Classifying circumstances of death through verbal autopsies: Final care pathways of adults in the periphery of a West African capital city (Ouagadougou, Burkina Faso)

Ariane Sessego, Ecole Normale Supérieure
Géraldine Duthé, Institut National d'Études Démographiques (INED)
Bruno Lankoandé, Joseph Ki-Zerbo University (UJKZ)
Kassoum Dianou, Université Catholique de Louvain (UCL) - Centre for demographic research

Identifying the barriers to healthcare access is crucial for public health action. In sub-Saharan Africa, urban areas benefit from better healthcare provision. However, major obstacles remain. In context of scarcity of health statistics, verbal autopsies (VAs) developed to estimate causes of death through interviews with final caregivers, also collect data on the circumstances of death. Using 1,175 VAs of adult deaths collected in 2010-2019 in the Ouagadougou HDSS, we propose a novel data-driven method to categorize circumstances of death using Hierarchical Clustering on Multiple Correspondence Analysis. We identify five typical final care pathways and illustrate them with relative’s narratives. Apart from sudden deaths (7%), hospital deaths without any reported issue remain a minority (35%) compared with hospital deaths with cost or healthcare issues (17%), deaths with cessation of care due to cost issue (17%), and a quarter of deaths occurring at home with no care (25%).