When the COVID-19 pandemic was at its peak in 2020 in India and across the world, 45% of the record deaths in the country did not receive any medical attention at the time of death, the Civil Registration System (CRS) report has revealed.
The number of people dying due to lack of medical attention in 2022 was the highest-ever, and in the previous year it was 34.5%. It has seen an increase in the last decade, from being only 10% in 2011.
India witnessed lockdowns and people suffered due to lack of medical facilities to treat COVID-19. Also, hospitals and other medical facilities had reserved most of their beds for COVID patients resulting in lack of medical attention for non-COVID patients.
The latest issue of the report on ‘Vital Statistics of India based on the Civil Registration System’ for the year 2020 provides an overview of the working of the Civil Registration System (CRS) in the country and presents a compilation of data on registered births, deaths, infant deaths and still births with rural-urban & sex-wise break-up and sex ratio at birth based on Civil Registration Records.
The data source for the report is the statutory Annual Statistical Report prepared by the Chief Registrars of Births & Deaths of States/Union Territories.
In India, the Civil Registration System covers registration of births and deaths. Civil registration system provides the best source of information on vital rates at all levels.
Under the title ‘Medical attention received at the time of birth and death’, the report said, “Institutional births occurred in about 73.7% of cases, 6.5% of the cases were attended by the Physicians/Nurse/Midwife. However, about 11.3% of the events are still attended by untrained Mid-wife/Dai and another 8.4% by others and Not stated/Not Available together.”
The complete information for 2020 in respect of birth by type of medical attention received at the time of delivery has been reported from only 34 States/UTs, the report stated.
As partial information has been submitted by two states – Maharashtra and Sikkim, their data has not been taken into account while consolidating the data. The data shows that majority of births have been occurred in an institution, either in Government or private hospitals, according to the report.
On the registered deaths in 2020, the report said, “Complete information on medical attention received by deceased at the time of death has been received from 34 states/UTs. Two States namely Maharashtra and Sikkim have submitted only partial data and therefore their data has not been used while consolidating the data.”
As per the report, 28% of the registered deaths in India in 2020, occurred in medical institutions, and 45% of the deceased did not receive any medical attention at the time of death.
“… 28.0% of the total registered deaths have occurred in institutions and is on a higher side than that of other places from where the deceased had received medical attention. About 16.4% of Registered Deaths were reported under Medical Attention Other than Institutions. About 1.3% of the total registered deaths during 2020 have received medical attention from qualified allopathic professional and practitioner of other system together and 45.0% of deceased did not receive any medical attention at the time of death,” it said.
The number of registered deaths has gone up from 76.4 lakh in 2019 to 81.2 lakh in 2020, an increase of 6.2%. Some states/UTs – Maharashtra, Bihar, Gujarat, West Bengal, Andhra Pradesh, Tamil Nadu, Karnataka, Madhya Pradesh, Rajasthan, Assam, and Haryana have contributed significantly to the increased number of deaths registered from 2019 to 2020.
The number of infant deaths registered show that the share of the rural areas is only 23.4% while that of the urban areas is 76.6% of total registered infant deaths during the year. The report said that non-registration of infant deaths in rural areas is a cause of concern which may be due to non-reporting of infant deaths to the Registrars especially in case of domiciliary events.
The number of registered births has decreased from 2.48 crore in 2019 to 2.42 crores in 2020 – a decrease of about 2.4%. In the case of registered births, there has been a fall in the year 2020 in almost all States/UTs except Bihar, Haryana, Madhya Pradesh, Rajasthan, Sikkim, A& N Islands, Jammu & Kashmir, Ladakh compared to 2019. Eleven States/UTs namely Uttar Pradesh, Telangana, Gujarat, Jharkhand, Delhi, Karnataka, Chhattisgarh, Andhra Pradesh, Maharashtra, Kerala and West Bengal have contributed significantly to the decrease in Registered Births in 2020 over 2019, the report said.