Mortality Surveillance at Burial Sites in Addis Ababa (Ethiopia): Major Methodological Issues and Opportunities for Research

Tekebash Araya, Addis Ababa University
Georges Reniers, University of Colorado at Boulder and University of the Witwatersrand
Gail Davey, Addis Ababa University
Yemane Berhane, Addis Ababa University
Eduard J. Sanders, Kenya Medical Research Institute (KEMRI)

In many developing countries, including Ethiopia, accurate information on vital events is lacking or –at best– incomplete. In this paper, we discuss the utility of a surveillance of burials as a partial substitute for a fully functioning vital registration system, and for monitoring AIDS mortality in particular. In the era of antiretroviral treatment, direct measurement of AIDS mortality rather than the conventional focus on HIV prevalence, will become an essential component of monitoring the success of interventions. We review fieldwork procedures, methodological strengths and weaknesses of the system as well as and some of the opportunities for research. One particular feature of system is that it records lay reports of causes of death. Despite a reluctance to explicitly label AIDS deaths as such, bereaved relatives often use euphemisms that are highly indicative of AIDS mortality and can be used for monitoring purposes.