Verbal Autopsies Provide Data for Change
Around the world, accurate, up-to-date information is the bedrock of informed public health decision-making. So when strengthened cause-of-death data systems in both the Philippines and Papua New Guinea (PNG) revealed high death rates due to noncommunicable diseases (NCDs), public health officials were quick to act.
Improving Cause‑of‑Death Data
Both the Philippines and PNG have historically struggled with incomplete or unreliable cause-of-death data, particularly for deaths occurring outside health facilities. To address this, the CDC Foundation, through the Bloomberg Philanthropies Data for Health Initiative, helps governments implement verbal autopsies, using trained health professionals like local nurses to interview the consenting relatives or caregivers of the deceased. That information is then provided to physicians or medical examiners to help determine the cause of death.
But determining the cause of death is only one step in the process. To maximize the impact of the information, health departments use verbal autopsy software to diagnose the underlying cause of death—the condition that led to the cause. The software not only explains how it arrived at the underlying cause, allowing physicians to revise their rulings for accuracy, but also produces population-level cause-of-death estimates, painting a clearer picture of the most prevalent causes of death. Equipped with that information, public health officials can then tailor health policies and direct public health resources towards the most pressing health threats.
Taking Action
In the Philippines, information gathered through verbal autopsy software showed that cardiovascular disease and diabetes were driving a rising burden of NCDs across the country. While many efforts to address NCDs were already in place before the use of verbal autopsy software, these findings paved the way for more focused interventions, particularly at the primary health care level. Since the Philippines began using verbal autopsy software in 2018, the country has published national health guidelines for NCD screening and management, expanded cancer screening services and released a new assessment form to improve NCD screening efficiency.
In PNG, where health systems have traditionally been focused on infectious disease threats, insights from verbal autopsy software showed that NCDs accounted for a much larger share of mortality than earlier estimates suggested, particularly from hypertension and diabetes. In fact, it revealed a triple-burden: deaths due to infectious diseases, injuries and NCDs. Further, it brought visibility to previously undocumented health threats in rural areas, where cause-of-death reporting was often more challenging.
Together, these data also helped advance interventions for infectious diseases such as malaria, tuberculosis and HIV. In line with the country’s current national health plan to reorient health systems toward preventing chronic disease and promoting wellness, PNG’s rural Western Highlands Provincial Health Authority opened its first public wellness clinic in 2024 to make NCD screening accessible to anyone in the community. The health authority raised funds, including donations from local businesses, to build the clinic and staff it with a trained community health worker, two nursing officers and a health extension officer, who are able to refer patients for further care as needed. The region has also introduced school-based programs that educate children on NCD risk factors, such as smoking and nutrition.
Systemic Change
In both countries, what began as an effort to improve mortality data evolved into a catalyst for systemic change. By revealing the true scale of NCDs, the verbal autopsy software has provided a clearer picture of underlying causes of death, empowering policymakers, health workers and communities to push for stronger, more relevant health interventions that address the evolving health threats they face to improve health outcomes and save lives.
