By: Deirdre Appel and Tawheeda Wahabzada, Open Data Watch
Here at Open Data Watch we understand that accurate and open data are a catalyst for action. Data gaps limit the ability to harness such impact. Many have their origin in civil registration and vital statistics (CRVS) systems that fail to record births, deaths, marriages, and divorces. Fortunately, over the recent years, more attention has been directed toward improving CRVS systems. Last month, ODW attended a workshop on “Gender, Civil Registration and Vital Statistics, and Legal Identification: Where Are the Gaps and How Can We Close Them?” at the Center for Global Development (CGD) where experts from CGD, Data2X, and the World Bank Group gathered to discuss how gender gaps in CRVS impact women and children. The topic will also be discussed at the High Level Political Forum at the U.N. in New York City this week. Hosted by PARIS21, the event “How can we strengthen CRVS systems as a means to improve gender equality?” will explore challenges, opportunities, and solutions to strengthen CRVS systems. ODW is a partner in the effort to strengthen CRVS. This blog post explores the sources of data gaps of CRVS systems and possible solutions for reducing them.
Civil Registration and Vital Statistics are data about life events, such as births, deaths, marriages, divorces. Civil registration systems under the auspices of local and national governments are responsible for registering births and deaths, issuing the respective certificates, and recording marriages and divorces. Despite the acknowledged importance of these data, many CRVS systems remain incomplete. Incomplete civil registration systems have consequences for the rights and well-being of all people, but women are particularly affected. There is a need to improve their coverage and quality and increase the availability, timeliness, and disaggregation by sex, location and other characteristics of the statistics derived from them.
Data help inform decisions and tailor policies and programs to the populations which they are intended to serve. To do so, data must fully represent all portions of the population. But data on women and children are often missing or cannot be disaggregated from data for the general population. These gaps originate in civil registration systems that fail to record complete information on births, marriages and divorces, and deaths.
Proper birth registration establishes individuals’ citizenship and their rights to services, such as, but not limited to, social security, health care, pension benefits, voting rights, and access to banking. It also provides the basis for compiling accurate and timely demographic statistics. According to UNICEF’s Every Child’s Birth Right report, about 230 million, or 35 percent of children under the age of five do not have registered births. The majority of these children are in South Asia and Sub-Saharan Africa.
Birth registration rates differ between countries and across socioeconomic classes and geographical regions within a country. Poor and uneducated women are less likely to register their children regardless of their location. Barriers to child registration include lack of registration knowledge, distance to registration sites, cost of travel and registration, and a requirement of father involvement in child registration process. As noted in Every Child’s Birth Right, children cannot be registered permanently without the father’s or grandfather’s name in countries such as Nepal, Nicaragua, and Bhutan. In Papua New Guinea, there is only one birth registration site for over 7 million people across more than 460,000 square miles and 600 islands.
Marriage and Divorce
In addition to birth registration, marriage and divorce registration are a core component of CRVS systems. Proper marriage and divorce registration contributes to a woman’s ability to inherit financial assets, ensure a fair division of assets, lay claim to spousal and child support, and provide proper birth registration for their child. Marriage registration, coupled with a proper birth registration, help deters early child marriages as well. Despite identified benefits, marriages and divorces often go unrecorded.
Marriage and divorce registration are often the last priority of CRVS systems behind birth and death. Culture can play a strong role in hindering marriage or divorce registration, particularly for women. The practice of polygamy – if not legal within the country – will fail to capture a large portion of marriage and divorce within society. According to the UN Economic Commission for Africa (UNECA), customary marriages are widely prevalent throughout Africa, therefore making civil registration of marriages and divorces uncaptured. Cultural practices along with poorly functioning CRVS exacerbate the difficulties in collecting this data.
Complete CRVS should record the time, place, and cause of death. Adequate death registration enables the family of the deceased to remarry, rightfully inherit property, receive their spouse’s pension, and obtain burial permits. Despite such benefits, a large portion of deaths in developing countries are never registered. In Cambodia, for example, only about 10 percent of deaths are currently registered.
Cause of death information is of great importance to public health authorities who monitor epidemiological trends. WHO’s Global Health Observatory notes that 85 countries produce subpar quality data on cause of death and 75 countries fail entirely to produce such data. According to UNICEF’s Strengthening Civil Registration and Vital Statistics Systems through Innovative Approaches in the Health Sector, deaths in health facilities are medically certified, whereas deaths outside health facilities are primarily certified through CRVS authorities. But countries that lack administrative capacity within health care facilities and registration agencies may fail to properly record deaths. Insufficient data on the cause of death leads to gender gaps. According to Data2X’s Civil Registration, Vital Statistics and Gender report, much of the data on maternal mortality are estimates based on surveys or models. Estimating maternal mortality from surveys is difficult and expensive. Complete registration of deaths, including maternal deaths, provides more accurate information on the health status of mothers and their children.
Closing the Gaps
An effective CRVS system is ultimately the result of a country’s will and capacity to maintain and improve its existing system. CRVS data are critical for the rights of people, necessary for research, and a strong evidence base for policy formulation. Here are five recommendations for strengthening CRVS systems.
Develop a Strategy: Identify strengths, weaknesses and opportunities within the existing system. This may require an evaluation of the existing legal frameworks for its CRVS system. Based on this analysis, a country should develop a national strategy for improving its CRVS system, such as Zambia’s National Strategic Action Plan for Reforming and Improving Civil Registration and Vital Statistics (2014-2019). A monitoring and evaluation mechanism should also be established to track implementation.
Build Capacity: Countries should strengthen the technical capacity of all administrative levels of its registration system. On the local level, health facilities and registration authorities should build the capacity to efficiently register births, marriages/divorces, and deaths. Health facilities play a crucial role, because their records of births and deaths capture demographic, epidemiologic, and social information.
Promote Centralization of Record Keeping: Once local registration authorities have the institutional, administrative, and technical capacity to adequately register deaths, countries should digitize and transfer data from the local level to central data processing sites. The Africa Programme for Accelerated Improvement of Civil Registration and Vital Statistics (APAI CRVS) provides a guidebook for digitizing existing CRVS data in low-resource settings. The digitization of existing CRVS data enables efficient transfer of data from the local level to the central data processing site.
Facilitate Coordination Between Ministries: CRVS systems benefit from strong inter-bureaucratic coordination among government ministries. In Cambodia, for example, the Ministry of Interior, National Statistics Office, and Ministry of Health are conducting a comprehensive evaluation on their existing death registration data. The results will help to identify gaps within the data at the local and national level, leading to better assessment of trends and potentially improving public health outcomes.
Discover incentives: There is a need for rigorous experiments to test incentives for improving CRVS systems. Such interventions could include cash transfers. In Gender Issues in CRVS and Access to Adult Identification Documentation, co-authors James C. Knowles and Gayatri Koolwal describe a conditional cash transfer program in Nepal that aimed to improve nutrition amongst the poor. In order for households to receive the cash transfer, they were required to provide their children’s birth certificates. Birth registration coverage improved significantly within the targeted group. A randomized control trial with similar results was conducted in Zimbabwe. Around 4,000 households received either a conditional cash transfer dependent on the registration of their under-18 children or an unconditional cash transfer. Registrations rate increased within households receiving conditional cash transfers.
Photo on blog index page by Nugroho Sunjoyo courtesy of World Bank.