Delhi at 66%, but only 22% deaths nationwide have certified cause | India News
New Delhi: Even as Delhi reports relatively strong medical certification of deaths, the national picture remains stark – only 22% of registered deaths in India were medically certified in 2023, exposing a serious gap in how the country tracks disease trends and plans health policies.The concern was flagged at the two-day National Symposium on Strengthening Mortality Information System held in the capital, which concluded on February 11. Experts warned that despite reform efforts over the years, large swaths of India’s mortality data remain incomplete.The latest civil registration data reveals stark disparities across states and union territories. Delhi recorded 66% of the registered deaths as medically certified, placing it among the well-performing regions. Goa (100%), Lakshadweep (99.2%) and Puducherry (91.4%) have near-universal certification, while Chandigarh (76.4%) and Andaman and Nicobar Islands (67.2%) also report high coverage. In contrast, several large states lag behind significantly — Maharashtra (42.4%), Tamil Nadu (39.1%), Telangana (38.4%), Karnataka (26.7%), Odisha (23.4%) and Gujarat (23.3%) — falling below the national average of 22%.Dr Harshal Ramesh Salve of AIIMS told TOI that 1 in 5 causes of death nationally undergo proper medical certification. A significant proportion of deaths – especially in rural areas – occur outside health facilities, where formal certification is often absent.Inaugurating the symposium, Dr. VK Paul, Member, NITI Aayog, emphasized that robust and interoperable mortality systems are essential for evidence-based governance. He said health planning must be driven by reliable, real-time data and stressed the need for coordinated action across sectors to ensure every death is counted and its cause scientifically determined.Experts say counting each death and accurately recording its cause is critical to estimating disease burden, identifying risk factors and designing prevention strategies. Without reliable cause-of-death data, health planning risks rely on assumptions rather than evidence. Strong data sharing between ORGI, the Ministry of Health and academic institutions, they added, will help create science-driven, decentralized policies and improve India’s self-reliance in disease estimation.Over the past decade, AIIMS and the Office of the Registrar General of India have strengthened surveillance through oral autopsies and digital systems. More than 10 lakh cases have been reviewed, and probable causes of more than 4 lakh deaths have been determined, employing nearly 1,000 trained doctors in 27 institutions. However, most of these support sample-based surveillance rather than universal coverage. With nearly 1 crore deaths reported annually, comprehensive certification is a work in progress.Verbal autopsy is used when a person dies outside a hospital. It involves interviewing family members about symptoms and circumstances before death, after which trained doctors determine probable causes using standard medical classification systems. While this improves national estimates, experts say expanding routine medical certification of deaths in hospitals and communities is essential.The symposium concluded with the launch of a National Consortium for Strengthening Mortality Data System to improve data quality, expand certification and accelerate nationwide digital integration.Public health experts say that while Delhi’s 66% certification rate reflects progress, the national gap underscores the urgency of ensuring that every death – and its cause – is systematically recorded.
