This project was aimed at strengthening vital event (birth & death) registration at the local administrative level through a combination of supply-side interventions (sensitization workshops for government officials, training for hospital staff and data-sharing partnerships) and demand-side interventions (such as publicity campaigns in the villages/towns). This was followed by active surveillance for vital events by lay-informants. The project was implemented in five mandals (subdistricts) – Palamaner, Gangavaram, Baireddypalle, V Kota and Ramakuppam – with a total population of 281,500 (in the year 2007) in Chittoor district of Andhra Pradesh state. At the end of 12 months, birth registration increased to over 80% from 50% in the pre-intervention phase and death registration increased to 61% compared with pre-intervention rates of 25%. We also employed verbal autopsy to study the cause-of-death epidemiology in this rural area; cardiovascular disease was found to be the commonest cause of death among adults in this region.