A strong, universal, responsive civil registration and vital statistics (CRVS) system is critical for Asia Pacific countries to recover from the COVID-19 pandemic , and ensure that the most vulnerable populations have access to healthcare, immunization and social welfare services.
This was emphasized in the Ministerial Declaration issued at the conclusion in Bangkok of the Second Ministerial Conference on CRVS (16–19 November) in Asia and the Pacific, organized by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP).
A WHO report revealed that nearly 40% of all deaths in 2020 were not recorded. A preliminary WHO estimate suggests that the excess mortality worldwide directly and indirectly due to COVID-19 is 1.2 million higher than the deaths in 2020.
“These two years that have passed have been a harrowing reminder of our inability to accurately count the human lives we lost during the COVID-19 pandemic. “There is no reason to be excused,” Samira Asma (WHO’s assistant director general for data, analytics, and delivery for impact) says.
She adds that “these mistakes cost us huge losses” and led to inefficient allocations of our scarce resources, including vaccines.
Even CRVS systems that worked well were subject to backlogs in death registrations, as well as diagnostic uncertainties that were impeded by COVID-19 restrictions imposed by the government, including lockdowns.
The Universal Declaration of Human Rights Article 6 states: “Everyone has the right to be recognized everywhere as a person before the law.” Civil registration systems, that track key life events like births or marriages, deaths, and deaths, support the realization of rights, good governance, and health.
In the world approximately 1,000,000 people do not have proof of being legally citizens. This includes a huge number of children, women refugees, as well as indigenous people.
According to an UNICEF report, nearly 64 million children who are under five years old in the Asia Pacific region still do not have their births recorded, which may deny them access to essential services like health, education, and other social protections.
While many countries are near to recording all deaths and births and deaths, other countries are quickly closing the gap. Yet, we need to get everyone in the picture.”
Armida Salsiah Alisjahbana is the executive secretary of ESCAP
The most important findings from the ESCAP review of the mid-term progress of the decade of CRVS (2015–2024) demonstrate that the total registration of deaths is lower than that for births in many Asia Pacific countries. Most countries have made significant progress in death registrations with notable increases in Samoa and Cambodia, Lao People’s Democratic Republic and Bangladesh.
In the region, there is a shift from manual registration to electronic recording of deaths and births. Two goals have been met by the majority of countries: a certificate is almost always free when births and deaths are registered as well as recording the deaths in hospitals.
The conference noted that the registration of deaths and births that are timely can be made much easier by shifting the primary responsibility for notification of births and deaths from families and individuals to health sector and civil registration authorities.
In Bangladesh, for example, health workers visiting communities are required to record the details of births and deaths. The Kaliganj model, also referred to as the Kaliganj method is being implemented across the country. It has led to an increase of complete birth registration, from 50 percent to 83 percent and death rates from less than 10 percent to 90 percent in just a few years.
“Determining the causes of death is essential for public health monitoring. In at least 13 countries, from Bangladesh to Rwanda to Colombia an autopsy that is verbal is carried out, in which family members or the people closest to the deceased are questioned to determine what may have been the cause of death,” Philip Setel, vice president of Public Health Programmes and director of CRVS Improvement at Vital Strategies informs SciDev.Net.
One of the commitments in the Ministerial Declaration is to conduct substantive identification and assessment of inequalities related to civil registration and vital statistics systems, and to take steps to remove any barriers to the civil registration of important events for vulnerable populations.
“We are currently working with five countries to help them in conducting an assessment of inequality of CRVS systems to be able to pinpoint and quantify who is being excluded,” Petra Nahmias, ESCAP head of the Population and Social Statistics Section, tells SciDev.Net.
The UN Sustainable Development Goals (SDGs) call for 100 per cent of births and 80% of deaths to be recorded all over the world by 2030.
A strong civil registration system and stats systems are crucial to track progress towards the SDGs. We need a clarion call to reach 75 percent complete births deaths, deaths and causes of death registration by 2025 and deliver on CRVS goals and targets by 2030,” Asma told the conference.
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