Learning to Listen

In this issue of Pediatrics, Lapidot et al¹ report the findings of modified verbal autopsies (VAs) conducted for infants from the ages of 4 days to 6 months who were brought in dead to the main teaching hospital in Lusaka, Zambia. Universal health coverage² and attaining the Sustainable Development Goals³ can only be achieved if the causes of death are known and actions to intervene are monitored. Yet, 1 in 2 deaths in low- and middle-income settings goes unreported because few low- and middle-income countries have a fully functional civil registration and vital statistics system in which to register deaths.⁴ These unregistered deaths occur in deprived communities in which health care is limited and poverty abounds. The investigators are based in Lusaka at the university teaching hospital, at which infants who have died out of a hospital are brought to have the deaths registered. The primary aim of the study is to identify the pathologic causes of death. Postmortems are performed after consent from the family. When obtaining permission and recording demographic details of a child, the interviewers ask the family some open-ended questions about the events leading up to the death. It is these narratives that Lapidot et al¹ report in this issue of Pediatrics.

The authors call the stories “modified verbal autopsies,” although a standardized and validated questionnaire was not used and the analyses were retrospectively …

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