Civil Registration Systems and Vital Statistics.

Civil registration system (CRS) is a legally mandated universally applicable and continuous system for compulsory recording of vital events such as births and deaths.

The CRS yields both private and public goods. Registration record of births and deaths provide the basis of legal identity, access to civic rights, social benefits and inheritance. Good public-health decision making is dependent on reliable and timely statistics on births and deaths (including the medical causes of death). A complete and up to date CRS, yielding timely and reliable vital statistics for small to large areas is a critical necessity to guide public health policy and practice.

Rudiments of the Indian civil registration system emerged in 1860s as Local Health Officers started registering deaths to guard against development of plague. Provincial Sanitary Commissioners, compiled mortality statistics from local health officers and passed on to Government of India. Initially, the focus was on registration of deaths to monitor need for sanitary measures and control epidemics. In 1866, the erstwhile Central Province of Berar introduced a system for registration of births and death. The Bengal Births and Deaths Registration Act was passed in 1873 (Chandra Sekhar, 1972; Padmanabha, 1980). The Central Births, Deaths and Marriages Registration Act was promulgated in 1886 to provide for voluntary registration throughout British India ( Government of India Act #06 of 1886.).

The subject of ‘vital statistics including registration of births and deaths’ is included in the concurrent list of the Constitution of India. The Registration of Births and Deaths (RBD) Act, 1969 enacted by the Union Government and Rules framed by respective States mandate the obligations, institutional arrangements and procedure for reporting and recording of vital events.

The Registrar General, India (RGI) monitors working of the CRS, provides technical guidance for CRS activities throughout the country and consolidates vital statistics based on the CRS. Thus, RGI publications about CRS can be grouped into following three categories, namely;

Working of the CRS in India,
Technical resources and technical guidance for vital statistics based on the CRS, and
Vital statistics of India based on the CRS, which usually is preceded by a brief review of the CRS. The first such report was published by the RGI was for the year 1958. Reports for 2009 onwards, are being released (online).

The registration work at various levels in States/UTs is performed by different Departments. In Andhra Pradesh and Telangana, CRS is implemented by the Health, Municipal Administration, Panchayati Raj & Rural Development (PR&RD) and Revenue & General Administration Departments. Director Public Health & Family Welfare acts as the Chief Registrar, assisted by the Dy. Director (Statistics) as the Dy. Chief Registrar. Commissioner & Director Municipal Administration, and a Dy. Commissioner in PR&RD department are designated Additional Chief Registrars. At district-level, the District Medial & Health Officer (DM&HO) acts as the District Registrar. The District Revenue Officer (of the Revenue & General Administration department), the District Panchayat Officer of the PR&RD department and the Commissioners of Municipalities act as Additional District Registrars. For rural areas, the Gram Panchayat Secretaries and Mandal Parishad Development Officers are designated as Registrars. In case of urban areas, the concerned Municipal Health Officer and/or the Executive Officer act as Registrar. Some states assign CRS to a single department at all levels.

The Chief Registrar of the States/UTs, who are the chief executive authorities for the activities on registration of Births and Deaths in the State/UT, are mandated to submit to the State Government Annual Report on Working of the Act in the State/UT along with the Statistical Report referred under section 19(2) on registered births and deaths for each year immediately following the year to which the report relates to. The Chief Registrars are also required to send a copy of these Reports to the Registrar General, India, Govt. of India. Although, the RGI publishes national compilations from time to time, state level publication of vital statistics based on the CRS is lacking. State-level annual reports, on working of the CRS and Vital Statistics based on CRS, remain mostly within official circles.

Some of the States do not bring out their Annual Statistical Reports in time. Many of the States, which prepare their annual report time, provide only limited information. In the preface to almost every issue of the ‘Vital Statistics of India based on the CRS’, the RGI at the time lament about non-availability of annual reports from some states and/or limited availability of information in the annual report of other states. This is illustrated by the following two extracts from preface to “Vital Statistics of India Based on the CRS” for 2020 and 2013.

"Ideally, an Annual Report on vital statistics containing more detailed information should have been brought out. However, due to limited availability of information contained in the Annual Reports of some of the States, the report for the year 2020 containing key information of events pertaining to the time period 1st January 2020 to 31st December 2020 has been brought out for the convenience of users." (Preface to Vital Statistics of India Based on the CRS for 2020;RGI, 2022).

The preface to reports for 2013 and earlier years mention about non-availability of Annual Reports as well as limited information contained in available annual reports.

"Ideally, an Annual Report on vital statistics containing more detailed information should have been brought out. However, due to non-availability of Annual Reports from some of the major States and limited availability of information contained in the Annual Reports of some other States, the report for the year 2013 containing key information has been brought out for the convenience of users." (Preface to Vital Statistics of India Based on the CRS for 2013; RGI, 2015).

Sustainable civil registration systems that yield reliable information about the state of a population's health should be a key development goal for the country. Public health policy analysts and health systems researchers should study working of the civil registration system in each State, and work towards regular publication of state-level annual reports of vital statistics based on the CRS. Such studies should measure and highlight the importance of timeliness, completeness, reliability and validity of such reports state- and district-level vital statistics reports based on the CRS.

A Study of the Andhra Pradesh Civil Registration System (AP CRS Study), 2013:

This study at IHS by G. Surendra, evaluated the civil registration system in Andhra Pradesh using the assessment framework for vital statistics derived from CRS, developed by the (WHO) – Health Metrics Network (HMN): Improving the quality and use of birth, death and cause-of-death information: guidance for a standards-based review of country practices;WHO, 2010.

Brief summary of findings from the APCRS Study, 2013:

Registration of births had increased from 39% in 1998 to 76% in 2009. Registration of deaths increased from 39% in 1998 to 68% in 2009. It was found that, 21% of the statistical part of birth reports and 19% of the statistical part of death reports were not sent by municipalities to the Vistal Statistics Division (VSD) in the Directorate of Public Health. Similarly, 11% of the statistical part of birth reports and 14% of the statistical part of death reports were not sent from rural areas to VSD. These unsent reports were missed in tabulation at state level which may result in under registration of births and deaths.
In statistical parts of the birth reports, the data for the key variables like mother's residence (9.73%), mother's age at the time of marriage (34.59%), mother's age at the time of delivery (47%), type of attention at delivery (2.16%), method of delivery (16.76%), birth weight (18.38%) and the duration of pregnancy (28.65%) were missing. In respect of statistical part of the death events, the data for most of the key variables like type of medical attention at the time of death (40%) and cause of death (15.9%) were missing. Incidence of missing data was more in rural areas than in urban areas.
The birth, death and infant mortality rates estimated as per CRS was far below the estimates of the Sample Registration System (SRS). There was no correlation between the CRS and SRS estimates for birth and death rates. However, there was strong correlation between Infant Mortality Rate (IMR) estimates from CRS and SRS.
Mean lag for sending monthly returns to VSD was 238 days for urban areas and 405 days for rural areas. The mean time for state-level compilation of annual vital statistics was 267 days past the concerned reference period.
The annual reports are being sent to the Registrar General with copy marked to Special Chief Secretary, Health, Medical and Family Welfare (HM&FW) Department, Director of Census Operations, and the Directorate of Economics and Statistics. There was no practice of disseminating the annual reports to academic, research or program implementing agencies. The data user group was restricted to four Government departments.
Very few characteristics like age, sex, locality, birth order, cause of death were being tabulated for inclusion in the annual reports. Only 7 tables were being compiled out of the 53 tables recommended by the Registrar General of India.

Read / download the APCRS Study Report (RP59/2013).

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