Civil Registration System
In Maharashtra state the Civil Registration System has been in operation as per the legal provision of Birth and Death registration Act 1969 and as per the revised rules framed by the Government of Maharashtra in the year 2000. The registration is done by DE–FACTO method, i.e. the events – births and deaths are registered where they are occurred.

The Civil Registration System is operational in five stages as follows

• Registration of vital events
• Preservation of records
• Reporting
• Analysis
• Feedback, inspection and supervision

Registration of Vital Events
For registration of vital events, following Officers are declared as a Registrar of birth & death at various levels.

Designation of Officer	Designation specified under the act	Jurisdiction
The Director of Health Services, Maharashtra State	Chief Registrar of Birth & Death	Maharashtra State
The Deputy Director of Health Services (SBHI&VS), Maharashtra State	Deputy Chief Registrar of Birth and Death	Maharashtra State
The District Health Officer of all Zilla Parishad in Maharashtra State	District Registrar of Birth and Death	Concern Revenue district
The Dy. Chief Executive officer (Panchayat) of all Zilla Parishad in Maharashtra State	Additional District Registrar of Birth and Death	Concern Revenue district
The Block Development Officer of all Blocks in Maharashtra State	Additional District Registrar of Birth and Death	Concern Revenue Block
The executive Health Officer/Health Officer/Chief Officer of all urban areas in Maharashtra State	Registrar of Birth and Death	Concerned Municipal Corporation/Council
The Cantonment Executive Officer of all cantonment Boards in Maharashtra State	Registrar of Birth and Death	Concern area of cantonment board
The Gram Sevak or if there is no Gram Sevak, Assistant Gram Sevak of all Gram Panchayats in Maharashtra State	Registrar of Birth and Death	oncern area of Village/Gram panchayat
The Administrator of the specified area in Maharashtra state	Registrar of Birth and Death	Concern specified area

Flow of Rural Area & Urban Area Reporting System

Analysis
On every 10th, monthly reports are received at state office of Deputy Chief Registrar of Birth and Death at Pune. From rural area 43,722 villages and from urban area 257 urban units are reporting every month to this office. Approximately 2,38,000 registered events of birth/death/stillbirths are reported to this office every month. The entire data is coded and computerized. Since Sept. 2004, decentralization of data is proposed at district level from rural area to begin with.

Feed back, inspection and supervision
In rural area, the Additional District Registrar for the block i.e. BDO and the Extension Officer (Panchayat) takes the review of village registrars for reporting as well as recording of events. In the same way the District Registrar i.e. District Health Officer (DHO), takes the review of the registration activities. At district, in Zilla Parishad, a Statistical Officer and a Statistical Investigator are specifically looking after reporting, monitoring analysis and feedback activities.

At the state level Bureau, the review of all districts is taken by analyzing the registered events. The activities are monitored and feedback is given to take corrective steps in the field. Regular inspection is also carried from state level/district level/block level officers in the field. Reporting
In rural area, the registrars submit the registered events of birth, death and stillbirth to additional district registrar at respective block level. At block level the village registers are maintained and updated every month, after the collection of reports from village registrars. The reports are compiled in a simple abstract. The copy of abstract is also given to district registrar i.e. District Health Officer, for monitoring and feedback at district level. The registrars of urban area send the monthly reports directly to Deputy Chief Registrar of birth and death – Pune, and a copy of abstract is submitted to District Registrar of respective district for monitoring and feedback at district level. Deputy Chief Registrar of Birth and Death – Pune, at the state level, complies & analyses the reports and district wise monthly and annual reports are submitted to Chief Registrar of Birth and Death, Maharashtra State and Registrar General, India, New Delhi.

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Strategy: Medical Certification of Causes of Death

• In the case of deaths occurred in the institutions, Head of the institution is responsible for submission of form no.4 to the Local Registrar.
• In the case of domiciliary death attended by any physician prior to death is responsible to submit form no.4A to the local registrar.
• It is the duty of the registrar to provide forms No.4 & 4A to the Institutions & Physicians in his jurisdiction.
• It is the duty of Registrar, to ask about form No.4 & 4A according to occurrence of death, while entering the death event.
• Civil Surgeon of District Hospital & District Health Officer Z.P. is responsible for review of quantity, quality & training of M.C.C.D. at district level.
• Deputy Director is responsible for compilation, coding & analysis of data received through MCCD according to ICD–10.

Strategy: Survey of Causes of Death Scheme (Rural)

1. The Paramedical staff (ANM & MPW) working in the selected villages is the important & root level worker called as “Field Agent”. The field agents are expected to keep House hold register, visit the community twice in a month & collect the data on fertility & mortality. In respect of mortality, they should contact the family members, collect the information on sign & symptoms, disease, duration of the diseased, by applying their experience in providing health services. The data collected under the scheme is according to De jury method.
2. Field agents are expected to submit the collected information in the prescribed format to the M.O. PHC at the end of the month.
3. Field recorder at PHC level is expected to supervise the villages selected under the scheme. He should consolidate the information received by the field agent every month. He should prepare the monthly report & submit to the Dist. level.
4. Six monthly survey are to be conducted to detect the omissions if any, by field recorder.
5. M.O.PHC is expected to verify all cause of death forms (C form). Based on sign & symptoms given by the field agent. He should write the probable cause of death, with the help of Classification of diseases made available to them. In case of Institutional deaths & the deaths in which any other Private Practitioners identify cause of death, MO should write the same cause of death.
6. M.O. is also responsible for the development of technique of field agent in respect of Post death verbal autopsy.
7. District Health Officer/Additional District Health Officer (A.D.H.O) are expected to monitor, supervise, evaluate, & verification of the scheme, time to time with the help of statistical wing at district level.
8. Deputy Director (State Bureau Of Health intelligence & vital Statistics) is the whole in charge of the scheme at State level. He is expected to review the scheme, take corrective actions in respect of progress Further he should generate the information on mortality statistics related to Causes, age, & sex. of the scheme. Similarly District & Circle wise fertility & mortality rates in the form of State Annual Report.