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Stillbirth Reporting
Sri Lanka
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Sri Lanka
Stillbirth Reporting
Reporting through the Civil Registration System
Reporting through the Civil Registration System
Compulsory coverage
Is stillbirth registration available and compulsory for all stillbirths occuring within the country's jurisdiction?
Allowed
Recommended Practice based on International Guidelines
Tracking stillbirths and other fetal deaths is important for statistical and public health planning purposes. Official recognition that the fetal death occurred can have significance for families and can help to facilitate cremation and burial if the family desires. If stillbirths are recorded via the civil registration system, then the law should require that all stillbirths are registered, in same way as live births and deaths. This means that an informant is legally designated with a dury to notifiy a stillbirth. Where they are recoded via the health sector, the system is often managed through guidelines and SOPs rather than via a law. However, those guidelines may be mandatory for the releavnt health instiutions or medical professionals.
The Births and Deaths Registration Act stipulates that it is the duty of the registrar to inform himself carefully of every stillbirth occurring in his division. Section 42 of the BDRA requires that a stillbirth be reported to the civil registrar before obtaining a permit for burial or cremation. This section applies to "Part V" areas, a provision that is no longer enforced. Circular 2-155 of 2015 requires all health facilities to declare stillbirths to the Registrar General and to provide a copy of the declaration form to the parents for use in registration. However, the obligation on parents to use this copy of declaration form for registration, is not clearly stated in the law.
Who is the designated primary informant for declaring stillbirths to the civil registrar?
Unclear
Recommended Practice based on International Guidelines
UN guidelines provide that, in priority order of preference, the informant for a fetal death is the same as for a live birth: first, the head of the health facility (for a fetal death that occurred in a health facility) or the birth attendant (for a fetal death that occurred outside a health facility with a birth attendant); second, the mother; third, the father; fourth the nearest relative of the mother; and fifth, any other adult person having knowledge of the facts.
The Birth and Deaths Registration Act does not clearly state who are the informants for stillbirths. Section 15 provides that the mother and the father are the primary informants for births. However, there is no equivalent provision for stillbirths. Section 47(2) specifies the informants for stillbirths occurring in "certain areas" (listed in Part V of the Act). This provision mostly focuses on stillbirths occurring out-of-facility. Under this provision, the father, if he was residing in the house where the stillbirth took place, is the primary informant. Moreover, this section foresees that "any person in attendance upon the mother at that time or within six hours thereafter" shall inform the medical authorities of any information they are aware of by filling in form W. Circlular 2-155/2015 provides that all health facilities are to declare stillbirths to the Registrar General.
What is the role of the health sector in stillbirth registration?
Notification
Recommended Practice based on International Guidelines
UN guidelines provide that the head of the health facility is the preferred informant for stillbirths. Where the stillbirths are registered via the civil registration system this should be specified in the law. As with live births, some countries require the health sector to notify information about stillbirths even where the designated informant is the mother and/or father. Where the mother and/or father is the primary informant, the health sector would usually be required under the law to provide a notice of some sort as evidence of the stillbirth for the purposes of registration.
Under the Birth and Deaths Registration Act, the role of the health sector is unclear. The only existing provisions are limited to specific geographic areas, and do not apply to the whole territory: - According to Section 47(5) of the Act, any medical officer who receives information on stillbirths occurring in "certain areas" (listed in Part V of the Act), shall report it to the registrar within 7 days. - Under Section 48 of the Act, for stillbirths occurring in "certain areas" (listed in Part V of the Act), the heads of health facilities shall send weekly information to the registrar about any stillbirths having taken place in their facilities. These provisions, anyway, are no longer enforced. Nonetheless, the role of the health sector in stillbirth registration has been expanded by Circular 2-155 of 2015. This circular requires the health sector to send a copy of the form "Declaration of Still Birth" to the Registrar General and give a copy of the declaration to the parent for use in registration.
Recommended Practice based on International Guidelines
If fetal deaths are reported through the civil registration system, the health facility, birth attendant or other informant should report a fetal death to the registration office in the location where the fetal death occurred, or at any location where access is available to the registration system, if the system is sufficiently networked. Where registration is required at the place of residence of the mother, this may reduce the rates of registration.
Under Section 10 of the Birth and Deaths Registration Act, stillbirths are reported at the place of occurrence. Moreover, under Circular 2-155 of 2015, the health sector declares the stillbirth to the registrar in the place of occurrence.
What is the reporting period for stillbirth registrations specified under the law?
Unclear
Recommended Practice based on International Guidelines
The time frame for reporting a fetal death is usually the same as that for a death. There should, however, be a procedure for late and delayed reporting pending a medical-legal decision if the fetal death status is unclear or disputed.
No relevant legal provisions under Sri Lankan laws.
Law Source
Register
Does the civil register contain a separate register for stillbirths, distinct from birth and death registers?
Yes
Recommended Practice based on International Guidelines
UN guidelines indicate that stillbirths should not be registered in the birth register or the death register, as they do not establish a legal identity, retire a legal identity or affect civil status. Including stillbirths in those registers can also make it harder to disaggregate the data for statistical purposes. Instead it is recommended that a separate register of stillbirths is established. However, some countries with digital systems do include stillbirths in the register of births .
Under the Births and Deaths Registration Act, Form C is the stillbirth registrarion entry form, which is separate from the birth entry (form A) and death entry (Form B).
Recommended Practice based on International Guidelines
No fee should be charged for the timely registration of a live birth, marriage, divorce, fetal death or death To encourage registration, the legislation should clearly state that registration of a birth, fetal death and death within the time period prescribed by the law is free of charge.
No relevant legal provisions under Sri Lankan laws.
Law Source
Burial Permits
Does the law require that funeral, burial and cremation services request proof of stillbirth registration or reporting?
Yes
Recommended Practice based on International Guidelines
In countries that record stillbirths via the civil registration system, and where the mother and/or father is the designated informant, the provider of the funeral, burial or cremation service may be required to request proof that the stillbirth was reported to the registrar or the health system before final disposition.
Section 43(1) of the Births and Deaths Registration Act stipulates that "no person" shall bury, cremate, or dispose of a stillborn child unless a certificate has been obtained by one of the following: the registrar, the superintendent of the estate, or the medical practitioner in attendance. However, note that Section 43(1) only applies to stillbirths occurring in certain areas (listed in Part V of the Act) and Part V of the Act is no longer in effect. Therefore, even though the law stipulates that burial cannot take place without stillbirth registration, in practice, only stillbirths that occurred in Part V areas were subject to this provision before Part V areas became obsolete under the law.
Does the law require that health facility or health professional attending a stillbirth record or equivalent document to facilitate burial or cremation?
No
Recommended Practice based on International Guidelines
If reporting takes place through the health sector only, the health facility should provide a medical record of the fetal death to the parents, if needed for burial or cremation of the fetus
