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Death Registration
Bolivia
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Bolivia
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?
Unclear
Recommended Practice based on International Guidelines
The law should establish clearly and unequivocally one person primarily responsible for providing the information needed for the registration. Moreover, the law may designate alternative informants and establish the order in which each of them must assume his or her responsibilities. . For natural deaths occuring in health facilities and in order of preference, the head of the health facility should be primary informant or 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.
The law does not clearly designate a single primary informant for deaths occurring in health facilities, as recommended by international guidelines. However, Article 48 of Supreme Decree No. 24247 of March 7, 1999, establishes that the Civil Registry Officer records the death upon presentation of the medical certificate attesting to the death, which implies that the physician is the person providing the information when the death occurs within a health facility. In places where no physician is available, the article states that the Civil Registry Officer must personally verify the death.
Who is designated primary informant for natural deaths occurring outside a health facility?
Unclear
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.
The law does not distinguish between deaths inside and outside of health facilities, and therefore does not alter the list of informants.
Article 48 of Supreme Decree No. 24247 of March 7, 1999, establishes that the Civil Registry Officer records the death upon presentation of the medical certificate attesting to the death, which implies that the physician is the person providing the information when the death occurs within a health facility. In places where no physician is available, the article states that the Civil Registry Officer must personally verify the death.
Who is designated primary informant for unnatural or suspicious deaths?
Other
Recommended Practice based on International Guidelines
Regardless of whether the death occurred with or without medical supervision, designating a specified officer of the medicolegal system as an informant has been most effective in notification and declaration of deaths in suspicious or unnatural death cases.
To ensure that unnatural and suspicious deaths are registered, legislation should clearly specify who is responsible for notifying the registrar of the fact of death. The fact of death should be notified within the required time frame, even if a coroner or medical examiner’s inquiry into cause of death is still underway.
Depending on the circumstances surrounding an unnatural or suspicious death, responsibility may be placed on emergency services, health workers, coroners, medical examiners, police or other medical-legal officers for ensuring registration of death. Responsibility should not be placed on the family, as that may result in the death not being declared to the registrar.
According to Article 48 of Supreme Decree No. 24247 of March 7, 1999, when a body is found and it is impossible to identify it, the death is registered upon a judicial order, and in the absence of a judge, with authorization from the administrative, military, or ecclesiastical authority. This provision implies that, in cases of unnatural or suspicious deaths, the judge is the primary informant responsible for authorizing the registration, while the administrative, military, or ecclesiastical authority assumes this role when there is no judge in the jurisdiction. The law, however, does not establish a broader medicolegal framework on informants.
What is the role of the health sector in death registration for 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, and establishing systems for the collection and recording of vital events, 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 attend the registry office to undertake a declaration for the death to be registered. Where the nearest relative is the informant, the health facility will usually be required to provide them with some form of evidence or record of the death that should be used by the informant for registration.
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.
The doctor is required to issue a medical certificate of the cause of death when the patient dies from the illness for which he or she was being treated.
What is the role of the health sector in death registration for deaths occurring outside health facilities?
Issuing evidence of death or other equivalent document
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 the health care worker may notify the civil registrar of the facts of death, but the nearest relative still needs to register the death. In some countries health workers may provide a document, such as a notice of death, to the nearest relative as official evidence of the death.
Medical attendant is designated as the person to issue the medical certificate of the cause of death. If death occurs outside of health facilities, a doctor of the closest facility is designated to issue the certification
What role do local leaders or local authorities have in death registration?
Yes
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 notify the registrar of the fact of death (but not cause of death), and the family may be required to provide additional information requested in the notification of death form to the registrar.
The death is registered at the request of the relatives of the deceased, or in the absence of relatives, by neighbors, or by the administrative, military or ecclesiastical authority of the place of death.
The Civil Registry Officer carries out the registration in view of the medical certificate proving the death.
In places where death occurs outside of medical supervision professional, the Civil Registry Officer, is required to confirm the event of death. Often, when there is no medical supervision during death, as is the case in some rural areas, the certificate must be completed by non-medical health personnel or by a local authority if there is no health personnel available.
