Inadequacies of the Civil Registration System

What is the issue?

In response to the WHO’s estimate of excess Covid deaths, several State Health Ministers have asserted that India has a robust, legal and transparent system for data collection and COVID mortality surveillance.

What is Civil Registration System?

• The history of CRS in India dates back to 1886 when a Central Births, Deaths and Marriages Registration Act was promulgated to provide for voluntary registration.
• The Registration of Births and De ath Act (RBD Act) was enacted in 1969 to promote uniformity and comparability in the registration of births and deaths across the country.
• With the enactment of the Act, registration of births, deaths and still births has become mandatory in India.
• The Registrar General, India (RGI) at the Central Government level coordinates and unifies the activities of registration throughout the country.
• The implementation of the statute is vested with the State Governments.

What are the actual levels of registration?

• The number of births and deaths registered in a year include those of earlier years as some births and deaths are registered only in the following year.
• To register a birth or death reported after a year of its occurrence requires an order of a First Class Magistrate issued after verifying the facts about the birth or death.
• In several States, this function has been given to the Sub-Divisional Magistrates.
• Based on a comparison with the vital rates obtained from the Sample Registration System (SRS), the RGI estimated that the country registered about 92.7% of births and 87.8% of deaths in 2019.
• Corresponding figures for 2020 are not available.

To know more about the death data in CRS, click here

What is the impact of COVID-19 on registration?

• COVID-19 could have significantly affected the efficiency of the CRS.
• The registrars could not work during lockdowns in many areas.
• People could not travel to the registrar’s office to report the births/deaths that had occurred at home within the prescribed time.
• In case of a delay of more than 30 days in reporting, the procedure of getting an affidavit or a Magistrate’s order as required under Section 13 of the RBD Act is difficult.
• In some States, the functionaries handling registration were deployed on COVID-19-related duties and could not register the events.
• The impact of these would not have been uniform across the country as some areas had longer periods of lockdowns or travel restrictions.
• It is likely that a reasonable number of deaths (among women and children) may not get registered because the family may not require the death certificates for settling inheritance, insurance claims, etc.
• Only about 20% of the deaths have a Medically Certified Cause of Death (MCCD) that conforms to the WHO standard.
• In other cases, the cause of death is provided by the attending medical practitioner in case of deaths in medical facilities and by the person reporting the death in domiciliary deaths.

What lies ahead?

• The CRS is yet to mature into a robust and resilient system that can ensure that every birth and death is registered even in normal times.
• The State governments must put in more effort which would require coordinated action by several departments of the State that have a stake in the CRS.
• It is also necessary to publish data in a timely manner so that so that it can aid the formulation of policies and programs backed by evidence.

Reference

1. https://www.thehindu.com/opinion/op-ed/inadequacies-of-the-civil-registration-system/article65456682.ece