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Institute for International Programs

Nigeria Verbal Autopsy and Social Autopsy Studies (VASA)

Completed in late 2013, the 40,680 household 2013 Demographic and Health Survey (DHS) supported by USAID and conducted by the National Population Commission (NPC) of Nigeria identified recent deaths of children under 5 years old from a full birth history of women age 15-49 years. With support from USAID and the BMGF’s grant to the US Fund for UNICEF on behalf of the CHERG, JHSPH faculty provided technical support to the NPC to implement a national VASA study on the platform of the DHS.

The VASA interviewers returned to households where a death was determined to have occurred in up to the prior 5 years to conduct the VASA interviews. Data on the biological causes and social and behavioral determinants of these deaths are vital to the Government of Nigeria’s efforts to develop effective interventions and could meaningfully contribute to global mortality estimates.  The VASA study directly measured neonatal and child mortality and its determinants in Nigeria, with the following three specific aims:

The VASA study sampled one under-five death from each of the 3,254 households identified by the 2013 NDHS to have had one or more under-five years deaths in the prior 5 years. Of these, 2944 (90.5%) had a completed VASA interviews, including 164 stillbirths, 723 neonatal (0-27 days) deaths and 2057 young child (1-59 months) deaths.  The study findings showed that the both parents, especially mothers, had little or no education, and most of the deceased children lived in households with poor socioeconomic conditions. There was a higher percentage of home deliveries in the Northern region as compared to the Southern region, and overall the Northern region had poorer outcomes than the Southern region. The majority of neonatal deaths throughout the country occurred during the first week of life, and more than half of neonatal deaths occurred at home. Sepsis, birth asphyxia and pneumonia were the three leading causes of neonatal deaths whereas malaria, diarrhea and pneumonia were the three leading causes of death among children (1-59 months). Detailed findings, conclusions and recommendations can be found in the study report


Beyond the causes of death: The social determinants of deceased children 1-59 months of age in Nigeria from 2009-2013. Koffi AK, Kalter HD, Loveth EN, Quinley J, Monehin J, Black RE. PLOS ONE 2017. In press.