Gender Disparities in Death Registration during the Covid-19 Pandemic in a Low-Resource Setting

Orsola Torrisi, McGill University
Ane Fisker, Bandim Health Project
Sabine Damerow, Southern University of Denmark
Stephane Helleringer, New York University Abu Dhabi

In many low-income countries, the completeness of mortality information collected by civil registration systems is poor, and often differs by gender. Using survey data collected among 477 randomly selected urban households followed by the Bandim Health Project Health and Demography Surveillance System in Guinea-Bissau, we examined (1) how many and which deaths were registered between 2020-23, a period of potentially high mortality; (2) whether gender was associated with death registration, and how this association manifested; and (3) gender differences in reasons for (non-)registration. In total, less than a quarter (24%) of the 610 reported deaths were registered with the civil authority. No infant death was registered. A large gender gap in registration was observed among those aged 15+ at death (45% male vs. 22% female). Results from a formal decomposition analysis showed that compositional factors, in particular educational differences among the deceased, explained 79% of the disparity. Post-mortem pecuniary transfers were the main reported reasons for registration, especially of male and more educated deceased household members. Independent of gender, low perceived benefits and unawareness of the registration process were the primary reasons for not registering deaths.

Keywords: Civil Registration and Vital Statistics, Gender Dynamics, Population and Development

See extended abstract.