INTRODUCTION:
Accurate cause of death data is essential for health system planning, yet Ghana faces significant gaps due to incomplete civil registration and vital statistics systems. Verbal autopsy, using structured caregiver interviews, has been employed to determine probable cause of death in maternal, neonatal and child deaths, but its integration into surveillance systems remains limited.

METHODS:
A scoping review was conducted in PubMed and SCOPUS (2000–2025) using terms such as “Verbal Autopsy,” “Ghana,” “Maternal Mortality,” “Neonatal,” and “Under-five Mortality.” Of 103 publications identified, 10 met inclusion criteria. Three reviewers independently screened and extracted data following PRISMA guidelines. Thematic synthesis explored verbal autopsy’s implementation, diagnostic accuracy, and system-level implications.

RESULTS:
Verbal autopsy data identified sepsis, birth asphyxia, pneumonia, malaria, and tuberculosis as leading causes of death, while stroke was a major non-communicable contributor. Verbal autopsy demonstrated high diagnostic accuracy in classifying neonatal deaths (sensitivity >70%, specificity >85%) and determining death timing (94–98%). Among women, infectious diseases and indirect causes of maternal death—predominantly obstetric—were prominent. Operational challenges included cultural sensitivities, respondent distress, and persistent gaps in neonatal facility care despite high admission rates.

CONCLUSIONS:
Verbal autopsy strengthens mortality surveillance in settings lacking civil registration and vital statistics systems, revealing underreported maternal and child deaths and care gaps. However, scale-up requires addressing ethical, cultural, and operational barriers, alongside investments in digital tools, culturally adapted protocols, and integration with health information systems. When embedded within responsive health systems, Verbal autopsy can inform more effective maternal, neonatal, and child health interventions in Ghana.