SOCIAL AUTOPSY

DR AMRUT ARUN SWAMI

TNMC, MUMBAI

SOCIAL AUTOPSY

A social autopsy is an in-depth investigation of a multitude of psychosocial

circumstances surrounding deaths occurring in a particular group of people.

Klinenberg's first book, Heat Wave: A Social Autopsy of Disaster in Chicago, was

published by the University of Chicago Press in 2002.

Increased use of social autopsy is needed to improve maternal, neonatal and child

health programmes in low-income countries. (WHO)

In essence, the social autopsy methodology is used to examine the contribution of

social, personal, health, and environmental variables to unusual mortality rates.

The data needed to estimate cause-specific mortality rates can be obtained through

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.

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 preventive and curative services.

Despite its importance, social autopsy has not been widely practiced and still lacks

standard methods for data collection and analysis.

Two key models, known as Pathway to Survival and Three Delays, have been used to organize the care-seeking data generated by social autopsy.

The pathway identifies and organizes modifiable social, cultural, and health system factors affecting home care practices, health care access and utilization, and the delivery of quality health care

Pathway to Survival

Three Delays to formal health care seeking and related constraints

1. Lack of knowledge of illness danger signs

2. Seeking traditional care

3. Lack of transportation, costs

The five key objectives of social autopsy are as follows:

(i) Essential elements of the care-seeking process to be described, including recognition of the illness, home care provided, outside-the-home care was sought (informal, formal, or both), delays to formal health care seeking and related constraints and the quality of health care provided.

(ii) A social diagnosis of the contributors to death to be made, i.e., household (behavioural), community (social), and health system determinants of the deaths to be identified.

(iii) The study should provide representative national or large area data; and the data should be utilized to support :

(iv) Health program or policy developmentand/or

(i) Community empowerment.