Chapter 2: Recording all deaths and causes of death

The COVID-19 pandemic has highlighted the critical need to monitor mortality and its causes, making sure everyone is included. As well as being essential for accurate , complete and timely vital statistics, death registration is also an important legal and administrative function, required for protecting inheritance rights and securing pension and survivorship claims. In addition, death registration and the issuance of a death certificate by the civil registration authority is needed to ‘retire’ a legal identity and ensure effective identity management systems where they exist.

There are six targets in the Regional Action Framework related to registration of death and recording of causes of death:

  1. Death registration within a year
  2. Provision of death certificate after registration
  3. Deaths for which cause(s) of death are recorded
  4. Deaths for which the underlying cause of death is coded
  5. Deaths with an ill-defined cause of death code
  6. Deaths covered by verbal autopsy

Death registration rates in the region remain lower than those for birth registration, with only eight countries reporting universal death registration within a year after the event. With a few exceptions, most countries progressed towards their targets for more complete death registration. However, the current pace of progress may not be sufficient for countries to reach their target by the end of the Decade.

Millions of unregistered deaths occur every year in the region, and no death certificates will be issued for those deaths. As a result, families may not be able to benefit from services or exercise rights that require a death certificate.

Medically certified causes of death are assigned for most deaths occurring in health facilities or with the attention of a medical practitioner. However, too often this information is of poor quality, resulting in many deaths for which the underlying cause is ill-defined. A greater emphasis on improving the quality of the information provided on medical certificates of cause of death is therefore needed to enhance the understanding of causes of death in the region.