Multi-Country Workshop for the Development of Accountability … · 4 Civil Registration and Vital Statistics Commission on information & accountability for Women’s and Children’s

Multi-Country Workshop for the

Development of Accountability Framework,

19-21 March 2012, Manila

Strengthening Civil Registration

and Vital Statistics: Introduction

Jan Smit

ESCAP Statistics Division

Civil Registration and Vital Statistics 2

ESCAP

Regional arm of the United Nations

Intergovernmental forum for all countries and

territories of the Asian and Pacific region

The largest of the five regional commissions of

the United Nations in terms of area covered,

people served and membership

53 members and 9 associate members,

representing over 60 percent of world’s

population

Statistics 1 of 7 substantive subprogrammes



Commission on information & accountability

for Women’s and Children’s Health

Recommendation 1: Vital events: By 2015, all

countries have taken significant steps to establish

a system for registration of births, deaths and

causes of death, and have well-functioning health

information systems that combine data from

facilities, administrative sources and surveys

Agenda for Action # 1: Develop roadmaps to

strengthen civil registration and the collection of

vital statistics supported by innovative ICTs


The UN defines Civil Registration as:

“The continuous, permanent, compulsory, and

universal recording of the occurrence and

characteristics of vital events (live births, deaths,

fetal deaths, marriages, and divorces) and other

civil status events pertaining to the population as

provided by decree, law or regulation, in

accordance with the legal requirements in each

country”

Principles and Recommendations for a Vital Statistics System Revision

2, p. 4: http://unstats.un.org/unsd/publication/SeriesM/SeriesM_19rev2E.pdf

http://unstats.un.org/unsd/publication/SeriesM/SeriesM_19rev2E.pdf


… and Vital Statistics as:

“The total process of:

(a) Collecting information by civil registration or

enumeration on the frequency or occurrence of

specified and defined vital events, as well as

relevant characteristics of the events themselves

and the person or persons concerned, and

(b) Compiling, processing, analyzing, evaluating,

presenting and disseminating these data in

statistical form” Principles and Recommendations for a Vital Statistics System Revision

2, p. 3


Uses of Vital Statistics

1. Estimating the natural increase (or decrease)

and the annual change in population size and

structure, and thus making sounder annual

population projections

2. Understanding the dynamics of reproduction

through information on live births

3. Calculating life tables and estimating the

probability of dying at various ages by studying

deaths, classified by age and sex, which are

also used for insurance and social security

purposes


Uses of Vital Statistics (cont.)

4. Estimating fertility and mortality for

understanding the growth dynamics of the

population

5. Monitoring the health status of a population by

directly measuring adult mortality and analyzing

causes of death and other characteristics of the

dead

6. Assessing for the planning of adequate health

intervention strategies by providing early insights

into trends in disease prevalence


Uses of Vital Statistics (cont.)

7. Analyzing nuptiality from the data on marriages,

divorces, annulments, and judicial separations

8. Setting targets and evaluating social and

economic plans, including monitoring of health

and population intervention programs

9. Measuring important demographic indicators of

levels of living or quality of life, such as

expectation of life at birth, infant mortality rate,

under-5 mortality rate, and maternal mortality

rate, among others


Potential sources of Vital Statistics

– Civil registration systems

– Household surveys (DHS, MICS, WHS, etc.)

– Sample vital registration systems – representative

samples of administrative areas for which demographic

events are recorded

– Demographic surveillance sites – recording of all

demographic events in geographic areas

– Hospital and health facility data

– Population censuses

– Administrative registers (police records, disease

registers, church registers, cemetery records, etc.)


Civil Registration preferred source …

... because it is the only source that:

Is available on a continuous and universal basis

and that is disaggregated to a level that enables

decision makers to identify marginalized groups

and vulnerable areas

Provides legal proof of identity, including family

relationship, age and evidence of death, that is

the basis for many legal and human rights

benefits

– Conversely, lack of identity puts vulnerable groups at

risk for adverse development outcomes (see examples)


Indonesia DHS 2007

Overall, 53% of births were reported as registered

Highest for births to mothers who:

– Live in urban areas (71%)

– Have completed secondary or higher education (74%)

– In the highest wealth quintile (84%)

Reasons given by mothers for non-registration

– Didn’t know that child has to be registered: 12%

– Didn’t know where to register the birth: 8%

– Place of registration is too far away: 8%

– No reason: 41%


Thailand: Ongoing UNESCO research

Highlanders without birth certificate / legal identity

/ citizenship are …

– ... compared to highlanders with citizenship:

– 73% less likely to enter primary school

– 94% less likely to enter secondary school

– 98% less likely to enter higher education

– Significantly less likely to receive healthcare

– Significantly more likely to be employed in exploitative

labour arrangements

– Significantly at risk of being trafficked and exploited

(single greatest risk factor)


Asia-Pacific-wide Rapid Assessment

Using WHO-University of Queensland Health

Information System Hub (UQ HISHub) tool – http://www.uq.edu.au/hishub/docs/WP%2002.pdf

Sent to all 58 ESCAP regional members

31 countries have reported as of to date

10 dysfunctional or weak

11 functional but inadequate

10 satisfactory: > 90% births & deaths registered

http://www.uq.edu.au/hishub/docs/WP 02.pdf


Common CRVS systems issues

Lack of strong legal framework, political

commitment and public awareness

Lack of national coordination and collaboration

– In particular between civil registrars, health ministries

and NSOs (but also Planning and Finance ministries)

Incompleteness of registration of vital events

Lack of availability and quality (in particular

timeliness) of vital statistics

Lack of dissemination and use of vital statistics


ESCAP Committee on Statistics (CST)

Forum of leaders of national statistical systems (i.e.

Chief Statisticians) of Asia-Pacific countries

– 1st session, February 2009:

– Recognized central role of vital statistics in generating

reliable population estimates and other development

indicators required for policy planning and evaluation

– Also noted persistent lack of progress in development

of vital statistics

– Requested ESCAP Secretariat to bring health

authorities, registrars-general and national statisticians

of member countries together


ESCAP CRVS improvement resolution

Adopted at 67th session, May 2011

Calls upon members to:

– Review and assess current functioning of civil

registration systems and quality of their vital statistics

– Use assessment results to develop and implement

comprehensive and costed strategies and plans to

strengthen CRVS systems

– Strengthen capacities of relevant institutions

Calls upon UN, international financial institutions,

development partners, NGOs, private sector to:

– Support countries in strengthening CRVS systems


Ongoing work and immediate next steps

Support to selected countries in conducting

detailed assessments of CRVS systems and the

formulation of costed improvement plans

– Assessments completed in Maldives, Philippines and

Sri Lanka; Indonesia ongoing; more to come

– Useful resources:

• WHO-UQ HISHub Guidance:

– http://www.uq.edu.au/hishub/docs/WP%2001.pdf

• UQ HISHub Resource Kit:

– http://www.uq.edu.au/hishub/docs/WP_19.pdf

– ESCAP & WHO, with support from ADB & UNDP

http://www.uq.edu.au/hishub/docs/WP 01.pdf

http://www.uq.edu.au/hishub/docs/WP_19.pdf


Ongoing work (cont.)

Development of Asia-Pacific Action Plan

– In consultation with member States

– And with key development partners, including WHO,

Health Metrics Network (HMN), UNDP, UNFPA, ADB

High-level regional forum

– In partnership with HMN

– Bangkok, 10-11 December 2012

– For senior officials of health authorities, registrars-

general and national statisticians

– Expected to endorse Regional Action Plan


Thank you

Strengthening the ‘evidence’ for

evidence-based policy making:

http://www.unescap.org/stat/

http://www.unescap.org/stat/social-stat/

Documents

Multi-Country Workshop for the Development of Accountability … · 4 Civil Registration and Vital Statistics Commission on information & accountability for Women’s and Children’s