Beruflich Dokumente
Kultur Dokumente
Contents: v. 1. Manual
All rights reserved. Publications of the World Health Organization are available on the WHO web site
(www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211
Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int).
Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial
distribution should be addressed to WHO Press through the WHO web site
(http://www.who.int/about/licensing/copyright_form/en/index.html).
The designations employed and the presentation of the material in this publication do not imply the
expression of any opinion whatsoever on the part of the World Health Organization concerning the legal
status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers
or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full
agreement.
The mention of specific companies or of certain manufacturers products does not imply that they are
endorsed or recommended by the World Health Organization in preference to others of a similar nature that
are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by
initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information
contained in this publication. However, the published material is being distributed without warranty of any
kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with
the reader. In no event shall the World Health Organization be liable for damages arising from its use. .
Acknowledgements
The production of this manual would not have been possible without the collaboration and
support of numerous organizations, institutions and individuals. The organizations
contributing to this work include World Health Organization (WHO), Health Metrics
Network (HMN), INDEPTH Network, Institute for Health Metrics and Evaluation (IHME),
All India Institute of Medical Sciences, Centers for Disease Control and Prevention (CDC),
Federal University of Minas Gerais, Ghana Health Service, Ifakara Health Institute, London
School of Hygiene & Tropical Medicine (LSHTM), Norwegian Institute of Public Health,
Swiss Tropical and Public Health Institute, Thailand Ministry of Public Health, The
University of Queensland, UCL Centre for International Health and Development, Ume
University, United Nations Population Fund (UNFPA), Office of the United Nations High
Commissioner for Refugees (UNHCR), University of Alexandria, University of the
Witwatersrand, Uttar Pradesh Center for Maternal, Neonatal and Child Health
This verbal autopsy instrument was produced and reviewed in collaboration with a WHO led-
expert group including Kanitta Bundhamcharoen, Thailand Ministry of Public Health; Peter
Byass, Ume University Centre for Global Health; Daniel Chandramohan, London School of
Hygiene & Tropical Medicine; Chanpen Choprapawon, Health Policy and Strategic Bureau;
Don de Savigny, Swiss Tropical and Public Health Institute; Edward Fottrell, UCL Centre for
International Health and Development; Elizabeth Frana, Federal University of Minas Gerais;
Frederik Fren, Norwegian Institute of Public Health; Gihan Gewaifel, University of
Alexandria; Bernardo Hernandez, IHME; Abraham Hodgson, Ghana Health Service; Sennen
Hounton, UNFPA; Kathleen Kahn, University of the Witwatersrand; Anand Krishnan, All
India Institute of Medical Sciences; Vishwajeet Kumar, Uttar Pradesh Center for Maternal,
Neonatal and Child Health; Jordana Leitao, London School of Hygiene & Tropical Medicine;
Alan Lopez, The University of Queensland; Rafael Lozano, IHME; Honorati Masanja, Ifakara
Health Institute; Lene Mikkelsen, University of Queensland; Dean Yergens, University of
Calgary; Thorkild Tylleskr, University of Bergen; Jrn Ivar Klungsyr, University of Bergen;
Carlos Navarro-Colorado, Centers for Disease Control and Prevention (CDC); Erin Nichols,
CDC; Sam Notzon, CDC; Mohammad Hafiz Rasooly, Afghanistan Ministry of Public Health;
Ian Riley, The University of Queensland; Osman Sankoh, INDEPTH Network; Paul Spiegel ,
UNHCR; Carla Abou-Zahr; Derege Kebede, WHO; William Soumbey Alley, WHO; Fatima
Marinho, WHO; Mohamed Ali, WHO; Enrique Loyola, WHO; Jyotsna Chikersal, WHO; Jun
Gao, WHO; Robert Jakob, WHO; Giuseppe Annunziata, WHO; Rajiv Bahl, WHO; Kidist
Bartolomeus, WHO; Ties Boerma, WHO; Bedirhan Ustun, WHO; Doris Chou, WHO; Lulu
Muhe, WHO; Matthews Mathai; Marc Amexo, HMN.
Table of Contents
v
The 2012 WHO verbal autopsy instrument Release candidate 1
This 2012 version of the WHO verbal autopsy instrument has been designed to become
suitable for routine use. Compared to the 2007 instrument, numbers of conditions and
questions have been reduced, based on evidence from the field. The questions have been
reformulated to allow for responses with a simple yes or no answer, or a duration in some
instances. This approach makes the instrument usable for software that assigns causes of
death.
The instrument is designed for all age groups, including maternal and perinatal deaths, and
also deaths caused by injuries.
Sets of questions address information relevant to vital registration, and information relevant
to assessment of the cause of death and the context.
This manual informs users on how to use the 2012 WHO verbal autopsy (VA) instrument.
The components of this manual include:
Background on VA;
Sample VA questionnaires for three age groups (under four weeks; 4weeks-14 years,
15 years and above);
The full matrix of questions, definitions and related skip patterns;
Instructions on how to use the matrix of questions;
Criteria for setting up a data collection infrastructure and the related databases;
Information about available software for assessing a cause of death;
Instructions on how to design a localized questionnaire;
General cause of death certification and coding guidelines for applying the
International Statistical Classification of Diseases and Related Health Problems, tenth
revision (ICD-10)1 to VA; and
A simplified cause of death list for VA with corresponding ICD-10 codes.
All materials (questionnaires, table of indicators with skip patterns and this manual) are
available separately for download at
www.who.int/healthinfo/statistics/verbalautopsystandards.
This manual and its resources are the products of a one-year effort by an expert group led by
the World Health Organization (WHO), consisting of researchers, data users, and
government agencies, with support by the Health Metrics Network (HMN), the University of
Queensland and the INDEPTH Network. The 2012 WHO VA instrument is intended to
allow for simple and inexpensive identification of causes of death in places where no other
routine system is in place and will serve the needs of countries civil registration and vital
statistics (CRVS) systems. Independently, this instrument can also be used in research and
disease specific programmes. All materials are easily and widely accessible on the WHO web
1
Purpose and content
site, in print, and will be incorporated into diverse resource kits, intended for strengthening
national vital statistics systems. Additional language versions will be made available through
similar channels.
Experience from the field and publications on the most widely used and validated VA
instruments and procedures (WHO VA standards, InterVA and Population Health Metrics
Research Consortium -PHMRC VA instrument)2-4 were systematically reviewed and also
assessed against experience in using software for cause of death assignment (InterVA and
PHMRC VA instrument). VA users were queried for use of VA instruments and utility of VA
questions. This resulted in a simplified VA instrument with a reduced number of questions
and causes of death. The systematic application of the 2012 WHO VA instrument will
facilitate the application of VA in routine surveillance of vital events and introduce more
consistency and cross-comparability of VA-derived mortality data. The correspondence table
(Appendix 1) allows for easy conversion to and from ICD-10. The application of a
standardized international set of questions will facilitate the compilation of larger databases
that finally would provide the evidence for stepwise improvement of VA questionnaires
internationally.
2
2012 WHO verbal autopsy instrument Release candidate 1
Reliable data on the levels and causes of mortality are cornerstones for building a solid
evidence base for health policy, planning, monitoring and evaluation. 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 certified as
to the cause or causes of death. 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 a community or 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. This 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 by a questionnaire and any other available information. Rules and guidelines,
algorithms or computer programs, may assist in evaluating the information to determine the
cause of death11. 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.
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.5
3
Introduction to verbal autopsy
Reproductive Age Mortality Studies (RAMOS), Matlab and Niakhar questionnaires first
emerged, several other questionnaires have been developed for use in research settings and in
national or large-scale regional surveys.6
The past two decades have seen a proliferation of interest, research and development in all
aspects of the VA process, including data-collection systems where VA is applied,
questionnaires content and format, targeting of different age groups, cause of death
assignment process, coding and tabulation of causes of death and of validation of VA
instruments.
In 2007, needs and demands for standardization led to the 2007 publication of the WHO VA
standards, which many researchers have adopted.8 The standards included:9
Verbal autopsy questionnaires for three age groups (under four weeks; four weeks to
14 years; and 15 years and above);
Cause of death certification and coding resources consistent with the International
Classification of Diseases and Related Health Problems, tenth revision (ICD-10); and
A cause-of-death list for verbal autopsy prepared according to the ICD-10.
However, the WHO 2007 instrument was modified in several projects to accommodate the
local needs. In 2011, evidence from use of the WHO instrument and related VA instruments
was used to formulate this 2012 VA instrument (document under publication). Besides
elimination of unreported causes and focus on useful questions, it was designed to facilitate
VA use in routine vital registration systems to improve national cause-specific mortality data.
4
2012 WHO verbal autopsy instrument Release candidate 1
5
2012 WHO verbal autopsy instrument Release candidate 1
The WHO standard VA instrument published in 2007 has been successfully applied in many
research settings since then. In recent years, there has been growing interest in strengthening
countries CRVS systems, and this has led to demand for a more simplified and practical VA
instrument that is associated with IT applications for data collection and analysis.
To produce a simplified VA instrument, WHO carried out a systematic review of the use of
VA and led an expert group of researchers, data users and other stakeholders, in collaboration
with HMN, the University of Queensland (UQ) and the INDEPTH Network. Based on the
compiled experience and evidence from the most widely-used and validated VA procedures
(WHO VA standards, InterVA and PHMRC VA instrument),2-4 consensus was reached on a
simplified VA instrument for routine use as part of civil registration and vital statistics
systems in settings where many deaths are not medically certified.
The simplified instrument (2012 WHO VA instrument) comprises a short list of causes of
death of public health importance that can be ascertained by way of a limited number of
questions suitable for use in interviews and amenable to software analysis to automate the
ascertainment of cause of death. The design allows for addition of narrative where so desired
and addition of locally relevant questions and diagnoses.
The list of causes of death resulting from the above process is presented in Appendix 1.
Using a minimum set of causes facilitates the merging and comparison of data from VA on an
international scale. The ICD-10 codes listed in the list of causes of death in Appendix 1 allow
1
In the simplification of the list of diagnoses attention has been given to the Global Burden of Disease (GBD) groupings. In view of the ongoing
edits of the GBD, the correspondence table does not include GBD references. The mentioned ICD-10 codes may serve to distribute cases to the
relevant GBD groups.
7
The development of the 2012 WHO verbal autopsy instrument
comparison with ICD-10 coded data from causes of death ascertained using the international
certificate of causes of death.
3.2 List of indicators and their definitions, relevant age and sex groups
and sample questions
The 2012 VA instrument has 192 cause of death related indicators, subdivided into 4 sections
and 118 subgroups. Within sections and subgroups, skip patterns are driven by age, sex,
maternal and perinatal information. The indicators were identified by reviewing
modifications of the WHO 2007 instrument, queries about used, useless and unused
indicators, and with input from analytical software use (InterVA and upcoming PHMRC VA
interpretation software). A final expert review of the results and consolidation of the results
led to the formulation of the present list of indicators.
A file is available for download at www.who.int/healthinfo/statistics/verbalautopsystandards
containing the full set of indicators that were considered and the rationale for inclusion or
exclusion of each indicator in the 2012 VA instrument.
VA cannot ascertain all causes of death. Furthermore, as many validation studies have shown,
VA does not perform equally well for all causes that it can ascertain. Taking these limitations
into account, the 2012 instrument was developed to ascertain all causes of death that may be
attributed with reasonable accuracy from a well-administered VA interview (Appendix 1).
The sections allow the addition of variables of topical interest (e.g. risk factors) where
necessary. While such augmentation of the 2012 instrument is not encouraged (see Section
4.2 Guidelines on augmentation, and local adaptation), as long as all the sections are
included and correct cause of death certification and coding procedures are used, it should be
possible to generate comparable data over time across populations.
8
2012 WHO verbal autopsy instrument Release candidate 1
This section describes the use of the 2012 WHO VA instrument and its implementation with
different options. It also provides requirements for design of local data collection software.
The 2012 WHO VA instrument is designed to be usable in routine assessment of cause of
death using VA. The number of questions and targeted diagnoses has been reduced. The
questions have been reshaped to be answered with simple yes or no. The durations of
indicators preceding death are asked for only a limited number of indicators. Responses to
questions on the duration of indicators need to be categorised in a second step in the analysis
of the cause of death (see 4.6.2).
The 2012 WHO VA instrument is designed for software use. It has a skip pattern embedded
that embraces all age groups and special cases in one big questionnaire. Sample
questionnaires are provided for three age groups (under four weeks; 4weeks-14 years, 15 years
and above), as shown in the Appendices 3-5.
Unique variable identifiers and notes for translators and interviewers facilitate the translation
of the instrument in the desired language. The English terms were chosen to ensure clarity of
the intent of the individual questions.
WHO will develop data collection software for generic Java-enabled mobile devices.
However, any other software can be designed for use with this instrument following the
instructions that are given below.
Software for interpreting VA indicators into causes of death without the use of physicians can
be used in the majority of cases. At present (2012) InterVA4 is fully compliant with the set of
indicators and can be linked for batch processing to the WHO data collection software.
9
Application and implementation of the 2012 WHO VA instrument
For sections 1 and 2, rules for privacy protection should be ensured, except for age and sex
information. Section 1a provides essential detail for assigning the cause of death and applying
the skip patterns. Section 1b allows linkages to vital registration data, and section 2 provides
information that is useful to quality assurance.
Section 3 provides essential information for assigning the cause of death. It has a skip pattern
by age, sex, and level of detail. This section has 93 cause of death related 1st level questions
that have to be asked and 87 sub-questions (2nd level) (31 sub-sub-questions 3rd level- and 10
4th level questions) that will be asked only if the respective 1st level questions have a positive
response.
Section 4 provides background information on deaths that occur in non-enumerated
populations, i.e. where there is no prior information about the deceased
Section 5 may be helpful to assess the diagnosis in cases where software assessment for the
diagnosis may not deliver reliable results and physician review is necessary. Its use is optional.
The common elements across age groups include, besides the death registration and
information about interviewer and respondent, general questions and questions that relate
to some causes of death and certain generalized signs and symptoms. The death registration
section the first page of each questionnaire contains key identifying and socio-
demographic information and data fields necessary for the management of completed forms.
It contains standard personal information:
A unique ID, control or reference number for the VA questionnaire being completed;
The date, place and time of the interview and identity of the interviewer;
Key characteristics of the respondent;
The time, place and date of death;
The name, sex and age of the deceased
These sections are, with few exceptions, the same across all age groups and are accordingly in
the sample questionnaires for the three age groups that are shown in the appendices. The
sections of each questionnaire that contains the essential information for certification of cause
of death have a checklist to note the signs and symptoms noted during the final illness.
With the exception of questions about injuries and accidents, and some questions about
generalized systemic signs and symptoms (e.g. fever or intestinal signs and symptoms), the
10
2012 WHO verbal autopsy instrument Release candidate 1
questions contained in the checklist of signs and symptoms vary depending on age and/or the
sex of the deceased.
11
Application and implementation of the 2012 WHO VA instrument
12
2012 WHO verbal autopsy instrument Release candidate 1
13
Application and implementation of the 2012 WHO VA instrument
14
2012 WHO verbal autopsy instrument Release candidate 1
Adding and removing questions will impact the comparability of the data but also may
compromise the usability of software assisted diagnosing. It may not be possible to use the
existing software for diagnosing the newly added causes of death.
15
Application and implementation of the 2012 WHO VA instrument
4.5 Translation
The language chosen in indicators and notes aims to convey the highest level of clarity about
the intent of a question. Indicators, instructions and software need to be translated for local
use. This is valid also for English because lay language differs between English speaking
regions. In the translation process and the notes will inform the translator, and both, notes
and questions, should be translated. Translators may need to adapt the wording of the
questions to the vocabulary in use in the locations where interviews will be conducted. The
notes will guide translators and interviewers. For quality assurance, a second translator
should carry out a back-translation to English.
For any translations, please use the translation table for the 2012 WHO VA instrument that
you can download at www.who.int/healthinfo/statistics/verbalautopsystandards. Fill in your
translations in the empty fields as indicated in the file. The given identifiers and the resulting
bilingual file will allow users to 1. re-use a translation as necessary for other projects, and 2.
load translations into the WHO software for immediate use, if so desired.
16
2012 WHO verbal autopsy instrument Release candidate 1
Where interviews are conducted for all age categories of deaths, ideally the interview data
should be captured electronically using the embedded skip patterns. Otherwise (using paper),
the interviewers should take always all three age group specific questionnaires during house
visits for VA interviews.
WHO is making available software for remote data collection and storage in a database.
Linkages to analytic diagnostic tools (software for VA diagnosis) are embedded in the data
collection software and allow the interviewer to receive the identified cause of death assigned
in real time. Independently, any other software can be programmed for using this instrument
for data collection, as long as all answers to all questions, assigned cause of death and method
of diagnosing are recorded in a database. Further, any tool for diagnosing the cause of death
can be used in conjunction, as long as the collected information is sufficient.
4.8 Infrastructure
In routine surveillance contexts, information needs to be timely and linked to a response that
involves effective dissemination mechanisms, appropriate use of data, and periodic evaluation
of the surveillance system. The latter can trigger formulation of recommendations for a
revision of the components of the 2012 WHO VA instrument to WHO and local workflows of
the VA system in use. Thus, use of VA in routine surveillance involves monitoring,
accountability, planning and programming.
To develop an adequate instrument for application in large-scale surveillance, the VA
instrument needs to be tested and needs to have a system that synergizes with other national
mechanisms that are already in place.
The infrastructure will depend largely on the given settings. Data should ideally be stored in a
centralized location but at a level that facilitates necessary queries. Usually this is likely to be
at the district level. All verified district data would then be forwarded to a central database at
the national level.
Arrangements regarding collection, storage and handling of the vital registration and cause of
death data should be made between the offices that are involved. Depending on the national
infrastructure these offices are most frequently the Statistical Office, Ministry of Health,
Ministry of Justice and Ministry of Interior.
Different arrangements may be necessary where VA is conducted in another context, as for
research or disease specific programmes.
4.8.1 Interviewers
Interviewers should be trained on the instrument and on conducting interviews with persons
that may still be in mourning. Interviewers should be given enough time to carry out their
task in VA. However, it is proposed that at least one VA interview per month should be
conducted by each VA interviewer to retain their proficiency in conducting VA interviews.
17
Application and implementation of the 2012 WHO VA instrument
Interviewers involved in the application of the VA should have the following minimum
qualifications:
Have completed at least secondary school and have good working knowledge in the
relevant local language(s);
Be acceptable to the local community; where possible, selected by the local
community;
Have good training in conducting VA interviews;
Know very well the content and uses of the VA instrument.
In the ideal training, first the interviewer could review all elements and the flow of questions
with the help of an expert VA trainer. After discussing any questions that need clarification
with the VA trainer, the interviewer can role play a VA interview using the VA trainer as
dummy VA respondent. For this role play the VA trainer should have different case
scenarios. Such scenarios would include the different variants of interviews (maternal,
perinatal, child, adult) and also probable local behaviour on the interview per se, and on
sensitive questions. In the next step, the interviewer would conduct real VA interviews in the
presence of the expert. The number of VA interviews to be conducted in the presence of the
VA trainer required to certify proficiency of individual trainee VA interviewer would vary
depending on the skills and abilities. Nevertheless typically it would take at least five VA
interviews to become confident in doing VA interviews.
18
2012 WHO verbal autopsy instrument Release candidate 1
In addition to the questions, a narrative can be helpful if there is any intention to use
physicians in the assessment of the cause of death, for quality assurance, and for later review.
This information should be stored in the database as well.
19
Application and implementation of the 2012 WHO VA instrument
20
2012 WHO verbal autopsy instrument Release candidate 1
ICD coding system facilitates the merging of data and the retention of as much detail as
needed in local settings.
The context and method of information gathering to assign cause of death from VA is
different from the medical certification of cause of deaths by a physician. The certainty of the
cause of death is much lower in VA, and VA cannot reliably ascertain some causes of death.
Data from these two methods should not be merged, as it would conceal differences that may
result from these methods and lead to misinterpretation of the results.
21
Application and implementation of the 2012 WHO VA instrument
5 Bibliography
1 International Statistical Classification of Diseases and Related Health Problems - Instruction Manual.
(World Health Organization, 2010).
2 Verbal autopsy standards: ascertaining and attributing cause of death. (World Health Organization,
2007).
3 InterVA. InterVA, <http://www.interva.net/> (2011).
4 Murray, C. J. et al. Population Health Metrics Research Consortium gold standard verbal autopsy
validation study: design, implementation, and development of analysis datasets. Popul Health Metr 9,
27, doi:1478-7954-9-27 [pii] 10.1186/1478-7954-9-27 (2011).
5 Soleman, N., Chandramohan, D. & Shibuya, K. Verbal autopsy: current practices and challenges. Bull
World Health Organ 84, 239-245, doi:S0042-96862006000300020 [pii] /S0042-96862006000300020
(2006).
6 Garenne, M. & Fauveau, V. Potential and limits of verbal autopsies. Bull World Health Organ 84, 164,
doi:S0042-96862006000300004 [pii] /S0042-96862006000300004 (2006).
7 Murray, C. J., Lopez, A. D., Feehan, D. M., Peter, S. T. & Yang, G. Validation of the symptom pattern
method for analyzing verbal autopsy data. PLoS Med 4, e327, doi:07-PLME-RA-0521 [pii]
10.1371/journal.pmed.0040327 (2007).
8 Abouzahr, C. Verbal autopsy: who needs it? Popul Health Metr 9, 19, doi:1478-7954-9-19 [pii]
10.1186/1478-7954-9-19 (2011).
9 Setel, P. W. Verbal autopsy and global mortality statistics: if not now, then when? Popul Health Metr 9,
20, doi:1478-7954-9-20 [pii] 10.1186/1478-7954-9-20 (2011).
10 Fottrell, E. Advances in verbal autopsy: pragmatic optimism or optimistic theory? Popul Health Metr
9, 24, doi:1478-7954-9-24 [pii] 10.1186/1478-7954-9-24 (2011).
11 Fottrell E, Byass P. Verbal Autopsy methods in transition. Epidemiologic Reviews 2010; 32:38-55
22
2012 WHO verbal autopsy instrument Release candidate 1
2012 cause of death list for verbal autopsy with corresponding ICD-10 codes.
Column 1 contains the code for the verbal autopsy entity. Column 2 lists the related titles. Column 3 lists the
ICD-10 codes that would be used if the condition labelled by column 2 were coded to ICD-10. Column 4 lists
the ICD-10 categories that need to be grouped to match the content of the relevant VA entity.
ICD-10 ICD-10
Verbal
Verbal autopsy title code (to codes (from
autopsy code
ICD) ICD)
A1-1
Non-communicable diseases
Note:
This group covers all non-communicable conditions. Any
infection of the systems that are listed in this section should be
assigned to the suitable infectious disease category. Any
maternal and perinatal condition should be assigned to the
maternal and perinatal causes below.
VAs-02 Neoplasms
VAs-02.01 Oral neoplasms C06 C00-C06
VAs-02.02 Digestive neoplasms C26 C15-C26
VAs-02.03 Respiratory neoplasms C39 C30-C39
VAs-02.04 Breast neoplasms C50 C50
Female reproductive neoplasms C57 C51-C58
VAs-02.05
A1-2
2012 WHO verbal autopsy instrument Release candidate 1
C60-D48
A1-3
VAs-03 Nutritional and endocrine disorders
VAs-03.01 Severe anaemia D64 D50-D64
VAs-03.02 Severe malnutrition E46 E40-E46
VAs-03.03 Diabetes mellitus E14 E10-E14
A1-4
2012 WHO verbal autopsy instrument Release candidate 1
A1-5
VAs-11 Stillbirths
VAs-11.01 Fresh stillbirth P95 P95
VAs-11.02 Macerated stillbirth P95 P95
Note:
The list of questions contains sub questions
that allow for more specificity for accidents.
V89 V01-V89
VAs-12.01 Road traffic accident
VAs-12.02 Other transport accident V99 V90-V99
VAs-12.03 Accidental fall W19 W00-W19
Accidental drowning and W74 W65-W74
VAs-12.04
submersion
Accidental exposure to smoke, fire X09 X00-X19
VAs-12.05
and flames
Contact with venomous animals and X29 X20-X29
VAs-12.06
plants
X49 X40-X49
Accidental poisoning and exposure
VAs-12.07
to noxious substance
VAs-12.08 Intentional self-harm X84 X60-X84
VAs-12.09 Assault Y09 X85-Y09
VAs-12.10 Exposure to force of nature X39 X30-X39
X59 S00-T99;
W20-W64;
Other and unspecified external cause
VAs-12.99 W75-W99;
of death
X50-X59;
Y10-Y98
R99 R95-R99
VAs-99 Cause of death unknown
A1-6
2012 WHO verbal autopsy instrument Release candidate 1
Read carefully the explanations given in section 4.1 of this manual, and the instructions in
the remaining sub-sections of section 4.
A1-7
WHO-VA 2012 RC1 Appendix 2 - List of indicators
AGE_65-Plus
FEMALE 12-
AGE_5_14Y
AGE1_11M
AGE_50-64
AGE_15-49
AGE_U28d
AGE_1_4Y
FEMALE
MALE
Threshold 2nd level 3rd level 4th level Notes for translators and
Variable Data type 1st level question
values question question question interviewers
A2-1
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A260A Calculated 65+ years Was (s)he aged 1 0 0 0 0 0 0 1 1 0 This can be derived from a
(Y/N/DNK) 65 years or over general question about the
at death? age of the deceased at the
time of death. Select this
for someone aged 65 years
or over at death.
1A260B Calculated 50-64 Was (s)he aged 0 1 0 0 0 0 0 1 1 0 This can be derived from a
(Y/N/DNK) years 50 to 64 years at general question about the
death? age of the deceased at the
time of death. Select this
for someone aged 50 to 64
years at death.
A2-2
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A260C Calculated 15-49 Was (s)he aged 0 0 1 0 0 0 0 1 1 0 This can be derived from a
(Y/N/DNK) years 15-49 years at general question about the
death? age of the deceased at the
time of death. Select this
for someone aged 15-49
years at death.
1A260D Calculated 5-14 years Was (s)he aged 0 0 0 1 0 0 0 1 1 1 This can be derived from a
(Y/N/DNK) 5 to 14 years at general question about the
death? age of the deceased at the
time of death. Select this
for someone aged 5 to 14
years at death.
1A260E Calculated 1-4 years Was (s)he aged 0 0 0 0 1 0 0 1 1 0 This can be derived from a
(Y/N/DNK) 1 to 4 years at general question about the
death? age of the deceased at the
time of death. Select this
for someone aged 1 to 4
years at death.
1A260F Calculated 1-11 Was (s)he aged 0 0 0 0 0 1 0 1 1 0 This can be derived from a
(Y/N/DNK) months 1 to 11 months general question about the
at death? age of the deceased at the
time of death. Select this
for someone aged 1 to 11
months at death.
1A260G Calculated 28 days Was (s)he aged 0 0 0 0 0 0 1 1 1 0 This can be derived from a
(Y/N/DNK) 28 days or less general question about the
at death? age of the deceased at the
time of death. Select this
for someone aged 28 days
or less at death.
A2-3
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A260H Calculated 24 hours Did the baby die 0 0 0 0 0 0 1 1 1 0 This can be derived from a
(Y/N/DNK) within 24 hours general question about the
of birth? age of a baby at the time of
death. Select this for a baby
who died within 24 hours
of being born.
1A260I Calculated >24h to Did baby die 0 0 0 0 0 0 1 1 1 0 This can be derived from a
(Y/N/DNK) 48 hours more than 24 general question about the
hours after but age of a baby at the time of
less than 48 death. Select this for a baby
hours from who died more than 24
birth? hours but less than 48
hours of being born.
1A260J Calculated >48 hours Did baby die 0 0 0 0 0 0 1 1 1 0 This can be derived from a
(Y/N/DNK) to 6 days more than 48 general question about the
hours from birth age of a baby at the time of
but within the death. Select this for a baby
first week of who died more than 48
life? hours after being born, but
within the first week of life.
A2-4
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-5
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A560 Single Hospital/ What was the site 1 1 1 1 1 1 1 1 1 1 Record the site of the
select Other of death? death.
health
facility/ho
me/other
/DNK
1A560A Calculated Hospital Did (s)he die in a 1 1 1 1 1 1 1 1 1 1
(Y/N/DNK) hospital?
A2-6
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A600 Single Single/Ma What was her/his 1 1 1 1 0 0 0 1 1 1 Record the marital status of
select rried/Divo marital status? the person who died.
rced/Wid
owed/Too
young/DN
K
A2-7
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-8
WHO-VA 2012 RC1 Appendix 2 - List of indicators
1A660 Single Mainly What was her/his 1 1 1 1 0 0 0 1 1 1 Record the main economic
select employed economic activity activity of the person who
/Mainly status in year died, before they became
unemploy prior to death? ill.
ed/Home-
maker/Stu
dent/Pens
ion/Other
/DNK
A2-9
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-10
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-11
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-12
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-13
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-14
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-15
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3A300 Number [0-999] For how long was 1 1 1 1 1 1 1 1 1 1 This reflects the time
[weeks] (s)he ill before period that the deceased
(s)he died? started feeling ill with
onset of symptoms until
the time of death.
3A300A Calculated < 3 weeks Was (s)he ill for 1 1 1 1 1 1 1 1 1 1 Select this if the final illness
(Y/N/DNK) less than 3 weeks lasted less than 3 weeks.
before death?
3A300B Calculated 3 weeks Was (s)he ill for 3 1 1 1 1 1 1 1 1 1 1 Select this if the final illness
(Y/N/DNK) weeks or more lasted 3 weeks or more.
before death?
3A310 Yes/No/D Did (s)he die 1 1 1 1 1 1 1 1 1 1 Select this either if the final
ontKnow= suddenly? illness lasted less than a
1/0/9 day, or if the final illness
seemed to be progressing
well and death was not
expected.
3B Section General signs and
symptoms
associated with
final illness
3B100 Yes/No/D Did (s)he have a 1 1 1 1 1 1 1 1 1 1 Select this if there were any
ontKnow= fever? signs of fever during the
1/0/9 final illness.
3B110 Number [0-99] For how long did 1 1 1 1 1 1 0 1 1 1 This reflects the period of
[weeks] (s)he have a time that the deceased had
fever? fever during the final
illness, continuously or on
and off.
3B110A Calculated < 2 weeks Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this is if the fever
(Y/N/DNK) fever for less lasted less than 2 weeks.
than 2 weeks
before death?
A2-16
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B110B Calculated 2 weeks Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the fever
(Y/N/DNK) fever for 2 lasted 2 weeks or more.
weeks or more
before death?
3B120 Yes/No/D Did (s)he have 1 1 1 1 1 0 0 1 1 1 If the "any fever" indicator
ontKnow= night sweats? is selected, select this one if
1/0/9 the deceased particularly
experienced heavy night
sweats.
3B130 Yes/No/D Did (s)he have a 1 1 1 1 1 1 1 1 1 1 Select this if there was any
ontKnow= cough? cough during the final
1/0/9 illness.
3B140 Number [0-99] For how long did 1 1 1 1 1 1 0 1 1 1 This reflects the duration of
[weeks] (s)he have a cough during the final
cough? illness.
3B140A Calculated < 3 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the cough
(Y/N/DNK) cough for less lasted less than 3 weeks.
than 3 weeks
before death?
3B140B Calculated 3 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the cough
(Y/N/DNK) cough for 3 lasted 3 weeks or more.
weeks or more
before death?
3B150 Yes/No/D Was the cough 1 1 1 1 1 0 0 1 1 1 If the "any cough" indicator
ontKnow= productive, with is selected, select this one if
1/0/9 sputum? the deceased regularly
coughed up sputum or
mucus.
A2-17
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B180 Yes/No/D Did (s)he have any 1 1 1 1 1 1 1 1 1 1 Select this if there were any
ontKnow= breathing problems of breathing
1/0/9 problem? during the final illness
(before the moment of
death).
3B190 Yes/No/D Did (s)he have 1 1 1 1 1 1 1 1 1 1 If the "any breathing
ontKnow= fast breathing? problem" indicator is
1/0/9 selected, select this one if
the deceased was an infant
or child who was breathing
much faster than normal.
3B200 Weeks [0-99] For how long 1 1 1 1 1 1 1 1 1 1 This reflects the time
did (s)he have period that the deceased
fast breathing? suffered from breathing
much faster than normal
during the final illness.
3B200A Calculated < 2 weeks Did (s)he have 1 1 1 1 1 1 1 1 1 1 Select this if the fast
(Y/N/DNK) fast breathing breathing lasted for less
for less than 2 than 2 weeks.
weeks?
3B200B Calculated 2 weeks Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the fast
(Y/N/DNK) fast breathing breathing lasted for 2
for 2 weeks or weeks or more.
more?
A2-18
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B220 Weeks [0-99] For how long 1 1 1 1 1 1 1 1 1 1 This reflects the time
did (s)he have period during the final
breathlessness? illness that the deceased
had difficulty breathing.
3B220A Calculated < 2 weeks Did (s)he have 1 1 1 1 1 1 1 1 1 1 Select this if the
(Y/N/DNK) breathlessness breathlessness lasted for
for less than 2 less than 2 weeks.
weeks?
3B220B Calculated 2 weeks Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the
(Y/N/DNK) breathlessness breathlessness lasted for 2
for 2 weeks or weeks or more.
more?
3B230 Yes/No/D Was (s)he 1 1 1 1 1 1 0 1 1 1 If the "any breathing
ontKnow= unable to carry problem" indicator is
1/0/9 out daily selected, select this one if
routines due to the deceased found it
breathlessness? particularly difficult to
breathe when physically
active, e.g. walking, going
up steps.
3B240 Yes/No/D Was (s)he 1 1 1 1 1 0 0 1 1 1 If the "any breathing
ontKnow= breathless while problem" indicator is
1/0/9 lying flat? selected, select this one if
the deceased found it
particularly difficult to
breathe even when lying
down to rest.
3B250 Yes/No/D Did you see the 0 0 0 1 1 1 1 1 1 1 If the lower ribs of chest
ontKnow= lower chest wall on both sides of the
1/0/9 wall/ribs being chest are pulled in when
pulled in as the the child breathes in.
child breathed?
A2-19
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B280 Yes/No/D Did (s)he have 1 1 1 1 1 1 1 1 1 1 Select this if there was any
ontKnow= diarrhoea? diarrhoea during the final
1/0/9 illness.
3B290 Weeks [0-99] For how long did 1 1 1 1 1 1 0 1 1 1 This reflects the time
(s)he have period during which the
diarrhoea? deceased suffered from
diarrhoea.
3B290A Calculated acute < 2 Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the diarrhoea
(Y/N/DNK) wks. diarrhoea for lasted for less than 2
less than 2 weeks.
weeks?
3B290B Calculated persistent Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the diarrhoea
(Y/N/DNK) 2-4 wks. diarrhoea for 2 lasted for 2 to 4 weeks, not
to 4 weeks? necessarily every day.
3B290C Calculated recurrent Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the diarrhoea
(Y/N/DNK) 4 wk. diarrhoea for 4 lasted more than 4 weeks,
weeks or more? not necessarily every day.
A2-20
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B310 Yes/No/D Did (s)he vomit? 1 1 1 1 1 1 1 1 1 1 Select this if there was any
ontKnow= vomiting during the final
1/0/9 illness.
3B320 Yes/No/D Did (s)he vomit 1 1 1 1 1 1 1 1 1 1 If the "any vomiting"
ontKnow= "coffee indicator is selected, select
1/0/9 grounds" or this one if the vomit
bright contained blood. The point
red/blood? is to identify if there was
any bleeding of the upper
gastrointestinal tract.
Whereas strong and acute
bleeding might show as
fresh or coagulated blood,
less strong bleeding would
expose the blood some
time to gastric acid, and
then it would look like
ground coffee (particles of
a size between 0.5-2 mm of
black or dark brown
colour). In local languages
there may be other
analogies to describe this
kind of presentation of
blood.
3B330 Yes/No/D Did (s)he have any 1 1 1 1 1 1 0 1 1 1 Select this if any abdominal
ontKnow= abdominal problem has been present.
1/0/9 problem?
A2-21
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-22
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B370 Weeks [0-99] For how long 1 1 1 1 1 1 0 1 1 1 This reflects the time
did (s)he have a period during the final
more than illness in which the
usually deceased had a more than
protruding usual protruding abdomen.
abdomen? The best wording would
depend on the local
language.
3B370A Calculated < 2 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the more than
(Y/N/DNK) more than usually protruding
usually abdomen lasted for less
protruding than 2 weeks.
abdomen for
less than 2
weeks?
3B370B Calculated 2 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the more than
(Y/N/DNK) more than usually protruding
usually abdomen lasted for 2
protruding weeks or more.
abdomen for 2
weeks or more?
A2-23
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B390A Calculated < 2 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the lump
(Y/N/DNK) lump inside the inside the abdomen lasted
abdomen for for less than 2 weeks.
less than 2
weeks?
3B390B Calculated 2 weeks Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the lump
(Y/N/DNK) lump inside the inside the abdomen lasted
abdomen for 2 for 2 weeks or more.
weeks or more?
3B410 Number [0-99] For how long did 1 1 1 1 1 1 0 1 1 1 This reflects the time
[weeks] (s)he have a stiff period during the final
or painful neck? illness during which the
deceased suffered from
neck pain or stiffness.
3B410A Calculated < 1 week Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the stiff or
(Y/N/DNK) stiff or painful painful neck lasted for less
neck for less than 1 week.
than 1 week?
3B410B Calculated 1 week Did (s)he have a 1 1 1 1 1 1 0 1 1 1 Select this if the stiff or
(Y/N/DNK) stiff or painful painful neck lasted for 2
neck for 1 week weeks or more.
or more?
A2-24
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-25
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B470 Number [0-60] For how long did 1 1 1 1 1 1 0 1 1 1 This reflects the
[minutes] the convulsions approximate duration in
last? minutes of convulsion
episodes suffered by the
deceased.
3B470A Calculated < 10 Did the 1 1 1 1 1 1 0 1 1 1 Select this if the
(Y/N/DNK) minutes convulsions last convulsions lasted for less
for less than 10 than 10 minutes.
minutes?
A2-26
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B490 Yes/No/D Did (s)he have any 1 1 1 1 1 1 0 1 1 1 Select this if there was any
ontKnow= urine problems? problem relating to urine
1/0/9 during the final illness.
A2-27
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B570 Weeks [0-99] For how long 1 1 1 1 1 0 0 1 1 1 This reflects the time
did (s)he have period during which the
the skin rash? deceased had a skin rash,
independent of the type of
skin rash.
3B570A Calculated < 1 week Did (s)he have 1 1 1 1 1 0 0 1 1 1 Select this if the skin rash
(Y/N/DNK) the skin rash for lasted less than 1 week.
less than 1
week?
3B570B Calculated 1 week Did (s)he have 1 1 1 1 1 0 0 1 1 1 Select this if the skin rash
(Y/N/DNK) the skin rash for lasted 1 week or more
1 week or
more?
3B580 Yes/No/D Did (s)he have 1 1 1 1 1 1 1 1 1 1 If the "any skin problem"
ontKnow= measles rash? indicator is selected, select
1/0/9 this one if the skin problem
was described as measles
rash.
3B590 Yes/No/D Did (s)he ever 1 1 1 1 1 0 0 1 1 1 If the "any skin problem"
ontKnow= have shingles or indicator is selected, select
1/0/9 herpes zoster? this one if the skin problem
was described as herpes
zoster or shingles.
A2-28
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B670 Yes/No/D Did (s)he have any 1 1 1 1 1 1 0 1 1 1 Select this if there was any
ontKnow= lumps? localised lump or lesion on
1/0/9 any part of the body, either
at the time of death, or
surgically removed prior to
death.
A2-29
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-30
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3B750 Yes/No/D Did (s)he have 1 1 1 1 1 1 0 1 1 1 Select this if the white parts
ontKnow= yellow of the deceased's eyes had
1/0/9 discoloration of turned distinctly yellow in
the eyes? colour (and possibly yellow
soles of the feet for small
babies).
3B770 Yes/No/D Did (s)he look pale 1 1 1 1 1 0 0 1 1 1 Select this if either blood
ontKnow= (thinning/lack of test results indicated
1/0/9 blood) or have anaemia or low
pale palms, eyes haemoglobin levels, or if
or nail beds? the person was unusually
pale (inner eyelids, palms
of hands, soles of feet)
during the final illness.
3B780 Yes/No/D Did (s)he have 0 0 0 0 1 1 0 1 1 0 Select this if the eyes were
ontKnow= sunken eyes? unusually sunken into the
1/0/9 face during the final illness.
A2-31
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-32
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3C110 Single only one Was she pregnant 0 0 1 0 0 0 0 0 1 1 Select this for a woman
select of the at the time of aged 12-50 years who was
Yes/No/D questions death? reported to have been
ontKnow= 3C100- pregnant at the time of her
1/0/9 130 can death. This means that a
be foetus, either at an early
answered stage of pregnancy or
with "yes" nearer full term, remained
inside her body at the time
of death. This includes a
woman who dies
undelivered during labour.
3C120 Single only one Did she die within 0 0 1 0 0 0 0 0 1 1 Select this for a woman
select of the 6 weeks of giving aged 12-50 years who was
Yes/No/D questions birth? reported to have delivered
ontKnow= 3C100- a baby within 6 weeks of
1/0/9 130 can her death. This means one
be or more potentially viable
answered babies, born either dead or
with "yes" alive, were delivered in the
previous 6 weeks.
3C130 Single only one Did she die within 0 0 1 0 0 0 0 0 1 1 Select this for a woman
select of the 6 weeks of a aged 12-50 years who was
Yes/No/D questions pregnancy that reported to have been at
ontKnow= 3C100- lasted less than 6 an early stage (first 6
1/0/9 130 can months? months) of pregnancy
be within 6 weeks of her
answered death, but the pregnancy
with "yes" had ended in a
spontaneous or induced
abortion at a stage before
the foetus was viable.
A2-33
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3C230A Calculated 0 (first Was this the 0 0 1 0 0 0 0 0 1 1 Select this for a woman
(Y/N/DNK) pregnancy woman's first aged 12-50 years who was
) pregnancy? reported to have been
pregnant for the first time.
A2-34
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-35
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-36
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-37
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-38
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-39
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3D Section Neonatal/child
history, signs and
symptoms
3D100 Yes/No/D Was the child part 0 0 0 0 0 1 1 1 1 0 Select this for a baby who
ontKnow= of a multiple was born as one of a
1/0/9 birth? multiple pregnancy.
3D110 Yes/No/D Was the child 0 0 0 0 0 1 1 1 1 0 Select this for a baby who
ontKnow= born in a was born in a complicated
1/0/9 complicated delivery, for example
delivery? lasting a long time or
needing special assistance.
A2-40
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-41
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-42
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-43
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3D290 Yes/No/D Did the baby cry 0 0 0 0 0 0 1 1 1 0 Select this for a neonate
ontKnow= after birth, even if who cried, even if just a
1/0/9 only a little bit? little, after birth.
3D340 Yes/No/D Was the baby able 0 0 0 0 0 0 1 1 1 0 Select this for a neonate
ontKnow= to suckle or bottle- who was healthy and
1/0/9 feed within the feeding within the first 24
first 24 hours hours from birth.
after birth?
A2-44
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3D360 Yes/No/D Did the baby have 0 0 0 0 0 0 1 1 1 0 Select this for a neonate
ontKnow= convulsions who had convulsions in the
1/0/9 starting within the first 24 hours after birth.
first day of life?
3D370 Yes/No/D Did the baby have 0 0 0 0 0 0 1 1 1 0 Select this for a neonate
ontKnow= convulsions who had convulsions 48
1/0/9 starting on the hours or more after birth.
second day or
later after birth?
A2-45
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3D500A Calculated 0 (first Was this baby 0 0 0 0 0 0 1 1 1 0 Select this for a neonate
(Y/N/DNK) pregnancy born from the who died, and who was
) mother's first born from the mother's first
pregnancy? pregnancy.
A2-46
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-47
WHO-VA 2012 RC1 Appendix 2 - List of indicators
3E Section History of
injuries/accidents
3E100 Yes/No/D Did (s)he suffer 1 1 1 1 1 1 1 1 1 1 Select this if there was any
ontKnow= from any injury or kind of injury or accident
1/0/9 accident that led associated with the final
to her/his death? illness.
A2-48
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-49
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-50
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-51
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-52
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-53
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-54
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-55
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-56
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-57
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-58
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-59
WHO-VA 2012 RC1 Appendix 2 - List of indicators
4A190 Yes/No/D Over the course of 1 1 1 1 1 1 1 1 1 1 Select this if the total costs
ontKnow= illness, did the incurred in the final illness
1/0/9 total costs of care were sufficiently great to
and treatment mean that other kinds of
prohibit other household expenses (food,
household fuel, travel, education etc.)
payments? could not be met, or
caused debt or sale of
household assets.
A2-60
WHO-VA 2012 RC1 Appendix 2 - List of indicators
A2-61
2012 WHO VERBAL AUTOPSY
SAMPLE QUESTIONNAIRE 1
Death of a child
Under 4 weeks (0-28 days)
Surname
Name
MONTH
YEAR
MORNING =1 HOUR
EVENING=2
MINUTES
Surname
Name
2A115 Did you live with the deceased in the period leading to her/his YES
death? NO
Name
MONTH
YEAR
MONTH
YEAR
1A260 How old was the deceased when s/he died? DAYS
HOURS
DON'T KNOW
4 Urban/Rural URBAN
RURAL
DON'T KNOW
4 Urban/Rural URBAN
RURAL
DON'T KNOW
4 Urban/Rural URBAN
RURAL
Surname
Name
Name
4 Urban/Rural
URBAN
RURAL
5 Name of local registrar
Surname
Name
DON'T KNOW
Could you tell me about the illness/events that led to her his/death?
I would like to ask you some questions concerning the mother and symptoms that the deceased had/showed at birth
and shortly after. Some of these questions may not appear to be directly related to the baby's death. Kindly be patient
and answer all the questions. They will help us to get a clear picture of all possible symptoms that [NAME] had.
3D500 How many births, including stillbirths, did the baby's mother have NUMBER OF BIRTHS/
before this baby? STILLBIRTHS
DON'T KNOW
3D210 How many weeks was the pregnancy when the baby was born? NUMBER OF WEEKS
DON'T KNOW
3D510 During the pregnancy did the baby's mother suffer from YES
high blood pressure? NO
DON'T KNOW
3D550 Did the baby's mother have vaginal bleeding during the last 3 months YES
of pregnancy but before labour started? NO
DON'T KNOW
3D520 Did the baby's mother have foul smelling vaginal discharge during YES
pregnancy and/or after delivery? NO
DON'T KNOW
3D540 During the last 3 months of pregnancy did the baby's mother suffer YES
from blurred vision? NO
DON'T KNOW
3D530 During the last 3 months of pregnancy did the baby's mother suffer YES
from convulsions? NO
DON'T KNOW
3D580 Was the child born somewhere else (e.g. on the way to a health facility)? YES
NO
DON'T KNOW
3D590 Did the mother receive professional assistance during the delivery? YES
NO
DON'T KNOW
3D120 Was the baby born 24 hours or more after the water broke? YES
NO
DON'T KNOW
3D130 Did the baby stop moving in the womb before labour started? YES
NO
DONT KNOW
3D170 Did the baby's bottom, feet, arm or hand come into the vagina YES
before its head? NO
DON'T KNOW
3D190 + Was the baby smaller than normal, weighing under YES
+ 2.5 kg? NO
DON'T KNOW
3D200 + Was the baby larger than normal, weighing over 4.5 kg? YES
NO
DON'T KNOW
3D220 Was the umbilical cord wrapped several times (more than once) around YES
the neck of the child at birth? NO
DON'T KNOW
3D300 Did the baby breathe after birth, even a little? YES
NO
DON'T KNOW
3D290 Did the baby ever cry after birth, even if only a little bit? YES
NO
DON'T KNOW
3D320 If the baby did not cry or breathe, was it born dead? YES
NO
DON'T KNOW
3D330 + Was the dead baby macerated, that is, showed signs of decay? YES
NO
DON'T KNOW
3E100 Did the baby suffer from any injury or accident YES
that led to her/his death? NO
DON'T KNOW
3E110 + Did the baby suffer from a road traffic accident? YES
NO
DON'T KNOW
3E170 + + Do you know anything about the counter-part that was hit YES
+ + during the road traffic accident? NO
3E340 + + Did (s)he suffer from any plant/animal/insect bite or sting that led YES
+ + to her/his death? NO
DON'T KNOW
3E530 + Was the injury or accident intentionally inflicted by someone else? YES
NO
DON'T KNOW
3E610 + + Was the baby injured from a stab, cut or pierce? YES
NO
DON'T KNOW
3A280 Did the baby die during the wet season? YES
NO
DON'T KNOW
3A290 Did the baby die during the dry season? YES
NO
DON'T KNOW
3A300 For how long was the baby ill before s/he died? NUMBER OF HOURS
NUMBER OF DAYS
DON'T KNOW
3D340 Was the baby able to suckle or bottle-feed within first 24 hours YES
after birth? NO
DON'T KNOW
3D350 + Did the baby stop suckling of bottle feeding 3 days after birth? YES
NO
DON'T KNOW
3D360 + Did the baby have convulsions starting within the first day of life? YES
NO
DON'T KNOW
3S370 + Did the baby have convulsions starting on the second day or YES
+ later after birth? NO
DON'T KNOW
3D380 Did the baby's body become stiff, with the back arched backwards? YES
NO
DON'T KNOW
3D430 Did the baby become cold to the touch before it died? YES
NO
DON'T KNOW
3B170 + Did the baby make a whooping sound when coughing? YES
DEMONSTRATE NO
DON'T KNOW
3B250 + Did you see the lower chest wall/ribs being pulled in as the child YES
+ breathed? NO
DON'T KNOW
3B260 + Did the baby have noisy breathing (grunting or wheezing)? YES
+ DEMONSTRATE NO
DON'T KNOW
3B300 + At any time during the final illness was there blood in the stools? YES
NO
DON'T KNOW
3B320 + Did the baby vomit "coffee grounds" or bright red/blood? YES
NO
DON'T KNOW
3B360 + Did the baby have a more than usual protruding abdomen? YES
NO
DON'T KNOW
3D440 Did the baby have redness or discharge from the YES
umbilical cord stump? NO
DON'T KNOW
3B540 + Did the baby have any ulcers, abscess or sores YES
+ anywhere except the feet? NO
DON'T KNOW
3B550 + Did the baby have any ulcers, abscess or sores on the feet? YES
NO
DON'T KNOW
3B560 + During the illness that led to death, did the baby have YES
+ any skin rash? NO
DON'T KNOW
3D460 Did the mother receive tetanus toxoid (TT) vaccine? YES
NO
DON'T KNOW
SECTION 9 TREATMENT AND HEALTH SERVICE USE FOR THE FINAL ILLNESS
3G110 Did s/he receive any treatment for the illness that led to death? YES
NO
DON'T KNOW
3G130 + Did s/he receive (or needed) intravenous fluids (drip) treatment? YES
NO
DON'T KNOW
3G150 + Did s/he receive (or needed) treatment/food through a tube passed YES
+ through the nose? NO
DON'T KNOW
3G160 + Did s/he receive (or needed) injectable (IV or IM) antibiotics? YES
NO
DON'T KNOW
3G170 + Did s/he have (or needed) an operation for the illness? YES
NO
DON'T KNOW
3G190 + Was s/he discharged from the hospital very ill? YES
NO
DON'T KNOW
4A100 In the final days, did the baby travel to a hospital or health facility? YES
NO
DON'T KNOW
4A110 + Did s/he use motorised transport to get to the hospital or YES
+ health facility? NO
DON'T KNOW
4A120 + Were there any problems during admission to the hospital or YES
+ health facility? NO
DON'T KNOW
4A130 + Were there any problems with the way (s)he was treated (medical treatment, YES
+ procedures, inter-personal attitudes, respect, dignity) in the NO
+ hospital or health facility? DON'T KNOW
4A140 + Were there any problems getting medications, or diagnostic tests YES
+ in the hospital or health facility? NO
DON'T KNOW
4A150 Does it take more than 2 hours to get to the nearest hospital or YES
health facility from the deceased's household? NO
DON'T KNOW
4A160 In the final days before death, were there any doubts about whether YES
medical care was needed? NO
DON'T KNOW
4A170 In the final days before death, was traditional medicine used? YES
NO
DON'T KNOW
4A180 In the final days before death, did anyone use a telephone or cell phone YES
to call for help? NO
DON'T KNOW
4A190 Over the course of illness, did the total costs of care and treatment YES
prohibit other household payments? NO
DON'T KNOW
SUPERVISOR'S OBSERVATIONS
Death of a child
aged 4 weeks to 14 years
Surname
Name
MONTH
YEAR
MORNING =1 HOUR
EVENING=2
MINUTES
Surname
Name
2A115 Did you live with the deceased in the period leading YES
to her/his death? NO
Surname
Name
MONTH
YEAR
MONTH
YEAR
1A240 How old was the deceased when s/he died? AGE IN YEARS
1A250
IF AGE IS LESS THAN 1 YEAR RECORD IN MONTHS AGE IN MONTHS
1A400 Was this a woman who died more than 42 days but less than 1 year YES
after being pregnant or delivering a baby? NO
DON'T KNOW
DON'T KNOW
4 Urban/Rural URBAN
RURAL
5 Other country OTHER COUNTRY (specify)
DON'T KNOW
4 Urban/Rural URBAN
RURAL
1A540 What was her/his place of normal residence 1 to 5 years before death?
DON'T KNOW
4 Urban/Rural URBAN
RURAL
DON'T KNOW
4 Urban/Rural URBAN
RURAL
YEAR
Surname
Name
Surname
Name
1A660 What was her/his economical activity status in year prior to death? USUALLY ECONOMICALLY ACTIVE
MAINLY EMPLOYED
MAINLY UNEMPLOYED
1A670 What was her/his occupation, that is, what kind of work did s/he mainly
do?
YEAR
4 Urban/Rural
URBAN
RURAL
5 Name of local registrar
Surname
Name
DON'T KNOW
Could you tell me about the illness/events that led to her his/death?
I would like to ask you some questions concerning the contexts and previously known medical conditions the deceased had;
injuries and accidents that the deceased suffered; and signs and symptoms that the deceased had/showed
when s/he was ill. Some of these questions may not appear to be directly related to his/her death.
Please bear with me and answer all the questions. They will help us to get a clear picture of all
possible symptoms that the deceased had.
3A120 Did s/he have a recent positive test for Malaria? YES
NO
DON'T KNOW
3A130 Did s/he have a recent negative test for Malaria? YES
NO
DON'T KNOW
3A210 Was there any diagnosis of Chronic Obstructive Pulmonary Disease YES
(COPD)? NO
DON'T KNOW
3A300 For how long was s/he ill before s/he died? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3E100 Did s/he suffer from any injury or accident that led to her/his death? YES
NO
DON'T KNOW
3E170 + + Do you know anything about the counter-part that was hit YES
during the road traffic accident? NO
3E340 + + Did (s)he suffer from any plant/animal/insect bite or sting that led to YES
+ + her/his death? NO
DON'T KNOW
3E530 + Was the injury or accident intentionally inflicted by someone else? YES
NO
DON'T KNOW
3D190 Was the child born smaller than normal, weighing under 2.5 kg? YES
NO
DON'T KNOW
3D210 How many weeks was the pregnancy when the baby was born? NUMBER OF WEEKS
DON'T KNOW
SECTION 8. SYMPTOMS NOTED DURING THE FINAL ILLNESS FOR ALL CHILDREN
3D240 + Did the child have a swelling or defect on the back? YES
NO
DON'T KNOW
3B110 + For how long did s/he have a fever? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B140 + For how long did s/he have a cough? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B200 + + For how long did s/he have fast breathing? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B220 + + For how long did s/he have breathlessness? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B230 + + Was s/he unable to carry out daily routine activities due to YES
+ + breathlessness? NO
DON'T KNOW
3B250 + Did you see the lower chest wall/ribs be pulled in as the child YES
+ breathed? NO
DON'T KNOW
3B290 + For how long did s/he have diarrhoea? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B300 + At any time during the final illness was there blood in the stools? YES
NO
DON'T KNOW
3B350 + + For how long before death did s/he have severe abdominal NUMBER OF DAYS
+ + pain? NUMBER OF WEEKS
DON'T KNOW
3B360 + Did s/he have a more than usual protruding abdomen? YES
NO
DON'T KNOW
3B370 + + For how long did s/he have a more than usual protruding NUMBER OF DAYS
+ + abdomen? NUMBER OF WEEKS
DON'T KNOW
3B380 + Did s/he have any lump inside the abdomen? YES
NO
DON'T KNOW
3B390 + + For how long did s/he have the lump inside the abdomen? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B410 + For how long did s/he have a stiff or painful neck? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B450 + Did the unconsciousness start suddenly, quickly (at least within YES
+ a single day)? NO
DON'T KNOW
3B470 + For how long did s/he have convulsions? NUMBER OF MINUTES
DON'T KNOW
3B480 + Did s/he became unconscious immediately after the convulsion? YES
NO
DON'T KNOW
3B520 + During the final illness did s/he ever pass blood in the urine? YES
NO
DON'T KNOW
3B560 + During the illness that led to death, did s/he have any skin rash? YES
NO
DON'T KNOW
3B570 + + For how long did s/he have the skin rash? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B600 Did s/he have bleeding from the nose, mouth, or anus? YES
NO
DON'T KNOW
3B640 Did s/he have stiffness of the whole body or was unable to open YES
the mouth? NO
DON'T KNOW
3B730 Did s/he have paralysis of one side of the body? YES
NO
DON'T KNOW
3B740 Did s/he have difficulty or pain while swallowing liquids? YES
NO
DON'T KNOW
3B770 Did s/he look pale (thinning/lack of blood) or have pale palms, YES
eyes or nail beds? NO
DON'T KNOW
3B790 Did (s)he drink a lot more water than usual? YES
NO
DON'T KNOW
CHECK QUESTIONS 1A110, 1A240 AND 1A250 FOR SEX AND AGE AT DEATH:
3C100 Was she neither pregnant, nor delivered, within 6 weeks of her death? YES skip pregnancy section if YES
NO
OR DON'T KNOW
3C130 Did she die within 6 weeks of a pregnancy that lasted less YES
than 6 months? NO
DON'T KNOW
3C230 + How many births, including stillbirths, did she have NUMBER OF BIRTHS/STILLBIRTHS
+ before this baby? DON'T KNOW
3C260 + During pregnancy, did she suffer from high blood pressure? YES
NO
DON'T KNOW
3C270 + Did she have foul smelling vaginal discharge during pregnancy YES
+ or after delivery? NO
DON'T KNOW
3C280 + During the last 3 months of pregnancy, did she suffer from YES
+ convulsions? NO
DON'T KNOW
3C290 + During the last 3 months of pregnancy, did she suffer from YES
+ blurred vision? NO
DON'T KNOW
3C300 + Did she give birth to a live, healthy baby within 6 weeks of death? YES
NO
DON'T KNOW
3C320 + + Was there vaginal bleeding during the first 6 moths YES
+ + of pregnancy? NO
DON'T KNOW
3C330 + + Was there vaginal bleeding during the last 3 months of YES
+ + pregnancy but before labour started? NO
DON'T KNOW
3C350 + + Was there excessive vaginal bleeding after delivering the baby? YES
NO
DON'T KNOW
3C365 + Did she deliver or try to deliver an abnormally positioned baby? YES
NO
DON'T KNOW
3C370 + Was she in labour for unusually long (more than 24 hours)? YES
NO
DON'T KNOW
3C420 Did she give birth elsewhere, e.g. on the way to a facility? YES
NO
DON'T KNOW
3C430 + Did she receive professional assistance for the delivery? YES
NO
DON'T KNOW
3C440 + Did she have an operation to remove her uterus shortly YES
+ before death? NO
DON'T KNOW
3C480 + Was the baby born more than one month early? YES
NO
DON'T KNOW
3G110 Did s/he receive any treatment for the illness that led to death? YES
NO
DON'T KNOW
3G130 + Did s/he receive (or needed) intravenous fluids (drip) treatment? YES
NO
DON'T KNOW
3G150 + Did s/he receive (or needed) treatment/food through a tube passed YES
+ through the nose? NO
DON'T KNOW
3G160 + Did s/he receive (or needed) injectable (IV or IM) antibiotics? YES
NO
DON'T KNOW
3G170 + Did s/he have (or needed) an operation for the illness? YES
NO
DON'T KNOW
3G180 + + Did s/he have the operation within 1 month before death? YES
NO
DON'T KNOW
3G190 + Was s/he discharged from the hospital very ill? YES
NO
DON'T KNOW
4A100 In the final days before death, did s/he travel to a hospital or YES
health facility? NO
DON'T KNOW
4A110 + Did s/he use motorised transport to get to the hospital or YES
+ health facility? NO
DON'T KNOW
4A120 + Were there any problems during admission to the hospital or YES
+ health facility? NO
DON'T KNOW
4A130 + Were there any problems with the way (s)he was treated (medical treatment, YES
+ procedures, inter-personal attitudes, respect, dignity) in the NO
+ hospital or health facility? DON'T KNOW
4A140 + Were there any problems getting medications, or diagnostic tests YES
+ in the hospital or health facility? NO
DON'T KNOW
4A150 Does it take more than 2 hours to get to the nearest hospital or YES
health facility from the deceased's household? NO
DON'T KNOW
4A160 In the final days before death, were there any doubts about whether YES
medical care was needed? NO
DON'T KNOW
4A170 In the final days before death, was traditional medicine used? YES
NO
DON'T KNOW
4A180 In the final days before death, did anyone use a telephone or cell phone YES
to call for help? NO
DON'T KNOW
4A190 Over the course of illness, did the total costs of care and treatment YES
prohibit other household payments? NO
DON'T KNOW
5A100
INTERVIEWER'S OBSERVATIONS
SUPERVISOR'S OBSERVATIONS
Death of a person
aged 15 years and above
Surname
Name
MONTH
YEAR
MORNING =1 HOUR
EVENING=2
MINUTES
Surname
Name
2A115 Did you live with the deceased in the period leading YES
to her/his death? NO
Name
MONTH
YEAR
MONTH
YEAR
1A240 How old was the deceased when s/he died? AGE IN YEARS
1A400 Was this a woman who died more than 42 days but less than 1 year YES
after being pregnant or delivering a baby? NO
DON'T KNOW
DON'T KNOW
4 Urban/Rural URBAN
RURAL
DON'T KNOW
4 Urban/Rural URBAN
RURAL
1A540 What was her/his place of normal residence 1 to 5 years before death?
1 Larger admin area (e.g., province) LARGER ADMIN AREA
DON'T KNOW
4 Urban/Rural URBAN
RURAL
DON'T KNOW
4 Urban/Rural URBAN
RURAL
YEAR
Surname
Name
Surname
Name
1A660 What was her/his economical activity status in year prior to death? USUALLY ECONOMICALLY ACTIVE
MAINLY EMPLOYED
MAINLY UNEMPLOYED
1A670 What was her/his occupation, that is, what kind of work did s/he mainly
do?
YEAR
4 Urban/Rural
URBAN
RURAL
5 Name of local registrar
Surname
Name
DON'T KNOW
Could you tell me about the illness/events that led to her his/death?
I would like to ask you some questions concerning the context and previously known medical conditions the deceased had;
injuries and accidents that the deceased suffered; and signs and symptoms that the deceased had/showed
when s/he was ill. Some of these questions may not appear to be directly related to his/her death.
Please bear with me and answer all the questions. They will help us to get a clear picture of all
possible symptoms that the deceased had.
3A120 Did s/he have a recent positive test for Malaria? YES
NO
DON'T KNOW
3A130 Did s/he have a recent negative test for Malaria? YES
NO
DON'T KNOW
3A210 Was there any diagnosis of Chronic Obstructive Pulmonary Disease YES
(COPD)? NO
DON'T KNOW
3A300 For how long was s/he ill before s/he died? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3E100 Did s/he suffer from any injury or accident that led to her/his death? YES
that led to her/his death? NO
DON'T KNOW
3E170 + + Do you know anything about the counter-part that was hit YES
during the road traffic accident? NO
3E340 + + Did (s)he suffer from any plant/animal/insect bite or sting YES
+ + that led to her/his death? NO
DON'T KNOW
3E530 + Was the injury or accident intentionally inflicted by someone else? YES
NO
DON'T KNOW
SECTION 7 AND 8
3B800 Did she have excessive vaginal bleeding in between menstrual YES
periods? NO
DON'T KNOW
3B810 Did her vaginal bleeding stopped naturally during menopause? YES
NO
DON'T KNOW
3C100 Was she neither pregnant, nor delivered, within 6 weeks of her death? YES skip pregnancy section if YES
NO
OR DON'T KNOW
3C130 Did she die within 6 weeks of a pregnancy that lasted less YES
than 6 months? NO
DON'T KNOW
3C230 + How many births, including stillbirths, did she have NUMBER OF BIRTHS/STILLBIRTHS
+ before this baby? DON'T KNOW
3C260 + During pregnancy, did she suffer from high blood pressure? YES
NO
DON'T KNOW
3C270 + Did she have foul smelling vaginal discharge during pregnancy YES
+ or after delivery? NO
DON'T KNOW
3C280 + During the last 3 months of pregnancy, did she suffer from YES
+ convulsions? NO
DON'T KNOW
3C290 + During the last 3 months of pregnancy, did she suffer from YES
+ blurred vision? NO
DON'T KNOW
3C300 + Did she give birth to a live, healthy baby within 6 weeks of death? YES
NO
DON'T KNOW
3C320 + + Was there vaginal bleeding during the first 6 moths YES
+ + of pregnancy? NO
DON'T KNOW
3C330 + + Was there vaginal bleeding during the last 3 months of YES
+ + pregnancy but before labour started? NO
DON'T KNOW
3C350 + + Was there excessive vaginal bleeding after delivering the baby? YES
NO
DON'T KNOW
3C365 + Did she deliver or try to deliver an abnormally positioned baby? YES
NO
DON'T KNOW
3C370 + Was she in labour for unusually long (more than 24 hours)? YES
NO
DON'T KNOW
3C420 + Did she give birth elsewhere, e.g. on the way to a facility? YES
NO
DON'T KNOW
3C430 + Did she receive professional assistance for the delivery? YES
NO
DON'T KNOW
3C440 + Did she have an operation to remove her uterus shortly YES
+ before death? NO
DON'T KNOW
3C480 + Was the baby born more than one month early? YES
NO
DON'T KNOW
3B110 + For how long did s/he have a fever? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B140 + For how long did s/he have a cough? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B200 + + For how long did s/he have fast breathing? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B220 + + For how long did s/he have breathlessness? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B230 + + Was s/he unable to carry out daily routine activities due to YES
+ + breathlessness? NO
DON'T KNOW
3B290 + For how long did s/he have diarrhoea? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B300 + At any time during the final illness was there blood in the stools? YES
NO
DON'T KNOW
3B350 + + For how long before death did s/he have severe abdominal NUMBER OF DAYS
+ + pain? NUMBER OF WEEKS
DON'T KNOW
3B360 + Did s/he have more than usual protruding abdomen? YES
NO
DON'T KNOW
3B370 + + For how long did s/he have a more than usual protruding NUMBER OF DAYS
+ + abdomen? NUMBER OF WEEKS
DON'T KNOW
3B380 + Did s/he have any lump inside the abdomen? YES
NO
DON'T KNOW
3B390 + + For how long did s/he have the lump inside the abdomen? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B410 + For how long did s/he have a stiff or painful neck? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B430 + For how long did s/he have mental confusion? NUMBER OF DAYS
NUMBER OF MONTHS
DON'T KNOW
3B470 + For how long did s/he have convulsions? NUMBER OF MINUTES
DON'T KNOW
3B480 + Did s/he became unconscious immediately after the convulsion? YES
NO
DON'T KNOW
3B520 + During the final illness did s/he ever pass blood in the urine? YES
NO
DON'T KNOW
3B560 + During the illness that led to death, did s/he have any skin rash? YES
NO
DON'T KNOW
3B570 + + For how long did s/he have the skin rash? NUMBER OF DAYS
NUMBER OF WEEKS
DON'T KNOW
3B600 Did s/he have bleeding from the nose, mouth, or anus? YES
NO
DON'T KNOW
3B630 Did s/he have mouth sores or white patches in the mouth YES
or on the tongue? NO
DON'T KNOW
3B640 Did s/he have stiffness of the whole body or was unable to open YES
the mouth? NO
DON'T KNOW
3B680 + Did s/he have any lumps or lesions in the mouth? YES
NO
DON'T KNOW
3B730 Did s/he have paralysis of one side of the body? YES
NO
DON'T KNOW
3B740 Did s/he have difficulty or pain while swallowing liquids? YES
NO
DON'T KNOW
3B770 Did s/he look pale (thinning/lack of blood) or have pale palms, YES
eyes or nail beds? NO
DON'T KNOW
3B790 Did (s)he drink a lot more water than usual? YES
NO
DON'T KNOW
SECTION 10. TREATMENT AND HEALTH SERVICE USE FOR THE FINAL ILLNESS
3G110 Did s/he receive any treatment for the illness that led to death? YES
NO
DON'T KNOW
3G130 + Did s/he receive (or needed) intravenous fluids (drip) treatment? YES
NO
DON'T KNOW
3G150 + Did s/he receive (or needed) treatment/food through a tube passed YES
+ through the nose? NO
DON'T KNOW
3G160 + Did s/he receive (or needed) injectable (IV or IM) antibiotics? YES
NO
DON'T KNOW
3G170 + Did s/he have (or needed) an operation for the illness? YES
NO
DON'T KNOW
3G180 + + Did s/he have the operation within 1 month before death? YES
NO
DON'T KNOW
3G190 + Was s/he discharged from the hospital very ill? YES
NO
DON'T KNOW
3F110 Did s/he smoke tobacco. (cigarette, cigar, pipe, etc.)? YES
NO
DON'T KNOW
4A100 In the final days before death, did s/he travel to a hospital or YES
health facility? NO
DON'T KNOW
4A110 + Did s/he use motorised transport to get to the hospital or YES
+ health facility? NO
DON'T KNOW
4A120 + Were there any problems during admission to the hospital or YES
+ health facility? NO
DON'T KNOW
4A130 + Were there any problems with the way (s)he was treated (medical treatment, YES
+ procedures, inter-personal attitudes, respect, dignity) in the NO
+ hospital or health facility? DON'T KNOW
4A140 + Were there any problems getting medications, or diagnostic tests YES
+ in the hospital or health facility? NO
DON'T KNOW
4A150 Does it take more than 2 hours to get to the nearest hospital or YES
health facility from the deceased's household? NO
DON'T KNOW
4A160 In the final days before death, were there any doubts about whether YES
medical care was needed? NO
DON'T KNOW
4A170 In the final days before death, was traditional medicine used? YES
NO
DON'T KNOW
4A180 In the final days before death, did anyone use a telephone or cell phone YES
to call for help? NO
DON'T KNOW
4A190 Over the course of illness, did the total costs of care and treatment YES
prohibit other household payments? NO
DON'T KNOW
5A100
INTERVIEWER'S OBSERVATIONS
SUPERVISOR'S OBSERVATIONS