Uncertified deaths hampering public healthcare: ICMR study – The Tribune

Council researchers further stressed that the substantial gap between registered deaths and MCCD underscored a critical challenge in tracking health outcomes and impeding the development of effective public health interventions.

According to the 2022 Sample Registration System (SRS) report, India in 2020 reported 87,59,522 deaths, with 80 per cent having registered death certificates. However, the Civil Registration System (CRS) report revealed that only 22.5 per cent of these deaths were medically certified.

This is the first such study to closely examine death certification patterns across all Indian states and UTs over the past 15 years, addressing a critical-gap in the literature by identifying regional patterns, disparities and healthcare variables that have previously been underexplored.

The study suggested that in order to improve health outcomes, India must better identify the leading causes of death and address challenges in death registration and certification across regions. It also flagged consequent disparities in healthcare access, and the number of doctors and hospitals across states.

As per the ICMR study, Lakshadweep consistently exhibited the highest MCCD percentage (94–95 per cent), demonstrating near-complete certification, followed by Puducherry and Chandigarh, with almost 70 per cent MCCD.

Additionally, Delhi demonstrated an overall improvement in MCCD from 57.46 per cent to 59.71 per cent over the past years. However, the North Indian region reported the lowest-average MCCD (13 per cent) among all regions during 2015–2020. The overall trend change presents a mixed picture, with Punjab (from 10.55 to 16.54 per cent) and Himachal Pradesh reporting consistent increases, while Haryana and Uttar Pradesh lag behind with incomplete data reporting between 2006 and 2015.

In contrast, South India led the country in overall improvement in MCCD reporting. Tamil Nadu showed a significant rise from 28.34 to 43.46 per cent, making it one of the highest MCCD states in the southern region. Karnataka and Andhra Pradesh follow closely with consistently high levels of certification.

The study said that India, which accounted for 17.8 per cent of the world’s population, the existing MCCD rate of 22.5 per cent, with only a 2.5 per cent improvement over the past decade, is strikingly concerning.

The ICMR said, “Improving MCCD rates has far-reaching public health implications and accurate death certification data is essential for understanding disease burdens, guiding resource allocation, and shaping health policy.”

It said the trends underscored the importance of increasing hospital density and accessibility in rural areas, which were vital for improving MCCD-rates in states with lower reporting.

“Additionally, it is crucial to verify that such increases in hospital density and accessibility translates to active MCCD reporting, as active hospital reporting has emerged as the greatest influence on healthcare variable affecting MCCD rates among all clusters,” the council added.