Suicide in South Asia: a scoping review of published and unpublished literature. Final Report
Abstract
This study reports on a scoping review of the published and unpublished literature on suicide incidence rates, that is, the rate of suicide deaths per one hundred thousand population, and other metrics related to suicide deaths in six South Asian countries (Afghanistan, Pakistan, India, Bangladesh, Sri Lanka, Nepal). It includes 114 reports and peer reviewed publications (n=64 and n=50, respectively), collected through searches by in-country consultants and systematic searches of scientific databases.
Key findings:
- There is a paucity of data on suicide incidence rates in South Asia, especially data that is both national level and of high quality.
- There is an urgent need to establish comprehensive national suicide data collection systems in the South Asian countries where they currently do not exist, evaluate the accuracy of the national suicide data collection systems in countries that currently have them (India and Sri Lanka).
- Best practice for establishing suicide rates identified in this review are studies that combine several data sources including data from large representative samples (i.e. national health/ mortality surveillance system or community survey) and systematic verbal autopsies.
- Overall, reported rates tend to be alarmingly high across countries, except the few official national rates that are available, which generally report lower rates. Most authors interpret the official national rates to be significantly underreported, an assessment that is supported by available comparison data.
- Overall, suicide rates are higher among men than among women in all but one country, Bangladesh. Younger women of reproductive age appear to be at higher risk than men in the other South Asian countries where information is available.
- Reported rates vary vastly between publications, which can be explained by differences in study population and/or quality of data collection. Higher quality studies consistently report higher rates compared to lower quality studies. Sub-population studies report higher rates than national level data, with official rates being the lowest reported rates. Official rates tend to be higher for countries that have better national mortality surveillance systems.
Citation
HealthNet TPO. Suicide in South Asia: a scoping review of published and unpublished literature. Final Report. HealthNet TPO, Amsterdam, Netherlands (2013) v + 123 pp.
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