{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:42:31Z","timestamp":1786117351293,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020412","name":"Vital Strategies","doi-asserted-by":"publisher","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100020412","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,7,24]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Accurate and timely reporting of deaths and causes of death is crucial evidence for health policy and planning. However, in practice, there is a low level of completeness of the death registration process in low-income settings such as Bangladesh and more so among females than males. An in-depth exploration of the barriers to low registration among females is needed in Bangladesh, a country bound by unequal gender norms and practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study relied on a qualitative approach and consisted of 33 key informant interviews with field-level implementers, policymakers and 13 focus group discussions among beneficiaries in eight subdistricts with low and high sex disparity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings show that poor awareness about the registration process, inheritance-driven need and missing accurate supporting information hinder and delay death registration. Deep-rooted male-dominated inheritance practices contribute to lower registration of female deaths. This is further compounded by complex registration procedures, including the requirement for a pre-existing birth certificate and difficulties in obtaining or verifying supporting documents. In addition, awareness activities often emphasise inheritance-related benefits, unintentionally reinforcing the perception that death registration is more important for men than for women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Policies need to be strengthened and adapted to improve death registration completeness by addressing the barriers. More gender-sensitive, stronger and context-appropriate policy reforms, along with better implementation and oversight, are needed to improve the completeness of female death registration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004371","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:40:31Z","timestamp":1786023631000},"page":"e004371","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Counting men, missing women: a qualitative exploration of barriers underlying sex disparity in death registration in selected districts of Bangladesh"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6309-234X","authenticated-orcid":false,"given":"Mrittika","family":"Barua","sequence":"first","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Protyasha","family":"Ghosh","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avijit","family":"Saha","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"},{"name":"Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-1540","authenticated-orcid":false,"given":"Muhammad Abdul","family":"Mannan","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Jahedul","family":"Islam","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6714-5716","authenticated-orcid":false,"given":"Shahrear","family":"Alam","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Mehjabeen","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3796-333X","authenticated-orcid":false,"given":"Syeda Tahmina","family":"Ahmed","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayema","family":"Akter","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"},{"name":"University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Santon","sequence":"additional","affiliation":[{"name":"Vital Strategies, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anushka","family":"Mangharam","sequence":"additional","affiliation":[{"name":"Vital Strategies, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moyeen","family":"Uddin","sequence":"additional","affiliation":[{"name":"Vital Strategies, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazrul","family":"Islam","sequence":"additional","affiliation":[{"name":"Vital Strategies, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malabika","family":"Sarker","sequence":"additional","affiliation":[{"name":"BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"},{"name":"Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080606401583000_4.3.e004371.1","doi-asserted-by":"crossref","DOI":"10.1186\/1478-7954-12-14","article-title":"A composite metric for assessing data on mortality and causes of death: the vital statistics performance index","volume":"12","author":"Phillips","year":"2014","journal-title":"Popul Health Metr"},{"key":"2026080606401583000_4.3.e004371.2","unstructured":"World Health Organization . 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