The need for a robust civil registration system

News: With Omicron, South Africa implemented a rapid surveillance mechanism that provided early alerts. India has also responded by setting up screening centres, ICU beds, etc. Despite no alarms, the threat remains so, all cautions should be observed.

How the mortality data can help in accessing pandemic situations?

Mortality data is important to guide patient care and the protection of the vulnerable population. But it is found that data is limited due to inadequate access to antemortem testing and causes that are attributed to mortality.

Hence, now it is being evaluated through the estimation of excess mortality. These estimates need reliable baselines, real-time data compilation and weekly updates. For South Africa, the national population register has served as a useful database.

For India, they are based on epidemiological models like month-wise death registrations. But they are hampered by uncertainty in baselines and delayed registrations. As per data, the excess mortality was estimated to be 2.8 to 5.2 million. But National Covid-19 surveillance program estimated deaths to be 4,30,000. This ten-fold variation is clearly not helpful.

What do the recent developments signify?

Many developments have created prospects of better estimates. The civil registration report for 2019 indicates high levels of registration completeness across India.

Prompt release of registered death by some states in 2021 indicates the efficient mechanism for data compilation.

What steps can be further adopted?

Capacity building: Local statistical capacity should be established at State registration offices for data quality evaluation, adjustments for data bias, and basic trend and forecast analysis.

Release of data: CRS data for 2020 and provisional data reports for 2021 should be released soon.

Standardize protocols: Standardize the data dissemination protocols by using a template for compilations of deaths tabulated by sex, broad age groups, a month of death occurrence, and district of usual residence. The CRS death reporting form should include all these details

These updated counts and CRS list will help in pandemic surveillance and help monitor the mortality impact of the current and future epidemics.

Source: This post is based on the article “The need for a robust civil registration system” published in The Hindu on 9th December 2021.