Strengthening cause-of-death certification in India: evidence from the 2021-2023 MCCD report

Abstract

Planning for public health and disease surveillance depends on precise cause-of-death information. The Medical Certification of Cause of Death (MCCD) system in India continues to experience difficulties, such as poor coverage, geographical differences, and problems with data quality. Using information from the 2023 national MCCD report, we sought to evaluate the level of medical certification, demographic trends, and cause-specific mortality. We conducted a descriptive secondary data analysis using the Office of the Registrar General, India's 2023 MCCD report. We examined medically certified deaths by location, age group, sex, and state. We also evaluated cause-of-death patterns and compared the findings with previous years' data and pertinent national statistics. We used descriptive statistics to look at certification coverage, demographic changes, and cause-specific mortality. Of the 8,659,679 deaths recorded in India in 2023, 1,900,956 (22.0%) were medically certified. The certification rates varied greatly between states; in Goa, it was 100%, whereas in Bihar, it was only 5.5%. Circulatory diseases continued to be the leading cause of death (36.4%), followed by respiratory disorders (11.5%) and symptoms and abnormal clinical findings (11.9%). Males accounted for 62.8% of certified fatalities, continuing the trend of male-dominated reporting. Despite an increase in the overall number of certified deaths, the nationwide coverage rate remains relatively constant at about 22%. The system still exhibits significant regional disparities as well as a bias towards institutional and male mortality. To improve, the 2023 RBD Amendment Act must be properly implemented, and medical personnel must get consistent training.