Researchers raise alarm over low death registration in Kenya

In three Kenyan surveillance sites, nearly eight out of ten adult deaths between 2022 and 2023 went unregistered, a new study reveals. Conducted by researchers from the KEMRI-Wellcome Trust and published in The Lancet Regional Health – Africa, the investigation analyzed deaths reported by households in Nairobi, Kilifi, and Kisumu.

Of the 1,387 deaths reported, only 22.8 percent of adult fatalities were registered, leaving a staggering 77.2 percent unregistered according to the study. Women saw a lower registration rate at 18.8 percent, compared to 26.1 percent for men. The study also found that the chances of registering a death were lower for those involving children, unemployed individuals, and those from poorer households.

Moreover, deaths occurring at home or recently were less likely to be recorded. The researchers attribute these low registration rates to factors like limited public awareness, perceived lack of benefits, and registration costs. However, the disparity between male and female registration rates is largely due to the circumstances surrounding their deaths rather than unequal treatment by the system.

Inheritance requirements and access to insurance or social benefits were the primary reasons families registered deaths, while legal obligations were a smaller factor. As national death registration rates have also decreased, the study suggests linking burial authorisation to completed death registration, reducing or eliminating the Sh500 late-registration penalty, and enhancing community-based death notification and public awareness.

Additionally, they recommend a review of inheritance laws to influence families' decisions to register deaths. The study cautions that its findings should not be considered a national estimate, as it only covered three surveillance sites, and notes that their definition of registration differs from that used in national administrative statistics.