INTRODUCTION
Mortality statistics when collected as per set procedure and processed carefully provides valuable information and this helps in implementing various programmes on both the preventive and curative sides, resulting into an improvement in the health conditions of the masses, because it is the key health indicator to assess the quality of life. This also helps in judging the effectiveness of public health programmes. At present, the information on mortality statistics is available as a by-product of the registration of death under civil registration system. Registration of Births and Deaths has been compulsory in Haryana since a long time. In order to improve the registration system in the country, the Registration of births and deaths Act, 1969 was enacted by the Government of India. The registration of Births and Deaths has been made uniform throughout the country with implementation of this Act. Following provisions have been made under the Act and Rules for MCCD.
Legal Provisions
10(2) In any area, the State Government, having regard to the facilities available therein in this behalf, may require that a certificate as to the cause of death shall be obtained by the Registrar from such person and in such form as may be prescribed.
10(3) Where the State Government has required under Sub-section (2) that a certificate as to the cause of death shall be obtained. In the event of the death of any person who, during his last illness was attended by a medical practitioner, the medical practitioner shall, after the death of that person, forthwith, issue without charging any fee, to the person required under this Act. To give information concerning the death, a certificate shall be received and delivered by such person to the Registrar at the time of giving information concerning the death as required by this Act.
Rule "7" The certificate as to the cause of death required under sub-section (3) of section 10 shall be issued in Form No. 4 or Form 4A and the Registrar shall, after making necessary entries in the register of deaths, forward all such certificate to the Chief Registrar through the District Registrar by the 10th of the month immediately following the month to which the certificates relates.
The scheme of medical certification of cause of death has been in operation in all the hospitals, with bed strength of 50 or more since the formation of Haryana State in November, 1966. After the introduction of Registration of Births and Deaths Act, 1969 and formulation of State rules there under in 1972 this scheme of certification of cause of death was extended to all the medical institutions including private and public, functioning in urban area. In the year 2006, notification was issued and the scheme was extended to cover medical institutions of rural area.
Objectives
The study of medical certification of cause of death for year 2006 was taken up with the following broad objectives in view:-
(a)To obtain reliable information of the underlying cause of death.
(b)To study the age and sex distribution of medically certified deaths.
(c) To point out the leading cause of death by sex and their proportion to total deaths.
(d) To discuss the seasonal trend in mortality.
(e) To study the age and sex distribution according to supplementary classification of external causes.
(f) To discuss the sex and year wise distribution of cause of deaths.
(g)To study causes of neonatal, infant, maternal deaths.
(h) To study external/unnatural causes.
Flow of data and processing
Causes of death forms were received in the Chief Registrar office from various medical institutions and physicians through Registrars. Forms received were centrally codified as per ICD-10 and compiled with the help of computer. Software for compilation of MCCD data has got developed in house by the department.
Coverage
22,020 certificates of cause of death were received from the State during the year 2007, 18247 such certificates received during year 2006. Percentage of medically certified deaths against registered deaths in urban and rural area was 49.45% and 11.20% respectively. Medically certified deaths in urban area were higher than as compare to rural, it may be because urban population gets a chance of availing medical facilities or receive treatment from medical practitioners. Following table contains number of certified deaths for the last five years.