Only 22% deaths in India medically certified; below 10% in some states

Only 22% of the registered deaths in the country are medically certified, with the proportion dipping below 10% even in some states generally regarded as developed. Among those medically certified, diseases of the circulatory system are not only the biggest killers but the fastest growing. Deaths caused by complications due to diabetes are also emerging as a significant chunk, shows data on causes of death released by the office of the Registrar General of India. Interestingly, more male deaths are medically certified, accounting for 61.9% of all medically certified deaths in the country. Med certification of deaths up from 13% to 22% in 27 yrs It seems more males are admitted to hospital during the last moments of life as compared to females, notes the report on medical certification of cause of death (MCCD). This could be because of property being mostly in the name of men and death certificates being crucial for inheritance. According to the report, progress in the implementation of medical certification of deaths has been slow, rising from 12.7% to 22% over the last 27 years. It has so far been implemented in only certain hospitals, generally in urban areas which are selected by the Chief Registrar of Births & Deaths and the coverage is not uniform across states. Out of an estimated 70 lakh deaths in 2017, over 60 lakh were registered, but just over 14.1 lakh were medically certified. Amongst bigger states, the highest level of medical certification of cause of death was in Tamil Nadu (43.3%) followed by Maharashtra (38.9%) and Karnataka (30.4%). Of those medically certified, deaths due to diseases of the circulatory system have seen the highest jump of 9.7 percentage points and this category of diseases now accounts for over 34% of deaths. The data reveals that, since 2000, diseases of the circulatory system such as heart diseases have not only been the top-most killer, but their share in total deaths has been steadily increasing. Ischemic heart disease alone accounted for over 10% of all medically certified deaths. Similarly, while endocrine, nutritional and metabolic diseases were the seventh leading cause of deaths (5.3%), diabetes mellitus alone under this category constituted 4.6% of medically certified deaths. Within infectious and parasitic diseases, which were the second leading cause of death (10.4%), septicemia alone accounted for 4.6%. Theaccounting for 9.2% of deaths and cancers accounting for 6.4%. Death of infants during birth accounts for 5.8%, including those due to slow fetal growth and fetal malnutrition. Given the low level of certification, it is possible that the data may not accurately mirror the actual picture of how many die from which disease, but the broad patterns are unlikely to be significantly different category on infectious diseases is followed by respiratory diseases.

Source: Times of India, 4/09/2019