Abstract
BackgroundReliable cause of death (COD) data are not available for the majority of deaths in Papua New Guinea (PNG), despite their critical policy value. Automated verbal autopsy (VA) methods, involving an interview and automated analysis to diagnose causes of community deaths, have recently been trialled in PNG. Here, we report VA results from three sites and highlight the utility of these methods to generate information about the leading CODs in the country.MethodsVA methods were introduced in one district in each of three provinces: Alotau in Milne Bay; Tambul-Nebilyer in Western Highlands; and Talasea in West New Britain. VA interviews were conducted using the Population Health Metrics Research Consortium (PHMRC) shortened questionnaire and analysed using the SmartVA automated diagnostic algorithm.ResultsA total of 1655 VAs were collected between June 2018 and November 2019, 87.0% of which related to deaths at age 12 years and over. Our findings suggest a continuing high proportion of deaths due to infectious diseases (27.0%) and a lower proportion of deaths due to non-communicable diseases (NCDs) (50.8%) than estimated by the Global Burden of Disease Study (GBD) 2017: 16.5% infectious diseases and 70.5% NCDs. The proportion of injury deaths was also high compared with GBD: 22.5% versus 13.0%.ConclusionsHealth policy in PNG needs to address a ‘triple burden’ of high infectious mortality, rising NCDs and a high fraction of deaths due to injuries. This study demonstrates the potential of automated VA methods to generate timely, reliable and policy-relevant data on COD patterns in hard-to-reach populations in PNG.
Highlights
And accurate cause of death (COD) data are essential to guide health policy debates and prioritize health investments, but this information is not available for the majority of deaths in Papua New Guinea (PNG)
We present data emanating from the application of automated verbal autopsy (VA) methods to help address the critical knowledge gap about COD patterns in PNG
This paper reports, for the first time, VA data collected in PNG through official channels in collaboration with National Department of Health (NDOH), the Provincial Health Authorities (PHAs) and Civil and Identity Registry (CIR)
Summary
And accurate cause of death (COD) data are essential to guide health policy debates and prioritize health investments, but this information is not available for the majority of deaths in Papua New Guinea (PNG). PNG suffered epidemics of newly-introduced respiratory and diarrhoeal diseases in the late 19th and early 20th century, followed by mortality declines associated with increased access to health care and malaria vector control after the Second World War.[2] there is uncertainty about the estimates for PNG, child mortality has steadily decreased from approximately 79.5 per 1000 live births in 1990 to 52.9 per 1000 live births in 2017; and life expectancy has increased over the same period from 57.3 to 61.2 in females and 52.0 to 56.2 in males.[3] the extent to which the epidemiological transition has progressed, associated with decreasing infectious mortality in children and increased non-communicable diseases (NCDs) in adults, is unclear given the lack of data This knowledge gap represents a serious challenge for informed health planning, with available studies suggesting there is likely to be significant variation in NCD prevalence across the Pacific region and significant differences in risk factors for NCDs within PNG.[4,5]. This study demonstrates the potential of automated VA methods to generate timely, reliable and policy-relevant data on COD patterns in hard-to-reach populations in PNG
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