VITAL STATISTICS DIVISION

Civil Registration System (CRS)

Civil Registration System (CRS), popularly known as birth and death registration system, is the recording of vital events i.e. Birth, Death & Still Birth under the statutory provisions on continuous and permanent basis. CRS falls under the Concurrent list of the Constitution of India at Sl. No. 30. Vital statistics generated from civil registration significantly contribute to the formulation of effective and efficient evidence-based policy across multiple sectors.

The registration of birth and death is done under the provisions of a central Act namely Registration of Births and Deaths (RBD) Act, 1969 and State Rules framed on the basis of Model Rules, 1999. This Act was enacted in the year 1969 and was enforced in most of the States/UTs from 1st April, 1970 to promote uniformity and comparability in the registration of Births and Deaths across the country.

Under the provisions of RBD Act, 1969, the registration of birth and death is mandatory. The events of births, still births and deaths are registered at the place of occurrence of the event i.e where the event took place. The normal period of reporting the event is 21 days from its occurrence, however, the event can be registered after the normal period under delayed registration provisions of Section 13 of the RBD Act.

REGISTRATION FUNCTIONARIES:

The Registrar General, India (RGI) at the Central level coordinates and unifies the activities of registration throughout the country and at the same time allowing enough scope for the State Governments to evolve an efficient system of registration suited to the characteristics of the respective administration and notify rules. As per the provisions of the Act, the contemporary system is implemented by State Governments/UT Administrations. Accordingly, the State authority (Chief Registrar) has been declared as the chief executive authority in the respective State for implementing the provisions of this Act, Rules and order framed thereunder. Similarly, the District Registrar for each district within the State is responsible for carrying into execution the provision of RBD Act and Rules in respective district. At lowest level, the Registrars are responsible for registering the events occurred in his/her area of jurisdiction and issue certificates of birth and death, as the case may be.

CURRENT STATUS:

The report “Vital Statistics based on Civil Registration System” for the year 2019 at the national level has been released on 15th June 2021.The proportion of registered births and deaths has witnessed a steady increase over the years. The registration level of births for the country has gone up to 92.7% in 2019 from 82.4% in 2011, whereas on the other hand, registration level of deaths during 2019 has increased to 92.0% from 66.4% in 2011.

Sample Registration System (SRS)

Registration of births and deaths is an important source for demographic data for socio-economic development and population control in developing countries. The data on population growth, fertility and mortality serves as the prime constituent for population projections. Apart from these vital indicators, an adequate evaluation of a number of programs in the health sector, including family planning, maternal and reproductive health, immunization programs, is dependent upon the availability of accurate, up-to-date fertility and mortality data. In India, the need for dependable demographic data was felt soon after independence heralding the era of five-year planning. The registration of births and deaths started on voluntary basis and there was no uniformity in statistical returns resulting in both under-registration and incomplete coverage. In order to unify the Civil Registration activities, the Registration of Births & Deaths Act, 1969 was enacted. Despite having the registration of birth & death compulsory under the statute, the level of registration of births and deaths under the Act has continued to be far from satisfactory in several States/UTs. With a view to generate reliable and continuous data on these indicators, the Office of Registrar General, India, initiated the scheme of sample registration of births and deaths in India popularly known as Sample Registration System (SRS) in 1964-65 on a pilot basis and on full scale from 1969-70. The SRS since then has been providing data on a regular basis.

 

The SRS in India is based on a dual record system. The field investigation under Sample Registration System consists of continuous enumeration of births and deaths in a sample of villages/urban blocks by a resident part time enumerator, and an independent six-monthly retrospective survey by a full time supervisor. The data obtained through these two sources are matched. The unmatched and partially matched events are re-verified in the field to get an unduplicated count of correct events. The advantage of this procedure, in addition to elimination of errors of duplication, is that it leads to a quantitative assessment of the sources of distortion in the two sets of records making it a self evaluating technique.

 

The revision of SRS sampling frame is undertaken every ten years based on the results of latest census. While changing the sample, modifications in the sampling design; wider representation of population; overcoming the limitations in the existing scheme; meeting the additional requirements etc. are taken into account. The first replacement was carried out in 1977-78 and the last being in 2014.

 

The main objective of SRS is to provide reliable estimates of birth rate, death rate and infant mortality rate at the natural division level for major States and at the State level for smaller States. Natural divisions are National Sample Survey (NSS) classified group of contiguous administrative districts with distinct geographical and other natural characteristics. It also provides data for other measures of fertility and mortality including total fertility, infant and child mortality rate at higher geographical levels.

 

Structure of the Sample Registration System
The main components of SRS are:

• Base line survey of the sample units to obtain demographic details of the usual resident population of the sample areas.
• Continuous (longitudinal) enumeration of vital events pertaining to usual resident population by the enumerator.
• Independent retrospective half yearly surveys for recording births and deaths which occurred during the half year under reference and up dating the Houselist, Household schedule and the list of women in the reproductive age group along with their pregnancy status by the Supervisor.
• Matching of events recorded during continuous enumeration and those listed in course of half yearly survey.
• Field verification of unmatched and partially matched events; and
• Filling of Verbal Autopsy Forms for finalized deaths.

Baseline Survey: The base line survey is carried out prior to the start of continuous enumeration. This involves preparation of a notional map of the area to be surveyed, house numbering and house listing and filling of a household schedule. The supervisor prepares a notional map with the help of the enumerator showing important landmarks and location of the houses to be covered in the sample unit. Subsequently, a list of houses/households to be covered by the sample in the House List (Form-1) is prepared and the Household Schedule (Form-2) is filled in. In the Household Schedule (Form-2), the residential status and other demographic particulars of each individual residing in the household viz. identification code, name, sex, date of birth, age, educational/marital status and relation to head of household, etc. are recorded. The inmates of public institutions like hotels, inns, schools and hospitals are excluded, but households living permanently within the compound of such institutions are covered. A list of all women in the reproductive span along with their pregnancy status is also prepared in Form 3 at the time of the base line survey.

Continuous enumeration: The enumerator maintains a Birth Record (Form 4) and a Death Record (Form 5) in respect of his/her area. The enumerator is expected to record all births and deaths occurring within the sample unit, as well as those of the usual residents occurring outside the sample unit. The events in respect of visitors occurring within the sample unit are also listed, but these are not taken into account while calculating rates. Thus, the events to be netted by the enumerator are those pertaining to: (i) usual residents inside the sample unit; (ii) usual residents outside the sample unit; (iii) in-migrants present; (iv) in-migrants absent; and (v) visitors inside the sample unit.

Half yearly survey: Half-yearly survey is carried out independently in each sample unit by a full time supervisor. The supervisor belonging to the statistical cadre of the State Census Directorates (either a Compiler or a Sr. Compiler or a Statistical Investigator or any suitable official) visits each household in the sample unit and records the particulars of births and deaths in Forms 9 & 10 respectively in respect of all the usual residents and visitors (only those occurring within the sample unit) which had occurred during the half yearly period (January June or July December) under reference. Simultaneously, the house-list, the household schedule and the pregnancy status of women are updated by making entries of changes, if any. While carrying out this survey the supervisor does not have access to the birth and death records of the enumerator for the same periods which are withdrawn from the field before the supervisor’s visit for the half yearly survey. The Half Yearly Surveys are retrospective in nature and therefore the first HYS for reference period January June of a year takes place in July- November period of that year and the Second HYS pertaining to July-December of a year takes place in January-May of the subsequent Year.

Matching: On completion of the half yearly survey, the events captured in the Forms 9 & 10 (filled in by the supervisors) are compared with those in the Forms 4 & 5 (filled in by the enumerators). This is done at the office of Directorate of Census Operations for all States. Every unmatched or partially matched event is verified by a visit to the concerned household. This is done either by a third person or jointly by the supervisor and the enumerator, depending upon the availability of staff. Final events are sent to office of the Registrar General India, New Delhi for compilation of data.

 

Medical Certification of Cause of Death (MCCD)

The age, sex and cause-specific mortality rates are important indicators for evidence-based monitoring of health trends in the population. The statistics on causes of death is essential for planners, administrators and medical professionals in undertaking appropriate curative and preventive measures for various health problems. It also plays an important role in furtherance of medical research and is fundamental for monitoring as well as improving the methods of diagnosis and analysis. Under the system of Registration of Births & Deaths, the scheme of Medical Certification of Cause of Death (MCCD) – an integral part of the Vital Statistics System, aims at providing a reliable and temporal database for generating cause-specific mortality statistics. The Office of the Registrar General, India, (ORGI) obtains data on causes of death from the Chief Registrar of Births and Deaths of different States and Union Territories, under the Registration of Births & Deaths Act, 1969.

 

The Conference on Improvement of Vital Statistics held in 1961 had recommended the introduction of the scheme of MCCD in limited areas to begin with, and its progressive implementation in phases thereafter. In the first phase, it was to be introduced in the teaching hospitals in the State headquarter-towns including field practice rural areas attached to them, missionary hospitals and such other hospitals which were willing to join. The main objective of the first phase was to gather the practical experience of the problems arising in the introduction of the scheme, so as to place it on sound lines. In the second phase, it was to be extended to District & Subdivision hospitals, specialized hospitals and other private hospitals which were willing to join. In the third phase, private and other public hospitals & Primary Health Units were to be covered and thereafter private physicians practicing modern medicine were all to be brought under the ambit of the scheme.

 

The Office of the Registrar General, India launched a programme of action, both short term as well as long term through a plan scheme, for development of a comprehensive system of vital statistics in the country. Accordingly, it was envisaged to introduce the scheme of MCCD in all major medical teaching institutions and other hospitals in different States/UTs. Owing to the lack of adequate medical facilities and consequent difficulty in obtaining medically certified cause of death in several parts of the country; it has been introduced in phases since early seventies.

 

It has got the statutory backing under sections 10(2), 10(3), 17(1) (b) and 23(3) of the Registration of Births & Deaths (RBD) Act, 1969.

   

The necessary data is collected in the prescribed Form No.4- Institutional Deaths as filled in by the concerned hospital authorities. A separate Form No.4A-Non-institutional Deaths has been prescribed for non-institutional deaths, which are attended to by the medical practitioners. These forms conform to the international format of medical certification of cause of death as evolved by the World Health Organization (WHO). These forms comprising two parts incorporate immediate and antecedent causes of death along with the identification and other particulars of the deceased.
Part- I provides for entering the diseases in a specific sequence of events leading to death, so that the immediate cause is recorded first and the underlying cause, the last. The underlying cause is that morbid condition which initiated the chain of events leading to death. Besides, there is also a provision for recording the approximate intervals between onset of disease and death in the sequence of events.
Part- II of the form allows recording information on other significant morbid conditions, but not directly related to the cause of death. Doctors attending to the deceased during his/her terminal illness are required to fill the forms up. World Health Organization (WHO) periodically reviews the system of International Classification of Diseases (ICD). Tenth revision of the ICD (ICD-10) was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member States as from 1994; however, it has been adopted in the ORGI for classification of causes of deaths since 1999 Report on MCCD. The statistics on medically certified causes of deaths has been tabulated as per the National List (ICD –10, modified according to Indian conditions) the underlying cause of death is taken into account while tabulating the cause-specific mortality.