Session 7 - Fiji

Improving Fiji’s Vital Statistics “TOGETHER”

The Fijian Experience on Civil Registration and Vital Statistics

Shivnay NaiduDirector Health Information, Research and

Analysis

Friday 19th April 2013Global Summit on CRVS (Bangkok, Thailand)

“Make Every Life Count”

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Layout

1. Fiji CRVS System

2. Personal Experience

3. Process Involved

4. Key Challenges Encountered

5. Benefits to Fiji

6. SWOT

7. Outcome

8. Progress

9. Way Forward

10.Lessons Learnt – can be applied?

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Structure of Civil Registration & Vital Statistics

Health

Register GeneralBureau of Statistics

National Vital Statistics

Medical Officers, Nurse Practitioners

1. Divisional Hospitals2. Sub-Divisional

Hospitals3. Health Centres4. Nursing Stations

Provincial Office

District Officers

Towns, Village

Birth and Death Occurrence

1. Ministers2. NGOs3. Donors4. Public5. Researchers6. Others

Data SourcesRegistration

Users of Statistics

General Public

ITC Services(Govnet – PATIS,

BDM)

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Experience

• Commitment and dedication was required on my behalf

and Mr Serevi

• Prioritization among other activities for these meetings

• Getting all stakeholders to meeting was a major

challenge (discussed later)

• Understanding the importance of CRVS and its benefits to

Fiji

• Trying to interpret and analyse assessments and tools

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Process Involved

Awareness and Advocacy of CRVS•HIS Short Course Aug 2011

•Bag Meeting (PHIN VP) Feb 2012

Establishment of CRVS Committee•Membership identification

•Support from Senior Executives for release of members

•Define what to do and why

Assessments Review•Previous Assessments (HMN etc)

•Rapid Assessments

Holiday Inn Workshop•Support from WHO, HIS Hub, SPC

Recommendations and Way Forward•19 recommendations for improvements

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Key Challenges for the Process

• Leadership and Governance

• Communications

• Meeting Logistics

• Incentives for meeting

• Accountability and Responsibility

• Attendance

• Technical Expertise

• Drivers for change

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Benefits to Fiji

• Understanding the importance of CRVS and use of it

• Strengthened relationship between stakeholders (MoH,

RG, BOS, ITC, PD)

• Country led and owned process of identifying areas of

improvement

• Developed prioritized recommendations and action plan

with estimated cost implications

• Some progress already made

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Attrition Change in Leadership

Change in Country PrioritiesNatural Disasters

Threats

Lack of Coordination between key agencies

Poor AttendanceCompeting Priorities

Staff TransfersData Extraction

Weaknesses

Unfavourable

Leadership & Management SupportTeam Work & CommunicationOwnership & Accountability

Finance and ResourcesPrevious Country Assessments

Strong ICT Infrastructure

Strengths

Favourable

Inte

rnal

Assistance from BAG, UQ HIS Hub and WHO

External ICT Audit – YalamanchilliMinister’s High Level Meeting

Pacific Vital Statistics PlanTraining and Capacity Building

Opportunities

Ext

ern

al

SWOT

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Holiday Inn – Milestone (after 10 committee meetings: 25th September 2012)

• Coordination, cooperation, collaboration and commitment

from all stakeholders for this meeting

• Joint effort in preparing slides and presenting

• Consensus on 19 recommendations

• Using HIS Hub tool WP23 – prioritization of

recommendations were made

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Some memories from the meeting.

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Outcome

Made under 5 different categories

• Legal

• Registration Practice

• ICD Compliant Practices

• Data Quality, Dissemination, Access

• Coordination

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Category No Recommendations1 Review of Legislation

2 Strengthen data sharing and define roles of each agency

3 Review of Policy - compliance and litigation

4 Increase registration in remote and diffi cult areas

5 Address late registration

6 Mass catch-up of registration

7 Engage with broader group of stakeholders (incl. local community)

8 Improve monitoring of collection process

9 Investments - capacity building and infrastructure

10 Improve death certification quality

11 Improve coding quality

12 Improve quality and reliabil ity of data

13 Improve human resources for data collection and analysis

14 Improve access to vital statistics data and reports

15 Build Local capability to use their own data/statistics.

16 TOR of committee - more committed

17 Improve Cordination - national and local

18Examine and Define roles and responsibil ities in administrative processes

19 Agree on administrative boundaries

Legal

Registration Practice

ICD Compliant Practices

Data Quality, Dissemination, Access

Coordination

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Progress

• Budget Approved for 2013o $20,000 by RG on improving registration

o MOH $100,000 for ICD 10 Coder Training $50,000 for CoD Training Nationally $10,000 for CRVS Training

o BOS

• Some budget for data analysis and production

• Legal o Sub-committee for review of legislation established

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Progress ….cont

• Registration Practiceso Production of awareness flyers in iTaukei language

o Mass Registration

o Workshop planned for May for developing strategies to conduct

mass registration

o Infrastructure: Interoperability of systems assessment being

undertaken

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Progress ….cont

• ICD Complianceo ICD 10 Train of Trainers 30th – 31st October 2012 (2 Medical

Officers)

o ICD 10 AM License Deed renewal obtained from Australia

o Contract term extended to 30th June

o CCOD training conducted in March for Central Division 30 MOs

(by ToT MO)

o ICD 10 Training for all medical recorders and coders in May

2013

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Progress…cont

• Data Quality, Dissemination and Useo Data sharing between BOS and MoH (2008 – 2010)

o Update of DC records with address and occupation completed

for 2008 -2010 completed on Feb 28th

o Use of ANACOD tool for quarter 1 data quality audit

o Provision of computers at HIU for BOS staff

o Provision of workstation at CWM for RGs staff for registration

(BDM)

o In-house training by CRVS Short Course participants at MoH

(others to follow MoH)

o Health Information Bulletin includes vital statistics

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Progress…cont

• Coordinationo 4 meetings already conducted in 2013

o TOR of committee in draft form

o Involvement of ITC Services for e-gov services (citizen portals)

o Technical/Donor coordination planning meeting to be

undertaken in May

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Category Way ForwardLegal Technical Assistance required for review of policy

Workshop Planning and Preparations

Develop Flyers in three languages

Develop media advertisement (content)

Meeting with Provincial District Officers

Targeting Remote Areas(Technology)

Training Materials

QUT time and commitment

Awareness with Senior Management

Data Analysis and Use

More training for staff

Finalise TOR

Develop and define roles and responsibil ities

Finalise MoH and EA boundaries

GIS Mapping and Use

Registration Practice

ICD Compliant Practices

Data Quality, Dissemination, Access

Coordination

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Lessons learnt – that can be applied

• Communicate, Communicate and Communicate

• Identify a champion (s) – driver of change

• Establish a CRVS Committee – dynamic and strong chairperson

• Identify strengths and build on it

• Conduct rapid assessment and prioritisation of

recommendations (of challenges) – work towards a CRVS Strategic

Plan

• Work on things that can be done quickly and get management

support – quick wins

• Data and knowledge sharing – MoU, Memos etc

• Get technical support and assistance from experts (BAG) but own

the process – its yours

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• Thank You for your Attention.

• Vinaka Vakalevu.

Travel

Session 7 - Fiji