In order to assess causes of deaths in a DSS setting at population level for health policy intervention, verbal autopsies (VAs) are conducted on all deaths that occur to all members registered into the DSS system. This is important considering the fact that cause of death data is lacking since most of these sites are located in remote rural areas and deaths mostly occur outside health facilities.  Vital statistics from vital registration systems are usually woefully incomplete.  During the regular field worker visits all deaths that are reported to have occurred to registered members are recorded by filling in a death registration form. These are passed onto the DSS data center during the weekly field workers’ meetings for data entry. A list of deceased members is generated weekly for trained field supervisors to visit and schedule interviews of relatives of the deceased on the circumstances of the final illnesses prior to the death of deceased. Using a VA questionnaire the respondent gives an unprompted account of events leading to death of deceased. The second part of the questionnaire asks questions on specific signs and symptoms that led to death of member. Completed questionnaires are checking for inconsistencies and blanks, and the forms are sent to computer center for data entry and subsequent distribution to physicians for coding.

Three types of questionnaires are used in conducting verbal autopsies. These are the neonatal, post neonatal and adult VA forms. It is, therefore, important to check on the age at death of deceased to know the appropriate questionnaire to use.

Because of possible errors, field supervisors need to establish the status of the deceased before doing the interview. There are instances where a person who is said to have died is found alive. This happens when permanent identification of the deceased is misquoted.  If that happens, checks are carried out and the error corrected for a VA to be conducted on the actual person. In some communities it is a taboo to declare someone dead when the person is alive that is why care should be taken by confirming the validity or otherwise of the death before sharing your condolences with the bereaved family members (traditional requirement) and then seeking permission to conduct the VA.