DDI_TZA_2011_SAVVY_v01_M Juan Manuel BLANCO 2014-05-21 NADA Version 02 (January 2015). Edited version based on Version 01 DDI (DDI_IHI_IMPACT_SAVVY_201405_v02) that was done by Ifakara Health Institute. Sample Vital Registration with Verbal Autopsy 2011-2012 SAVVY 2011-12 TZA_2011_SAVVY_v01_M Honoraty Masanja

Gregory S. Kabadi

Isaac Lyatuu

Paul Smithson

Eveline Geubbels

Richard Amaro

Sylvia Meku

Wilfred Yohama

Mary Kibona

Mark Urassa

Joanna A. Schellenberg

 Ifakara Health Institute Ministry of Health and Social Welfare National Bureau of Statistics National Institute for Medical Research Ifakara Health Institute NADA US Centre for Disease Control UK Department for International Development Irish Aid Norwegian Agency for Development Cooperation Swiss Agency for Development & Cooperation Isaac Lyatuu Ifakara Health Institute SAmple Vital event registration with Verbal autopsY (SAVVY) research project is a demographic surveillance system within Sentinel Panel of District (SPD) platform that collects and analyzes health community-based information data with intent to determine community birth trends and cause-specific mortality fractions in a population that has no complete or incomplete vital registration system. SAVVY provides nationally representative estimates of mortalities based on age, sex, residence and zone, and it covers about 2% of Tanzania mainland population.The cause-specific mortality fraction is determined based on verbal autopsy interviews with next of kin or other caregivers. The Sentinel Panel of Districts (SPD) is a nationally-representative sample of 23 districts (plus an additional 4) in Mainland Tanzania for health monitoring, evaluation and research. The panel has two "arms". The population-based arm (SAVVY1) tracks vital events in a total population of around 800,000 people. This will produce annual estimates of age- and cause-specific mortality as well as other key demographic variables. SAVVY started with baseline enumeration censuses in March 2011 and continued in phases until it reached a full scale of all 23 districts in March 2014. Follow-up enumeration censuses will be conducted from 2015. Monitoring of vital events and conducting verbal autopsy (VA) interviews in enumeration areas began shortly after commencement of baseline censuses and is done prospectively. The data collected will be archived on a yearly base. SAVVY BASELINE CENSUS DEPLOYEMENT PER DISTRICT (2011/14) DistrictsCENSUS IMPLEMENTED PERIOD Starting dateCompletion date Bagamoyo05.06.201115.07.2011 Kinondoni 05.06.201115.07.2011 Geita 07.06.201108.2011 Kahama 21.03.201103.06.2011 Sumbawanga02.04.201228.05.2012 Mbozi 28.03.201228.05.2012 Iringa Urban28.03.201213.05.2012 Songea Urban02.04.201213.05.2012 Muleba 16.04.201228.06.2012 Musoma Rural12.04.201212.06.2012 Kilosa 15.10.201211.12.2012 Mtwara Urban08.10.201219.11.2012 Ruangwa 08.10.201219.11.2012 Babati 30.01.201322.03.2013 Kondoa 28.01.201322.03.2013 Singida Rural28.01.201323.03.2013 Kasulu 05.04.201323.05.2013 Uyui 02.04.201323.05.2013 ILALA 27.05.201308.07.2013 TEMEKE 27.05.201308.07.2013 Arusha Urban10.02.201421.03.2014 Moshi Rural10.02.201421.03.2014 Tanga Urban12.02.201423.03.2014 SAVVY is a demographic surveillance system built around vital events monitoring. It operates in a similar way to existing Health and Demographic Surveillance (HDSS) but is distributed across the country and sampled to generate estimates that are nationally representative. The system is based on a periodic census of the sample population that provides information on population age, sex, household characteristics and migration. During the year, community key informants report births and deaths and probable cause of death is determined through verbal autopsy. Tanzania SAVVY is part of the Sentinel Panel of Districts (SPD), a nationally-representative sample of 23 districts (plus an additional 4) in Mainland Tanzania for health monitoring, evaluation and research. Attention: the totality of distrcits has been reached only in March 2014! Individuals in sampled households. Resident population (nationally representative), longitudinal. Event/transaction data [evn] Health services Mortality rate Demographic data Ifakara Health Institute District Coordinators A two-stage probability sampling approach was employed. District sampling aims to permit disaggregation of results by residence (urban/rural) as well as by zone. Within selected districts, enumeration areas were randomly selected from the national master sample frame, to yield a total sample of 167,000 households comprising about 800,000 individuals (~2% of Mainland Tanzania population). SAVVY data collection is grouped into three categories: census enumeration, birth and death notifications, and VA interviews. During initial setup of the SAVVY arm, baseline censuses were conducted in all districts enumerating all households within the selected enumeration areas and captured a snapshot of the population. Each household was visited and family structure data were collected including details of the head of household, each member's name, gender, occupation, and education. Follow up questions were asked for female household members on number of children. During baseline census, retrospective death events of the past 12 months were also collected. A notification system of vital events was set up following the baseline censuses. Each birth or death event occurring in SAVVY enumeration areas triggered a notification message sent by a community key informant using a mobile phone. In addition to reporting of vital events, SAVVY also promotes vital registration through use of government registers provided by the Registration Insolvency and Trusteeship Agency (RITA). SAVVY started with baseline enumeration censuses in March 2011 and continued in phases until it reached a full scale of all 23 districts in March 2014. Follow-up enumeration censuses will be conducted from 2015. Monitoring of vital events and conducting verbal autopsy (VA) interviews in enumeration areas began shortly after commencement of baseline censuses and is done prospectively. FBIS data collection began in January 2010 and is conducted regularly on monthly basis from all health facilities in SPD districts. Census enumeration, birth and death notifications, and VA interviews. Data collection instruments include two registers (births, deaths) and three questionnaires (household census, and verbal autopsy questionnaires for neonates, children and adults). The household census questionnaire includes household identification, location, household members, dates of birth, highest educational attainment, occupation and births in the past twelve months. The births and deaths registers record individual and household identity, location and date of event. The verbal autopsy questionnaires have an identification section; history of chronic illness; verbal account of the events leading to death; symptoms checklist; lifestyle (use of alcohol, drugs and smoking), and sequential use of health services prior to death. Each death notification event is followed by a VA interview with the head of household or a person who took care of the deceased. Interviewers use the three standard World Health Organisation’s 2002 VA questionnaires: for newborns (0-28 days), children (29 days -14 years) and adults (15 years and above).9 These questionnaires are designed to collect background information of the deceased including their age, sex, marital status, and health data prior to death. Other information collected in verbal autopsy interviews include history of chronic illness, a narrative account of events leading to death, symptom checklist and duration, lifestyle (use of alcohol, drugs and smoking) and a sequence of use of health services prior to death. All information on verbal autopsy interviews (those captured retrospectively and prospectively during baseline census) are sent to trained physicians in order to establish a probable cause of death. Each death is coded independently using the World Health Organisation International Classification of Diseases and Health Related Conditions version 10 (ICD 10). Ifakara Health Institute supervision and training of districts coordinators. Number of districts 23 districts Total Population 644,217 people Males (%) 48% Population rural (%) 70% Ongoing study Ifakara Health Institute Ifakara Health Institute http://data.ihi.or.tz/index.php/catalog/3 Cost: None Lincesed access. Data Unit SPD Unit "Sentinel Panel of Districts - Ifakara Health Institute,Tanzania Sample vital registration with verbal autopsy (SAVVY) (May 2014), provided by Ifakara Health Institute, Dar es Salaam, Tanzania. data.ihi.or.tz" Licensed dataset The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses. coding SAVVY data collection is grouped into three categories: census enumeration, birth and death notifications, and VA interviews. During initial setup of the SAVVY arm, baseline censuses were conducted in all districts enumerating all households within the selected enumeration areas and captured a snapshot of the population. Each household was visited and family structure data were collected including details of the head of household, each member's name, gender, occupation, and education. Follow up questions were asked for female household members on number of children. During baseline census, retrospective death events of the past 12 months were also collected. A notification system of vital events was set up following the baseline censuses. Each birth or death event occurring in SAVVY enumeration areas triggered a notification message sent by a community key informant using a mobile phone. In addition to reporting of vital events, SAVVY also promotes vital registration through use of government registers provided by the Registration Insolvency and Trusteeship Agency (RITA). 0 6 household SAVVY data collection is grouped into three categories: census enumeration, birth and death notifications, and VA interviews. During initial setup of the SAVVY arm, baseline censuses were conducted in all districts enumerating all households within the selected enumeration areas and captured a snapshot of the population. Each household was visited and family structure data were collected including details of the head of household, each member's name, gender, occupation, and education. Follow up questions were asked for female household members on number of children. During baseline census, retrospective death events of the past 12 months were also collected. A notification system of vital events was set up following the baseline censuses. Each birth or death event occurring in SAVVY enumeration areas triggered a notification message sent by a community key informant using a mobile phone. In addition to reporting of vital events, SAVVY also promotes vital registration through use of government registers provided by the Registration Insolvency and Trusteeship Agency (RITA). 0 11 members SAVVY data collection is grouped into three categories: census enumeration, birth and death notifications, and VA interviews. During initial setup of the SAVVY arm, baseline censuses were conducted in all districts enumerating all households within the selected enumeration areas and captured a snapshot of the population. Each household was visited and family structure data were collected including details of the head of household, each member's name, gender, occupation, and education. Follow up questions were asked for female household members on number of children. During baseline census, retrospective death events of the past 12 months were also collected. A notification system of vital events was set up following the baseline censuses. Each birth or death event occurring in SAVVY enumeration areas triggered a notification message sent by a community key informant using a mobile phone. In addition to reporting of vital events, SAVVY also promotes vital registration through use of government registers provided by the Registration Insolvency and Trusteeship Agency (RITA). 0 7 1 Male 2 Female 3 Unknow 1 Male 2 Female Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth