Mortality surveillance system

Under the leadership of the Byrraju Foundation, the collaboration established a mortality surveillance system in 45 villages in East and West Godavari districts.


The aim of this study was to determine the leading causes of death in this rural region of India and ascertain if a mortality surveillance system, based on the verbal autopsy method could be incorporated into the routine work of a primary healthcare system.


The surveillance system was designed to record, and assign causes to all deaths in a defined population. It involved the following three main stages:

  1. Identification of all deaths in the community, and data collection using a standard verbal autopsy tool by trained multipurpose primary healthcare workers (MPHW)
  2. Independent assignment of cause of death by trained physician reviewers and
  3. Collation of reports and summary statistics

A study website was established in 2005 which enabled data entry and cause of death assignment over the internet.


The primary outcome for the mortality surveillance was the rates of death from major causes by age and sex groups. Estimates were prepared for each calendar year of the study.


About 6000 deaths were recorded over four years with verbal autopsies completed for 98%. In the first year of the study, a total of 1354 deaths were reported and the crude death rate was 7.5/1000. A specific underlying cause of death was assigned for 82% of all verbal autopsies done.