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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
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60
70
HIS Infrastructure HIS Institutions, humanresources and financing
Policy and planning
Per
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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– [email protected]
Key Points
• Turning Point for Civil Registration in Africa
• Unprecedented Global Commitment for CRVS
• Standards-driven CRVS systems