A Retrospective Analysis of Lessons Learned and Perspectives on Expansion of Verbal Autopsy Implementation in Zambia, 2023.

Accurate cause-of-death statistics are vital for public health policy, but less than one-third of deaths globally are assigned a cause. Verbal autopsy (VA) methods are crucial in low- and middle-income countries lacking complete civil registration and vital statistics (CRVS) systems. We explored VA implementation in Zambia by using a previously developed framework. The National Mortality Surveillance Subcommittee under the Monitoring and Evaluation Technical Working Group within the Ministry of Health coordinates mortality surveillance activities in Zambia. To date, passive, non-population-representative VA data collection mechanisms have been used, leading to underrepresentation of some communities. In spite of the use of electronic data collection tools, VA systems have not been electronically linked to public health surveillance or CRVS systems. Funding for VA has largely been donor driven. Increasing government funding may ensure sustainability, while the adoption of sample-based platforms while linking VA information technology systems may make VA data more useful, timely, and accessible.