June 05, 2026
In his Hindustan Times column, Vital Signs, OHT’s Dr. Ramanan Laxminarayan writes that India relies too heavily on large periodic surveys to track basic health indicators, such as infant mortality and sex ratios at birth, instead of maintaining a complete, real-time system for recording births, deaths, and causes of death. The debate was sparked by the latest National Family Health Survey (NFHS), which no longer reports several key indicators, including anemia prevalence and child mortality.
Dr. Laxminarayan explains that this dependence on surveys has roots in the colonial era, when population counts were prioritized over civil registration systems. While surveys remain valuable for measuring issues such as nutrition, health behaviors, and sanitation, they should not be the primary source for vital statistics.
Drawing comparisons with countries such as the United Kingdom, Sweden, and China, Dr. Laxminarayan suggests that modern health systems require comprehensive and routine registration of births, deaths, and causes of death. Such systems provide timely, accurate data that can guide public health decisions and improve accountability. “We should run health surveys, as every developed country does, to measure the nutrition, behaviors, and exposures no register can capture. But the unfinished business of Viksit Bharat is to make the registration of every birth, death, and cause so complete and routine that the most basic facts of a citizen’s life and death are never again something we have to go looking for every five years.”
Read it here.
