Using an undertaker's data to assess changing patterns of mortality and their consequences in Swaziland

This paper measures AIDS mortality using routinely collected data from one of two nationally operating undertakers in Swaziland. The business recorded a marked increase in the number of deaths it handled between 1998 and 2002, most obvious in the 0-4 and 20-49 age categories. Cost data reflects this increase in mortality. Prices for funerals and coffins have declined in real terms. Recorded causes of death were of little use in determining the extent of AIDS mortality. This was due to stigma and denial, the relatively small number of people dying in hospitals and lack of accurate reporting of medical diagnoses. Key informant interviews were done to support the undertaker's data and determine how families bear the burden of burying deceased relatives. Despite a disproportionate increase in deaths in certain age categories and evidence of worsening poverty, funerals remain large and elaborate affairs.