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Krishna Kumar, Jawaharlal Nehru University
Nandita Saikia, International Institute for Population Sciences (IIPS)
Nadia Diamond-Smith, University of California, San Francisco
Vital statistics generated by the Civil Registration System (CRS) are essential for developing healthcare interventions at all administrative levels. This study investigates CRS's performance barriers from the perspective of CRS staff and community members in Bihar. We conducted a primary qualitative survey in the two districts of Bihar from February-March 2020 with CRS staff (n=15) and community members (n=90). The perceived need for death registration is far lower than that for birth registration. While birth registration was higher among female children than male children, death registration was lower among females. Most participants faced challenges in reporting birth and death due to poor delivery of services at the registration centres, higher indirect opportunity cost, and demand for a bribe by the CRS staff for providing the certificates. We found a lack of adequate investment, shortage of dedicated staff, a shortage of required computer and internet services. There was no periodic training and supervision at the block offices. Death registration level can be increased by strengthening health institutions' linkage with registration centres, mobile registration in far-flung areas, and regular CRS staff training. Provision of mandatory death registration before burial or cremation of deceased persons could improve death registration level.
Keywords: Civil Registration and Vital Statistics (CRVS), Mortality, Qualitative data/methods/approaches, Policy