Research, Maternal, Child and Reproductive Health

What Do People Die Of in Developing Countries?

Article published in The Lancet Global Health


On Monday 29 July, The Lancet Global Health published an article by a group of researchers from CRESIB, ISGlobal's research centre, about the CaDMIA project, an initiative funded jointly by the Bill & Melinda Gates Foundation and the Spain's Instituto de Salud Carlos III. The aim of the project is to develop an alternative post-mortem procedure which is less invasive than a full autopsy to help reduce uncertainty about the causes of death in developing countries.

In resource-poor settings, complete diagnostic autopsies are performed only infrequently because of the lack of facilities and trained human resources or due to cultural or religious apprehension about the practice of post-mortem procedures. In recent years, the concept of minimally invasive autopsy (MIA) has been proposed as an alternative to classic complete diagnostic autopsy (CA).  Although little experience has been gained with minimally invasive techniques to date, in developed countries they have been shown to produce reliable results comparable to those obtained with CA. MIA also offers a chance to improve our understanding of the origin and course of diseases that can only be fully studied if we have human samples.

In its present form, however, MIA is not a feasible option in resource-poor settings, and  procedures to make it feasible and acceptable in developing countries need to be defined and standardised. This is one of the main objectives of the CaDMIA project. Confirmation that MIA is a feasible, valid, and reliable method for obtaining information about the cause of death could make it possible to introduce minimally invasive techniques as an alternative to traditional autopsies or as a complement to verbal autopsies and clinical diagnoses.

More information

Development of a post-mortem procedure to reduce the uncertainty regarding causes of death in developing countries