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Death Registration
Colombia
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Colombia
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.
Decree 1260 of 1970, Article 74 designates the following informants for deaths: the surviving spouse, closest relatives, people living in the place where the death occurred, the doctor who attended the deceased in their last illness, and the funeral home. When the death takes place in an institution—listed in the Article as including barracks, convents, hospitals, clinics, asylums, jails, and other public or private establishments—the director or administrator of that institution is also required to report it. The decree does not define “health facility,” but hospitals and clinics appear explicitly within this list of institutions. Article 74 does not establish any hierarchy among the informants; all persons listed are equally entitled and obligated to report the death.
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.
Decree 1260 of 1970, Article 74 assigns the same informants for all deaths, including those that occur outside health facilities. For deaths occurring in homes or other non-institutional settings, the obligated informants are: the surviving spouse, the closest relatives, the people living in the place where the death occurred, the doctor who attended the deceased in their last illness, and the funeral home handling the burial. The police authority must report the death if the body is found unidentified or unclaimed. Article 74 does not establish any hierarchy among informants; all listed persons are equally entitled and obligated to report the death.
Who is designated as the primary informant for unnatural or suspicious deaths?
Other
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.
For unnatural or suspicious deaths, Decree 1260 of 1970, Article 74 assigns the same informants as for any other death: the surviving spouse, closest relatives, people living in the place where the death occurred, the doctor who attended the deceased in their last illness, and the funeral home. If the death occurs in an institution (including hospitals, clinics, barracks, convents, asylums, jails, or other establishments), the director or administrator must also report it. In cases of unknown or unclaimed bodies, the police authority must make the report. Additionally, Article 79 requires judicial authorization before a violent death can be registered, but it does not change the list of informants. The law does not establish any hierarchy among these informants; all are equally permitted and obligated to report an unnatural or suspicious death.
What is the role of the health sector in death registration for natural deaths occurring in health facilities?
Issuing of evidence of death, death record or equivalent document
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.
Decree 1260 of 1970, Article 76 assigns the health sector a central role in confirming deaths that occur in health facilities. A medical doctor must issue the medical certificate of cause of death that allows the civil status registrar to complete the death registration. The certificate must be provided free of charge by the doctor who attended the deceased in their last illness; if unavailable, it must be issued by a forensic doctor, then a public health doctor, and, if none are present, by any doctor working in the area or holding an official medical post. Only when no doctor is available may two competent witnesses confirm the death. Other than issuing the medical certificate of cause of death, the law does not assign health sector workers a role in reporting or completing the death registration.
What is the role of the health sector in death registration for natural deaths occurring outside health facilities?
Providing Medical Certificate of Cause of Death
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.
For deaths occurring outside health facilities, Decree 1260 of 1970, Article 76 assigns the health sector the same role as in all other settings: a medical doctor must issue the medical certificate of cause of death, which is required for the civil status registrar to complete the death registration. The certificate must be issued free of charge by the doctor who attended the deceased in their last illness; if unavailable, it must be issued by a forensic doctor, then a public health doctor, and, if none are present, by any doctor working in the area or holding an official medical post. Only if no doctor is available may two competent witnesses confirm the death. Aside from issuing the medical certificate of cause of death, the law does not assign health-sector workers a role in reporting or registering deaths that occur outside health facilities.
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.
Colombian law assigns a limited role to local authorities in death registration. Under Decree 1260 of 1970, Article 74, a local police authority must report a death only when the body is unknown or unclaimed. Beyond this, the law does not give community leaders or other local authorities a role in reporting, confirming, or registering deaths. Article 76 specifies that confirmation of death must be done through a medical certificate of cause of death issued by a doctor (or, if no doctor is available, by two competent witnesses), and does not assign any responsibilities to local leaders.
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.
Colombian Decree 1260 of 1979, Article 74 designates cemeteries, funeral homes, or cremation services as informants of deaths and they are required to share information with the civil registrar. However, in practice, cemeteries, funeral homes, or cremation services act as intermediaries of the civil registrars. They will require the Medical Certificate of Cause of Death (MCCD) to proceed with their services, and then they will share the information with the National Civil Registry to register the death. This is reflected in Resolution 5194 of 2010 which only requires these providers to keep internal records and verify the MCCD and municipal inhumation/cremation license before proceeding, which indirectly ensures prior registration but creates no reporting obligation toward the civil registry.
