www.healthmetricsnetwork.org04/21/231

IMPLEMENTING IMPROVEMENTS IN CIVIL REGISTRATION AND VITAL

STATISTICS SYSTEMS

_______________Conference of Africa Ministers Responsible for Civil Registration

Addis Ababa, Ethiopia. 10-14 August, 2010

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

• Inter-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 for social services

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

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: 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

• A functional CRVS systems requires multi-sectoral action and commitment

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

Network Role

• Support for CRVS resolution and its implementation

• Facilitate countries' access to resources:– Common platform for linkage to health standards– Technical support network– Resource mobilization (especially GFATM)– Documenting efficiencies and impacts– healthmetrics@who.int

Key Points

• Turning Point for Civil Registration in Africa

• Unprecedented Global Commitment for CRVS

• Standards-driven CRVS systems