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Death Registration
Uganda
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Uganda
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 informant is the person who reports to the local registrar the occurrence of a vital event within the prescribed time limit. The law should establish, clearly and unequivocally, one person primarily responsible for providing the information needed for death registration to the civil registrar. The law may designate alternative informants and establish the order in which each of them must assume his or her responsibilities. For natural deaths occurring in health facilities, the head of the health facility or other health staff should be primary informant. Alternative informants, in order of priority, are: 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 on this issue is unclear, with an apparent contradiction between the Registration of Persons Act and the Registration of Persons (Births and Deaths) Regulations. Section 43 of the Act makes the primary informant for all deaths the next of kin or relative of the deceased who is present at the time of death, followed by the next of kin or relative who resides or is present in the same area as the deceased and other alternative informants. Regulation 19(1) states that these are the primary informants only where a death occurs outside a medical facility.
According to Regulation 17, where a death occurs inside a medical facility, the administrator of the facility has a duty to obtain the relevant particulars and to record the death, acting under the guidance of the registration officer of the area. Most medical facilities have been designated as registration centers, making it unclear if the administrator of the medical facility acts as the primary informant, or obtains the particulars of the death and records them as part of the duties of a registration center.
Who is designated primary informant for natural deaths occurring outside a health facility?
Relative present at the time of death
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. Alternative informants, in order of priority, are: nearest relative, or any other adult having knowledge of the facts.
The following persons have a duty to notify a registration officer of a death that occurs outside a health facility, in order of responsibility: (a) the next of kin or relative of the deceased who is present at the time of death; (b) the next of kin or relative of the deceased who resides or is present in the same area as the deceased; (c) where the death occurred in a home, anyone who occupies the house; (d) any person finding the body of the deceased person; (e) any person taking charge of the body of the deceased person (such as an undertaker); or (f) anyone causing the body of the deceased person to be disposed of (such as the person in charge of burial or cremation of the body).
Who is designated as the primary informant for unnatural or suspicious deaths?
Other
Recommended Practice based on International Guidelines
To ensure that unnatural and suspicious deaths are registered, legislation should clearly specify who is responsible for reporting the death to the registrar. The primary informant for an unnatural or suspicious death should be an officer of the mediolegal system, regardless of whether the death occurred with or without medical supervision.
Such officers may include: coroners, medical examiners, police or other medicolegal officers. Responsibility should not be placed on the family, as that may result in the death not being declared to the registrar.
The Inquests Act applies where a body is found or where a person has died in circumstances suggesting that the death may have been caused or accelerated by violence or wrongful conduct. Any person who finds a body or becomes aware of a suspicious death must report this to the police, either directly or via a village chairperson. Police must then investigate and give notice of the death to a coroner. The coroner decides whether to refer suspicious deaths for a post-mortem report on the cause of death. The coroner is required to hold an inquest in some circumstances but has discretion to decide whether an inquest will be held in other situations. The coroner must record the results of all inquests in inquest books kept at every Magistrate’s Court and transmit the record of any inquest proceeding to the Registrar of the High Court. The presiding Magistrate must forward a certified copy of the inquest finding on the cause of death to the registration officer for entry in the register of deaths.
The normal procedures for notifications of deaths appear to apply to all particulars aside from the cause of death even when an inquest takes place. The law is silent on the duty of notification where a suspicious death occurs but no inquest takes place, so the normal procedures for notification of deaths would also seem to apply in these cases.
What is the role of the health sector in death registration for natural deaths occurring in health facilities?
Notification, Registration
Recommended Practice based on International Guidelines
When a death occurs in a healthcare facility,designating the head of the health facility as the informant, 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 declare the death to the civil registrar in order for the death to be registered. When the health facility is the notifer, the health facility will usually be required to provide the family with some form of evidence or record of the death to be used by the informant for registration. In some countries, the health sector is neither informant nor notifier, but instead simply issues a document to the family that serves as proof of the death. Finally in some countries, specified health staff may be designated as registrars or assigned some registrar functions, which helps bring registration closer to the people.
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 administrator of a medical facility has a duty to obtain and record the particulars of a death that occurs in that medical facility, although it is not clear if the administrator acts as an informant or records information obtained from other sources as part of the facility’s duties as a registration office.
What is the role of the health sector in death registration for natural deaths occurring outside health facilities?
Providing Medical Certificate of Cause of Death
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 Alternatively, the health care worker may notify the civil registrar of the facts of death, but the nearest relative still needs to register declare the death to the civil registrar in for the death to be registered. Finally, in some countries health workers may only provide a document, such as a notice of death, to the nearest relative as official evidence of the death, which the informant submits when declaring the death.
In terms of the Registration of Persons Act, regardless of where a death occurs, any medical officer who attended the deceased during their last illness must sign a certificate stating the cause of death and forward it to the registration officer for entry into the register of deaths.
According to the Registration of Persons (Births and Deaths) Regulations, where a person dies outside a medical facility, a certificate stating the cause of death must be forwarded to the registration officer by the person who carries out the postmortem examination, with no time frame specified.
What role do local leaders or local authorities have in the registration process for deaths that occur in the community?
Registration
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 act of informant, or to notify the registrar of the fact of death (but not cause of death). If a local leader is the informant, the family may be required to provide additional information to the registrar in order to register the death. In some instances, a local leader, such as a village chief, may act as a facilitiator, helping the family member (the informant) complete the death registration application and submitting this form to the local civil registrar.
The following have been designated as registration centers for death registration: all headquarters of subcounties, town councils and municipalities in Uganda; the headquarters of divisions in Kampala Capital City; and the offices of village and parish councils. The registration process at these registration centers does not differ from that at other registration centers.
Does the law require that funeral, burial, and cremation services share records with civil registrar?
No
Recommended Practice based on International Guidelines
In countries where death registration is not a precondition for issuing a permit to dispose of bodies, custodians of funeral facilities, crematoriums and burial sites may be required to maintain a record of all deaths and to report the deaths to the civil registrar, which would alert the registrar of fact of death when death has not been registered.
A local authority is required to keep a cemetery register for every cemetery under its control, including a cemetery plan with the graves marked and numbered, but there is no requirement that this information be shared with the civil registrar.
