Adult death registration in Matlab, rural Bangladesh: completeness, correlates, and obstacles

Abstract

Civil registration of vital events such as deaths and births is a key part of the process of securing rights and benefits for individuals worldwide. It also enables the production of vital statistics for local planning of social services. In many low- and lower-middle-income countries, however, civil registration and vital statistics (CRVS) systems do not adequately register significant numbers of births and, especially, deaths. In this study, we aim to estimate the completeness of adult death registration (for age 15 and older) in the Matlab health and demographic surveillance system (HDSS) area in Bangladesh and to identify reasons for (not) registering deaths in the national CRVS system. We conducted a sample survey of 2538 households and recorded 571 adult deaths that had occurred in the 3 years preceding the survey. Only 17% of these deaths were registered in the national CRVS system, with large gender differences in registration rates (male = 26% vs. female = 5%). Respondents who reported that a recent death in the household was registered indicated that the primary reasons for registration were to secure an inheritance and to access social services. The main reasons cited for not registering a death were lack of knowledge about CRVS and not perceiving the benefits of death registration. Information campaigns to raise awareness of death registration, as well as stronger incentives to register deaths, may be needed to improve the completeness of death registration in Bangladesh.

Population perspectives and demographic methods to strengthen CRVS systems: introduction

“…They find that underregistration of deaths is mostly associated with household-level poverty, low educational attainment, and higher population density per civil registration center. In contrast to earlier assessments that documented notable subnational sex differentials in death registration completeness in Ecuador, Morocco, and Bangladesh (Haider et al, 2021 ; Peralta et al, 2019 ; Silva, 2016 ;), their findings are more consistent with Castanheira and Monteiro da Silva ( 2022 ) and Adair et al ( 2021 ), who document the non-existence of sex differentials in Peru and several other countries.…”

“…In the seventh paper of the thematic series, Haider et al ( 2021 ) explore the level and determinants of death registration in a rural area of Bangladesh—a country with historically low birth and death registration completeness (United Nations, 2021 ). In their study of the levels and determinants of death registration in rural Bangladesh, the authors found only 1 in 6 adult deaths were registered in a recent 3-year period.…”

“…The research by Haider et al ( 2021 ) suggests the need for more research and investigation into community outreach and strengthening of behavioral incentives to register deaths in Bangladesh (Castle et al, 2020 ; United Nations Statistics Division, 2019a ). This work builds on a growing body of important research that leverages the information and research infrastructure of health and demographic surveillance areas when studying the determinants, levels, and consequences of vital event underregistration (Arudo et al, 2003 ; Byass et al, 2002 ; Clark, 2004 ; de Savigny et al, 2018 ; Garenne et al, 2016 ; Joubert et al, 2014 ; Kabudula et al, 2014 ; Prasartkul & Vapattanawong, 2006 ).…”

“…This Genus thematic series highlights the gender dimensions of CRVS systems—through the study of sex-specific differentials in completeness of registration of vital events (Haider et al, 2021 ), and through the analysis of gender aspects that shape the laws, social norms, and bureaucratic processes related to civil registration systems (Cheong & Balthazar, 2021 ; Fall et al, 2021 ).…”

Collecting mortality data via mobile phone surveys: a non-inferiority randomized trial in Malawi

“…In both study groups, the consent scripts included similar explanations of how phone numbers were selected, and statements about that the interview would take approximately 15 minutes to complete. Consent scripts in both groups also mentioned that participants would receive a small amount of airtime (1,200 Malawian Kwachas, or 1.5 US Dollar) as a token of appreciation upon completion of the interview. Since the main themes of the interview differed between treatment and control groups, the description of other study procedures included differed between the two groups (see supporting documents).…”