Death registration coverage in India: Results from nationally representative survey

ObjectiveTo investigate the disparity and predictors of death registration in India. MethodsWe used National Family Health Survey (NFHS-2019-21) data. Based on eligible household members reports, we estimated death registration coverage among 84,390 deaths in all age groups across the country. We did multilevel binary logistic regression to examine demographic and socio-demographic predictor variables of death registration at state, district, and individual levels. We used GIS software for spatial mapping of the level of death registration at the district level, disaggregated by sex. FindingsThe death registration at the national level is 71%. We found that out of 707 districts in 2019, 122 and 53 districts recorded death registration level below 40 percent among females and males, respectively. There was a considerable difference in the death registration level by sex (male-74% and female-66%). Death registration level was higher in urban areas compared to rural areas (83% vs. 66%). We found death registration level was higher among households with BPL cards (72%), bank accounts (71%) and covered with health insurance (77%). Females, rural populations, people from disadvantaged castes, poorest wealth quintile, Muslims, and not having BPL cards have a lower likelihood of death registration in India. District-level predictors were not statistically significant in the model. ConclusionDemographic and socioeconomic characteristics of the deceased are significantly associated with their death registration. We suggest periodic awareness programs on death registration procedures and facilitating easy access to death registration offices in lower performing districts and areas among the marginalised population groups.