Certified causes for 1 in five registered deaths: ’18 data

NEWDELHI:OF the estimated 8 million deaths in India in 2018, about 6.9 million were registered. Out of these, just over one in five had a medically certified cause of death, numbers released by the Union home ministry showed on Thursday.

India has been making progress on registering deaths but this has not been accompanied by an increase in deaths where the cause has been medically certified. Among medically certified deaths, diseases of the circulatory system (the heart and blood vessels) were the leading cause of death. Even these numbers need to be read with caution, as reporting is not uniform across states. Bihar reported this data from just five more hospitals than Andaman & Nicobar Islands.

The registration rate of deaths increased for the eighth consecutive year in 2018, to reach 86%. Medical certification of deaths has hovered around the 20% mark since 2010.

Share of registered deaths and medically certified deaths has been depicted in the chart.

Even this data needs to be read with caution. Just about half of medical institutions having in-patient facilities report this data. This number varies drastically at the state level. Andaman and Nicobar Islands has 37 inpatient institutions, all of which reported MCCD data. Bihar on the other hand had just five more institutions covered under MCCD out of its 683 inpatient institutions, which itself is likely to be an underestimate. Telangana, which has 7,144 of 7,827 inpatient institutions covered under MCCD, reported the data from only 284 institutions.

Even states that had all inpatient institutions registered under MCCD, such as Assam and Maharashtra, do not appear to be reporting this data regularly. In both these states, the share of medically certified deaths came down between 2017 and 2018. In Assam, it dropped from 31.2% to 12%, while in Maharashtra it went down by around four percentage points from the 2017 value of 38.9%.

Diseases of the circulatory system or cardiovascular diseases were the leading causes of death among the deaths that were certified, accounting for nearly a third (32.9%) of all such fatalities, followed by diseases of the respiratory system (9.4%), and infectious and parasitic diseases (9.4%). Infectious and parasitic diseases were the leading cause of deaths among children aged 1-4 years (21% of such deaths) and 5-14 years (22.3%) and among those of age 15-24 years (17.5%).