME-LINE
• 1976: The South-East Asia Regional Office of WHO called for a
working group on lay reporting
– Here a detailed list, based on symptom associations, was devised
with the aim that it would be useful for primary health care
personnel in all parts of the world. From that detailed list, two
short lists were derived: one for causes of death and the other for
reasons for contact with primary health care services.
• 1977: Field trials of a pilot nature were carried out in Burma, India,
Maldives, Sri Lanka, Thailand as well as in several areas of the
Western Pacific Region.

7. TIME-LINE
• The results from these trials demonstrated that
– The International lists, when adapted to suit local and regional
needs, can be used to supply crude diagnostic data on death - or
medical services in areas where previously little or no
information was available.
– The quality of such data is obviously directly related to the level
of ability of the personnel involved with the responsibility for
operating the primary health care scheme at its lowest level.
– The experiment should involve larger areas in the country or
self-contained segment of the health care system - headed by an
official who is responsible for decision making at that segment
and could, after analysing the information, transmit it to the next
higher level.

8. TIME-LINE
• From the data provided, together with a complement of information
concerning their quality, the person with administrative
responsibility for the management of the primary health care system
should be able to obtain a reasonable picture about:
– Incidence of cases and their variations
– Relationship between cases and treatment (drug consumption)
– Uses of health services in general
– Management of emergencies and
– Handling of referrals.
• The administrator should be able to consider priorities in the
management of health care and prevention in the area under his
supervision and advice on short and long-term policies.

9. TIME-LINE
• 1978: Lay Reporting of Health Information booklet was published,
by WHO. The list was revised and published in a form in which they
could be readily adapted to suit the individual needs of countries.
• 1979: The Lay Reporting System was considered at an All-India
Workshop on Health Statistical Standards conducted in December.
The consensus was drawn that this tool be used for collecting data
on morbidity and mortality.

10. TIME-LINE
• 1980: Meeting on Lay Reporting of Health Information held in the
Regional Office for South-East Asia Region, New Delhi.
• The objectives of the meeting were:
– To assess the lay reporting system as it now operates in the
countries of the Region and the use being made of it by decision
makers, particularly those involved in the primary health care.
– To examine the potential range of health information which can
be collected at the peripheral level by the lay reporters having
regard to the difficulties of collecting and processing data at this
level.
– To suggest how the lay reporting system can be improved so as
to achieve a more effective monitoring and evaluation of the
primary health care at the peripheral level

11. TIME-LINE
• Recommendations in the meeting:
1. The lay reporting system be developed to cover the reporting of
primary health care activities by lay persons, including not only
morbidity and mortality but also information required to
monitor and evaluate the primary health care programme
within the community.
2. Countries developing lay reporting system continue to do so
and those currently not actively developing to do so at the
earliest.
3. Countries to provide realistic national support to lay reporting
in view of the potential benefits to the national interests in
promoting the health of the people.

12. TIME-LINE
4. Evaluation of primary health care activities ultimately must be
the responsibility of the community leader. The government can
assist with the development of an appropriate system but it is
the community who will assess the success of the primary
health care programme.
5. The lay reporters may best be employed within small
communities in collecting data on causes of mortality.
6. The lay reporting system be designed to meet the specific local
needs and must cover data collection, processing,
summarization, interpretation and presentation of results. In
addition, it is desirable that the system contains some
mechanism for assessing the quality of the data being gathered
and processed.

13. TIME-LINE
7. Emphasis must be on simplicity and on the potential usefulness of
the information to the primary health care worker, the community
leaders and the district health officers. Moreover the information
must pass into the national health information system and be used
for regional and national evaluation purpose.
8. Member countries of the South-East Asia region to use the
classification list for Lay Reporting of mortality and morbidity as
published by the WHO, making such changes as are necessary to
emphasize health problems which are of specific local interest.
9. WHO list for lay reporting of health information be revised
periodically jointly by WHO and the member countries in the
Region to determine, on the basis of interim experience in lay
reporting and primary health care, whether alterations should be
made.

14. TIME-LINE
10. Member countries should develop active programmes for the
initial and continued training of lay reporters. Special training
programmes and techniques will have to be developed,
particularly in the use of symptom-association lists, to
overcome the problem of the limited educational standard of
many of the reporters.
11. Regional Office to continue its role of stimulating the
development of lay health reporting within the context of
primary health care and compatible with the national health
information systems.

15. FEASIBILITY AND UTILITY
• Under Indian conditions the wide network of PHCs are a convenient
means for introducing lay reporting of morbidity and mortality as
part of the activities of health services.
• As a part of the routine activities, it seems feasible to extend the
survey to cover the whole countryside.
• The approach of lay reporting can give only the probable causes of
morbidity and mortality. It is not conceived as a substitute for the
medical certification of cause of death or the diagnosis given by the
treating physician. However, the resultant data can be utilized for
health planning.

16. FEASIBILITY AND UTILITY
• The percentage distribution of the major groups of diseases indicates
their relative importance. In major groups important specific
diseases can be identified. The data can also be utilized for
evaluating the impact of health services over a period of time

17. THE CAVEATS
• Caveat No. 1: Don't allow uncoordinated requests from sub-
agencies of the health bureaucracy to place on the primary health
care worker an overload of reporting responsibilities.
• Caveat No.2 Eliminate the concept and word of "Diagnosis" from
lay reporting processes. Diagnosis, in its classic medical sense, is the
business of personnel well trained in medical sciences and practice.
But for the purposes of reporting, documentation and treatment,
primary health care workers should be asked to classify or
categorize the conditions they see and treat, particularly upon the
basis of symptom-history models.

18. THE CAVEATS
• Caveat No. 3: Reporting format
– Design recording and reporting instruments (forms, etc.) according
to the general level of education and training of the lay workers
expected to use them.
– Do not use forms originally designed for highly trained
professional workers.
– Reduce form content to the minimum useful numbers of items
needed by management.

19. THE CAVEATS
• Caveat No. 3: Reporting format
– For example: The SOAP approach which was used (Subjective
symptoms, Objective symptoms, Assessment, Plan of Treatment),
in its original form, presumed that the user was a fully trained
practising physician. The only guides the lay workers had were the
medical standing orders for treatment. The result of imposing this
system on the lay workers was a disaster as far as case
documentation and reporting was concerned. The agency gained no
useful information on the categories and there were variety of
problems causing workload.

20. THE CAVEATS
• Caveat No.4:
– Wherever possible, make the case reporting form identical to, or part of,
the case recording form and, when economically possible, make the report
a copy of the record, to spare the time used in the documentation process
and to provide something useful at the local level.
– For example, a health agency simultaneously set two different medical care
reporting systems in operation.
• One system required that the health care worker extract the clinical
record and place the information on the reporting form.
• The other system used a duplicating record form which was structured
to simplify recording; the original became the local clinical record on
the patient, the copy was sent to the data centre as a report.
• In the first system, which required the server to prepare an additional
report, the error and omission rate was high. The reliability of data was
also dubious.
• In the second system, where recording and reporting happened
concurrently, the error problems had never been a cause for alarm.

21. THE CAVEATS
• Caveat No. 5:
– Make sure that simple, analysed information is routinely
provided to the primary health care workers which will assist
them in understanding the broader epidemiological and clinical
picture of their communities.
– Provide comparisons with other like communities.
– This type of feed-back promotes conscious attention to the
details of reporting.
• Caveat No. 6: Make sure that the reporting process services the
logistics needs of administration and that the administration uses the
output to plan, operate and evaluate health services. Reports that
only fill file cabinets are a dead loss to an agency.
• Caveat No. 7: Let the reporting bring beneficial results to the servers
and the utilizers of a system. People tire of a system of reporting if
there is no evident return in benefits.

22. THE CAVEATS
• Caveat No. 8:
– Do not presume that the data obtained represent, either
qualitatively or quantitatively, the actual epidemiological status of
the community served.
– The data represent only the disease experiences of the part of the
population which desired care and had access to it.
– A trained health worker would not be able to maintain a disease
index system but should be capable of recording the nature of the
symptoms being treated.

23. THE CAVEATS
• Caveat No. 8:
– As long as lay persons receive adequate initial and refresher
training and technical aids, their work commensurate with the
degree of performance expected
– And as long as they are motivated by good treatment in the system
and a sense of social responsibility, there is no basis for doubting
the validity of statistics derived from lay reports any more than
there is reason to doubt the validity of information from physician
reports.

24. IMPROVEMENT AND EXPANSION
• Improvement and expansion of Lay Reporting System: Each country
will have its own particular problems and the system developed will
have to be modified to overcome these problems.
• Factors to be considered are:
1. The degree of community participation:
 This covers whether the village has its own administrative
infrastructure, how extensive and effective it is and its
relationship with the district and regional organization.
 Awareness among the community of their health problems and
how far they are willing to take action to overcome these
problems.

25. IMPROVEMENT AND EXPANSION
2. The availability of suitable persons for recording information
relating to the health of the community. The person could be a local
government official, a health worker, a school teacher, or a house-
wife with the appropriate education.
3. The type of health services being provided- health activities such as
treatments, vaccinations, antenatal and postnatal care, water supply,
sanitation, food supplementation and health education, and also the
number of people benefiting from the services.
4. The frequency at which the reports are likely to be required.
Reports about conditions treated should be at short intervals for
epidemiological surveillance but more general information on
births, deaths, immunization, water supply, education etc., can be
gathered at long intervals of six months or one year.

26. IMPROVEMENT AND EXPANSION
5. Care should be taken that the data are useful. For example, for
epidemiological surveillance, it may be sufficient for a doctor at the
district level to maintain a graph/chart showing the number of cases
of a particular condition treated in the village during the month. If
the number exceeds a certain level then this could be taken as a
warning signal to arrange for an investigation to be made.

27. VERBAL AUTOPSY
• The term “verbal autopsy” was first proposed by Arnold Kielman and
co-workers in 1983.
• Defined as “a procedure to exploit the information provided by the
relatives of a deceased person to reconstruct the events and symptoms
that preceded the death so as to deduct a medically acceptable cause, or
causes, of the death”.
• The study of causes of deaths was first presented at a seminar on “New
Approaches to the Measurement and Analysis of Mortality” organized
in Sienna, Italy, in 1986 by the International Union for the Scientific
Study of Population (IUSSP) and published in French as part of the
proceedings.
• The First International Workshop on Verbal Autopsy was organized by
the Department of International Health of the Johns Hopkins School of
Public Health in March 1989.

28. VERBAL AUTOPSY
• 1994: First workshop focusing on maternal deaths was convened by
the London School of Tropical Medicine and Hygiene.
• Main conclusions were
– The collection of information to determine cause of death is
feasible “where there is no doctor”, provided there are well-
trained interviewers.
– Precisely the term “probable cause” suggests that it can be
probed.
• 1999: Verbal autopsy promoted as a part of sample registration of
vital events in communities with incomplete statistics.

29. Features of a verbal autopsy method
1. Data Collection
a) Questionnaire format
i. Unstructured (Open method)
ii. Structured (Closed method)
iii. Combined
b) Interviewer
i. Education
ii. Interviewing skills
iii. Knowledge of local language and dialect Validation of
iv. Training findings against a
c) Respondent gold standard :
i. Presence during illness and time of death
a. Post mortem
d) Recall period
b. Hospital
i. Greater than or less than5 years
record
2. Cause of death assignment
a) Cause of death assignment
i. Medical assessment (Physician review )
ii. Diagnostic algorithms or guidelines
b) Single or multiple causes of death

30. MORTALITY REPORTING IN INDIA
Registrar General of India
Vital statistics division of the
Directorate of Health Services
Civil Registration System Sample Registration System (SRS)
(CRS) Covers the entire Covers a representative sample of the
population urban and rural population

31. MORTALITY REPORTING IN INDIA
– Cause of death reports originate from lay reporters.
– The reports reach the State Vital Statistics office through the
primary health centre, in case of rural areas, and the municipal
health office for urban areas.
– Tabulation is usually done at the state level but the statistics are
published by the RGI.
– A health worker from the PHC is designated as the field agent
who undertakes the primary survey.
– For each death occurring, the field agent identifies one or more
persons having knowledge of the circumstances of death,
interviews them and records the symptoms and circumstances of
death in Form-7.

32. MORTALITY REPORTING IN INDIA
– The field agent arrives at a probable cause of death by applying
the questionnaire based on symptoms and circumstances
recorded.
– The cause of death thus arrived is reported.
– The PHC statistician is designated as the recorder of events
reported by the field agent.
– Half-yearly verification of the household list is done by the
recorder.
– Medical officer of the PHC is expected to check and certify the
correctness of cause of death assignment by the field agent.

33. MORTALITY REPORTING IN INDIA
– From January 1999 a cause of death component has been added
to the SRS (RGI, 1999). This is called as the SRS-COD
component.
– The SRS part-time enumerator (PTE) records cause of death in
column 16 and the code in column 17 of the revised Form-5.
– A departure from the Survey Cause of Death-Rural form (used
previously) in this format is the elimination of the structured
questionnaire.
– In case of the urban areas, a medical certification of cause of
death (MCCD) scheme is operational.

34. MORTALITY REPORTING IN INDIA
– All medically attended deaths are expected to be registered along
with cause of death reports in a format which is similar to what
is prescribed by the WHO for International Classification of
Cause of Death (ICD).
– The responsibility for reporting cause of death rests with the
doctor /health care provider who last attended on the deceased.
– Reports are sent to the municipal health authorities, who forward
them to the concerned state vital statistics office.
– SRS covers 7597 sample units in India covering a
population of 73 lakhs. Haryana – 210 sample units
covering a population of 2.15 lakhs.

35. MORTALITY REPORTING IN INDIA
Three stages in SRS-COD form:
Stage I: To isolate major groups of disease
Stage II: Tries to aggregate similar symptoms pertaining to specific
diseases in each major group
Stage III: Symptoms specific to a particular disease are collected
leading to the probable cause of death

36. SRS FORMS
• Baseline Survey Forms
• Form 1: House List
• Form 2: Household Schedule
• Form 3: Pregnancy Status of Women
• Continuous Enumeration Forms
• Form 4: Outcome of Pregnancy recorded by Enumerator (jan-june;july-dec)
• Form 5: Deaths recorded by Enumerator
• Form 6: Monthly report of Outcome of Pregnancy
• Form 7: Monthly report of Deaths
• Compilation Tabulation Forms
• Form 8: Consolidated monthly report on births and deaths
• Form 11: Finalized list of Outcome of Pregnancy (jan-june;july-dec)
• Form 12: Finalized list of Deaths (jan-june;july-dec)
• Form 13: Results of HYS for Outcome of Pregnancy (jan-june;july-dec)
• Form 14: Results of HYS for deaths (jan-june;july-dec)

37. SRS FORMS
• Half yearly Survey Forms
• Form 9: Outcome of Pregnancy recorded by Supervisor (jan-june; july-
dec)
• Form 10: Deaths recorded by Supervisor (jan-june; july-dec)
• Form 15: Distribution of usual resident population by age, sex &
marital status
• Form 16: Distribution of Female population by broad age groups and
levels of education (as on 1st July/1st January)
• Form 17: Number of females who got married by age at effective
marriage (jan-june; july-dec)

38. Base Line Survey
(By supervisor with the help of enumerator)
Houselist Household schedule List of pregnant women
(Form 1) (Form 2) (Form 3)
Continuous Enumeration by Retrospective Survey by supervisor
(Half Yearly Survey)
Part Time Enumerator (PTE)
Updating Forms
BIRTHS DEATHS 1,2 & 3
(Form 4) (Form 5) BIRTHS DEATHS
Monthly report Monthly report MATCHING (Form 9) (Form 10)
(Form 6) (Form 7) Births: Form 4 with
Form 9
Deaths: Form 5 with
Form 10
Completely matched
Partially matched or unmatched
Form 11: Finalised list of births
RE-VERIFICATION
Correct birth & death Form 12: Finalised list of deaths
(Independently to another
Form 13: Result of HYS for births
supervisor) Transmission of Form 11 to
Form 14: Result of HYS for deaths
17 to ORGI

39. MORTALITY REPORTING IN INDIA
• Major groups of diseases covered are:
1. Accidents and injuries
2. Child birth and pregnancy
3. Fevers
4. Digestive disorders
5. Disorders of respiratory system
6. Disorders of central nervous system
7. Diseases of circulatory system
8. Other clear symptoms
9. Causes peculiar to infancy
10. Senility and
11. The rest

40. MORTALITY REPORTING IN INDIA
Under each one of the broad groups provision is made to record
specific diseases which are important. Such as:
• Rabies • Pneumonia
• Suicide • Paralysis
• Toxemia • Heart disease
• Puerperal Sepsis • Measles
• Typhoid • Tetanus
• Malaria • Cancer
• Cholera • Diabetes
• Malnutrition • Pre-maturity
• Tuberculosis • Cord infection etc.
Under each major group a „non-classifiable‟ group is provided

41. MORTALITY REPORTING IN INDIA
• The medical officer in charge supervises the entire work and trains
the staff in the scheme.
• The cause of death in every case is scrutinized by him. Besides, he
himself investigates the cause of death independently for at least one
out of every ten of the total deaths, in a month, by personally
visiting households and following the questionnaire. In case there is
a difference in cause of death by the medical officer and the field
agent, the one given by the medical officer is taken as final.
• It is considered that this independent investigation will not only
improve the accuracy of data but also serve as a check on the quality
of work.

42. COMMUNITY BASED MDR
• INFORMATION
– In case any maternal death takes place, ASHA/AWW
telephonically informs BLOCK MO & ANM of the area
immediately.
– ANM ensures that every maternal death in her area is reported to
the BLOCK MO immediately telephonically within 24 hrs of its
occurrence, and simultaneously she also gives information to the
BLOCK MO in report.
– BLOCK MO informs this maternal death immediately within 24
hours of receipt of information from ASHA/AWW/ANM to the
Civil Surgeon.

43. COMMUNITY BASED MDR
• LINE LISTING OF ALL DEATHS OF WOMEN OF AGE 15‐49
YEARS
– ASHA/AWW line lists all deaths of women of age 15 to 49 years
during the month, irrespective of cause or pregnancy status, and
she submits the monthly report to ANM by 5th of the following
month.
– In addition, she informs every such death to the ANM
telephonically also within 24 hours of its occurrence.
– The ANM cross checks every death line listed by ASHA/AWW
and submits the final report to the BLOCK MO by 10th of the
following month.

44. COMMUNITY BASED MDR
• INVESTIGATION
– BLOCK MO on receipt of information of the maternal death
deputes the designated investigation team for Community
Based Investigation (Verbal Autopsy) to be completed within 3
weeks of the death.
– BLOCK MO discusses and analyses the findings of every
maternal death investigated with the Investigation Team,
completes the Case Summary Sheet in duplicate for every
confirmed maternal death during the month and sends the report
to the Civil Surgeon within four weeks of the occurrence of the
death while keeping one copy for record.

45. COMMUNITY BASED MDR
• KEEPING RECORD OF ALL DEATHS OF WOMEN OF AGE
15‐49 YEARS
– All the deaths of women of age 15‐49 yrs, irrespective of the
cause of death or pregnancy status be line listed by the
ASHA/AWW every month and submitted by ANMs after cross
checking, are serially recorded at PHC by the BLOCK MO in
the Community Based MDR Register ( including the
confirmed maternal deaths).
• PARTICIPATION IN THE MEETING OF DISTRICT MDR
COMMITTEE
– BLOCK MO participates in the monthly review meeting of the
District MDR Committee chaired by the Civil Surgeon in the
following month.

46. COMMUNITY BASED MDR
• DISTRICT LEVEL MATERNAL DEATH REVIEW BY CIVIL
SURGEON (FBMDR + CBMDR)
– Civil Surgeon will constitute the District MDR Committee
comprising of MO (Obs. & Gynae.), Anaesthetist, Officer I/c
blood bank/blood storage centre, a Senior Nurse and invited
members from Facilities/Block PHCs as Members, and District
Nodal Officer MDR as Member Secretary of the Committee.
– Monthly review meeting of the District MDR Committee chaired
by Civil Surgeon and convened by District Nodal Officer every
month on a prefixed date.

47. COMMUNITY BASED MDR
• MATERNAL DEATH REVIEW BY DISTRICT HEALTH
SOCIETY UNDER THE CHAIRMANSHIP OF DEPUTY
COMMISSIONER (FBMDR + CBMDR)
– The review meeting will be attended by all the members of the
District Health Society or a selected group of DHS members as
deemed fit by the Deputy Commissioner.
– The other members to attend will be the District MDR
Committee members and any other member
incorporated/suggested by the DC which may include the family
members of the deceased who were present with the mother
during the treatment of complications or at the time of death.
– Monthly review meeting chaired by DC, convened by the
Civil Surgeon and assisted by the District Nodal Officer (2
relatives of the deceased to attend).

48. COMMUNITY BASED MDR
• STATE LEVEL MATERNAL DEATH REVIEW BY STATE
LEVEL TASK FORCE (SLTF). (FBMDR + CBMDR)
– Review meeting once in 3 months chaired by Principal
Secretary Health & Family Welfare (PSHFW).

54. Table : Countries where verbal autopsy studies have been conducted
WHO Countries
Region
South- Afghanistan, Bangladesh, India, Nepal,
East Asia Pakistan, Indonesia
Africa Angola, Benin, Cameroon, Egypt, Ethiopia,
Gambia, Ghana, Guinea-Bissau, Kenya,
Malawi, Namibia, Nigeria, Senegal, South
Africa, Sudan, Tanzania, Uganda
South Mexico, Bolivia, Nicaragua
America
Western Papua New Guinea
Pacific
region
Eastern Syria, Jordan, Lebanon, Yemen
Mediterr
anean
Region

55. RECENT DEVELOPMENTS
• Currently, 36 Demographic Surveillance Sites (DSS) in 20
countries, the Sample Registration System (SRS) sites in India, and
the Disease Surveillance Points (DSP) in China regularly use VA on
a large scale, primarily to assess the causes-of-death structure of a
defined population.
• Despite such a widespread use of verbal autopsy, its difficult to
assess how consistent and reliable the data are.
• Another drawback: unable to replicate procedures used to assign
cause of death as verbal autopsy data sets are not widely shared, and
it is impossible to independently assess the quality of the
assignment.

56. RECENT DEVELOPMENTS
• WHO has now published (2012) : Verbal autopsy standards:
ascertaining and attributing cause of death.
• The new standards include:
– Verbal autopsy questionnaires for three age groups (under four
weeks; four weeks to 14 years; and 15 years and above);
– A cause-of-death list for verbal autopsy prepared according to
the ICD-10.

57. SAMPLE OF A DIAGNOSTIC ALGORITHM

58. REFERENCES
• Lay reporting of health information for Primary health care. SEARO 1980
• Setting international standards for verbal autopsy. Available from:
www.who.int/bulletin/volumes/85/8/07-043745/en/index.html
• A Standard Verbal Autopsy Method for Investigating Causes of Death in
Infants and Children. World Health Organization Department of
Communicable Disease Surveillance and Response. Available from:
http://www.who.int/emc
• Causes of death in Rural Andhra Pradesh, India, Central Clinical School
Faculty of Medicine, University of Sydney June 2006.
• Framework and standards for country health information systems / Health
Metrics Network, World Health Organization. Available from:
http://www.healthmetricsnetwork.org.
• Guidelines for HMIS Reporting Format. 8th July, 2010
• SRS 2012. Available from:
http://www.censusindia.gov.in/vital_statistics/srs/Chap_1_-_2010.pdf

59. REFERENCES
• SRS flowchart. Available from:
http://www.censusindia.gov.in/vital_statistics/srs/Executive_Summary_201
0.pdf
• Status of Mortality Statistics Reporting in India A Report March 2007.
Central Bureau of Health Intelligence (CBHI). Available from:
www.cbhidghs.nic.in
• Lay reporting of health information. Geneva: World Health Organization;
1978
• Beyond the numbers: reviewing maternal deaths and complications to make
pregnancy safer. Geneva: World Health Organization; 2004.
• World Health Organization. International Statistical Classification of
Diseases and Related Health Problems (ICD). 10th Revision, Second
Edition. Geneva, World Health Organization, 2005. Available from:
http://www.who.int/classifications/icd/en/
• Applying ICD-10 to Verbal Autopsy. Available from:
9789241547215_part3_eng.pdf