how to write a death certificate. advantages step by step

1. DEATH CERTIFICATION
Dr Abdallah Abdiaziz
Death is so final, where as Life is full of possibilities
Man is mortal & Death is
inevitable

2. Objectives
Definition of Death Certificate
Importance of Death Certificate
NIRA
Why do you need a Death Certificate
Components of Death Certificate
Significance of Death Certificate
General Tips of Death Certificate
Examples of Death Certificate

3. What is death certificate
A documentary evidence stating the DATE , FACT & CAUSE OF
DEATH
issued by the government or Medical professional.

4. Importance of Death Certificate
Useful in providing data for mortality statistics
Useful in surveillance of specific diseases particularly in countries
where registration is complete
Useful in evaluation of disease control programs
Rise in certified deaths from a particular cause is an indicator for
a serious outbreak.
The completed death registration form is a permanent legal record
of the fact of death of an individual.

5. NIRA
 The Registration of Person Act 2015 created the National
Identification and Registration Authority (NIRA).
 The Organization is mandated to register Deaths that happen
in Uganda.
 Death Registration in Uganda is FREE AND COMPULSORY.
 Every death shall be registered immediately, or not more
than 3 months after the death has occurred.

6. What does one need to process
a death certificate
1) A Death Notification Record from a medical facility or from sub
county/Division
2) Medical cause of death from hospital issued by the medical doctor who
attended to the deceased or a postmortem report from a pathologist who
conducted the postmortem
3) Attach Photocopy of the national Identification card of the applicant and
present the National ID card of the deceased.
4) Payment receipt in the names of the deceased from the bank of
UGX5000/= for citizens and USD 40 for non-citizens
5) A death certificate is free for a refugee that dies in Uganda on
presentation of proof of Refugee status

8. Why do you need a Death
Certificate?
1) It is a legal requirement to register death as soon as it occurs or
not later than 3 months after the death has occurred.
2) It protects the family from persons who would take advantage and
rob the family of their inheritance.
3) Helps fast track other inheritance processes and gives the family
access to the deceased pension, life insurance and other
arrangements made for the family after the death
4) Helps government stem corruption arising from paying persons
who might be deceased.
5) Early death registration acts as an early warning system in
pandemic and epidemic situations and helps government to
enforce

10.  SECTION 1 : General details of the patient

11.  Part 2 : Cause of Death

12.  Part 3 :Manner of death Identification
marks and signature of the medical D.

13. Cause of Death
First part includes :
1. Immidate cause
2. Anticedent cause
3. Other significant
conditions .
Second part includes:
Other significant
conditions contributing
to death
It has Two parts

14. Immediate
cause
◦ It is the disease injury or
complication that
directly preceded death
of a person
◦ Ex..
◦ In case of voilent death
enter the cause of death
as an external factor viz
. Fracture of vault of
skull ,
Crushed chest , ETC
Antecedent
cause
This condition must
be antecedent to the
Immediate cause of
death both with
respect to time and
etiological or
pathological
relationship.
Eg
Road traffic accident
or fall from tree.
Other
significant
condition
contributing to
death but not
related to the
disease or
conditions
causing it should
be here

15. Manner of Death
 Manner of death reffers to way in which the cause of
death was produced weather natural or unnatural ie.
Accidental, suicidal or homicidal
 Death not due to external causes should be identified as
Natural.
If the cause is not known and requires further
investigation then Pending investigation is to be
selected

16. Significance of Death Certificate
Help in assessing the effectiveness of public health
programs
1.Feedback for future policy and implementation.
2.Essential for better health planning and
management
3.Has very essential medicolegal importance

17. General Tips
1.Issue free of charge.
2.do not delay in giving the certificate.
3.Consider all clinical findings.
4.Do not write two or more conditions on a single line.
5.Avoid abbreviations.
6.Issue a single copy and retain a duplicate copy for reference.
7.Certification by a medical practitioner who has attended the
deceased during the letter’s last illness
(Births & Deaths Act 1969).

20. • The casualty officer on-call receives a 68 year-old female who
was diagnosed 6 months ago with carcinoma of the lung. She
has a 45-year history of smoking 2 ppd, a 5 year history of
COPD with frequent bouts of pneumonia and bronchitis. She
stops breathing and dies bedside.
• Part I …(a) Respiratory Arrest hours
due to
(b) Metastases to abdomen and pleura 2 months
due to
(c) Bone metastases 2 months
due to
(d) Carcinoma of lung (primary) 6 months
• Part II Smoking, 45 years COPD, 5 years
Smoking is reported in Part II as a contributing factor. When
reporting neoplasms always indicate the organ or part FIRST affected
(the primary site) and secondary sites if they are known.
 EXAMPLE

21. • A 79 year-old female has suffered a right hip fracture due to a
fall at home four months previous. Since the date of the injury,
her health declined to the point that it rendered her bedridden
and immobile. She has a long history of osteoporosis.
• Part I (a) Respiratory arrest..............................................minutes
due to
(b) Pneumonia.......................................................10 days
due to
(c) Immobility….....................................................4 months
due to
(d) Right hip fracture………...................................4 months
• Part II Osteoporosis..............................................................years
Where a cause of death is an injury or fracture reported in Part I or in Part II, you
are required to complete the accidental or violent death section in the DC.
EXAMPLE 2

22. • A 59 year-old female with a history of hypertension for 10 years was
admitted to hospital for investigation following complaint of persistent
headache for weeks. Exploratory craniotomy revealed she was suffering from
an inoperable tumor of left temporal lobe. Biopsy showed tumor to be an
astrocytoma. Patient wished to die at home. Palliative care was instituted
through discussion with family and physician. Patient died after 2
months.
• Part I(a) Astrocytoma of left temporal lobe..........Months
• Part II Hypertension (benign) ........................10 years
• In some cases a single disease or cause of death which describes
completely the sequence of events or may be wholly responsible for the
death may be reported alone in Part I.
• The death may have been expected and occurred at home but not
witnessed by anyone. In such cases line 1(a) can serve as both the
underlying and immediate cause of death.
EXAMPLE 3

23. • A 33 year-old male was diagnosed HIV positive five years ago. He was transferred
to a hospice for palliative care after he developed AIDS and diagnosed with
Pneumocystis Carinii Pneumonia.
• Part I(a) Pneumocystis carinii pneumonia…1.5
weeks
due to
(b) AIDS...............................................4 months
due to
(c) HIV infection ....................................5 years
• Part II Kaposi’s sarcoma...............................4 months
EXAMPLE 4

24. A lady was admitted with 80% suicidal burns injuries died of septicemia after 3 days of
admssion
Part I(a) Septicemic shock ------------------3 days
(b) Burn(80% superficial & deep)- 3 days
(c) Intentional self harm by fire & flames-3 days back
Part II ..............Nil
Manner of death
1. Natural 2. Accident 3. Suicide 4. Homicide 5. pending investigation
EXAMPLE 5

25. Further reading
• Handbook on Medical Certification of Death
(http://www.publications.serviceontario.ca/ecomlinks/016600.pdf)
• http://medind.nic.in/maa/t04/i3/maa
• http://www.mlam.in/pdf/medicalcertificates/mccd.pdft04i3p261.pdf
• https://www.nira.go.ug/media/2022/11/DEATH-REGISTRATION-
HANDBOOK-final.pdf

26. "Death is nothing, but
to live defeated and
inglorious is to die
daily".

27. «Thank You»