In the recently published fact sheet of the National Family Health Survey-5 (2019-20) conducted by the Union Ministry of Health and Family Welfare, in collaboration with the International Institute for Population Sciences, Mumbai on 131 socio-demographic, health and economic indicators, it has come to light that the birth and death registration rates are comparatively low in the north-eastern States and Bihar. According to this report, Bihar, Manipur, Meghalaya and Nagaland are witnessing low birth and death registration, while Assam and Sikkim are the other north-eastern States which show a distorted picture in death registration. This first phase of NFHS-5 covers 22 States/UTs. Though the NFHS started to collect the information on birth registration since its third round (2005-06), the NFHS-5 is for the first time providing the information about the registration of deaths by civil authority.
Despite the fact that the country witnessed the Registration of Births and Deaths Act long back in 1969, the percentage of birth and death registrations are still far from achieving the optimum 100% level in many Indian States. Goa and Lakshadweep top the tally with 100% of birth registration. Mizoram (99.4%), Kerala (99%), Ladakh (98.6%), West Bengal (98.2%), Dadra Nagar & Daman and Diu (98.1%), Himachal Pradesh (97.9%) and Gujarat (97.5) are among the other promising States in terms of birth registration. Hundred per cent of the deaths are being documented officially in Goa. Six other States and UTs, namely Kerala, Lakshadweep, Dadra Nagar & Daman and Diu, Himachal Pradesh, Gujarat and Andaman & Nicobar Islands have seen more than 90% of death registration in 2019-20.
It is known well that the fertility and mortality are important components of population change. The registration of these vital events facilitates the calculation of birth rate, death rate, population growth rate, etc. With the registration of birth and death of a person, he/she receives a certificate of birth/death which acts as a legal proof for different purposes at various levels. While the certificate of birth helps in getting admission into school, inclusion of name in the family identity card, getting citizenship certificate, etc., the registration of death is beneficial to the concerned family for getting final payment from banks, insurance claims, family pension and many more. Birth and death registration benefit the nation and society in planning and allocating the budget of the country. The civil registration of birth and death in developing countries especially in India are incomplete, inadequate and non-timely thus compromising on the usefulness of the data. Incomplete death registration is due to the failure to cover geographic area as well as the failure to register all deaths in an area.
The civil registration in India started in the middle of the 19th century with the registration of deaths to introduce sanitary reforms and not much for studying the population trends. There is a huge State-wise variation in India when it comes to the coverage, especially the coverage of deaths.
A pathetic situation is observed for both birth as well as death registration rates in Bihar. It is assumed that every birth and death should be registered in the country. In spite of this fact, nearly two-thirds of the deaths and one-fourth of births are not being registered in Bihar. It also marks that States like Manipur, Assam, Meghalaya, Sikkim and West Bengal look promising in birth registration, while the registration of deaths is far away from the target of 100%. Assam and Manipur have shown more than 30 percentage points gap in the registrations of birth and death.
The birth registration rate has risen in all the States (except Sikkim and Andaman & Nicobar). Manipur, Ladakh, Jammu & Kashmir, Bihar and Andhra Pradesh have experienced more than 10 percentage points growth in the registration of births between 2015-16 to 2019-20.
While the registration of birth has improved during the last two successive NFHSs in majority of States, a considerable variation is observed in urban and rural population in the Indian States. According to this report, Nagaland, Assam, West Bengal, Andhra Pradesh and Bihar show that highest percentage point urban-rural gap in birth registration rate in 2019-20.
There is a wide difference in the percentage of birth and death registration in the north-eastern States of Manipur, Assam, Meghalaya, Sikkim and West Bengal, and Ladakh, the registration of birth being much higher than that of death. This is because the registration of birth is compulsory to avail the benefits of the welfare schemes initiated by the Central and State governments, like the additional cash transfers after institutional delivery. Birth registration is well perceived by the society, it being mandatory for Aadhaar registration, school enrolment and also the incentives provided by the schemes like Mukhyamantri Kanya Utthan Yojana, Janani Suraksha Yojana, etc. People find death registration necessary only if the deceased had any vested interests and thus registration will help in inheriting land holding and claiming insurance.
The internal and the international migration patterns and the political issues that affect the north-eastern region is also responsible for the under-registration of vital events. The online registration of deaths is not properly implemented as a result there is a backlog in death registration and thus the inaccuracy in the estimates.
In order to improve the registration of birth and death, initiatives should be taken to increase the knowledge among the people regarding the benefits of birth as well as death registration. The performance of the State, district and sub-district functionaries should be monitored and strengthened. Though the State-wise targets for civil registration is set by the Registrar General of India, the targets for the district and sub-district level should be set with some scientific methodology. It should be explained to make deaths registered as it is equally important as birth registration. Just as the Government has made strategies through ASHA and ANM workers for birth registration and institutional deliveries, similar strategies are needed for death registration to increase the registration of vital events throughout the country.