Background: Multidimensional issues confront the use of standard verbal autopsies (SVAs), such as the WHO’s verbal autopsy standards and the Population Health Metrics Research Consortium’s gold standard verbal autopsy, to improve the mortality data performance of civil registration and vital statistics (CRVS) systems in low- and middle-income countries (LMICs). Objective: This paper attempts an inclusive analysis of these issues and their implications for policies intending to integrate routine SVAs into CRVS systems to enhance mortality data coverage in LMICs. Methods: Issues were identified from the verbal autopsy and CRVS literature, official documents, and the authors’ field experiences with the Nigerian CRVS system. These were analysed using a problem (key issues) analysis methodology. Results: Two classes of issues were shown to impinge on the use of SVAs within CRVS systems. One class is generic to SVAs (technical complexity, cost, and standardization issues) and to CRVS systems (contextual, resource, and infrastructural limitations) in LMICs. The other is related to the incompatibility of SVA and CRVS system functions, operations, instruments, and data. Conclusions: The results indicate a need for alternative solutions to the mortality data challenges of CRVS systems in LMICs that are more pragmatic than SVAs, especially in the short and medium term. Such alternatives must involve less complex data procedures and costs and must be adapted to CRVS system functions, operations, and socioeconomic contexts in LMICs. Contribution: The paper contributes to the discourse on the use of SVAs to improve the mortality data capacity of CRVS systems in LMICs.

中文翻译：

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使用标准口头尸检提高低收入和中等收入国家民事登记和生命统计系统的死亡率数据能力：关键问题分析（作者：Nnamdi Maduekwe、Olufunmilayo Banjo、Mike O. Sangodapo、Aisha Abdulazeez）

背景：使用标准口头尸检（SVA）（例如世界卫生组织的口头尸检标准和人口健康指标研究联盟的黄金标准口头尸检）以提高民事登记和人口动态统计（CRVS）系统的死亡率数据性能时面临多维问题低收入和中等收入国家 (LMIC)。目标：本文试图对这些问题及其对旨在将常规 SVA 纳入 CRVS 系统以提高中低收入国家死亡率数据覆盖范围的政策的影响进行包容性分析。方法：根据口头尸检和 CRVS 文献、官方文件以及作者使用尼日利亚 CRVS 系统的现场经验来确定问题。使用问题（关键问题）分析方法对这些进行了分析。结果：研究表明，有两类问题会影响 CRVS 系统中 SVA 的使用。一类适用于中低收入国家的 SVA（技术复杂性、成本和标准化问题）和 CRVS 系统（背景、资源和基础设施限制）。二是与SVA和CRVS系统功能、操作、仪表、数据不兼容有关。结论：结果表明，中低收入国家需要寻找比 SVA 更务实的替代解决方案来应对 CRVS 系统的死亡率数据挑战，尤其是在短期和中期。此类替代方案必须涉及不太复杂的数据程序和成本，并且必须适应中低收入国家的 CRVS 系统功能、运营和社会经济背景。贡献：