Adaptation of the VA intervention
| Country | Need | Adaptation |
| Philippines | MCCOD by physicians is mandated for all deaths, not just those that occur in hospitals. | SmartVA was adapted for physicians and a novel application of VA called ‘SmartVA for Physicians’ was introduced. Here doctors use SmartVA as a tool for medical certification in the event of a community death. |
| PNG | ‘Dead on arrival’ cases assigned to ‘unknown’ or unusable cause on the MCCOD | SmartVA for Physicians was introduced for dead on arrival cases (similar to the Philippines model). |
| Solomon Islands | Dead on arrival cases were not assigned a cause of death as physician certification was reserved for patients who were admitted or who had significant physician contact before/on arrival at hospital. | VA for dead on arrival cases was provided by nurses so that these cases could be assigned a cause of death. |
| Myanmar | Information from MCCOD (~16% of deaths) was used for annual population statistics. With increased community cause of death information from VA the government requested technical assistance to combine the data to obtain more representative estimates. | VA cause of death and MCCOD data were integrated for inclusion in the Myanmar Annual Statistical Yearbook. A workshop was held for the D4H team to capacitate staff to do this and to produce baseline values for non-communicable disease indicators for Sustainable Development Goals. |
| China | Researchers wished to investigate if COVID-19 related questions in VA could reliably predict this disease as a cause of death and the relationship between smoking and COVID-19 mortality. | Following pilots of the standard SmartVA questionnaire, questions were added to the SmartVA interview related to COVID-19, disease exposure and to tobacco use. This was tested against known hospital cases of COVID-19. |
D4H, Bloomberg Philanthropies Data for Health Initiative; MCCOD, medical certification of cause of death; VA, verbal autopsy.