Evidence map›Paper›PMID 42666286›Full record

ArticleFrontiers in public health2026

Gender differentials in death registration completeness in Gujarat, India: a policy analysis of structural, economic, and socio-cultural barriers.

Astha Vala, Om P Bera, Pradeep Aggarwal, Krupal Joshi, A M Kadri

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Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Astha ValaState Health System Resource Centre - Gujarat, Gandhinagar, India.
Om P BeraGlobal Health Advocacy Incubator, Washington, DC, United States.
Pradeep AggarwalAll India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Krupal JoshiAll India Institute of Medical Sciences Rajkot, Rajkot, India.
A M KadriGovernment of Gujarat, Gandhinagar, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Civil Registration and Vital Statistics (CRVS) systems are fundamental to evidence-based governance and public health. In India, a persistent gender disparity exists in death registration: approximately 73% of male deaths are officially recorded compared to only 64% of female deaths nationally (NFHS-5). Gujarat, despite its relatively advanced socio-economic standing and near 93.1% overall death registration rate (CRS 2023), continues to exhibit this troubling gap. Objective: This study analyses the structural, economic, and socio-cultural drivers of gender disparities in death registration in Gujarat and proposes policy interventions aimed at achieving universal and gender-equitable registration completeness. Methods: This study employs a mixed-method policy analysis framework, synthesizing secondary data from the National Family Health Survey (NFHS-5), the Civil Registration System (CRS) 2023 Annual Report, Sample Registration System (SRS) data, and peer-reviewed literature. Qualitative insights are drawn from administrative case studies, district-level reports from Gujarat, and comparative analysis of high-performing states (Kerala and Tamil Nadu). Results: The gender gap in death registration was widest among the poorest wealth quintile (13 percentage points) and narrowed substantially among the richest quintile (4 percentage points). Key barriers included: (i) an economic-utility logic, whereby male deaths are prioritized due to implications for asset succession ("Varsai"); (ii) higher prevalence of female home deaths linked to healthcare access inequities; (iii) administrative and bureaucratic barriers at the Panchayat level; and (iv) under-reporting of socially sensitive female deaths, including maternal mortality and suicides. Conclusion: Closing gender gaps in death registration requires a rights-based approach that integrates administrative simplification, strengthened community-level reporting through ASHA and Anganwadi networks, expanded digital infrastructure, and targeted public awareness initiatives. If equitably implemented, Gujarat's digital governance architecture has the potential to substantially reduce female invisibility in official mortality statistics.

Indexed as

Death CertificatesVital StatisticsFemaleHumansIndiaMalePolicy MakingSex FactorsSocioeconomic Factorscivil registration and vital statisticsdeath registrationdigital governancegender disparitygender equityGujarathealth policymaternal mortality

Identifiers

PMID42666286
PMCPMC13522170

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