# Telephonic verbal autopsies among adults in South Africa: a feasibility and acceptability pilot study

## TL;DR

This study tests if phone interviews can effectively collect death cause data in South Africa, finding it feasible and acceptable but with some logistical challenges.

## Contribution

The study introduces telephonic verbal autopsies as a feasible alternative in resource-limited settings, emphasizing their acceptability and practical implementation challenges.

## Key findings

- Telephonic verbal autopsies were found acceptable to participants and valuable for public health planning.
- Feasibility was challenged by incomplete or incorrect contact details for next-of-kin.
- Only one question showed a significant difference in non-informative responses between teleVAs and face-to-face VAs.

## Abstract

This pilot study explores the feasibility and acceptability of using telephonic verbal autopsies (teleVAs) in South Africa to collect information on causes of death.

Quantitative and qualitative data collection methods were used to evaluate the feasibility and acceptability of these telephonic interviews.

The teleVA pilot was conducted in South Africa’s Western Cape province. The qualitative component also included two rural South African Population Research Infrastructure Network nodes (Africa Health Research Institute in KwaZulu-Natal and Agincourt in Mpumalanga), which had transitioned to teleVAs during COVID-19, allowing exploration of teleVA’s feasibility in both urban and rural settings.

We recruited 229 respondents to participate in a pilot teleVA. After each VA, VA interviewers filled in a survey to assess their perceptions and discern if they experienced any technical challenges. We also conducted 18 in-depth interviews with both interviewers (n=6) and respondents (n=12) to explore their views on the acceptability of the teleVA. We conducted a thematic analysis of these interviews.

VA was piloted over the phone, instead of face-to-face.

Primary outcomes focused on the feasibility and acceptability of phone VAs among both interviewers and respondents. Secondary outcomes evaluated the quality of teleVAs.

Participants expressed willingness to participate in teleVAs, considering them valuable for public health planning and decision-making. The feasibility of collecting next-of-kin information proved challenging, with incomplete or incorrect contact details posing future logistic issues. Only one question out of 76, showed a statistically significant difference in the proportions of non-informative teleVA compared with face-to-face VA.

The study offers valuable insights into using teleVAs to gather cause of death information in resource-limited settings. It highlights the feasibility and acceptability of teleVAs while emphasising the need for comprehensive planning, integration with the civil registration and vital statistics system and community participation enhancement.