Conceptual frameworks for understanding the acceptability and feasibility of the minimally invasive autopsy to determine cause of death: Findings from the CADMIA Study in western Kenya

PLoS One. 2020 Dec 14;15(12):e0242574. doi: 10.1371/journal.pone.0242574. eCollection 2020.

Abstract

Establishing the cause of death (CoD) is critical to better understanding health and prioritizing health investments, however the use of full post-mortem examination is rare in most low and middle-income counties for multiple reasons. The use of minimally invasive autopsy (MIA) approaches, such as needle biopsies, presents an alternate means to assess CoD. In order to understand the feasibility and acceptability of MIA among communities in western Kenya, we conducted focus groups and in-depth interviews with next-of-kin of recently deceased persons, community leaders and health care workers in Siaya and Kisumu counties. Results suggest two conceptual framework can be drawn, one with facilitating factors for acceptance of MIA due to the ability to satisfy immediate needs related to interest in learning CoD or protecting social status and honoring the deceased), and one framework covering barriers to acceptance of MIA, for reasons relating to the failure to serve an existing need, and/or the exacerbation of an already difficult time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autopsy / ethics*
  • Autopsy / methods
  • Biopsy, Needle / ethics
  • Biopsy, Needle / psychology*
  • Cause of Death*
  • Feasibility Studies
  • Female
  • Focus Groups
  • Health Personnel / psychology
  • Humans
  • Kenya
  • Male
  • Middle Aged
  • Surveys and Questionnaires

Grants and funding

The CaDMIA research project (Validation of the minimally invasive autopsy tool for cause of death investigation in developing countries) is funded by the Bill & Melinda Gates Foundation (Global Health grant numbers OPP1067522 and OPP1128001) and by the Spanish Instituto de Salud Carlos III (FIS, PI12/00757; CM, Acciones CIBER). ISGlobal is included in the CERCA Programme /Generalitat de Catalunya CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID). QB has a fellowship from the program Miguel Servet of the ISCIII (Plan Nacional de I+D+I 2008-2011, grant number: CP11/00269). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.