Making Every Person Count: Vital Strategies in Conversation with Farnaz Malik and Robert Mswia
Note: This interview was originally published on Vital Strategies’ website.
Vital statistics — data on births, deaths, and cause of death — produced by complete and well-functioning civil registration systems provide fundamental information needed for effective government planning. ‘Complete’ data means that every person is counted and that information is inclusive of each member of the population. Data on vital events is also critical in measuring a country’s progress toward achieving many of the UN Sustainable Development Goals (SDGs).
Through the Bloomberg Philanthropies Data for Health Initiative, Vital Strategies’ Civil Registration and Vital Statistics (CRVS) and Data Impact teams have published two new resources, a guide to Estimating Completeness of Birth and Death Registration and a resource kit for the Production of a Vital Statistics Report, to aid governments in two important ways: generating vital statistics reports and assessing completeness of birth and death registration.
To learn more, we sat down with Farnaz Malik, Technical Advisor, and Robert Mswia, Senior Technical Advisor for Verbal Autopsy.
Q: How do vital statistics reports help governments improve planning and priority setting?
A: Civil Registration and Vital Statistics (CRVS) is at the root of good governance. The regular production of a vital statistics report–which includes the numbers of births and deaths in a population–serves important governmental needs for monitoring and priority-setting across that include cause of death data can enhance public understanding of critical public health issues. For example, these reports can provide transparency and accountability for progress in health, demographic, and social indicators, and help identify health and social sector priorities, inequities or gaps.
Q: How can the new resource kit help governments improve their CRVS systems?
A: Globally, at least 25% of births of children under age 5 and 40% of deaths remain unregistered. By regularly producing vital statistics reports, governments can identify gaps and limitations in the existing CRVS system, such as incomplete birth and death registration data, and increase investment to improve the system.
To help governments generate these reports, our team at Vital Strategies worked with our partners at the United Nations Economic Commission for Africa (UNECA), the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP) and Statistics Norway to create a new resource kit for the Production of a Vital Statistics Report. This is a revision and augmentation of the “Guidelines and Template for Developing a Vital Statistics Report” published in 2017. This new update includes a separate, editable template and an Excel workbook to generate tables and graphs.
This new toolkit includes a Vital Statistics Report Guide, Template and Excel Workbook to provide government staff with the tools needed to generate annual vital statistics reports and track progress toward the SDGs. An interim version of the Template was used by the National Institute of Statistics of Rwanda to produce the country’s first-ever vital statistics report. The guide is also being used by the National Statistics Bureau of Bhutan to develop its first-ever vital statistics report and we anticipate the resource will be used by several more countries with assistance from Vital Strategies and regional partners such as UNESCAP and UNECA through the Data for Health Initiative.
Q: What is the importance of estimating birth and death registration completeness?
A: Completeness, or the principle of “universality,” is at the heart of the civil registration mission. Measuring birth and death registration completeness tells us how many people are being left behind in the effort to attain and maintain the continuous and universal record of all vital events in a population within CRVS systems.
This is important for two reasons. First, those whose births, deaths, marriages or divorces are not registered lack the rights, protections, and/or access to services that come with the official registration of each of those vital events. For example, it may be difficult to assert all the rights and protections available for a child bride whose birth was not registered and hence has no official document to prove she is under-aged. Second, reliability of statistics based on civil records, and how well they represent the full population, depends largely on how well the system achieves its goals of universal completeness. It is important for statisticians to understand where registration is because, unless adjusted or well-contextualized, it may produce a skewed or biased understanding of local conditions.
Understanding the completeness of birth and death registration thus allows governments to address gaps in CRVS systems for the direct benefit of those whose vital events are not registered in the population, and to improve the quality and representativeness of the vital statistics upon which governments rely.
Q: How can the new guide “Estimating Completeness of Birth and Death Registration” help government achieve birth and death registration completeness?
A: Our new guide, Estimating Completeness of Birth and Death Registration, provides governments with a toolbox to routinely assess CRVS system performance and outlines interventions for improvement. The guide also serves as an important resource for governments to track progress toward SDGs and targets that aim for universal birth registration and 80% death registration.
The guide is already being used in Cambodia by the General Department of Identification, Ministry of Interior, to begin an initial completeness assessment.
Q: How can these new tools help governments in their progress toward SDGs?
A: Sixty-seven of the 231 Sustainable Development Goal indicators can be measured effectively by using data derived from well-functioning CRVS systems, according to the World Bank. These indicators cover 12 of the 17 SDGs, and include targets and indicators directly related to CRVS systems including: “proportion of children under 5 years whose births have been registered with a civil authority.”
Five of the nine health-related targets can be measured by mortality statistics from CRVS records that include cause of death information produced to WHO standards. For example, Target 3.1 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. Furthermore, improving CRVS systems is an SDG target in its own right, as Target 16.9 calls for providing legal identity for all by 2030, including birth registration. Target 17.18 calls for enhanced support for countries to improve the quality, timeliness, reliability, and disaggregation of their statistical data, of which CRVS is an integral component.
We have provided technical support for governments in 29 countries and with the release of these guides, even more governments will have access to the resources and tools they need to develop their own robust — and complete — registration system.
We believe that everyone should count. The production and dissemination of a vital statistics report is a key step toward ensuring that no one is left behind, strengthening a country’s civil registration system, and identifying health and social sector priorities that can bring countries closer to reaching SDGs.
Farnaz Malik was a 2015–2016 Global Health Corps fellow and is a Technical Advisor at Vital Strategies.
Global Health Corps (GHC) is a leadership development organization building the next generation of health equity leaders around the world. All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. To learn more, visit our website and connect with us on Twitter/Instagram/Facebook.