Abstract: This report documents results of a cognitive interviewing study to examine the performance of the 2016 WHO Verbal Autopsy (VA) Instrument. Composed of three questionnaires and designed under the auspices of the World Health Organization (WHO), the goal of the VA instrument is to provide timely and valid vital statistics for both national ministries/departments of health and for international health organizations. VA is a tool that can be used for identifying probable cause of death in the absence of medical personnel to medically certify cause of death. The VA process generally involves conducting an interview with the next of kin or a caregiver of the deceased after a culturally appropriate mourning period. In July 2012, WHO released a simplified VA instrument that includes a separate questionnaire for three age groups: 1) under four weeks (referred throughout this report as “neonates”), 2) four weeks to 14 years (referred to throughout this report as “child” or “children”), and 3) 15 years and above (referred to throughout this report as “adult”). The aim of the simplification process was to develop an abbreviated VA instrument that could be used on a routine basis, including in the context of a national civil registration and vital statistics system. This 2012 questionnaire was evaluated using cognitive interviewing by NCHS in 2014 in western Kenya . The results of that evaluation, along with contributions from across a WHO working group on VA, led to a series of changes and the release of the 2016 questionnaires. One limitation of the 2014 cognitive interviewing study was that interviews were conducted in only one country. Because of this, it was unclear if question problems and variations in question interpretations were due to item wording or cultural context. In order to avoid that in the current evaluation, cognitive interviews were conducted in two locations—Lusaka, Zambia beginning in January of 2019 and Rabat, Morocco beginning in February of 2019. (A third location—Mumbai, India—was planned, but funding and logistic issues prevented the cognitive interviews from taking place.) The overall goals of this round of cognitive interviewing were to continue to understand how VA items are understood by respondents, the extent to which proxy respondents know the information about the decedent that is requested during the VA interview, and whether and how the respondents understand the medical and health-related terms used throughout the VA questionnaires. Not all of the VA questionnaires’ item were probed during the cognitive interview, due largely to time constraints. Rather, a specific sub-set of questions were evaluated by the cognitive interviewers. This report will present a question-by-question analysis of those items. The full VA questionnaires are available from the WHO’s website .