Title: Meeting the SDG target: challenges of estimation of causes of death due to NCDs in India

Abstract:

The 2030 Agenda for Sustainable Development recognizes noncommunicable diseases (NCDs) as a major challenge for sustainable development.(1) More than half of all countries are predicted to fail to reach the UN target to reduce premature deaths from cancers, cardiovascular disease, chronic respiratory disease, and diabetes by 2030 (2).  The challenge is seen at many levels: detecting, treating and ensuring follow up and keeping disease status under control. In addition, one often neglected aspect is the ascertainment of NCD as a cause of death. This is a crucial element to determine whether a country has achieved SDG Target 3.4 .In developing countries like India, most deaths take place at home without medical attention and a proper certification of the cause of death is often not available. In India, the system of death verification is done through the Sample Registration System (3) whereby a verbal autopsy is conducted in a sample of deaths by trained persons after which a trained physician assigns the cause of death.  This system has its advantages and disadvantages. Verbal autopsy takes place approximately six months after death, therefore recall of events leading to death is likely to be compromised. Secondly, NCDs like diabetes, hypertension are usually not the immediate cause of death. They are the underlying conditions which lead to complications and death.  However the advantage of the system is that the SRS is a continuous activity which is done by trained persons, and carried out in a representative sample of households, thereby providing a trend of deaths on the community. This system also ensures that all deaths even the ones that take place at home without medical attention are also captured by the system. This paper looks into the challenges of estimating the cause of death in a sample of deaths using verbal autopsy.

Biography:

Baridalyne Nongkynrih, trained in public health and currently working as a faculty in  Community Medicine  All India Institute of Medical Sciences New Delhi India since 2003. My area of interest is  Non Communicable Diseases and health systems. I have  worked extensively in the area of primary health care in NCDs with the WHO and Ministry of Health Government of India. Currently since 2017,  I am also involved in the  sample registration system of India and verbal autopsy based  cause of death assignment under the Office of the Registrar General of India where we are developing a system for cause of death estimation for the country.