1. Birth and Death Registration Statistics- Compilation of Indicators
Anandasagar Reddy, M.B.A
District Statistical Officer, Bidar

2. Birth and Death Registration Statistics- Compilation of Indicators
“A group of official facts, which shows such things, as number of births and deaths in a particular area.”
Birth and Death statistics are perhaps the most widely used national, state, and local data for identifying and addressing major public health issues .i.e. the data relating to birth or natality, death or mortality, health and disease or morbidity.

3. The History of Vital Statistics
The registration of births, marriages, and deaths has a long history in the United States, beginning with registration laws enacted by the Grand Assembly of Virginia in 1632 and the General Court of the Massachusetts Bay Colony in 1639.
The origin of vital statistics in the modern sense can be traced to an analysis of the English bills of mortality published by John Graunt in Similarly, the clergyman Cotton Mather noted, in 1721, during a severe smallpox epidemic in Boston, that more than one in six of the natural cases died, but only one in sixty of the inoculated cases died.

4. In the nineteenth century, the industrial revolution resulted in rapid urbanization, overcrowding of cities, and a deterioration of social and living conditions for large sectors of the population. Public health reformers became acutely conscious of the need for general sanitary reform as a means of controlling epidemics of disease, particularly cholera.
These early sanitarians used the crude death statistics of the time to arouse public awareness of the need for improved sanitation, and in the process they pressed for more precise statistics through effective registration practices and laws. Thus, the history of public health is largely the history of vital registration and statistics.

5. Present Status of Birth and Death Statistics
A Civil Registration System of recording vital events such as Births and Deaths is a legal requirement after the enactment of Births and Deaths Act 1969.
The Registrar General of India in consultation with the law ministry has brought out model rules in 1970.
Consequently the model rules were revised and Karnataka Registration of Births and Deaths rules 1999 have been brought. Registration of Birth/Death provides to citizens a gateway to social status and individual benefits.

6. The system provides the individual
with a unique identity (his/her name)
with a record of parental relationships
provides a statement of place of birth of the child and usually of one or both parents, which are the basic grounds on which nationality can be established depending on the law.

7. The birth registration record is required for
Establishing proof of age for school entry,
Employment,
Obtaining a driving license,
Entering into legal contracts,
Marriage , Passport etc.,
The death registration record may be required for
Settlement of inheritance,
Insurance claims,
Claiming family allowances and other social security benefits etc.,

8. Measures of Birth and Death Statistics
The Birth and Death statistics system provides counts of the number of times specified Birth and Death events have occurred. These counts are useful in themselves. For example, the numbers of Births and Deaths are used in the estimation of population size.
For most purposes, however, other statistical measures are needed. For example, a comparison of births in one place with those in another requires information on the population size of each area.

9. The simplest and cleanest method of making such comparisons is to compute rates that relate the events to the population exposed to the risk of the event (e.g., the number of births to the number of women of child-bearing age).
Many types of relative numbers are used in the analysis of vital statistics. Those used most frequently are listed below.
Crude Rate: - The number of events in a given time period divided by the population produces Crude Rates. The result is multiplied by a constant (typically 1,000 or 1,00,000) for ease of presentation. Common crude rates include Birth and Death.
Specific Rate: - Crude Rates may be limited to a specific group, such as deaths from a specified cause or in a specific age group.

10. Infant Mortality Rate: - Infant Mortality Rates reflect the risk of Deaths to infants under the age of one year. For infant deaths, the most commonly used estimate of the population (denominator) is the number of live births during the period.
Maternal Mortality Rate: - Maternal Mortality Rates reflect the risk of Deaths to mothers during pregnancy and delivery.
Life tables and life expectancy: - A life table is used to measure the effect of mortality on longevity. It shows the mortality experience of a hypothetical group of infants born at the same time and subject to the mortality rates of a specific population group. A life table provides numerous statistics; perhaps the most widely used is life expectancy at birth.

11. International Classification of Diseases:-
Causes of death are classified for purposes of statistical tabulation according to the International Classification of Diseases (ICD), which is published by the World Health Organization.
Traditionally, a single cause of death is selected for statistical tabulations. When the certifying physician indicates that more than one cause contributed to death, a procedure is required for selecting the single cause to be tabulated.

12. The ICD provides the basic ground rules used to code and classify causes of death, to identify the underlying cause of death, and to compensate for inconsistencies in the reported cause-of-death statement.
It also includes definitions of terms such as "underlying cause of death," "live birth," "maternal death," as well as tabulation lists which define the cause-of-death groupings to be used for international comparisons. The ICD delineates the format of the medical certification of death and specific regulations regarding the compilation and publication of statistics on diseases and causes of death.

13. Gaps
1.Deaths by cause of death compared to medically certified cause of deaths shows that Deaths for some of the ailments are under medical supervision only, for e.g. cholera, typhoid, TB, Leprosy, Malaria, Cancer, etc., during
2. Medically certified deaths showing the age not stated. The doctors are the authority for certification of age, for e.g Deaths during 2005 and 6190 Deaths during
3. Since, the definite cause of death to remaining 70% of Total deaths is not available, drawing the inferences may mislead.

14. Deaths by Cause of Deaths during 2005
Sl.no
Cause of deaths
Total Deaths
Medically Certified Deaths
Remarks
Age not stated
Age stated 1 2 3 4 5 6 7
Cholera
110
182
Typhoid
2355
Food Poisoning
337
Dysentery 48
1726
1094
Tuberculosis
270
7984
Leprosy 95
Diphtheria 29 8
Whooping Cough 25

15. 1 2 3 4 5 6 7 9
Tetanus
562
396 10
Acute Polimyelitis 11
Measles 77 43 12
Rabies 8
428
240 13
Malaria
707 14
Cancer
261
7430 15
Diabetes Mellitus
254
5618
4575 16
Anaemia
139
2007 55
1706 17
Meningitis 74
1528 18
Heart Diseases &Heart Attacks
1441
36566
33862 19
Pneumonia
421
2664
352
2191

16. 1 2 3 4 5 6 7 20
Bronchitis & Asthama
24708
7711 21
Jaundice
2895
1752 22
Chronic Liver Disease & Cirrohsis
180
3173 23
Ulcer of Stomach & Duodenum
292
1049 24
Appendicities 84
480 25
Syphilis &Other diseases of Genito Urinary System
182
2762 26
Abortions 65 27
Complication Related to Pregnancychild Birth
7689
972 28
Certain condition such as Birth-injuries 29
Paralysis
334
5294 30
Senility 14
47243
18246

17. 1 2 3 4 5 6 7 31
Others not elsewhere classified
19387
91032
10466
56876 32
Bites of Stings of Venomous animal
135
944 11
556 33
Accidental Burn 95
2467 34
Falls & Drowning 74
537
254 35
Accidental Posising
202
3068 36
Transport Accidents
212
2630
2536 37
Other Accidents
137
1790 38
Suicide
1267 39
Homicide
182 40
Not Stated
35197
93842
9569
38578
Total
59450
364415
24550
221552

18. 2. Medically certified deaths showing the age not stated
2. Medically certified deaths showing the age not stated. The doctors are the authority for certification of age, for e.g Deaths during 2005 and 6190 Deaths during 2010

19. Deaths by Cause of Deaths during 2010
Sl.no
Cause of deaths
Medically Certified Deaths
Remarks
Age not stated
Age stated 1 2 3 4 5
Certain Infectious and Parasitic
743
13900
Neoplasms
367
7567
Diseases of the blood & blood forming organs
142
1991
Endocrine, Nutritional and Metabolic Diseases
331
7786
Mental and Behavioural disorders
113 6
Diseases of the nervous system
186
3288 7
Diseases of the eye and adnexa 8
Diseases of the ear and mastoid process

20. 1 2 3 4 5 9
Diseases of the circulatory
2163
37245 10
Diseases of the respiratory
615
10410 11
Diseases of the digestive system
530
7859 12
Diseases of the skin and subcutaneous tissue 43
688 13
Diseases of the musculoskeletal system and connective tissue 8
154 14
Diseases of the genitourinary system
241
4179 15
Pregnancy, childbirth and the puerperium 36
848 16
Certain condition originating in the perinatal period
10802 17
Congenital malformations, deformations &chromosomal abnormalities
1696 18
Symptoms, signs and abnormal clinical & laboratory
202
2315 19
Injury, poisoning and certain causes
581
10503 20
All Causes
6190
121347

21. 3. Since, the definite cause of death to remaining 70% of Total deaths is not available, drawing the inferences may mislead.

22. Other Important Materials for the notice of Economics and Statistics Fraternity:-
Reliable cause specific mortality statistics is required on a regular basis by Administrators, Policy Planners, Researchers and other Professionals for evidence based decision making with regard to resource allocation , monitoring of indicators. Identifying the Priorities for programmers and other related activities in the area of public health, the scheme of Medical Certification of Cause of Death (MCCD) was introduced in the Country under the provisions of Registration of Birth and Death (RBD) Act Section 10(2) of the Act empowers the State government to enforce the provision relating to Medical Certification of Cause of Death (MCCD) in specified area taking in to consideration the availability of medical facilities.

23. Section 10(3) of the Act provides for issuing of the cause of death by the medical practitioner who has attended on the deceased at the time of death.
The age, sex and cause specific mortality rates are important indicators for evidence based monitoring of health trends in the population of state. 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.

24. Recommendations to fill the Gaps: -
To overcome the aforesaid problems, following are recommended.
1) Cause of Death should invariably obtained before the Registration of death, as the doctors say that more than 90% of deaths were treated by them in one way or other (both institutional & non-institutional death).
2) Age column of deaths should be filled compulsorily for medically certified before issuing the Death Certificate, as the Doctors have the authority to issue age certificate in the absence of records.
3) Once in five years, the census of deaths, to be conducted for getting the reliable data on the cause for all the deaths.

25. Conclusion
The age of the deceased plays an important role in all the death cases. This helps in identifying the relationship between age and the death due to various diseases other than pregnancy and child birth causes.
The age, sex and cause specific mortality rates are important indicators for evidence based monitoring of health trends in the population of a state.
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.

31. Thank You
Anandasagar Reddy, M.B.A
District Statistical Officer, Bidar