Less than one out of five deaths in India is medically certified to denote cause of death. Deaths with medical certification of the cause were a mere 2.5% of estimated deaths in Jharkhand, 3.1% in Uttar Pradesh and 4.7% in Bihar. This emerges from an analysis of data from two reports recently released by the census commissioner’s office. This assumes greater significance at a time when a debate is raging on whether Covid-19 deaths are being accurately counted. The problem in states such as Bihar, UP and Jharkhand is two-fold – a low level of registration of deaths and a low proportion of even registered deaths being certified for cause. In Bihar, for instance, data from the Civil Registration System (CRS) for 2018 shows that only 35% of all deaths were registered, the lowest proportion among major states. And, of those registered, only one in seven was certified for cause of death, according to the report on Medical Certification of Cause of Death (MCCD).