In 2011, only 67% of an estimated 8.5 million deaths in India were registered. Although the number of registrations increased to 76% (of an estimated 8.1 million deaths) in 2016, the proportion of medically certified deaths is only 22%, as per the Registrar General of India’s report on Medical Certification of Cause of Death (MCCD), 2015.
These figures indicate the huge gap between deaths registered and deaths medically certified. Besides, in the deaths which are medically certified, the existing system only records the mode of dying (mentioning the immediate cause of death). The underlying and contributing causes of death are not captured and this is creating a gap in analysing mortality statistics.
To address this issue and bridge the gap between deaths registered and deaths medically certified, the National Centre for Disease Informatics and Research under the Indian Council of Medical Research (NCDIR-ICMR) has developed an electronic mortality (e-Mor) software.
NCDIR Director Prashant Mathur told The Hindu that it is not just the low proportion of availability of information on the cause of death, but the lack of completeness and the quality of information on the cause of death in medically certified deaths that is a matter of concern.
“It is largely observed that medical practitioners record the mode of dying or the immediate cause rather than the underlying /antecedent cause that led to death. At present, the information is largely incomplete and inaccurate,” he said. According to the World Health Statistics 2018 released by the World Health Organisation Organisation (WHO) for Monitoring Health for the Sustainable Development Goals, the completeness and quality of cause of death information is only 10%.
“The e-Mor software is for strengthening cause of death reporting systems in hospitals and improve death audits with use of appropriate tools for classifying deaths (International Classification of Diseases-10). This can bridge the gap and lead to better death statistics and surveillance in India,” Dr. Mathur explained.
“The software has been put to use in eight hospitals in the northeastern States. We are now in talks with the State governments of Karnataka and Tamil Nadu to get the software installed in all hospitals. If any State wants to install this software in their hospitals, we will be happy to assist. The software is available free of cost,” he said.
“The software will help hospitals maintain a mortality register and issue death certificates, and enable doctors to record accurate cause of death, and prepare Form 4 and generate Form 2, which can be submitted with the MCCD form to the Local Registrar,” the doctor said.
This e-mortality software will have a larger impact on research and public health. “Our institute that has been maintaining a national cancer registry from 1982 will be able to collate mortality incidence data for the cancer registry if all hospitals in the country adopt the e-Mor software. We can also record patient survival analysis, cause of mortality statistics and vital event registration,” Dr. Mathur said, adding that, recently, a registry for stroke and heart failures has also been started.
All registered clinics, nursing homes, hospitals, medical institutes and general physicians who certify deaths can use this software, he added.
