With only 26% deaths having certified cause, Karnataka keen to enhance rate

Following concerns that only 26.73% of registered deaths in Karnataka currently have medically certified causes — a major gap affecting disease surveillance and health planning —  the State Health Department has issued a set of directives to improve the coverage and quality of Medical Certification of Cause of Death (MCCD) reporting in the State.

In a circular issued by Harsh Gupta, Principal Secretary, Health and Family Welfare, the department noted that reliable cause-specific mortality data is critical. The MCCD system, mandated under the Registration of Births and Deaths (RBD) Act, 1969 (as amended in 2023), is intended to provide cause-specific mortality data at the State and national level.

Mr. Gupta told The Hindu that the recent amendment to the Karnataka Registration of Births and Deaths Rules, 2024, effective from January 16, 2025, has made it mandatory for all government and private health facilities to issue a certificate of the cause of death in Form 4 for hospital deaths and Form 4A for deaths occurring at home or other locations.

Through e-JanMa

All registered hospitals — public and private — must issue medical cause of death certificates in Form 4 for hospital deaths and submit them electronically through e-JanMa to the local registrar, while also providing a copy to the next of kin.

For deaths occurring outside medical institutions —  homes, transit, prisons, old-age homes and similar facilities —  attending doctors must issue Form 4A for free.

Hospitals are also required to report monthly death counts and submit “nil reports” where no deaths occur.

Local registrars must ensure that every reported death (Form 2) is accompanied by a cause-of-death certificate.

Non-hospital deaths

For non-hospital deaths, priority for issuing the certificate is assigned to the doctor who treated the deceased during the final illness, any doctor familiar with the patient’s medical history or government medical officers (PHCs, CHCs, taluk and district hospitals).

In medico-legal cases, the certifying doctor must provide the cause of death following an inquest or autopsy. Deaths must be reported and certified within 21 days across rural and urban areas. Private hospitals must report deaths occurring under their care to the respective registrar.

Monitoring

To ensure compliance and improve data quality, each district will establish a review and monitoring committee headed by the District Health Officer, with experts from clinical and public health departments. The committee will meet monthly to review samples of certificates, support local registrars and hospitals, and organise training where needed.