• Highlights

• In 2024, the estimated percentage of underreporting was 0.95% of births in the year, the lowest in the time series that started in 2015, and the first time the indicator was below 1%. The highest percentage was observed in the North and Northeast, where Roraima (13.86%), Amapá (5.84%), Amazonas (4.40%), Piauí (3.98%) and Sergipe (3.10%) stand out. Conversely, the lowest rates were found in Paraná (0.12%), Federal District (0.13%), São Paulo (0.15%), Rio Grande do Sul (0.21%) and Minas Gerais (0.23%).
• In 2015, it was estimated that 3.94% of the births in hospitals were not registered in a registry office; in 2024, this percentage fell to 0.83%.
• Live births of mothers aged under 15 had the highest percentage of underreporting (6.10%) in comparison with other ages. This percentage falls with the increase of age and reaches its lowest figure in the group aged 35 to 39 years (0.63%).
• In 2024, the estimated proportion of underreported deaths in the country was 3.40%. The highest percentages were found in Maranhão (24.48%), Amapá (17.47%), Piauí (16.15%), Pará (16.10%) and Roraima (10.91%). On the contrary, the lowest rates were registered in Rio de Janeiro (0,14%), Federal District (0.17%), Paraná (0.56%) and São Paulo (0.65%).
• The lowest rates of underreporting of deaths were observed in (2.85%) and in other health establishments without hospitalization (2.55%).
• By age of the deceased person, the highest underreporting estimates were observed for persons under 1 year of age (infant mortality), 10.80% and for persons aged 1 to 4 (child mortality), 7.74%.
• The estimated underreporting of child mortality in Major Regions reached highest figures in the North Region (26.55%) and in the Northeast Region (17.58%). The Southeast Region recorded the lowest rate (2.67%), followed by the South (2.96%) and Central West (5.86%).

In 2024, the estimated rate of under-registration of live births was 0.95%, and stood below 1% for the first time. That represents a decrese of 3.26 percentage points from the start of the time series, in 2015, when the rate was 4.21%. Data come from the Estimates of Under-registration of Births and Deaths, released today (20) by the IBGE. 

With this result, Brazil gets even closer to the target of universal coverage of live births, as recommended by UN. “This evolution indicates significant advances in the coverage of the Vital Statistics System,” says José Eduardo Trindade, analyst from the IBGE's Division of Population and Social Indicators (Copis). “That was a level expected by many, especially because it considers the attempt to eradicate under-registration ."

In Brazil, two agents are mostly responsible for the collection of statistical information on live births and deaths: the IBGE, by means of the system of Vital Statistics, using data obtained from Civil Registry offices and the Ministry of Health, by means of the Information System of Live Births (Sinasc) and the Information System on Mortality (SIM), fed by information reported by health establishments and medical services.

The estimated under-reporting rate, in Sinasc was 0.39%, with a drop of 1.62 percentage points since 2025 (when it was 2.01%), also showing improvementt in the coverage of the health information system. “The synergy between these systems, by means of linkage and matching techniques, allows the improvement of quality and the completeness of vital statistics in the country,” Trindade explains. 

Jailson Assis, also an analysts from IBGE's Copis, highlights the importance of data for citizenship. “In the case of live births, civil registry ensures children's right to protection, access to school, healthcare and social programs.” On the other, under-registration and underreporting reveal constraints: the under-registration of 0;95% represents, approximately, 22,902 children without a legal identity document, with direct implications on the access to basic essential services.

Rate of under-registration of deaths reaches 3.4% in 2024

In 2024, the estimated rate under-registration of deaths was 3.40%, representing a decrease of approximately 1.5 p.p. from  2015, when the rate was 4.89%. That corresponds to a coverage rate of 96.6% for the system of Vital Statistics.

Under-reporting of deaths in SIM in 2024 also had a trend to decrease and stood at 1.00%, with a decrease of approximately 1.32 percentage points since 2015.

“These results represent a gradual trend to decrease in both indicators, although at a lower pace in comparison with live birth records,” remarks José Eduardo Trindade. He explains that the years 2020 to 2022, marked by the COVID-19 pandemic, presented changes in historical patterns, with a temporary increase of the absolute volume of deaths and possible impacts on the coverage of registry systems, resultimg from the overburden of healthcare services and of changes in the flows of service and registration. “From 2023 on, a resumtpin of the downward trend is observed, pointing to resilience and continuity of efforts for qualification of vital statistics.”

North and Northeast Regions record highest under-registration rates

In the comparison by Major Region, the highest percentages of under-registration were found in Federation Units located in the North and Notheast, both in relation to deaths and to live births. According to the survey analysts, these disparities reflect differences in the health infrastructure, in the density of civil registry offices, in demographic characteristics (rural, indigenous and quilombola population) and in regional socioeconomic development.

The highest under-registration rates of live births were found in Roraima (13.86%), Amapá (5.84%), Amazonas (4.40%), Piauí (3.98%) and Sergipe (3.10%), all of which are states located in the North and Northeat Regions. On the other hand, the lowest rates were those of Paraná (0.12%), Federal District (0.13%), São Paulo (0.15%), Rio Grande do Sul (0.21%) and Minas Gerais (0.23%), concentrated in the South and Southeast Regions.

“A possible reason for these high rates in the North is the difficulty of access to civil registr offices, when users need to travel long distances," says Jailson Assis. “Many times it is only possible to cover this distance by boat, so it is a kind of characteristic difficulty in this Major Region.”

At municipal level, the concentation is even more evident: the ten municipalities with the highest birth under-registration rates are, exclusively, in the North and Northeast Regions. Among the  212 municipalities with under-registration equals to or above 5%, 39% are located in the North and 43%, in the Northeast Region. The spatial pattern of underreporting is more dispersed geographically, with three municipalities in three different Major Regions recording a rate of approximately 20%.

As for the under-registration of deaths, the geographic distribution presents an even more unequal spatial pattern than in the case of live births. the highest percentages, above 10%, were in Maranhão (24.48%), Amapá (17.47%), Piauí (16.15%), Pará (16.10%) and Roraima (10.91%). Conversely, the lowest rates were those of Rio de Janeiro (0.14%), Federal District (0.17%), Paraná (0.56%) and São Paulo (0.65%). These disparities reflect differences in health infrastructure, in the density of civil registry offices, in demographic characteristics (rural, indigenous and quilombola population) and in regional socioeconomic development.

The underreporting of deaths in SIM had its highest rates in Piauí (7.14%), Acre (3.07%) and Maranhão (3.04%). The highest rates were observed in the Federal District (0.18%), Rio de Janeiro (0.25%), Espírito Santo (0.29%) and Paraná (0.37%), reinforcing the pattern of better coverage in the South and Southeast.

Only 0.83% of births in hospitals were not registered 

Births in hospitals and similar establishments, which concentrate the vast majority of registries and reporting, tend to present significantl lower under-registration rates, in comparison with birth at home or in other places. In 2015, it was estimated that 3.94% of the live births in hospitals were not registered in a registry office; in 2024, this percntage fell to 0.83%. Births in other health establishments without hospitalization fell from 6.83%, in 2015, to 2.23% in 2024. The steepest drops, also in the 2015/2024 comparison, were those of under-rgistration of births at home (from 24.32% to 9.26%) and in other places (from 35.14% to 19.35%) which, in spite of higher percentages, represent the smallest part of the number of births.

This difference reflects the increased integration between civil registry systems and information systems in hopspitals and similar establishments, where the Live Birth Certificate (DN) and the e oreferral for civil registration is a routine procedure facilitated by the presence of Interconnected Units,” Jailson Assis explains. “In the hospital itself, when a child is born, the father can go to the unit inside the hospital and see to the child's registration. This initiative has grown significantly.  Document regularization campaigns and integration of computerized systems also took place.” 

As for underreporting, births at home stand out, with the biggest proportional decrease in the time series, with current rates (3.05%) below that of the category "other locations” (3.51%). This indicates an improvement in the coverage of Sinasc for household events, possibly fostered by the work of teams in primary Attention and by Community Healthcare Agents, Assis remarks. 

Under-registration among teenage mothers reaches 39% in Roraima

Live births to mothers under 15 years of agrecorded the highest percentage of under-registration (6.10%) compared to other ages. This percentage decreases with the increase in age and reaches its lowest figure among mothers aged 35 to 39 years (0.63%). In the comparison between 2024 and 2015, it is possible to observe a decrease in all the age groups. “All the groups of mothers aged 25 to 49 years of age had rates below 1%. But the most concerning group is mothers under 15 years of age,” Assis highlights. “In this group, the state of Roraima recorded the highest percentahe of under-registration (39.35%), followed by Amapá (22.31%) and Amazonas (14.63%). 

“There are some reasons accouting for that, such as the lack of support to this teenage mother and guidance on the most appropriate way to register the child," says Trindade. This increased vulnerability in birth registries of teenage mothers is particularly concerning, considering implications on the access to essential services (health, education, social programs) and for the impementation of rights of both mother and children.  

As for underreporting, the observed pattern is reversed: the highest rates are concentrated in older age groups (mothers aged ), suggeting a smaller coverage of  Sinasc for births to mothers at older ages. 

Under-registration of deaths is lower in events occurred in health establishments

In 2024, the lowest rates of under-registration of deaths in events were observed in hospitals (2.85%) and other health establishments without hospitalization (2.55%). That reflects the biggest inetgration between healthcare systems and civil registry in these environments, with institutional flows established for the issuing of the Death Certificate (DO) and referral for civil registration and reorting to the SIM.

In comparison with 2015, there were drops in all the areas surveyed: from 4.00% to 2.85% in hospitals; from 3.13% to 2.55% in other health establishments without hospitalization; from 7.03% to 4.76% at home; from 7.08% to 5.15% in a public place and from 8,26% to 5,74% for other.

As for underreporting, there is a similar pattern, with rates of 0.76% for hospitals and of 0.72% for other health establishments, and with a relevant decrease in underreporting of home deaths, which went from 5.18% in 2015 to 1.65% in 2024.

Deaths of those ged 0 to 14 years had highest under-registration percentages 

The analysis by age of the deceased person, the highest occurrence of under-registration is found among persons under 1 year of age (infant mortality), with a rate of 10.80%, and 1 to 4 years (child mortality) with a rate of 7.74%. The estimated under-registration of infant mortality in the Major Regions reached its highest values ​​in the North Region (26.55%) and the Northeast Region (17.58%). The Southeast Region recorded the lowest rate (2.67%), followed by the South Region (2.96%) and the Central-West Region (5.86%).

According to José Eduardo Trindade, potential difficulties in registering deaths among this population include deaths occurring at home in remote areas, weaknesses in the investigation process for infant deaths, and difficulties accessing registry offices for vulnerable families. "This pattern indicates that attention should be primarily focused on childhood, an age group where under-registration directly compromises the monitoring of the Sustainable Development Goals related to child health," he assesses.

More about the survey

The Estimates of Under-regitration of Births and Deaths are obtained through record linkage between databases of Vital Statistics (IBGE) and of the Ministry of Health (Sistema de Informações sobre Nascidos Vivos - Sinasc and Sistema de Informações sobre Mortalidade – SIM). The release presents under-registration and underreporting estimates of live births and deaths in 2024, disaggregated by Federation Unit and Municipality. the survey analyzes variables such as place of occurrence of the event, age of the mother (live births) and age of the deceased (deaths). The publication also presents the time series since 2015, allowing the assessment of trends and the contribution of these statistics in the monitoring of the 2030 Agenda of Sustainable Development Goals.