www.healthmetricsnetwork.org1

IMPLEMENTING IMPROVEMENTS IN CIVIL REGISTRATION AND VITAL

STATISTICS SYSTEMS

_______________Conference of Africa Ministers Responsible for Civil Registration

Addis Ababa, Ethiopia. 10-14 August, 2010

Key Points

• Turning Point for Civil Registration in Africa

• Unprecedented Global Commitment for CRVS

• Standards-driven CRVS systems

Outline

• Role of the health sector• Vital Statistics• Cause of Death• MoVE-IT for MDGs• Policy and Legal Framework for CRVS• Tools and Resources

Role of the Health Sector

• Many births and deaths occur in health facilities• Pregnancies – need for early detection and recording• Health sector should be legally required to record

and report births and deaths• Statistics sector should be legally required to provide

mortality rates and to demand cause of death data• Sector linkages are often weak or absent

Vital Statistics

• Recent attention to the shortcomings of estimates used in the health sector

• Opportunity to mobilize health sector donors for CRVS improvements to achieve MDGs

• Increasing recognition to utilize actuarial and cause of death data for forecasting and financial planning

Cause of Death

• Mortality patterns inevitably demand explanations

• International Classification of Diseases (ICD) enables standard coding of diagnoses and cause of death

• Health worker training for certification of death and cause of death is weak

Cause of Death

• Even strong CRVS systems have "garbage code" problems

Percentage of garbage codes by type of GCs and ICD version, all ages.

Source: Naghavi et al, 2010

Cause of Death

• Garbage Code Distribution

Source: Naghavi et al, 2010

Fraction of deaths assigned to GCs in the latest ICD-10 year since 2000

MoVE-IT for the MDGs• HMN Priority Strategic Initiative• Monitoring of Vital Events - using Information

Technology • Birth, death & cause of death for MDGs 4/5/6 • Every Birth, Death, and Cause of Death

Recorded and Certified• Civil Registration System - Sustainable Source

of Vital Statistics, and Quality Information

MoVE-IT for the MDGs: Partners

• Bill and Melinda Gates Foundation

• G8 and H8 Leaders• Government of Canada• IHME• PARIS 21• PHII• Rockefeller Foundation• The Lancet• UN Foundation• UNDESA/UNSD• UNFPA• US Government• Women Deliver• IN-Depth Network

• Countdown 2015• GAVI• Government of Norway• m-Health Alliance• PATH• R4Development• Global Fund to Fight AIDS, TB and

Malaria• DfID- UK• UNAIDS• UNDP• UNICEF• WHO• The World Bank• PMNCH

Policy and Legal Framework

• HMN assessments reveal that policy is among the weakest components of country information systems

• Countries have expressed an urgent need for analysis of policy options and preparation of models or templates for legislation

• Participants are invited to indicate interest in working with HMN to draft a common framework for health information policy in the context of CRVS systems (e-mail: healthmetrics@who.int )

Policy: as a Weakest HIS Domain1

0

10

20

30

40

50

60

70

HIS Infrastructure HIS Institutions, humanresources and financing

Policy and planning

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1 Based on HIS Assessment conducted during 2006-2010 by 27 Africa Countries that used HMN Assessment Tool

Policy Challenges

• CRVS Policy can be enacted from national constitution, statistical system legislation, freedom of information legislation, or international conventions

• Requires multi-sectoral action and commitment for a functional CRVS system

• Privacy, security, confidentiality and rights must be balanced against the need to share data to detect emerging risks or epidemics

HMN Role

• Support and advocacy for CRVS resolution • Facilitate countries access to resources on

CRVS policy• Platform for CRVS information exchange

– Health un-Bound" (HUB) web community– Promote "best practices" for strengthening CRVS

systems– UNSD guidelines and documents

Tools and Resources• Tools

– MoVE Resource Kit– CRVS System Assessment Tool

• Resources– HUB (Health UnBound) - On-line Partners Forum – ICD coding and web-based training– Guidelines on Resource Mobilization (including GFATM Proposal

Guidelines)– List of Institutional and Individual Technical Support Resources– Assistance for measuring efficiencies and impact of ICT, mobile devices

• Send Request e-mail to: healthmetrics@who.int

Key Points

• Turning Point for Civil Registration in Africa

• Unprecedented Global Commitment for CRVS

• Standards-driven CRVS systems

THANK YOU