Abstract
Background: Verbal Autopsy/Social Autopsy (VASA) tools should be based on a well-holistic conceptual framework, allowing them to record and organize a wide range of determinants and contributors of child mortality in developing countries. This paper aims to review how successfully VASA studies have been able to record and organize biological and social determinants of child mortality, in pursuit of World Health Organization’s (WHO) guidelines for verbal autopsy (VA) and Kalter’s recommendations for social autopsy (SA).
 Methodology: A systematic search of literature from January 1995 to January 2018 was conducted on primary studies which attempted VA and SA on deceased cases of under-5 child mortalities using VA and SA questionnaires. A thorough search revealed 16 directly relevant papers.
 Results: Sixteen relevant studies from 14 countries revealed the two most common conceptual frameworks which were utilized for VASA studies. VA component of three studies followed W.H.O.’s guidelines, while the SA component of the other three studies followed Kalter’s recommendations. The most robust VA tools identified were INDEPTH Network VA tool, INCLEN VA tool, and WHO VA tool; while CHERG SA tool and BASICS SA tool were found as the most robust SA tools.
 Conclusion: Due to the fact that only separate recommendations for VA, and conceptual frameworks for SA exists and no evidence on integrated conceptual framework exists, we suggest that there is a great need for developing a conceptual framework, based on which an integrated VASA tool can be developed and utilized in VASA based child mortality investigations in developing countries.
Highlights
To improve the child health and survival of developing countries, where the child mortality estimates are clustered; availability of reliable, accurate and timely data on the estimates of child deaths and information as to why such deaths occurred is critically important[1]
Search strategy An electronic literature search was conducted for searching primary studies, reports and reviews using keywords and MeSH Terms: ‘mortality’, ‘death’, ‘child’, ‘verbal autopsy’ and ‘social autopsy’ on the online databases of PubMed, Cochrane library, World Health Organization (WHO), Science Direct, Embase, Google Scholar, BioMed Central and Google database
All included studies should have used the primary data, where the researcher have conducted verbal and social autopsies either in segregation, or as a single tool/questionnaire with an aim to identify the biological-cause of death and the social determinants linked with the death of deceased children died during age from birth to 5 years of age
Summary
To improve the child health and survival of developing countries, where the child mortality estimates are clustered; availability of reliable, accurate and timely data on the estimates of child deaths and information as to why such deaths occurred is critically important[1]. In most of the developing countries of Sub Saharan African and South Asian regions, large number of the child deaths fails to get registered with the National Civil and Vital Registration System (NCVRS)[1]. Failure of getting in touch with the healthcare practitioners or facilities (in case of home-based mortalities or mortalities occurring in non-accessible areas) may result in non-registration of such deaths with health care facilities and with national database2&3. Such deaths have their cause of death not being assigned[3]. Conclusion: Due to the fact that only separate recommendations for VA, and conceptual frameworks for SA exists and no evidence on integrated conceptual framework exists, we suggest that there is a great need for developing a conceptual framework, based on which an integrated VASA tool can be developed and utilized in VASA based child mortality investigations in developing countries
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