Context:

• Several Indian states have raised their COVID-19 death toll sharply higher after the discovery of thousands of unreported cases. It is lending weight to suspicion that India’s overall death tally is significantly more than the official figure.

 

Civil Registration System (CRS) 

• It is the process of continuous, permanent, compulsory and universal recording of births and deaths in the country. The Registration of Births and Deaths Act, 1969 (Act No. 18 of 1969) provides for the compulsory registration of births and death
• It is a Continuous, Permanent and Systematic recording of births and deaths obtained under the Registration of Births and Deaths Act, 1969.
• The data generated through a complete and up-to-date CRS isessential for socio-economic planning.
• The CRS moved online relatively recently (between five and three years ago in most States), and State-level portals now display data for every day from January 1, 2018 to the present day. 

Why is CRS data vital?

• Countries need to know how many people are born and die each year – and the main causes of their deaths – in order to have well-functioning health systems. The only way to track every citizen is through civil registration. Civil registration provides the basis for the individual legal identity of a citizen and helps the government give them access to their rights as a citizen, including entitlements to social security benefits if any.
• For the government, the requirement of a complete CRS system is a must as the data generated through a complete and up-to-date CRS is essential for socio-economic planning and evaluating the effectiveness of various social sector programs. At the national level, the vital statistics data generated through Civil Registration is also quite useful for medical research and in the study of sex ratio, mortality and morbidity rates and also in the study of causes of deaths.
• The Annual Report on Vital Statistics of India based on the Civil Registration System for 2019 has been brought out on the basis of reports provided by the Chief Registrar of Births and Deaths of respective States/Union Territories. The main features of the Annual Report are summarized below:

 

Registration of Birth and Death rules 1969:

• The registration of births, deaths and still births are compulsory, in all parts of the Country.
• The normal period of 21 days (from the date of occurrence) has been prescribed for reporting the birth, death and still birth events.
• If the event of a birth or death is reported for registration to the prescribed authority within the normal period of 21days, no fee would be charged.
• The responsibilities for reporting the events have been prescribed separately for domiciliary events as well as Institutional events:
  • In respect of birth or death occurred in a house, it is the duty of the Head of the house/household or nearest relative of the head present in the house or in the absence of any such person, the oldest male person present therein during the said period is responsible to report the event to the concerned Registrar/ sub Registrar.
  • These events can also be reported through the prescribed Notifiers such as Anganwadi Workers, ANM’s, ASHA’s and others.
  • In respect of birth or death that occurred in a hospital, health centre, Maternity or nursing home or other such institutions, the medical officer In-charge or any person authorized by him on this behalf is responsible for reporting.
• Under the provision of Section 7 of the RBD Act, the Registrars of Births and Deaths are appointed for each local area comprising the area within the jurisdiction of the Municipality, Panchayat or other local authority.
•  The Sub- Registrars are also appointed under section 7(5) of the Act and assigned to them any or all powers of Registrars.
• The Registrars / Sub Registrars are deemed to be the public servant under section 21 of the Indian Penal Code.
  • In Rural areas following have been appointed as Registrar of Births and Death:
    • Panchayat Secretaries/Karmi/Gram Sevak in 15 States and 3 UTs.
    • Medical Officer In-charge or equivalent in 7 States and 3 UTs– (Assam, Haryana, Meghalaya, Orissa, and Punjab, Sikkim, Manipur (Partly), A & N Island, Delhi and Lakshadweep)
    • Village Accountants / Village Administrative Officers in 2 States - Karnataka and Tamil Nadu.
    • SHO/Police Officials in Jammu & Kashmir and Chandigarh UT (Rural).
    • School Teachers in Mizoram and Nagaland. Circle Officer/Village Level Workers in Arunachal Pradesh.
  • In Urban Areas: The Municipal Health Officer, Health Officer or Equivalent Officers are appointed as Registrar of births and deaths.
• In case, any child born outside India, his/her birth would be registered under the Citizenship Act 1955 and Citizens (Registration at Indian consulates) Rules, 1956 at the Indian Missions.
  • However, under Section 20 of the RBD Act, if the parents of the child return to India with a view to settling therein, the said birth can be registered within sixty days from the date of arrival of the child in India at the place of settling.

 

Undercounting of COVID-19 deaths in India

• Over the last month, Indian journalists from across the country have accessed and reported on State-level all-cause mortality from theCivil Registration System (CRS),currently confidential and closed to the public.
• This data has been able to show alarge rise in excess mortality in the surge monthsof the second wave of April and May 2021 in particular.
• For example, thenumbers for Madhya Pradesh show over 1.18 lakh excess deathsin 2021, which is over 26 times the official COVID-19 death toll for the same period.
• The other States too show excess mortality in 2021 even assuming full registration.

 

Why the data from Civil Registration System is considered inaccurate?

• First, the CRS numbers underestimate total mortality.
• For example, The Union government last published annual Civil Registration System data for 2019.
• This data shows that India registered 92 of every 100 deaths as of 2019. But there was a large variation between States. Bihar, for instance, registered just half of all deaths.
• Additionally, the online portals show lower numbers than what was published by the Union government for 2018 and 2019.
• The second possible source of error. If mortality was either naturally increasing over time, or if registration was getting better, or if both were taking place. If any of these three phenomena was taking place, the magnitude of excess mortality in 2020 and 2021 could be moderated by these processes.
• For instance, let us assume that Madhya Pradesh achieved 100% registration by May 2021.
• Given the flattening of mortality in the State, let us assume that the total mortality in 2021 in ‘normal’ times would have been about the same as the total estimated deaths for 2019 5.53 lakh deaths.
• Even then, the numbers for Madhya Pradesh show over 1.18 lakh excess deaths in 2021, which is over 26 times the official COVID-19 death toll for the same period.

• The other States, too, show excess mortality in 2021 even assuming full registration.

 

Initiatives

• Uniform Software Application for Registration of Births and Deaths: A software application for online and offline registration of birth and death has been developed. This application covers the entire gamut of the Civil Registration System – Registration of events, Generation of certificates and Generation of Statistical Tables and Reports. The application that is presently available in English is being customized in 13 Indian languages.
• Database of Institutions: A nationwide database of medical Institutions has been prepared. This comprehensive database has the address, telephone numbers and other contact details of the institutions where events occur. The plan is to electronically monitor the registration of events occurring in these institutions through an ICT enabled platform.
• Application to Monitor Institutional Events: An SMS based application called ‘Event Monitoring System for Registration has been developed and is currently under pilot testing. This application attempts to track the events at the level of institutions and ensure their registration.
• Capacity Building of Registrars: A standard training manual has been developed for training the registration functionaries in 13 languages. Regular training of registration functionaries has been introduced by providing financial assistance to the State Governments.
• Data digitization: Project to keep old records in easy to retrieve digital form has been started. This will help in storage of registers in electronic format and allow easy access to the records.
• Advocacy and Publicity: An intensive multi-modal publicity and awareness campaigns on birth and death registration is already underway. Plans are being formulated to expand this campaign in all regional languages in order to increase the coverage of the CRVS system.
• Demand Generation: Creating a policy environment for demand generation for birth and death registration is one of the basic needs identified by a National task force set up for the strengthening the CRVS. As per its recommendations, the Registration of events has been linked to various welfare schemes of the Government.
• National Population Register: India is in the process of setting up a National Population Register (NPR - 2010). The Civil Registration System has been linked to the NPR.