Post on 21-Jun-2015
The Pacific Counts.Improving civil registration and vital statistics
Policy and planning uses of CRVS in the Pacific
Audrey AumuaTechnical Advisor
WHO Pacific HIS Knowledge Hub
University of Queensland
Karen CarterVital Statistics and Civil Registration
SpecialistStatistics for Development Division
Secretariat of the Pacific Community
• Isolated islands and territories
• Small pockets dispersed of populations
• Complex and fragmented CRVS systems (collection and legislation
• Lack of awareness of registration
• Significant problems with accuracy of cause-of-death data
• Lost data due to events occurring offshore
• Limited analysis and use of data
• Duplication of responsibilities for vital registration
• Poor cause-of-death certification practices.
• Limited data sharing between agencies
The Challenge of CRVS in the Pacific
The importance of CRVS in the Pacific for Policy and Health
HEALTH PLANNING• Identifying Priorities – NCD’s / Maternal and Child health• Targeting Health Programs – Populations at risk• Service Delivery - Immunisations / Population s / Midwives etc• Monitoring and Evaluation – funding / international agreements
GOVERNMENT SERVICES• Education – planning for number and location of teachers• Social Security – i.e. age of retirement• Population Statistics
IDENTITY AND SECURITY• Passports• Electoral Rolls• Disaster Planning (populations at risk and follow up)
LAND RIGHTS and INHERITENCE
Drivers for better information in the Pacific
• Priorities articulated in the Pacific Plan of regional Heads of
Governments
• Ten Year Pacific Statistics Strategy (TYPSS) 2011-2020.
– The TYPSS has been endorsed by statistical agencies from all
Pacific Islands and subsequently also endorsed by:
• SPC’s 40th CRGA meeting and subsequent Ministerial conference, and
• PIFS’ Finance and Economic Ministers Meeting (FEMM)
• Donor initiatives to improve health systems through improving
knowledge about health information systems, (WHO, AusAID)
• Global initiatives such as the Millennium Declaration and MDGs and
maternal and child health
The overarching aim of the plan is to assist Pacific countries to improve their statistics on birth, deaths, and cause-of-death through routine collections and thereby provide decision-makers with the evidence needed for effective planning.
The Pacific Vital Statistics Action Plan
Policy Use
Data accessibility and interpretation
Data
collection
and quality
• Non-communicable diseases (NCDs) are the leading cause-of-death in Pacific Island Countries and Territories and are responsible for over 70% of all deaths
• Life expectancy in several Pacific Countries has not improved in many years with Life expectancy in some countries less than 60 years of age.
• Improvements in maternal and child health have been offset by high premature adult mortality – hence high mortality rates remain in some countries
• While health professionals all have a “sense” of the issue – CRVS is important for EVIDENCE – monitoring changes and obtaining resources
NCDs – a critical emerging health issue
Ministers of Health Meeting Solomon Is; 28 – 30 Jun 2011
Example: Age-standardized rates showing increase in NCD’s over time
Carter KL, Hufanga S, Rao C, Akauola S, Lopez AD, Rampitage R, Taylor R. Causes of death in Tonga: quality of certification and implications for
statistics. Popul Health Metr. 2012 Mar 5;10(1):4.
Age-standardized mortality for males (selected causes) for Tonga, 2001–2009 (plausible range based on upper and lower mortality scenarios).
• Good quality data is important to ensure that other important health issues are not lost in the push to address NCD’s
For example –
• when calculated by age, the leading cause of death for adult males 15-59 years in Niue is external causes (mostly suicide) – not NCD’s
• Infant and child mortality remains an issue in places like Kiribati where protein malnutrition remains a leading cause of death in children
• Infectious diseases such as Malaria continue to be an issue in several countries and need to be monitored
• Septicemia is an important cause of death in several countries and is not always linked to diabetes - important in monitoring infection control
• TB is re-emerging in a number of populations as a disease of public health importance.
There is more than one story….
• The Pacific Vital Statistics Action Plan encourages a national approach –
across sectors
• Drives governance and accountability
– Country voice in international discussions ie the post 2015 development
agenda
– Population statistics- size / distribution and representation
– Funding and accountability (i.e. Compact of association)
• High adult mortality (and morbidity) in working age adults affects
development / family structure / the economy / dependency ratios etc
– Mortality data is critical in addressing reasons and responses to this
high adult mortality.
• Workshops / assessments based on a multi-sectoral approach and BAG
agencies agree to support TA to a national plan / set of priorities
Good civil registration and vital statistics supports development
Thank you
ON BEHALF OF THE BRISBANE ACCORD GROUP OF PARTNERS