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Disclaimer / Limitations
This country’s legal measures were reviewed by our legal staff in consultation with in-country lawyers and/or CRVS legal experts. All efforts were made to ensure the accuracy of the legal analysis, however, if you consider there to be any discrepancies or if there have been changes in the law of the country since our staff last updated the legal analysis, we welcome any additional information or insights. Please contact us via this form.
Cause of Death
Ghana
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Ghana
Cause of Death
Medical Certification
Medical Certification
Compulsory Certification
Does the law require a cause of death (CoD) to register a death?
Yes medical certificate of cause of death required
Recommended Practice based on International Guidelines
Ideally, every death will have a cause of death (COD) medically certified by a trained physician. However, in circumstances where a medically certified cause of death (MCCD) is not available, the death should be registered without COD information. Cause of death should never be determined by a non-medical professional.
In some countries, an MCCD is a precondition for registering a death. In countries where there are not sufficient health professionals adequately trained in completing a MCCD, and in countries where many deaths occur at home, this can lead to low death registration rates. Policymakers should carefully consider whether an MCCD or COD is required to register a death, or if evidence of the fact of death alone may be submitted to the registrar.
Under Section 29 of the Registration of Births and Deaths Act, death registration requires a medical certificate of cause of death from a medical practitioner or the supervising medical practitioner of a health practitioner (such as a nurse, midwife or physician assistant) if any of these professionals attended during the illness of the deceased. Under Section 30(1)-(2) of the Act, where a death has been referred for an inquiry by a coroner, death registration requires a certificate from the coroner stating the cause of death.
The Form to be submitted by the informant to the District Registrar (Form 3) requires entry of the cause of death, which is obtained from the medical certificate of cause of death where there is one. The law is silent on how cause of death is to be determined in a case where the death is not referred to the coroner, but no medical practitioner or health practitioner was in attendance during the deceased’s last illness.
The Form to be submitted by the informant (which is usually the nearest relative) to the District Registrar (Form 3) requires entry of the cause of death. However, this form is submitted together with a medical certificate of death from a medical practitioner, or the supervising medical practitioner of a health practitioner (such as a nurse, midwife or physician assistant), who was in attendance during the deceased’s illness; it also requests entry of the name and qualification of the medical practitioner who certified the cause of death. The instructions for death registration on the Births and Deaths Registry website indicate that the information on place, date, cause of death and the name and qualification of the person certifying the cause of death will be based on the medical certificate of death that must be provided at the time of death registration.
The law is silent on how cause of death is to be determined in a case where no medical practitioner or health practitioner was in attendance during the deceased’s illness.
Does the law clearly state who is responsible for medically certifying cause of death, for natural deaths occurring in a health facility?
Yes
Recommended Practice based on International Guidelines
The law should state what person is responsible for certifying cause of death. The certifier may vary, based on the circumstances of the death. For natural deaths that occur in health facilities, the head of the health facility should be required by law to ensure a death is medically certified. Ideally, the certifier of the cause of death should be the physician or surgeon who attended the decedent during their terminal illness, although in countries that lack a sufficient number of medical doctors to staff health facilities, a nurse or other health professional may be trained to certify cause of death.
In every case where a registered medical practitioner or health practitioner (such as a nurse, midwife or physician assistant) attended during the deceased’s illness, regardless of the place of death, the Births and Deaths Registration Act requires the medical practitioner, or the health practitioner’s supervising medical practitioner, to provide a certificate of the cause of death.
Does the law designate a certifier of cause of death, for natural deaths occurring under medical supervision but outside a health facility?
Yes
Recommended Practice based on International Guidelines
For a home-based death due to natural causes, a certifier may include a doctor, nurse, or other trained health professional who attended the deceased during that person’s illness.
In every case where a registered medical practitioner or health practitioner (such as a nurse, midwife or physician assistant) attended the deceased during his or her last illness, regardless of the place of death, the Births and Deaths Registration Act requires the medical practitioner, or the health practitioner’s supervising medical practitioner, to provide a certificate of the cause of death.
Does the law clearly state who is responsible for medically certifying cause of death when deaths are unnatural or suspicious, or otherwise referred to the MLDI authority?
Yes
Recommended Practice based on International Guidelines
Deaths due to unnatural causes (such as accident, self-harm or violence); man-made or natural disasters; suspicious causes, or where CoD cannot be determined by the attending physician should be referred to the Medicolegal Death Investigation (MLDI) authority for medical certification of cause of death. The certifier of cause of death should be the forensic physician working with the MLDI authority who conducted the post-mortem examination on the deceased.
A coroner who holds an inquiry must complete and sign a certificate that states the cause of the death. The coroner may direct a registered medical practitioner to make a post-mortem examination of the body or to conduct analyses, tests or other special examinations for the purpose of discovering the cause of death. According to Section 30(2) of the Registration of Births and Deaths Act, the recipient of the coroner’s certificate, who is not identified, must submit it to the District Registrar, who will register the particulars of the deceased in the register of deaths.
However, the Coroners Act provides for direct transmission of the certificate of cause of death from the coroner to the national Registrar of Births and Deaths within 7 days from key points in the inquest process – from the date when the coroner decides that no formal enquiry need be held, from the date of the conclusion of a formal inquiry or from the date when a formal inquiry is adjourned because of criminal proceedings relating to the death.
Does the law provide a form to certify cause of death? If yes, does the form accord with WHO Medical Certificate of Cause of Death Form?
Yes the law provides a form for certifying cause of death that does not accord with WHO Standard MCCD Form
Recommended Practice based on International Guidelines
The WHO international form of Medical Certificate of Cause of Death (WHO MCCD) is the recommended form for recording information regarding cause of death for certification of all deaths, including stillbirths and unnatural or suspicious deaths. There may be modifications to the form including addition of biographical information of the deceased in an administrative section. Countries may also modify the Manner of Death section in Frame B as appropriate for their context; however, the form should always include Frame B, including a manner of death section.
The Registration of Births and Deaths Regulations include Form 29: Medical Certificate of Cause of Death. This form is a modification of the WHO Medical Certificate of Cause of Death Form. It includes a declaration from the certifying medical practitioner and the particulars of the deceased, a statement of the cause of death (including direct, antecedent and contributing conditions) and the particulars and qualifications of the attending/certifying medical practitioner. However, it omits information on manner of death and "Frame B: other medical data" contained in the WHO Form.
Is the same form used for all types of deaths, including natural deaths and deaths referred to MLDI?
Unclear
Recommended Practice based on International Guidelines
It is recommended practice to use the same MCCD form which should be WHO MCCD compliant) for all types of deaths, including natural and unnatural deaths (and fetal deaths).
The Registration of Births and Deaths Regulations provide only a single “Form 29: Medical Certificate of Cause of Death” for all kinds of deaths.
The Coroners Act does not include a form for the certificate of cause of death that is provided by a coroner in cases that have been referred to the coroner for inquiry. The Coroners Act authorizes the Minister of Justice to prescribe forms to be used for the purposes of the Act by executive instrument, but no form for the coroner’s certificate of cause of death has been located. Thus, it is not clear what forms are used by the coroner, or by a medical practitioner who is asked by the coroner to conduct a post-mortem examination to discover the cause of death.
