HMIS data: All India excess mortality

One way to look at excess mortality from the Covid-19 Pandemic is through the Health Management Information System (HMIS) dataset. While this has many drawbacks, the most pertinent one being that deaths are underreported here as well, It does give us a nationally representative picture of the excess mortality due to Covid-19 across the two waves of the pandemic.

The graph above is based on all-cause deaths for adults and adolescents, and also reflects maternal mortality. From this graph, we can clearly see a spike in April-May of 2021, clearly the worst time in the pandemic for India so far, and significantly higher than deaths recorded in 2020. However, July 2020 onwards, every month has witnessed higher deaths than the corresponding month in 2018 and 2019. A recent analysis by Rukmini S for IndiaSpend delves into the insights from the HMIS data in greater detail.

While the HMIS has data going all the way back to 2008–09, there was a major reporting change in Financial Year 2017–18. This coincides with the National Health Mission being extended in FY 2017 for another 3 years. We therefore report only 2018 and 2019 as reference years for excess deaths.

Geographical Distribution of All-Cause Adult Deaths Across the Country

The first map plots all adult deaths recorded in the HMIS per 10000 population (taken from the 2011 Population Census) across all districts for the first 5 months of 2020. While not necessarily an indicator of which districts had it worse since reporting might vary between districts, we can compare it with a similar map above for the first 5 months of 2021.

Nearly every district lights up more in 2021 compared to 2020, an indication that even with underreporting, the pandemic’s second wave was more devastating than its first.

The HMIS also has data on immunization, medical stock of vaccines, infant and maternal health, inpatient and outpatient admissions, and medicine stocks. The HMIS data, linked with census identifiers at the district level can be accessed at the Development Data Lab’s open access COVID platform here.

****************************
— Kritarth Jha & Sankalp Sharmaa