REPOR T ON MEDIC AL CER TIFIC A TIO N OF C A USE OF …

1 REPORT. ON. MEDICAL CERTIFICATION. OF. CAUSE OF DEATH. 2013. OFFICE OF THE REGISTRAR GENERAL, INDIA. GOVERNMENT OF INDIA, MINISTRY OF HOME AFFAIRS, VITAL STATISTICS DIVISION, R. K. PURAM, NEW DELHI. REPORT. ON. MEDICAL CERTIFICATION. OF. CAUSE OF DEATH. 2013. OFFICE OF THE REGISTRAR GENERAL, INDIA. GOVERNMENT OF INDIA, MINISTRY OF HOME AFFAIRS, VITAL STATISTICS DIVISION, R. K. PURAM, NEW DELHI. Preface This Report for the year 2013 is the fortieth in the series of the publication presenting statistics on causes of death obtained through the Civil Registration System under the Registration of Births and Deaths Act, 1969.

2 Section 10(2) of the Act empowers the State Government to enforce the provision relating to medical certification of cause of death in specified areas taking into consideration the availability of medical facilities. Section 10(3) of the Act provides for issuing a certificate of the cause of death by the medical practitioner who has attended on the deceased at the time of death. At present, the scheme has been made applicable to limited areas and selected hospitals. 2. In the Report, data on medically certified deaths received from 31 States/UTs has been tabulated in conformity with the International Classification of Diseases (ICD) - Tenth Revision (1993).

3 The statistics on causes of death have been presented, cross tabulating them by age and sex. The time series data on medically certified deaths by major cause groups for the previous years have also been added. 3. The Report intends to maintain the continuity in the time series of data on causes of death under Medical Certification of Cause of Death (MCCD) which is of immense use to health planners and epidemiologists and is distinct from the Report on Causes of Death in India-2001-2003 and 2004- 2006 which is based on Special Survey of Deaths conducted under the domain of SRS.

4 The two Reports are starkly different in terms of coverage, methodology of data collection, assignment of causes of death etc. and hence the findings are not strictly comparable. 4. I take this opportunity to express my sincere gratitude to the State Governments and Union Territory Administrations and, specially, the Chief Registrars of Births & Deaths for furnishing the data, on the basis of which the Report has become possible. I am thankful to each one of them for their cooperation. I am hopeful for the similar response from other states and, overall, more vigorous implementation of the provisions on Medical Certification of Cause of Death in future, shall help reduce the time gap and establish this as a reliable source of information on the causes of deaths for the country.

5 5. The Report has been prepared by the officers and staff of the MCCD Unit of the Vital Statistics Division of this office. I must record my appreciation for the efforts put in by Shri. Kameshwar Ojha, Additional Registrar General, Smt. & Shri , Deputy Registrar Generals, Shri & Shri Sandeep Rai, Assistant Directors, Smt Gurdish Gambhir, S. I. Gr. I and Ms. Sujata Sharma, Consultant who have been involved in the preparation of this report. New Delhi Dr. C. Chandramouli December, 2015 Registrar General &. Census Commissioner, India TABLE OF CONTENTS-2013.

6 DESCRIPTION PAGE NO. Preface Executive Summary i - iii CHAPTERS. Chapter I Introduction 1-3. Chapter II Scheme of MCCD Status of Implementation 5-12. Chapter III Distribution of Deaths by Cause 13-44. Chapter IV Specific cause of Mortality in different age groups 45-55. APPENDICES. Appendix-I Statistical Tables 56-173. Medical Certificate of Cause of Death for Hospital Events 174. Appendix-II. (Form No. 4). Medical Certificate of Cause of Death- for Non-Hospital Events 175. Appendix-III. (Form No. 4 A). Appendix-IV Major Groups and the description of ICD -10 176.

7 Appendix-V National List based on ICD-10 177-185. List of States/Union Territories supplied MCCD data during 186. Appendix-VI. 2004 to 2013. ExecutiveSummary Reliable cause-specific mortality statistics is required on a regular basis by Administrators, Policy Planners, Researchers and other Professionals for evidence-based decision-making with regard to resource allocation, monitoring of indicators, identifying the priorities for programs and other related activities in the area of Public Health. Keeping this in view, the scheme of Medical Certification of Cause of Death (MCCD) was introduced in the country under the provisions of Registration of Births and Deaths (RBD) Act, 1969.

8 Since then, it has been operational in the country, but with varying levels of efficiency across the States/Union Territories. Under the scheme, the Office of the Registrar General, India (ORGI) obtains data on medically certified deaths as collected, compiled and tabulated by the Offices of the Chief Registrars of Births and Deaths of the States/UTs. Methodology: The necessary data is collected in the prescribed forms (Form 4 for Hospital deaths and Form 4A for Non-institutional deaths). Both these forms have been designed by World Health Organization (WHO).

9 The forms are filled-up by the medical professionals attending to the deceased at the time of terminal illness. Thereafter, these forms are to be sent to the concerned Registrars of Births and Deaths for onward transmission to the Chief Registrar Office for tabulation as per the National List of Causes of Death based on Tenth Revision of International Classification of Disease (ICD-10). The States/UTs subsequently send it to the Office of RGI in the form of Statistical Table-9 for consolidation at the national level.

10 Scope of the report: The report on MCCD-2013, is based upon 9,28,858(Males: 5,75,710and Females: 3,53,148) total medically certified deaths ( per cent of total registered deaths). supplied by31 States/UTs. As mentioned above, owing to different levels of efficiency of medical certification across the States/UTs, the number of deaths reported therein may lack the representative character in the strict sense, however, it may be sufficient to throw some valuable insights into deaths by various cause groups and their gravity.