When a qualified doctor certifies the actual medical cause of death, it gives the government and health agencies reliable data on what people are dying from, and formulate policies accordingly.
Published Dec 07, 2025 | 12:31 AM ⚊ Updated Dec 07, 2025 | 12:31 AM
Certificates specifying the cause were issued to only 26.73 percent of all registered deaths in Karnataka.
Synopsis: The rules, notified on 31 December 2024 and effective since 16 January 2025, had been approved by the central government under Section 30 of the Registration of Births and Deaths Act, 1969 (Amendment 2023). However, causes of death were not strictly certified, prompting the government to issue a circular for the strict Implementation of Medical Certification of Cause of Death.
To strengthen public health surveillance and ensure evidence-based policymaking, the Karnataka government has added more teeth to the Karnataka Registration of Births and Deaths (Amendment) Rules, 2024.
This measure aims at dramatically improving the coverage and quality of medically certified causes of death across the state.
The rules, notified on 31 December 2024 and effective since 16 January 2025, had been approved by the central government under Section 30 of the Registration of Births and Deaths Act, 1969 (Amendment 2023).
However, causes of death were not strictly certified, prompting the government to issue a circular for the strict Implementation of Medical Certification of Cause of Death (MCCD).
According to the health department, certificates specifying the cause were issued to only 26.73 percent of all registered deaths in Karnataka. It has been hampering public health planning.
Speaking to South First, Dr Natraj K, an Orthopaedic Surgeon in Bengaluru, welcomed the “good” move as it was absolutely important to know the cause of death for monitoring public health.
“When a qualified doctor certifies the actual medical cause of death, it gives the government and health agencies reliable data on what people are dying from,” he said.
“This is the backbone of disease tracking, health surveillance, and epidemic preparedness. This rule has been in existence, but not everyone issues the certificate. Now, if the issuance will be mandatory and monitored, and it is a very good move,” the surgeon added.
If data shows an increase in deaths due to heart disease, cancer, road accidents, or infections, governments can allocate budgets, launch prevention programmes, and strengthen hospitals accordingly.
Without MCCD, planning becomes guesswork, Dr Natraj further said.
Health and Family Welfare Department Principal Secretary Harsh Gupta said in the order issued that the lack of complete and accurate mortality data directly affected resource allocation, disease monitoring and identification of health priorities.
“This amendment is critical for building a strong public health intelligence system,” he explained.
Under the new rules, all public and private hospitals must issue an MCCD in Form 4 for deaths occurring within the respective hospital premises.
The certificate must also be uploaded electronically through the state’s e-Janma System and a copy must be provided free of charge to the deceased’s relatives.
The hospital must also report monthly death counts and MCCD submissions, including filing a “nil” report if no deaths had occurred during the reporting period.
For deaths outside medical institutions, such as home, in transit, old-age homes, hostels or other public places, a certificate in Form 4A must be issued by:
The circular also stated that doctors issuing Form 4A must document the case history based on medical records or information provided by the deceased person’s family members.
Meanwhile, the health department stated that registrars across Karnataka must ensure Form 2 (death report) is accompanied by Form 4/4A wherever applicable, guide families to obtain the correct certificate, proceed with registration even when a medical certificate cannot be obtained, marking the death as “not medically certified”.
Doctors who spoke to South First said the clause provided a good option, preventing officials from taking undue advantage of the rule and harassing the families.
The registrar also must verify forms for legibility, avoid abbreviations and ensure accuracy.
The health department has mandated the reporting of all deaths within 21 days, and entries will be recorded through e-JanMa by panchayat secretaries, health officers or health administrators, depending on jurisdiction.
For deaths requiring a police inquest, the investigating officer must provide details to the registrar.
The medical practitioner, who had attended to the deceased or conducted the autopsy, must submit Form 4/4A.
Each district will establish a Review and Monitoring Committee headed by the District Health Officer and comprising doctors from Medicine, Surgery, Emergency Medicine, Obstetrics, Paediatrics, Anaesthesiology, Community Medicine, Forensic Medicine departments and a District Statistical Officer.
The committee will:
If any medical practitioner refuses or neglects to issue a certificate and individuals who fail to submit it to the registrar may face a fine.
(Edited by Majnu Babu).
