Following concerns that only 26.73% of registered deaths in Karnataka currently have medically confirmed causes – a major gap affecting disease surveillance and health planning – the health department has issued a set of guidelines to improve the coverage and quality of Medical Confirmation of Cause of Death (MCCD) reporting in the state.
In a circular issued by Harsh Gupta, principal secretary for health and social welfare, the ministry noted that reliable data on cause-specific mortality is critical. Mandated by the Registration of Births and Deaths (RBD) Act 1969 (as amended 2023), the MCCD system is designed to provide cause-specific mortality data at the state and national levels.
Mr. Gupta told The Hindu that the recent amendment to the Karnataka Registration of Births and Deaths Rules, 2024, effective from January 16, 2025, makes it mandatory for all government and private medical facilities to issue cause of death certificates in Form 4 for hospital deaths and Form 4A for deaths occurring at home or other places.
Through e-JanMa
All registered hospitals – public and private – must issue a medical cause of death certificate in Form 4 for hospital deaths and send it electronically via e-JanMa to the local registrar, while providing a copy to the next of kin.
In the case of death outside medical facilities – homes, transit, prisons, retirement homes and similar facilities – attending physicians must issue Form 4A free of charge.
Hospitals are also required to report the number of deaths on a monthly basis and submit “zero reports” if no deaths have occurred.
Local registrars must ensure that every death reported (Form 2) is accompanied by a certificate of cause of death.
Out-of-hospital death
For out-of-hospital deaths, the doctor who treated the deceased during the last illness, any doctor familiar with the patient’s medical history or state doctors (PHC, CHC, taluk and district hospitals) shall have priority in issuing the certificate.
In medico-legal cases, the medical examiner must state the cause of death after an examination or autopsy. Deaths must be reported and confirmed within 21 days in rural and urban areas. Private hospitals must report deaths that occur in their care to the appropriate registrar.
Tracking
To ensure compliance and improve data quality, each district will establish a control and monitoring committee headed by a district hygienist with experts from clinical and public health departments. The committee will meet monthly to review sample certificates, support local registrars and hospitals, and organize training where necessary.
Published – 07 Dec 2025 21:21 IST
