Key Details
The Report on Medical Certification of Cause of Death 2024 documents continued improvements in India's Medical Certification of Cause of Death (MCCD) system following the Registration of Births and Deaths (Amendment) Act, 2023, which made medical certification a statutory responsibility for all medical institutions, irrespective of ownership.
Indicator | 2024 |
|---|---|
Registered deaths | 89,38,301 |
Medically certified deaths | 20,66,117 |
Share medically certified | 23.1% |
Increase over 2023 | +1,65,161 medically certified deaths |
States/UTs reporting MCCD data | 36 |
When only deaths that reportedly received medical attention during the terminal illness are considered, certification coverage rises to approximately 63%, indicating substantially higher reporting among medically attended deaths.
Medical Certification Is Now Backed by Law
A major institutional change underpinning the report is the Registration of Births and Deaths (Amendment) Act, 2023.
The amended law requires:
every medical institution, public or private, to issue a Medical Certificate of Cause of Death free of cost;
attending medical practitioners to certify eligible non-institutional deaths;
cause-of-death certificates to be submitted to the Registrar as part of death registration.
These changes move medical certification from a programme implemented with varying levels of participation towards a clearer statutory obligation, with the objective of improving the completeness, quality and reliability of mortality statistics.
National Coverage Continues to Improve
India recorded 20,66,117 medically certified deaths during 2024—an increase of 1,65,161 over the previous year.
Consequently, the proportion of registered deaths that were medically certified increased from 22.0% in 2023 to 23.1% in 2024, representing the highest level since the COVID-19 pandemic period.
The report attributes this improvement to sustained efforts by the Office of the Registrar General of India and State Governments, supported by the rollout of the digital Civil Registration System and the strengthened statutory framework.
State Performance Remains Highly Uneven
National progress masks substantial differences in implementation across India.
Among States and Union Territories:
Goa maintained 100% medical certification.
Lakshadweep recorded 98.5%.
Puducherry recorded 91.0%.
Andaman and Nicobar Islands recorded 88.0%.
Chandigarh recorded 75.6%.
Among major States:
Maharashtra recorded 44.3%.
West Bengal recorded 40.0%.
Tamil Nadu recorded 38.7%.
Telangana recorded 38.3%.
Karnataka recorded 27.5%.
At the other end of the spectrum:
Bihar recorded 3.6%.
Haryana recorded 6.4%.
Uttar Pradesh recorded 6.7%.
Arunachal Pradesh recorded 8.7%.
Madhya Pradesh recorded 9.9%.
These differences indicate that the availability of reliable cause-of-death information continues to depend significantly on where deaths occur.
Better Mortality Data Supports Better Health Policy
Reliable cause-of-death statistics enable governments to:
identify emerging disease burdens;
monitor epidemiological transition;
evaluate disease-control programmes;
allocate health resources more effectively;
strengthen age- and disease-specific planning.
At the same time, the report cautions that MCCD statistics represent medically certified deaths, not all deaths registered in India. Because certification coverage varies substantially across States and Union Territories, users should exercise caution when drawing conclusions about national mortality patterns.
Policy Relevance
Prioritise nationwide implementation of the amended law. The strengthened legal framework now needs consistent enforcement across public and private healthcare providers.
Reduce interstate disparities in certification. Large differences in coverage limit the comparability and representativeness of mortality statistics across India.
Improve data quality alongside coverage. Expanding certification should be accompanied by continued training of medical practitioners in accurate cause-of-death certification and ICD-10 coding.
Use mortality surveillance to guide health investments. More complete and reliable cause-of-death data can improve planning for non-communicable diseases, infectious diseases, maternal and child health, and population ageing.
Strengthen digital civil registration. Continued integration of medical certification within the digital Civil Registration System can improve timeliness, completeness and policy use of mortality statistics.
Follow the Full Report Here: Report on Medical Certification of Cause of Death 2024, Office of the Registrar General of India.