What percentage of mortality were medically certified among total registered mortality in 36 States &amp; UTs of India during 2018-2020 and COVID-19 mortality age-sex distribution pattern in India: A cross sectional observational research study
Authors: Kumar Piyush , Anupama Advocate 
Published: June 2022

Abstract
The most significant event of birth and death must be certified medically / non-medically to prove or support the evidence of existence of birth and death of a particular person legal existence between the certified date / timings of birth and death. Apart from this legal significance, footage of births and mortality is central basic data required for policy and planning about a population group / country such as provisioning of fundamental requirements like food, cloth, housing, health care, transportation, education etc. The national / state programmes planning, management, implementation can be effectual and triumphant only if this statistical information of birth and death is specific, reliable, timely and correct. Hence, the certification / registration of births and mortality are significant as well as necessity of modern era. We aimed to assess percentage of mortality medically certified among total registered mortality in 36 States & UTs of India during 2018–2020 and COVID-19 mortality age-sex distribution pattern in India during 2020 medically certified due to pandemic in India with available data resources. The mortality data for this cross sectional retrospective observational study were obtained through Civil Registration System of India under the RBD Act, 1969. The data available were obtained on medically certified cause of deaths from States/UTs has been collected, tabulated, analysed in compliance with the ICD - Tenth Revision (1993). The total registered death during 2018 was 6911197 for 2019 it was 7596849 and in 2020 8062070. The figure increased continuously during successive years but there is a question mark on this data. The total RD increased by 685652 numbers in 2019 compared to 2018 whereas despite the COVID-19 PANDEMIC impact the increase in figures during 2020 was 240148 only which are highly questionable? The researcher found that this controversy is also raised by several global highly accredited international organizations like WHO etc. This research study revealed that Bihar which is second most populous state in India ranked lowest in medical certification of cause of death, 2020 which is amazing. Bihar ranked lowest with only 3.4 percent medically certified deaths during 2020 the COVID-19 pandemic era. Hence a large number of mortality during COVID-19 era remains uncertified till date in states like Bihar. This observational research study revealed that the majority of COVID-19 mortality was found in the age group of 45 years and above accounting for 82.7 per cent of total deaths in the group. The percentage of female mortality aged 34 years and below as well as for 55–64 years age group and 65–69 years age group, to total female deaths are greater in comparison to corresponding age groups mortality for male while in other groups male mortality were more than females. Particularly in poor states like Bihar in India the lower socio-economic strata of population may be more affected by low MCCD which is chiefly due to failure of Public Health Management related largely to corruption, posting and other scams. Bihar ranked lowest with only 3.4 percent medically certified deaths during 2020 the COVID-19 pandemic era. Hence a large number of mortality during COVID-19 era remains uncertified till date in states like Bihar. The researcher has found that in states like Bihar the total registered deaths have increased continuously during study period while MCCD decreased continuously during the study period which is due to failure of public health management and corruption, posting scams etc., by which such states are putting highly incapable / untrained person on state programme officer etc vital posts. These irregularities or ignorance have put India’s data credibility in doubt at international level bringing shame to the nation.