{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:30:22Z","timestamp":1787056222860,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 4","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate death registration is one of the most fundamental components of an effective public health system. Mortality data provide critical insights into disease patterns, demographic transitions, healthcare needs, and social inequalities. In India, the civil registration and vital statistics (CRVS) system and the sample registration system (SRS) collectively serve as the primary sources of mortality information. However, despite decades of efforts to improve registration completeness, substantial disparities continue to exist across states and union territories. Analysis of National Family Health Survey-5 (NFHS-5) data demonstrates marked variations in death registration coverage, ranging from universal registration in some regions to less than 40% in others. An unexpected finding is the higher death registration rate in rural areas compared with urban areas at the national level. These disparities reflect deeper differences in governance, administrative efficiency, digital infrastructure, public awareness, accessibility, and socio-cultural practices. Incomplete death registration weakens mortality surveillance, hampers health planning, limits evidence-based policymaking, and obscures the true burden of disease. This viewpoint argues that strengthening death registration should be viewed not merely as an administrative responsibility but as a public health, governance, and social justice priority. A six-pillar framework involving legal reforms, institutional strengthening, digital transformation, community engagement, service integration, and data-driven monitoring is proposed to achieve universal and equitable death registration across India.<\/jats:p>","DOI":"10.4103\/ijcm.ijcm_290_25","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:01:55Z","timestamp":1786986115000},"page":"S591-S595","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Counting Deaths: Why India must Strengthen Civil Registration and Vital Statistics Systems for Equitable Health Governance"],"prefix":"10.4103","volume":"51","author":[{"given":"Sudip","family":"Bhattacharya","sequence":"first","affiliation":[{"name":"Department of Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abha","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Naturopathy and Yogic Sciences, Faculty of Naturopathy and Yogic Sciences, SGT University, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanisree","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Department of Public Health, Dr. Vishwanath Karad World Peace University, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Director, ICMR\u2013National Institute of Health Research (ICMR-NIHR), Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Statistics, Institute of Integrated and Honours Studies, Kurukshetra University, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishat Ahmed","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Om Prakash","family":"Bera","sequence":"additional","affiliation":[{"name":"Global Health Advocacy Incubator, US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"R5-20260818","doi-asserted-by":"crossref","first-page":"020368","DOI":"10.7189\/jogh.10.020368","article-title":"National sample vital registration system: A 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registration and sample registration system: Challenges and initiatives","volume":"1","author":"Kakkar","year":"2017","journal-title":"SRHU Medical Journal"},{"key":"R11-20260818","doi-asserted-by":"crossref","first-page":"15","DOI":"10.47203\/IJCH.2025.v37i01.004","article-title":"Civil registration, legal reforms, public health, and SDG 16.9: Catalyzing social inclusion for transgender persons in India","volume":"37","author":"Bera","year":"2025","journal-title":"Indian J Community Health"},{"key":"R12-20260818","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12939-021-01534-y","article-title":"Have inequalities in completeness of death registration between states in India narrowed during two decades of civil registration system strengthening?","volume":"20","author":"Basu","year":"2021","journal-title":"Int J Equity Health"},{"key":"R13-20260818","doi-asserted-by":"crossref","first-page":"191","DOI":"10.2471\/BLT.22.288906","article-title":"Stillbirth undercount in the sample registration system and national family health survey, India","volume":"101","author":"Dandona","year":"2023","journal-title":"Bull World Health Organ"},{"key":"R15-20260818","doi-asserted-by":"crossref","first-page":"758","DOI":"10.47203\/IJCH.2024.v36i06.002","article-title":"Strengthening civil registration and vital statistics (CRVS) systems in India: An investment case for governance, public health, and socio-economic development","volume":"36","author":"Bera","year":"2024","journal-title":"Indian J Community Health"}],"container-title":["Indian Journal of Community 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