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IMPLEMENTING IMPROVEMENTS IN CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS _______________ Conference of Africa Ministers Responsible for Civil Registration Addis Ababa, Ethiopia. 10-14 August, 2010 1 www.healthmetricsnetwork.org 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 Fraction of deaths assigned to GCs in the latest ICD-10 year since 2000 Source: Naghavi et al, 2010 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: [email protected] ) Policy: as a Weakest HIS Domain1 70 Percentage of maximum score 60 50 40 30 20 10 0 HIS Infrastructure 1 HIS Institutions, human resources and financing Policy and planning 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: [email protected] Key Points • Turning Point for Civil Registration in Africa • Unprecedented Global Commitment for CRVS • Standards-driven CRVS systems THANK YOU