Inadequacies of the Civil Registration System

News: Recently, the World Health Organization (WHO)’s estimated excess deaths due to COVID-19 in India which has triggered several responses.

What has been the government’s response against WHO estimates?

Various State Health Ministers slammed the WHO estimates. They asserted that India has a “robust, legal and transparent system for data collection and COVID mortality surveillance”, referred to as the Civil Registration System (CRS).

System for registration in India

The Registration of Births and Deaths (RBD) Act, 1969 mandates the registration of births and deaths.

The State governments are responsible for the establishment and management of the registration system.

The Registrar General of India (RGI) coordinates and unifies the activities of registration.

The Sample Registration System (SRS) is used for further analysis of the birth and death registration in India.

A birth/death should be registered within 21 days. After 21 days, birth/death can be registered under the RBD Act with an order of a First-Class Magistrate issued after verifying the facts about the birth or death.

What are the issues with India’s registration system?

The SRS figures are not available for the year 2020 in which Covid-19 hit India.

Further, Past studies on the SRS indicate that the vital rates are underestimated by 2-3%.

Further, 2020 annual reports have shown that the number of births and deaths registered one year after occurrence is quite high. For example, more than 15% of the births registered had occurred in earlier years in Uttarakhand, Jharkhand, Rajasthan and Assam. However, such a proportion of delayed registration was lower in case of deaths.

Many deaths like female deaths and child deaths have low level of registration because the family may not require the death certificates for settling inheritance, insurance claims, etc. For example, Female deaths formed only 39.8% of the total registered deaths in 2020.

Only about 20% of the deaths have a Medically Certified Cause of Death (MCCD) that conforms to the WHO standard. The State governments have not issued statutory notifications to increase the coverage of MCCD.

Impact of COVID-19 on registration

The Covid-19 lockdowns significantly affected the efficiency of the CRS in the following manner.

One, the registrars could not work during lockdowns in many areas.

Two, people could not travel to the registrar’s office to report the births/deaths that had occurred at home within the prescribed time.

Three, in case of a delay in reporting, the procedure of getting an affidavit or a Magistrate’s order as required under Section 13 of the RBD Act is a very cumbersome process.

Four, the functionaries handling registration were deployed on COVID-19-related duties and could not register the events.

It means a large number of births and deaths that had occurred in 2020 would have been reported for registration in 2021 or even later.

Way Forward

A robust system should be instituted to ensure the registration of almost every birth and death within a short time after its occurrence.

COVID-19 may act as an eye-opener on the importance of the CRS. The CRS has several shortcomings. India does not have a robust system of registering births and deaths.

While the law and a registration system are in place. The State governments should put in more effort to ensure that all births and deaths are registered and more deaths have medically certified causes. This would require coordinated action by several state departments.

The data should be published in a timely manner so that it can aid in the formulation of evidence-based policies and programs.

Source: The post is based on an article “Inadequacies of the Civil Registration System” published in the “The Hindu” on 25^th May 2022.