2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Background:
The Medical Certificate of Cause of Death (MCCD) is a critical document issued by physicians, serving as a primary source of mortality data. Accurate completion is essential for generating reliable statistics, which guide disease-control measures and inform health interventions. However, errors in MCCD completion remain common.

Objectives:
To assess the knowledge and accuracy of junior doctors in completing the MCCD and to evaluate the effect of a structured educational intervention on improving death certification practices.

Methods:
A quasi-experimental, hospital-based quality improvement study was conducted at a tertiary hospital in Bengaluru, India, involving 120 junior doctors (MBBS graduates and postgraduates) across 10 clinical departments. A baseline survey and model MCCD completion exercise was administered using simulated death scenarios. Errors were assessed using the University of Melbourne MCCD Assessment Tool based on WHO’s Form 4 and ICD-10 guidelines. Participants then received a structured training session on the importance, components, and correct completion of MCCD. A post-intervention assessment was conducted to evaluate improvements.

Results:
At baseline, knowledge regarding MCCD was low (mean score: 4.94 ± 2.21), and all participants committed at least one avoidable error. The most frequent errors included omission of time intervals (75.8%), use of abbreviations (60%), and incorrect sequencing of causes (25.8%). After training, knowledge scores improved significantly to 8.18 ± 0.77 (p < 0.001). Major errors were markedly reduced—use of abbreviations declined from 60% to 12.5%, omission of time intervals from 75.8% to 51.6%, and overall, correctly completed certificates increased from 54.1% to 65.0%.

Conclusion:
Structured educational interventions significantly improve the accuracy of Medical Certification of Cause of Death (MCCD), thereby strengthening the quality of mortality data. Scaling up such training across medical colleges and health facilities can enhance national health information systems, guide evidence-based policy, and contribute to global health priorities, including the Sustainable Development Goals (SDGs) on health and data monitoring.