Increased use of social autopsy is needed to improve maternal, neonatal and child health programmes in low-income countries.

Editorials 403 Although 2015 is only three years away, many countries are not on track to reach the United Nations Millennium Development Goals (MDGs), particularly goals 4 and 5, which call for reductions in child and maternal mortality rates. Targeted interventions are needed for rapid progress to take place. However, reliable estimates of the numbers, causes and determinants of death are needed to design the interventions. Such estimates are the basis of functional health information systems, which are the sources of data for the development and monitoring of evidence-based health policies and programmes. 1 Countries unable to record the number of people who die or why they die cannot realize the full potential of their health systems. 2 Nonetheless , many countries lack data on the social, behavioural and health systems determinants of child and maternal deaths. In some high-mortality settings, civil registration systems are so deficient that most deaths go unrecorded. 3 Globally , fewer than one third of the 350 000 maternal deaths and 7 600 000 child deaths 4 occurring annually are medically certified. 5 The data needed to estimate cause-specific mortality rates can be obtained through alternative methods such as verbal autopsy, which consists of the use of standardized interview tools to question the caretakers of recently deceased persons about the symptoms that preceded the death. 2 Area-specific disease profiles generated from these data can help subnational and national health planners improve health resource allocation, as illustrated by the United Republic of Tanzania's Essential Health Interventions Project. 6 Yet despite the resources invested in developing verbal autopsy methods and tools, the non-biological factors contributing to a death cannot be determined from verbal autopsy data. This has led to the development of a complementary interview method known as " social autopsy " , which explores the social, behavioural and health systems determinants of maternal and child deaths. 7 During social autopsy, the caretaker of the deceased is interviewed in detail regarding any preventive care received by the deceased, the diagnostic procedures followed, the type and timing of any treatment provided inside or outside the home, and any barriers encountered during care seeking. 8 While verbal autopsy data can be used to prioritize health problems and evaluate health programme impact, social autopsy data, which focus on modifiable factors present in the home, community and health system, can inform policies and practices for increasing access to and use of …