The Government of Nepal’s Ministry of Health and Population has issued the Procedure Relating to Hospital Death Record Management System, 2082 to make hospital death recording more systematic, reliable and consistent. The system is intended to cover deaths occurring in hospitals, people brought dead, and bodies examined through post-mortem procedures, with implementation across federal, provincial and local-level hospitals. It is designed to electronically record and authenticate deaths and their causes according to international standards and to become interoperable with the Vital Event Registration and Social Protection Management Information System (VERSP-MIS), Health Management Information System (HMIS) and other relevant digital health systems.
Hospitals must record accurate personal, medical and death-related information before the body is discharged. The attending doctor is responsible for medically determining the cause of death, with the sequence recorded from the underlying cause to antecedent and immediate cause according to ICD-11 mortality coding rules. The procedure also distinguishes natural and unnatural deaths and provides separate handling for post-mortem cases, people brought dead, stillbirths and cases where complete information is unavailable. Once the record is entered, the system generates a Unique Identification Number (UIN), and a medical certificate stating the cause of death is issued to the deceased’s family. A process is also provided for correcting errors in the certificate.
The medical death certificate and UIN are intended to serve as the basis for formal death registration by the relevant local registrar, with hospitals required to advise families to complete civil registration. Hospitals must also prepare monthly death reports and submit data through the prescribed reporting system and HMIS. The procedure requires hospitals to analyze mortality data and prepare preventable-death reduction action plans, using the findings to improve quality of care, hospital management and patient-safety measures. Where determining a cause of death is difficult, hospitals may use a formal death audit process.
The framework establishes federal and provincial coordination mechanisms and allows coordination committees at local level, with responsibilities covering system expansion, technical support, capacity building, data quality, monitoring and evaluation. Hospitals must designate responsible personnel, maintain confidentiality of personal information, and ensure timely and accurate reporting, while the ministry may conduct system audits and prepare annual mortality reports. The annexes provide standardized forms for individual death records, medical certification of cause of death, certificate corrections, monthly mortality reporting and hospital death-reduction action planning.
