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Death Registration
Bangladesh
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Bangladesh
Death Registration
Declaration and Notification
Declaration and Notification
Informants
Who is designated as the primary informant for natural deaths that occur in a health facility?
Nearest relative
Recommended Practice based on International Guidelines
The informant is the person who reports to the local registrar the occurrence of a vital event within the prescribed time limit. The law should establish, clearly and unequivocally, one person primarily responsible for providing the information needed for death registration to the civil registrar. The law may designate alternative informants and establish the order in which each of them must assume his or her responsibilities. For natural deaths occurring in health facilities, the head of the health facility or other health staff should be primary informant. Alternative informants, in order of priority, are: the nearest relative/next of kin or any adult with knowledge of the facts. Additionally, the legislation should explicitly state what type of facility is considered a “health facility” for purposes of being an informant.
The Births and Deaths Registration Act, Section 8, places responsibility for reporting a death on the "son, daughter or guardian of the deceased, or any prescribed person." Section 9 of the Act adds a long list of other people who "may" report a death to the registrar, including local authorities and health workers. The Birth and Death Registration Rules further adds that if any of the persons in Section 8 "are not present at the time of death," then the responsibility to report the death falls on "the father, mother, brother, sister, daughter-in-law, son-in-law, grandson, granddaughter, grandchildren" or "the institutional Head or the person authorized by him, in the event of . . . death at any institution." Taken together, the law is interpreted as placing primary responsibility on the nearest relative, for death in or outside health facilities.
Who is designated primary informant for natural deaths occurring outside a health facility?
Nearest relative
Recommended Practice based on International Guidelines
In the case of death outside health facility but under medical supervision, the most effective approach is to designate the health professional as primary informant. Alternative informants, in order of priority, are: nearest relative, or any other adult having knowledge of the facts.
The Births and Deaths Registration Act, Section 8, places responsibility for reporting a death on the "son, daughter or guardian of the deceased, or any prescribed person." Section 9 of the Act adds a long list of other people who "may" report a death to the registrar, including local authorities and health workers. The Birth and Death Registration Rules further adds that if any of the persons in Section 8 "are not present at the time of death," then the responsibility to report the death falls on "the father, mother, brother, sister, daughter-in-law, son-in-law, grandson, granddaughter, grandchildren." Taken together, the law is interpreted as placing primary responsibility on the nearest relative, for death in or outside health facilities.
Who is designated as the primary informant for unnatural or suspicious deaths?
Nearest relative
Recommended Practice based on International Guidelines
To ensure that unnatural and suspicious deaths are registered, legislation should clearly specify who is responsible for reporting the death to the registrar. The primary informant for an unnatural or suspicious death should be an officer of the mediolegal system, regardless of whether the death occurred with or without medical supervision.
Such officers may include: coroners, medical examiners, police or other medicolegal officers. Responsibility should not be placed on the family, as that may result in the death not being declared to the registrar.
The law does not explicitly address reporting of deaths dues to unnatural causes. In general, the nearest relative is the informant in cases of unnatural deaths, just as for natural deaths. There are two exceptions to this rule. If a relative is unavailable and a death occurs in road transport, water transport, or airplane, the person operating the vehicle is responsible for reporting the death. If a relative is unavailable and a death occurs on the street or at an open place (whether natural or unnatural), the officer in charge of the police station having jurisdiction over the street or open place is responsible for reporting the death.
What is the role of the health sector in death registration for natural deaths occurring in health facilities?
Notification
Recommended Practice based on International Guidelines
When a death occurs in a healthcare facility,designating the head of the health facility as the informant, is the most effective way of ensuring that all deaths in health facilities are registered in a timely and accurate manner. In some countries the health facility performs a notification function, collecting relevant information about the death and passing it to the civil registrar. In that situation, the informant (usually the nearest relative) still needs to declare the death to the civil registrar in order for the death to be registered. When the health facility is the notifer, the health facility will usually be required to provide the family with some form of evidence or record of the death to be used by the informant for registration. In some countries, the health sector is neither informant nor notifier, but instead simply issues a document to the family that serves as proof of the death. Finally in some countries, specified health staff may be designated as registrars or assigned some registrar functions, which helps bring registration closer to the people.
For information on the role of health facilities in determining cause of death and completing medical certificates of cause of death, see the "Cause of Death" topic.
Section 9 of the Births and Deaths Registration Act includes health workers among a long list of people who "may" provide information about deaths to the Registrar. Birth and Death Registration Rules, Rule 20(1), states that "medical institutions or health workers may submit the birth or death information of a person eligible for registration online to the Registrar." These provisions provide the legal support for the current process for in-facility deaths, which is as follows: when a death occurs in a health facility, health workers enter the death registration information into the online system, then print and provide a copy of the information entered online to the informant. The informant then must go to the Registrar's office to complete the registration process in person [Rule 20(4)] .
What is the role of the health sector in death registration for natural deaths occurring outside health facilities?
Notification
Recommended Practice based on International Guidelines
The health sector can play an important role in notifying vital events, such as deaths, that occur outside health facilities where health workers attend patients and their families in the community. Countries may designate medical officers or community health workers as informants for deaths that occur in the community. Or Alternatively, the health care worker may notify the civil registrar of the facts of death, but the nearest relative still needs to register declare the death to the civil registrar in for the death to be registered. Finally, in some countries health workers may only provide a document, such as a notice of death, to the nearest relative as official evidence of the death, which the informant submits when declaring the death.
Section 9 of the Births and Deaths Registration Act includes health workers among a long list of people who "may" provide information about deaths to the Registrar. Birth and Death Registration Rules, Rule 20(1), states that "medical institutions or health workers may submit the birth or death information of a person eligible for registration online to the Registrar." These provisions provide the legal support for a pilot project in Kaliganj, referred to as the Kaliganj model. In the Kaliganj model, Health Assistants go door to door and collect information regarding deaths in the community. These Health Assistants submit completed registration forms to the assistant health inspector who sits in a community clinic or local health center and verifies any missing information before submitting the form to the Registrar online. Based on this information alone, the death is registered. The family need not report to the registrar, except to collect the death certificate. This process is used in some jurisdictions, but not all, for out of facility deaths.
What role do local leaders or local authorities have in the registration process for deaths that occur in the community?
Notification
Recommended Practice based on International Guidelines
In some countries, there may be remote locations where the health system is not readily accessible. In such instances, responsibility may be assigned to a local leader to act of informant, or to notify the registrar of the fact of death (but not cause of death). If a local leader is the informant, the family may be required to provide additional information to the registrar in order to register the death. In some instances, a local leader, such as a village chief, may act as a facilitiator, helping the family member (the informant) complete the death registration application and submitting this form to the local civil registrar.
Section 9 of the Births and Deaths Registration Act includes village police among a long list of people who "may" provide information about deaths to the Registrar. This provision provides the legal support for a pilot project that uses village police (staff from local union councils, not regular police) in the process to collect death information from families and submit completed forms to the civil registration office. The village police thus acts as an intermediary between families (who remain the informant) and the civil registration office.
Does the law require that funeral, burial, and cremation services share records with civil registrar?
No
Recommended Practice based on International Guidelines
In countries where death registration is not a precondition for issuing a permit to dispose of bodies, custodians of funeral facilities, crematoriums and burial sites may be required to maintain a record of all deaths and to report the deaths to the civil registrar, which would alert the registrar of fact of death when death has not been registered.
