Cause of death reporting systems in India: a performance analysis

Mahapatra, P. and Rao, Chalapati P. V. (2001) Cause of death reporting systems in India: a performance analysis. National Medical Journal of India, 14 3: 154-162.

Author Mahapatra, P.
Rao, Chalapati P. V.
Title Cause of death reporting systems in India: a performance analysis
Journal name National Medical Journal of India   Check publisher's open access policy
ISSN 0970-258X
Publication date 2001-01-01
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 14
Issue 3
Start page 154
End page 162
Total pages 9
Editor Sahni, Peush
Place of publication New Delhi
Publisher All India Inst Medical Sciences
Language eng
Subject 321200 Public Health and Health Services
Formatted abstract
Reliable statistics on the causes of death in the population are essential for setting priorities in the health sector. Most cause of death reporting systems in developed countries rely on medical certification of the cause of death according to the International Classification of Death (ICD-10), and have achieved near-total coverage. Developing countries such as India, where adequate medical facilities are not available, depend on lay reporting of the cause of death in rural areas, using a sample registration system. The use of the cause of death statistics in India is questioned in view of the poor coverage, and poor compliance with guidelines for cause of death reporting, coding and classification.

A brief description of the reporting system in India is followed by the characteristics of a usable cause of death reporting system. We identified 9 criteria based on a review of the literature and our own assessment of the problem. The performance of the cause of death reporting system for rural and urban areas of India was examined against each of the 9 criteria. We offer a subjective rating on a three-category rating scale consisting of (i) satisfactory, (ii) tolerable, and (iii) poor.

The major factors affecting the use of the cause of death statistics in India are: (i) poor coverage; (ii) high incidence of unclassifiable deaths; (iii) long delay and irregular publication of statistics; and (iv) lack of systematic screening.


We recommend the following steps to improve the usability of cause of death statistics in India. Introducing periodical reviews jointly by the Departments of Health and Municipal Administration to identify non-reporting municipalities, sample units, and further identification of non-reporting health care institutions sustained over a period of, say, five years will raise coverage substantially. The other measures include: (i) training programmes to build up cause of death report writing skills among physicians; (ii) compilation and publication of cause of death statistics at the state level; (iii) sponsored research on the cause of death reporting structure and its implications for policy-making; and (iv) computerization of filling, tabulation and flow of cause of death statistics at the municipality and the state levels. To reduce the unusually high level of unclassifiable deaths, the Registration of Births and Deaths Act should be amended to ensure that hospitals and health care institutions maintain medical records. For accurate cause of death data from rural areas, we recommend that the performance of the sample registration survey-cause of death (SRS-COD) component be evaluated according to the above criteria.
Keyword Adolescent
Cause of Death
Child, Preschool
Death Certificates
Forms and Records Control/ organization & administration
Infant, Newborn
Quality Control
Reproducibility of Results
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 26 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 21 Sep 2007, 20:52:06 EST