Gender Disparities in the Completeness of Death Registration in India

🧭 Background

Civil registration and vital statistics (CRVS) systems play a key role in recording births and deaths, helping establish legal identity and supporting access to public services (Setel et al. 2007). They are also important for planning and policy, making them central to governance and development (Carla AbouZahr et al. 2015). 📑

Countries with stronger CRVS systems tend to see better health outcomes (Phillips et al. 2015). But in many low- and middle-income settings, these systems remain weak — a situation often referred to as the “scandal of invisibility” (Setel et al. 2007; Carla AbouZahr et al. 2015; Phillips et al. 2015). 🌍

Gender gaps in registration reflect deeper inequalities. In many places, especially where legal and cultural norms limit women’s access to property or pensions, deaths of women are less likely to be officially recorded (Buvinic and Carey 2019; C. AbouZahr, Joshi, and Thomas 2019). Men’s deaths are more often registered because they are tied to claims and inheritance processes. ⚖️

India’s CRS was formalised through the Registration of Births and Deaths Act in 1969 and is managed by the Office of the Registrar General of India (ORGI) (ORGI 2022b). To fill gaps in coverage, the Sample Registration System (SRS) was introduced in 1970 as a complementary data source (ORGI 2022a). Reforms in the 2000s helped push forward improvements (Setel et al. 2007; Mahapatra et al. 2007; Hill et al. 2007; Carla AbouZahr et al. 2007).

Since then, progress has been uneven. Birth registration increased from under 60% in 2001 to more than 80% in 2010. Death registration also improved, reaching 69.3% in 2007, but gains slowed after that (C. AbouZahr et al. 2014; Kumar, Dandona, and Dandona 2019). Renewed efforts around 2014 led to more consistent improvements. Still, gaps remain. In 2018, men were nearly 13% more likely than women to have their deaths registered (Adair et al. 2021).

🎯 Study Objectives

This study focuses on three main objectives:

  1. To estimate completeness of death registration (by sex and total) in bigger Indian states (2014–2021).

  2. To assess district-level gender disparities in death registration in 2021.

  3. To explore the direct and indirect effects of gender, with asset ownership as a mediating factor, for the years 2015 and 2020.

Together, these questions aim to show how gender affects registration and whether material differences — such as owning household assets — help explain the gap. 📈

📚 References

AbouZahr, Carla, John Cleland, Francesca Coullare, Sarah B Macfarlane, Francis C Notzon, Philip Setel, and Simon Szreter. 2007. “Who Counts? 4 The Way Forward” 370.
AbouZahr, Carla, Don de Savigny, Lene Mikkelsen, Philip W. Setel, Rafael Lozano, Erin Nichols, Francis Notzon, and Alan D. Lopez. 2015. “Civil Registration and Vital Statistics: Progress in the Data Revolution for Counting and Accountability.” The Lancet 386 (10001): 1373–85. https://doi.org/10.1016/S0140-6736(15)60173-8.
AbouZahr, C, SY Azimi, LGS Bersales, C Chandramouli, L Hufana, K Khan, G Kulkayeva, J Marskell, and L Sauyekenova. 2014. “Strengthening Civil Registration and Vital Statistics in the Asia-Pacific Region: Learning from Country Experiences.” Asia-Pacific Population Journal 29: 39–73.
AbouZahr, C, R Joshi, and J Thomas. 2019. “Making CRVS Systems Workfor Women and Children: A Country Perspective.”
Adair, Tim, U S H Gamage, Lene Mikkelsen, and Rohina Joshi. 2021. “Are There Sex Differences in Completeness of Death Registration and Quality of Cause of Death Statistics? Results from a Global Analysis.” BMJ Global Health 6 (10): e006660. https://doi.org/10.1136/bmjgh-2021-006660.
Buvinic, Mayra, and Eleanor Carey. 2019. “Leaving No One Behind: CRVS, Gender and the SDGs.” Ottawa, Ontario.
Hill, Kenneth, Alan D Lopez, Kenji Shibuya, and Prabhat Jha. 2007. “Interim Measures for Meeting Needs for Health Sector Data: Births, Deaths, and Causes of Death.” The Lancet 370 (9600): 1726–35. https://doi.org/10.1016/S0140-6736(07)61309-9.
Kumar, G. Anil, Lalit Dandona, and Rakhi Dandona. 2019. “Completeness of Death Registration in the Civil Registration System, India (2005 to 2015).” The Indian Journal of Medical Research 149 (6): 740–47. https://doi.org/10.4103/ijmr.IJMR_1620_17.
Mahapatra, Prasanta, Kenji Shibuya, Alan D Lopez, Francesca Coullare, Francis C Notzon, Chalapati Rao, and Simon Szreter. 2007. “Civil Registration Systems and Vital Statistics: Successes and Missed Opportunities.” The Lancet 370 (9599): 1653–63. https://doi.org/10.1016/S0140-6736(07)61308-7.
ORGI. 2022a. “Sample Registration System Statistical Report 2020.” New Delhi, India.
———. 2022b. “Vital Statistics of India Based on the Civil Registration System 2020.” New Delhi.
Phillips, David E., Carla AbouZahr, Alan D. Lopez, Lene Mikkelsen, Don de Savigny, Rafael Lozano, John Wilmoth, and Philip W. Setel. 2015. “Are Well Functioning Civil Registration and Vital Statistics Systems Associated with Better Health Outcomes?” The Lancet 386 (10001): 1386–94. https://doi.org/10.1016/S0140-6736(15)60172-6.
Setel, Philip W, Sarah B Macfarlane, Simon Szreter, Lene Mikkelsen, Prabhat Jha, Susan Stout, and Carla AbouZahr. 2007. “A Scandal of Invisibility: Making Everyone Count by Counting Everyone.” The Lancet 370 (9598): 1569–77. https://doi.org/10.1016/S0140-6736(07)61307-5.