Getting everyone in the picture by 2024
Civil registration and vital statistics in the Pacific
February 2015 - If someone asks you to prove who you are, you would show them your driver's licence, passport or birth certificate – official documentation that confirms your name, date of birth, where you were born and your family relationships. This proof-of-identity is used to enrol a child in school, drive a car, open a bank account, travel the world, vote in an election and get married; many of life's milestones!
However, many children are born and people of all ages die without their births and deaths ever recorded. The only way to count everyone is through civil registration. Civil registration and vital statistics (CRVS) is the recording of every birth, marriage, death, adoption and divorce in a country.
Strong health systems begin with CRVS
The information generated guides governments and leads to good governance, decision making and the protection of human rights and legal identity. CRVS systems provide a critical platform for country planning and development needs.
Countries need to know how many people are born and die each year – and the main causes of their deaths - to develop well-functioning health systems and to design effective public health policies and measure their impact. CRVS allows countries to identify their most pressing health issues, inequities in service delivery and the burden of disease in each population.
Coordinated Pacific action to improve CRVS
Many Pacific Island countries do not have adequate CRVS systems and face many legal, financial, human resource and geographical barriers. There is a strong need for active coordination and collaboration among all involved. Institutional capacities need to be strengthened and legislative gaps filled. Awareness on the benefits of CRVS and its importance for development must continue to be generated.
The Pacific Islands governments are improving CRVS data under the Pacific Vital Statistics Action Plan (PVSAP), which is led by the Brisbane Accord Group and part of the Secretariat of the Pacific Community's ten year Pacific Statistics Strategy, 2011-2020. Under this Action Plan, 15 countries and 3 territories in the Pacific region have completed rapid CRVS assessments within 4 years. Almost all (89%) of these countries have undertaken more in-depth assessments and over one third have developed a draft or final national CRVS improvement plan.
WHO is assisting the implementation of the PVSAP by strengthening Health Information Systems in the region, training doctors on causes of death, and providing support on International Classification of Diseases coding.
Pacific islands progress in CRVS
Pacific Island governments are making progress towards establishing more robust CRVS systems. Improving births, deaths and cause of death data for policy making was also reaffirmed as a regional priority at the 2014 Pacific Health Ministers Meeting. Below are a few examples of country-specific progress.
Fiji has rolled out CRVS certification trainings for doctors and training on certification has also been incorporated as a standard and compulsory part of the medical degree offered by Fiji National University.
Kiribati is undertaking a comprehensive assessment of their CRVS system which will form the basis of a national CRVS improvement plan. The assessment has engaged a broad group of stakeholders, recognizing that community leaders and churches are essential to improving CRVS in Kiribati.
Samoa has formalized their national CRVS committee. The committee developed a draft National CRVS Improvement Plan and began implementing projects to improve CRVS. Linking the Improvement Plan to the national strategy for the development of statistics allows CRVS to be elevated in the national agenda.
Access to registration is improving in Solomon Islands; just 20 births were formally registered in 2007 but by June 2014, more than 35,000 people legally had their birth registered. Fifteen additional “satellite service centers” in health facilities were opened to provide more access to registration.
In Tonga, a 2011 exercise to reconcile CRVS data revealed higher than anticipated early adult mortality from non-communicable diseases (NCDs). As a result, existing NCD responses were reviewed and Tonga was able to attract additional support for health programs.
Vanuatu has improved birth registration by registering children through schools as part of their initial enrolment processes and new births at hospital prior to discharge. They have also included “catch up days” in remote areas. In one year (2013 to 2014), birth registration rates for children under 1 year increased from 35% to 57%.
Asia-Pacific CRVS Decade, 2015 to 2024
The first Ministerial Conference on CRVS in Asia and the Pacific was held in November 2014 and an agreement to achieve universal and responsive CRVS systems by 2024 was made. The Ministers endorsed a Regional Action Framework of goals, national targets and action area and adopted a Ministerial Declaration to “Get everyone in the picture” in Asia and the Pacific. The ‘Asia-Pacific CRVS Decade, 2015 to 2024’ was born.
This means that by 2024, the births and deaths of more Pacific Islanders will be registered, enabling governments to design more effective public health policies and build stronger health systems.