Obstacles to civil registration, including poverty, unemployment, limited education, ethnicity, disability and lack of knowledge about the benefits of civil registration, affect people, especially women
Almost twice as many male deaths were registered compared to female deaths across the country
A majority of Indian women remain devoid of civil rights because of lack registration of births, deaths and marriages, a report released on Monday said pointing out yet another manifestation of gender discrimination in the country.
Many obstacles to civil registration, including poverty, distance from registration services, unemployment, limited education, ethnicity, disability and lack of knowledge about the benefits of civil registration, affect people, especially women, according to the report titled, Empowering Women and Girls Through Civil Registration Systems, released by the Centre of Excellence for Civil Registration and Vital Statistics (CRVS), a global research and advocacy.
“Due to lack of birth registration, girls are disproportionately affected by child marriage, which leaves them at risk of death or ill-health associated with early childbearing. There is also evidence that the non-registration of deaths is more common for women than for men," the report added.
Almost twice as many male deaths were registered compared to female deaths, in some states and Union territories in India. The report found that of the total 6.35 million deaths registered in India in 2016, 55% were males compared to 38% females with more than 7% being recorded as “unknown gender".
Only 22% of the total registered deaths in India in 2015 were medically certified, of which 62% were males and 38% females, according to the report. “In other words, the Indian government has information on the medical causes of only 14% of the estimated annual 10 million deaths in the country, and the majority of these are among males," the report said.
“Exclusion of women and girls from civil registration is a serious problem. There is a need to generate more evidence about the extent and impact of gender inequities in civil registration, and then create remedial mechanisms to secure women’s rights and entitlements," said Carla Abouzahr, the lead author of the report and Senior Technical Adviser on CRVS to the Data for Health Initiative at the University of Melbourne.
Lack of birth registration leaves children vulnerable throughout their lives as they do not have basic identification information such as name or age. Researchers also observed that when marriages are not registered, women face barriers accessing spousal or widowhood rights. The report has recommended improving CRVS systems for women and girls. It suggested looking at birth registration within the context of healthcare provision to women and infants. It recommended adopting a proactive approach that links the provision of care through the health sector at the facility and community levels to the civil registration of births, stillbirths, and pregnancy-related deaths.
It recommended a similar approach for facilitating the registration of deaths, where civil registration can be linked to health care facilities to provide information on deaths obtained from a variety of health registers, such as hospital admissions and discharges, mortuary records, and disease-focused mortality surveillance. Deaths that take place in the hospital should be certified by a doctor who has been trained in the medical cause of death certification (MCCD), it said.
“Doctors certifying the medical cause of death need to be made aware of these barriers and trained in MCCD," said Rohina Joshi, associate professor, George Institute of Global Health, Sydney, Australia, and co-author of the report.
The report has also recommended providing free civil registration to reduce the burden on women who are unable to raise cash, considering their other household priorities. It called for the removal of legal and regulatory impediments to civil registration, such as requiring unmarried women to disclose the identity of the child’s father.
Other recommendations include generating and using reliable sex-disaggregated data on the gendered aspects of civil registration, providing support to health workers to facilitate links between community-based health care and the registration of vital events, and creating demand for birth and death registration services by raising awareness about the benefits that civil registration can bring among women and girls.