New Delhi: There has been little or no improvement in the proportion of medically proven deaths for cause of death in India over a decade (2009-19). Even though registration of deaths improved from 67 per cent to 92 per cent over the same period, the proportion that is clinically proven for the cause remains around 20%. Progress in half-a-dozen states has been offset by worsening in other states, while many are stagnant.
According to the latest Civil Registration System (CRS) report of 2019, of the total registered deaths, more than 32% are institutional and 14.4% have received “other than institutional medical assistance”. Despite medical assistance for about 50% of those whose deaths were recorded, the medical certification of the cause of death remains at about 20% (according to the medical certification of the cause).MCCD) 2019 report
Chhattisgarh has seen the most improvement in MCCD from 9% to 21% between 2009 and 2019, followed by Tamil Nadu from 33% to 43.5% in 2009 and West Bengal from 6% to 14% over the same period. Among the larger states and union territories, Delhi has the highest coverage at 62%, but this is a small improvement from 60% in 2009. Unlike most other states, institutional deaths constitute 66% of the registered deaths in Delhi.
“Data on why people are dying is important information that we need to know to see if we need to plan our policies properly. one of sustainable development goals (SDG) that India has also signed in 2016 to reduce premature mortality from non-communicable diseases by one third through prevention and treatment by 2030. national health mission in Tamil Nadu.
“Tamil Nadu is working to improve the proportion of medically certified deaths as the state government plans to use this data to plan policies and programmes. Easy to ensure medical certification of 30-40% who Can die in hospitals. The challenge lies in medically certifying the deaths at home,” he said.
This is echoed by Dr Soumya Swaminathan, Deputy Director General of WHO, who, as Director General of the Indian Council of Medical Research (ICMR), pushed for reforms in the MCCD. “One of the main difficulties in ensuring medical certification of death is that most deaths in rural areas occur at home and are therefore not certified by a doctor. Hence MCCD does not. We need to learn about a different system of certification such as training. Village level functionaries to fill up a simple form, which can then be validated by a PHC doctor. In case of death in hospitals, most of the doctors are not trained in MCCD, specially In using the International Classification of Diseases (ICDA compulsory course in death certification after MBBS and PG will help and online courses have been developed for the same,” Dr Swaminathan said.
Jasveen Duggal, Registrar (Births and Deaths) North Delhi Municipal Corporation, also talked about the need to train doctors and hospital staff entering death registration data to improve the quality of data, without which, “it would just be garbage, garbage out”.
In Bihar, Uttar Pradesh, Andhra Pradesh and Uttarakhand, MCCD coverage has worsened, while it has stabilized mostly in Kerala, Karnataka and Odisha, where there has been a slight improvement over a few years and is back to previous levels.
The introduction of the MCCD report every year faithfully reiterates this paragraph: “The report is based on medically certified deaths occurring in hospitals (whether public or private) covered under the scheme. Since only selected hospitals, and that too mostly from urban areas.” , currently covered under the scheme of MCCD, the profile presented here may not give a reliable pattern of specific mortality rates prevailing in the states/country. In short, the MCCD report has little or no data on deaths in rural India. Where 65% of the population lives.
According to the latest Civil Registration System (CRS) report of 2019, of the total registered deaths, more than 32% are institutional and 14.4% have received “other than institutional medical assistance”. Despite medical assistance for about 50% of those whose deaths were recorded, the medical certification of the cause of death remains at about 20% (according to the medical certification of the cause).MCCD) 2019 report
Chhattisgarh has seen the most improvement in MCCD from 9% to 21% between 2009 and 2019, followed by Tamil Nadu from 33% to 43.5% in 2009 and West Bengal from 6% to 14% over the same period. Among the larger states and union territories, Delhi has the highest coverage at 62%, but this is a small improvement from 60% in 2009. Unlike most other states, institutional deaths constitute 66% of the registered deaths in Delhi.
“Data on why people are dying is important information that we need to know to see if we need to plan our policies properly. one of sustainable development goals (SDG) that India has also signed in 2016 to reduce premature mortality from non-communicable diseases by one third through prevention and treatment by 2030. national health mission in Tamil Nadu.
“Tamil Nadu is working to improve the proportion of medically certified deaths as the state government plans to use this data to plan policies and programmes. Easy to ensure medical certification of 30-40% who Can die in hospitals. The challenge lies in medically certifying the deaths at home,” he said.
This is echoed by Dr Soumya Swaminathan, Deputy Director General of WHO, who, as Director General of the Indian Council of Medical Research (ICMR), pushed for reforms in the MCCD. “One of the main difficulties in ensuring medical certification of death is that most deaths in rural areas occur at home and are therefore not certified by a doctor. Hence MCCD does not. We need to learn about a different system of certification such as training. Village level functionaries to fill up a simple form, which can then be validated by a PHC doctor. In case of death in hospitals, most of the doctors are not trained in MCCD, specially In using the International Classification of Diseases (ICDA compulsory course in death certification after MBBS and PG will help and online courses have been developed for the same,” Dr Swaminathan said.
Jasveen Duggal, Registrar (Births and Deaths) North Delhi Municipal Corporation, also talked about the need to train doctors and hospital staff entering death registration data to improve the quality of data, without which, “it would just be garbage, garbage out”.
In Bihar, Uttar Pradesh, Andhra Pradesh and Uttarakhand, MCCD coverage has worsened, while it has stabilized mostly in Kerala, Karnataka and Odisha, where there has been a slight improvement over a few years and is back to previous levels.
The introduction of the MCCD report every year faithfully reiterates this paragraph: “The report is based on medically certified deaths occurring in hospitals (whether public or private) covered under the scheme. Since only selected hospitals, and that too mostly from urban areas.” , currently covered under the scheme of MCCD, the profile presented here may not give a reliable pattern of specific mortality rates prevailing in the states/country. In short, the MCCD report has little or no data on deaths in rural India. Where 65% of the population lives.
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