Karnataka has introduced stricter rules to improve the accuracy of cause-of-death reporting, prompted by a low rate of medically certified deaths  currently only about 26.7% of all registrations. The move follows recommendations from a recent state review and a national study by the Indian Council of Medical Research, both of which highlighted the need for standardised and reliable mortality data.

Under the new guidelines, all government and private hospitals must issue a Medical Certificate of Cause of Death (Form 4) for every in-house death, upload it to the state’s e-JanMa portal, and provide a copy to the deceased’s family. For deaths occurring outside medical institutions, the responsible doctor or authorised medical officer must issue Form 4A, and this must be provided to families free of charge.

Registrars handling death registrations are now required to ensure that Form 2, the basic death report, is always accompanied by the correct medical certification either Form 4 or Form 4A. They must also forward all certificates to the Chief Registrar by the 10th of the following month. Hospitals and registration offices must submit monthly consolidated reports as well, even if no deaths occurred, a measure intended to strengthen transparency and consistent record-keeping.

Officials say these enhanced requirements are crucial for improving the reliability of mortality statistics, which guide public-health planning, disease surveillance, and resource allocation. By enforcing standardised certification and reducing gaps in reporting  particularly for deaths outside institutions  the state aims to prevent undercounting and misclassification, ultimately supporting better policy decisions and a more responsive health system.