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News18
39 minutes ago
- Health
- News18
Only 22% Deaths Medically Certified In India In 2022, Heart Disease Tops Causes
Last Updated: Despite a legal mandate under the Registration of Births and Deaths Act, the MCCD scheme is underutilised, with only 54 per cent of covered hospitals reporting data. Heart disease remained to be the leading cause of death in India, accounting for more than 40 per cent of 'medically certified" deaths in 2022, according to the latest 'Annual Report on Medical Certification of Cause of Death (MCCD)" released by the Office of the Registrar General of India. However, only 22.3 per cent of the 86.5 lakh registered deaths were medically certified, raising concerns over the reliability of mortality data in the country. Out of 19.32 lakh certified deaths, diseases of the circulatory system — particularly ischemic heart disease and other heart conditions — were the top cause, followed by respiratory diseases (9.7 per cent), and infectious and parasitic diseases (7.4 per cent). Neoplasms (4.3 per cent), renal failure, and diabetes were also major contributors. The report highlights disparities across states. Goa reported 100 per cent medical certification of deaths, while states like Bihar (5.4 per cent) and Uttar Pradesh (10.4 per cent) lagged far behind. Medical certification coverage fell slightly from 23.4 per cent in 2021 to 22.3 per cent in 2022. Male deaths dominated the certified data at 64 per cent, with female deaths at just 36 per cent. Alarmingly, younger populations (15–34 years) faced high death rates due to cardiovascular conditions and injuries, while perinatal conditions remained the leading cause for infants. Despite a legal mandate under the Registration of Births and Deaths Act, the MCCD scheme is underutilised, with only 54 per cent of covered hospitals reporting data. Experts warn this undermines efforts in health policy planning and disease prevention. The report urges stronger implementation, especially in rural and non-institutional settings, to improve India's mortality data and public health response. The failure to fill MCCD Forms (Form 4/4A) as required leads to poor data capture. The report calls for better training of doctors, improved monitoring systems, and stricter follow-up mechanisms. Certification Crisis: Only 22% of Deaths Accounted For Out of 86,49,930 registered deaths, only 19,32,540 (22.3 per cent) were medically certified. This marked a drop from 23.4 per cent in 2021. Moreover, just 46.5 per cent of the deceased who received any medical attention before death had their deaths certified. This low coverage impedes efforts to accurately assess disease burden, track health trends, and design responsive policies. State-Wise Gaps: Goa at 100%, Bihar at 5.4% The report shows vast disparities in certification. Goa (100 per cent), Lakshadweep (99.2 per cent), and Puducherry (91.4 per cent) led with the highest certification rates. In contrast, Bihar (5.4 per cent), Nagaland (9.0 per cent), and Uttar Pradesh (10.4 per cent) recorded the lowest. Young Adults Vulnerable to Heart Disease and Injuries In the 15–24 and 25–34 age groups, circulatory diseases were the leading cause of death, contributing 29.6 per cent and 32.2 per cent of deaths respectively. Injuries, poisoning, and other external causes followed closely, accounting for 13.7 per cent and 10.8 per cent in these age groups. Infant Mortality Still Driven by Perinatal Issues Infants under 1 year represented 6 per cent of medically certified deaths. Among these, 64.5 per cent were attributed to perinatal conditions, including birth asphyxia, hypoxia, and neonatal infections. Male Deaths Outnumber Female by Nearly 2:1 Of the medically certified deaths, 64 per cent were male (12,36,683), and 36 per cent female (6,95,805). The sex ratio of certified deaths stood at 563 female deaths per 1,000 male deaths, highlighting significant gender disparity. Call for Full MCCD Implementation Across India Though all states except Kerala, Ladakh, and Meghalaya have notified the scheme, implementation is inconsistent. Of 87,809 hospitals with in-patient facilities, only 41,549 (54.4 per cent) reported certified cause-of-death data. The report urges full coverage of private hospitals, rural health centres, and non-institutional deaths. Without universal implementation, India risks flying blind on crucial health data needed to drive policy and preventive strategies. Get breaking news, in-depth analysis, and expert perspectives on everything from politics to crime and society. Stay informed with the latest India news only on News18. Download the News18 App to stay updated! tags : heart disease Location : New Delhi, India, India First Published: June 06, 2025, 12:45 IST News india Only 22% Deaths Medically Certified In India In 2022, Heart Disease Tops Causes
News18
an hour ago
- Health
- News18
Bihar Records Lowest Sex Ratio At 891, Nagaland Tops List With 1,068
Last Updated: Infant deaths increased slightly to 1.43 lakh in 2022 from 1.36 lakh in 2021. Urban areas saw 81.5 per cent of these. The latest Civil Registration System (CRS) Report 2022, released by the Office of the Registrar General of India, reveals a major gender imbalance in birth statistics. The Sex Ratio at Birth (SRB), defined as the number of female births per 1,000 male births, is very low in several states. As per registered births in 2022, Nagaland recorded the highest SRB at 1,068, followed by Arunachal Pradesh (1,036), Ladakh (1,027), Meghalaya (972), and Kerala (971). On the other hand, Bihar reported the lowest SRB at 891, followed by Maharashtra (906), Telangana (907), Haryana (909), and Uttarakhand (910). The report also says the States of Bihar and Uttar Pradesh have not provided any information in the report on imposing penalties for non-registration, non-reporting and for negligence or refusal to register the event. 'The State of Arunachal Pradesh, Bihar, Jharkhand, Kerala, Nagaland, Tamil Nadu, Uttarakhand have not furnished the details of birth & death certificate issued under Section 17 of the Act, although such details are given under Section 12 of the Act. Section 12 and 17 wise break-ups has not been provided by Rajasthan, Sikkim, Uttar Pradesh, Delhi and Jammu & Kashmir," the report says. Infant Deaths Slightly Up, Mostly Urban Infant deaths increased slightly to 1.43 lakh in 2022 from 1.36 lakh in 2021. Urban areas saw 81.5 per cent of these, with rural areas accounting for just 18.5 per cent. Birth Registrations Rise Registered births increased to 2.54 crore in 2022, up from 2.42 crore in 2021. Of these, 52.4 per cent were male and 47.6 per cent female. Urban areas accounted for 56.5 per cent of these births, while rural areas contributed 43.5 per cent. Fewer Registered Deaths in 2022 The number of registered deaths declined from 1.02 crore in 2021 to 86.5 lakh in 2022. This does not reflect a drop in registration performance, but rather a likely return to pre-pandemic mortality levels. Institutional Events Dominate A significant 75.5 per cent of births and 25 per cent of deaths were reported from health institutions. This indicates greater medicalisation of births and deaths, particularly in urban areas. Timely Registration Still Lagging Only 13 States/UTs achieved over 90 per cent timely birth registration (within 21 days of occurrence). For deaths, 9 States/UTs met the same threshold. Digitisation Grows, But Uneven Online birth and death registration via is widespread but not universal. States like Rajasthan, Goa, and Kerala have nearly full digitization, while rural and remote regions still face connectivity gaps. Penalties Rarely Enforced Despite legal provisions, most States did not impose penalties for delayed or non-registration of births and deaths. States like Kerala and Rajasthan reported a few actions, but compliance enforcement remains weak. First Published: June 06, 2025, 12:02 IST
Indian Express
21-05-2025
- General
- Indian Express
Top 10 Indian states/UTs with highest and lowest literacy rates: Mizoram becomes 1st ‘fully literate' state
Literacy Rates of Indian States Full List: India's literacy rate was only 14% at the time of independence, which has increased over the years as more people have received better education. Statista indicates that the country achieved an approximately 76.32 per cent literacy rate in 2022; however, data still falls short of being comprehensive, as there are significant disparities in literacy rates across different states. On Wednesday, May 21, 2025, Mizoram's Chief Minister Lalduhoma declared that the state has achieved 'full literacy' status, surpassing the 95% literacy rate threshold set by the Ministry of Education. Ranked as the third most literate state in India, with a 91.33% literacy rate according to the 2011 Census, Mizoram has recently achieved 98.2%, according to the government statement. Contrastingly, Andhra Pradesh and Bihar recorded the lowest literacy rates in India, standing at 72.6% and 74.3% respectively, for both urban and rural populations, according to the PLFS 2023-24 MoSPI survey. The total literacy rate of India, including all individuals (men and women), aged 7 and above, from rural and urban populations, accounts for 80.9% fn the period 2023-24. To identify potential for intellectual and educational progress, the literacy rate is a crucial indicator of a country's economic progress; according to the Office of the Registrar General of India, a person aged 7 years and above who can read and write with understanding in any language is considered literate. Data source: MoSPI PLFS 2023–24, (Men and Women, 7 years and above, Rural + Urban combined) Data source: MoSPI PLFS 2023–24, (Men and Women, 7 years and above, Rural + Urban combined) Cherry Gupta is an Assistant Manager - Content at The Indian Express. She is responsible for crafting compelling narratives, uncovering the latest news and developments, and driving engaging content based on data and trends to boost website traffic and audience engagement. One can connect with her on LinkedIn or by mail at ... Read More
The Hindu
17-05-2025
- Health
- The Hindu
Why is there variation in India's fertility rates?
The story so far: The Sample Registration System (SRS) Statistical Report of 2021, released by the Office of the Registrar General of India recently, showed that India has maintained its Total Fertility Rate (TFR) at 2.0 — the same as reported in 2020. While the national average for TFR has remained the same, there is a wide regional variation in TFR data for States and Union Territories (UTs) reported independently. Which State saw highest TFR? The highest TFR was recorded in Bihar at 3.0 and the lowest was reported for West Bengal and Delhi at 1.4. The data went on to reveal that in the decade between 2009-11 and 2019-21, TFR has been on an overall decline, in States, and nationally, albeit at different rates. What does TFR measure? The SRS report calculates TFR to measure the number of children each woman in India is expected to have throughout her reproductive age, which the survey defines between 15 and 49 years. According to the report, this value is derived from other indicators for fertility — more specifically age-specific fertility rates put together through a formula. Age-specific fertility rates measure the number of children women of a particular age range are expected to have. This data is gathered as part of the SRS survey, which is the largest demographic survey conducted by India to measure various fertility and mortality indicators annually. The SRS 2021 survey was conducted across 8,842 sample units in all the States and UTs, and compiles data gathered from a sample size of about 84 lakh people. What do fertility indicators record? Within fertility indicators, the SRS report broadly measures the Crude Birth Rate (CBR), Sex Ratio at Birth, General Fertility Rate, Age-Specific Fertility Rate, and Total Fertility Rate, among other indicators. Crude Birth Rate measures number of live births per 1,000 people in the population, and General Fertility Rate measures live births per 1,000 women of reproductive age (15-49 years). The surveys also measure another indicator — Gross Reproduction Rate, which reflects the number of daughters a woman is expected to have, and who will, in turn, bear children. The report further notes that the TFR of India at 2.0 has come down below the replacement level of 2.1. The replacement level TFR is measured as the number of children each woman should have for each generation to replace the previous generation's population. According to the TFR data for 2021, just six States had TFR above the replacement level of 2.1. These were Bihar (3.0), Madhya Pradesh (2.6), Jharkhand (2.3), Uttar Pradesh (2.7), Chhattisgarh (2.2), and Rajasthan (2.4). All other States had reported a TFR at or below the replacement level. According to the SRS report, India's CBR is at 19.3 for 2021, which has declined at a rate of 1.12% every year from 2016 onwards. While all bigger States and UTs across the country are reporting a declining CBR, Uttarakhand was the only outlier, reporting a slight increase in CBR from 2016. Among the States and UTs, the rate of decline in CBR is highest for Kerala, Tamil Nadu, and Delhi, where the CBR is declining at almost twice the rate of the national average. How do experts read fertility data? Based on a reading of the numbers, Professor Praveen K. Pathak of Jawaharlal Nehru University's Centre for the Study of Regional Development, explains, 'It clearly tells us TFR has come down below replacement levels and there are remarkable differences in data of States.' He says there is a 'clear indication' that in southern States and some States in the north, which are doing socio-economically well, the TFR is 'far below' the replacement level, whereas States like Bihar, U.P., and M.P. are reporting much higher TFRs. 'The reason being that some of these States still need human development policies, greater female education, and improving healthcare policy action. There are about six to seven States, bigger ones, where these issues persist,' he said. But moving on to the States where TFR has come down below the replacement level, Prof. Pathak cautioned that they might have their own set of challenges. He cited Sikkim, for instance, where the TFR is below 1, which is equivalent to South Korea's. 'It is a reality that in many parts, people simply do not want kids. It may be because of changing family structure, opportunity cost for parents, and increasing stresses associated with caregiving.' While the States with higher TFR need to tailor policies on human development that can bring them closer to the replacement level, the States reporting lower TFR have a 'different set of challenges altogether', Prof. Pathak explained.
The Hindu
17-05-2025
- General
- The Hindu
Estimates of existence: How does India count the lives of its citizens?
The story so far In May 2025, the Office of the Registrar General of India (ORGI), functioning under the Ministry of Home Affairs (MHA), released three key reports for the reference year 2021: the Sample Registration System (SRS) Statistical Bulletin, the Civil Registration System (CRS) Vital Statistics, and the Medical Certification of Cause of Death (MCCD) Annual Report. This long-delayed release—nearly four years after the reference year—offers a snapshot of India's demographic numbers. While the numbers have triggered debates among policymakers and analysts, what deserves deeper understanding is the machinery behind the statistics. What are vital statistics? Vital statistics refer to data on life events—births, deaths, marriages, migration and stillbirths—within a population. They form the backbone of demographic analysis, enabling accurate social planning, health policy, and welfare distribution. Reliable vital statistics are essential for designing targeted programmes and tracking national development indicators over time. Vital statistics, including the registration of births and deaths, are listed under Entry 30 of the Concurrent List in the Seventh Schedule of the Constitution. A colonial blind spot Mahatma Gandhi, during the Independence movement, said, '100,000 Englishmen simply cannot control 350 million Indians if those Indians refuse to cooperate.' While this emphasised the power of non-violent resistance, it may not have taken into account, another, invisible force at play that enabled colonial rule: data. The British Raj mastered the art of governance through record-keeping—be it through the Survey of India (1767), the Great Trigonometrical Survey(1802), Geological Survey of India (1851), Archaeological Survey of India (1861), Census (from 1865), Botanical Survey of India (1890), and Zoological Survey of India (1916). These surveys, rudimentary by today's standards, were among the most sophisticated data collection tools of their time. Through them, the British measured human lives, understood flora and fauna, culture and ethnicity, and mapped the length and breadth of land, rivers, mountains and seas across the Indian subcontinent —enabling taxation, land control, plunder of natural resources and military interventions. In short, colonisation was underwritten by meticulous measurement of land, sea, river, culture and its people. While India inherited systematic record-keeping from the British, its evolution has fallen short of the digital age. Reliance on the decennial censuses (the last being in 2011), sample-based SRS, partially filled Medical Certification of Cause of Death (MCCD) forms, incomplete CRS coverage, and the absence of full digitisation (currently ongoing) of vital events underscores the inadequacy of our present infrastructure for real-time, responsive governance. Census The census in India is conducted once a decade using the de-jure method by the Office of the Registrar General and Census Commissioner, India (ORGI). It is the largest administrative exercise in the country, covering every household, individual, and structure. The Census collects data on age, sex, religion, language, literacy, marital status, employment, migration, disability, and housing conditions. It is conducted in two phases: the House listing and Housing Census, followed by the Population Enumeration. While exhaustive and universal, its decadal frequency makes it unsuited for timely policy planning or dynamic welfare targeting. Given the Census is decennial, India requires systems like CRS, SRS, and MCCD to capture vital events every year to support timely policymaking. Sample Registration System The Sample Registration System (SRS) was born as a stopgap and introduced on a pilot basis in 1964–65 and became fully operational in 1969–70 with 3700 sampling units. It was conceived to temporarily supplement the Civil Registration System (CRS), which was still under development following the passage of the Registration of Births and Deaths Act 1969. Yet, even today, SRS remains the mainstay for estimating India's birth rate, death rate, infant mortality rate, maternal mortality rate, cause of death, abridged life tables and fertility patterns. The SRS begins with a baseline survey, during which a map of the sample area is prepared, all households are listed, and demographic details—including age, sex, education, marital status, and reproductive history—are recorded. This is followed by continuous enumeration of vital events, especially births and deaths, by part-time local enumerators (typically local Anganwadi workers or teachers). Full-time supervisors independently conduct retrospective surveys every six months to update household rosters and verify reported events. The data from both sources are then matched. Unmatched or partially matched events are re-verified through field visits to ensure accuracy and completeness. SRS then deploys 'Verbal Autopsy' to ascertain causes of death that are without medical certification. Trained investigators collect narratives from family members of the deceased, which are reviewed by two independent physicians under the Minerva project, coordinated with the Centre of Community Medicine, AIIMS. The causes of death are classified per the International Classification of Diseases (ICD-10), ensuring comparability with global health standards. The SRS currently operates across 8,842 sample units—4,959 rural areas and 3,883 urban locations. It covers approximately 8.4 million people—barely 0.6% of India's population. Each SRS sample unit covers around 2,000 people in rural areas and 750–1,000 in urban enumeration blocks. The sampling units are updated once in 10 years, the last being in 2014. By its very nature, SRS carries an inherent scientific limitation: it is an estimate based on a sample of roughly 8.4 million people used to extrapolate for a population of over 1.4 billion. Hence, all indicators carry upper and lower confidence intervals with no district-level data. While SRS remains a methodologically rigorous source for national-level mortality and fertility estimates, these figures must be interpreted with statistical caution—they are informed estimates, not actual counts. It was designed to provide annual estimates of vital indicators at state and national levels—not exact counts. Civil Registration System Enacted through the Registration of Births and Deaths (RBD) Act 1969, the Civil Registration System is the system that records births, deaths and stillbirths universally across India as a continuous, compulsory, and routine process. Much of the data is generated within the health system that reports events to the registrar. However, for vital events occurring outside health facilities, the revenue department and gram panchayats play a vital role in registration. In 2021, the CRS recorded 2.42 crore births, 1.02 crore deaths, and over 50,000 stillbirths. These are actual counts, not estimates, and provide legal documents necessary for inheritance, education, and social benefits. CRS data is also used to calculate future population projections, sex ratio, medical research and provide real-time data at the sub-district level. MCCD The Medical Certification of Cause of Death (MCCD), introduced alongside the RBD Act, mandates that deaths in medical institutions be certified by a physician (Sections 10(2) and 10(17)). Yet, coverage remains dismal. In 2021, only about 23% of all registered deaths had a medically certified cause. This gap has serious consequences. Cause-specific mortality statistics are crucial to track health trends, plan interventions, and advance research. Physicians certify the cause of death using WHO standards in Form IV/IVa, detailing immediate, antecedent, and comorbid conditions. Vital events like births and deaths though biological means, establish legal existence, underpinning citizenship, internal security, benefits and inheritance. Thus, data for MCCD, SRS and CRS originates in the health system, but ORGI, under MHA, compiles and publishes it for use across welfare ministries. NFHS Beyond SRS and CRS, India has also been conducting health surveys since the 1990s. Foremost among them is the National Family Health Survey (NFHS), initiated in 1992–93 and conducted by the International Institute for Population Sciences (IIPS), Mumbai. NFHS gathers data on nutrition, fertility, reproductive health, child immunisation, contraception, domestic violence, and non-communicable diseases. While NFHS offers invaluable insights into health behaviours and socio-economic determinants of health, it is a sample survey, not a registry. It cannot be used for administrative purposes like issuing documents or real-time tracking. The need for a continuous population registry In an era of digital governance, periodic surveys and retrospective registrations like SRS, CRS, and NFHS are no longer adequate. A Continuous Population Registry (CPR)—a real-time, digital database that continuously records births, deaths, and migrations—is already used in some countries. India needs such a unified system. The SRS, though useful, is a sample and a stopgap; MCCD remains incomplete, and NFHS is not governance-oriented. A CPR is essential to citizen-focused data infrastructure for timely, targeted policymaking. (Dr. C. Aravinda is an academic and public health physician. The views expressed are personal. aravindaaiimsjr10@
