7 September 2012

South Africa: Poor Civil Registration, Vital Stats Disadvantage Women, Children

Durban — Women and children, the most vulnerable groups in Africa, were placed at a distinct disadvantage in the absence of proper civil registration and accurate vital statistics.

This is according to Prof Miriam Were of the independent Expert Review Group (iERG) on Information and Accountability for Women's and Children's Health.

One of the functions of the iERG, which was established by the World Health Organisation's (WHO) Commission on Information and Accountability for Women's and Children's Health, is to track progress in establishing functional civil registration and vital statistic systems in 75 high burden countries.

During her presentation to the 2nd Civil Registration and Vital Statistics Conference in Durban, Were said without civil registration and vital statistic systems countries could not measure progress towards achieving Millennium Development Goals (MDGs) related to reducing child mortality and improving maternal health.

The highest levels of mortality rate for children under the age of five were found in Sub-Saharan Africa.

Evidence suggested that MDG targets could be reached, but only with substantial and accelerated action to eliminate the leading killers of children - pneumonia, diarrhoeal diseases, pre-term birth complications and birth asphyxia.

Maternal mortality, although mostly avoidable, was also a major burden in many developing countries. Maternal deaths were concentrated in sub-Saharan Africa and Southern Asia, which together accounted for 87%of such deaths globally in 2008, she noted.

Working on the health of women and children meant ensuring that they had access to health care services and commodities.

"This cannot be accomplished if they are not taken into account at the time of sectoral planning and policy making. But, before they are considered for planning and policy making, they have to be "counted" - this means their births, deaths and causes of deaths have to be registered properly," she noted.

When it came to the most vulnerable, women and children, there were no functioning civil registration and vital statistic systems in most of the high-burden countries.

There was a low coverage of birth and death registration, poor hospital reporting of causes of death and limited capacity to conduct accurate certification and coding.

"Good data enable first of all registering people and then tracking how much is spent, on what (including child and maternal health), and by whom with a focus on the results that are achieved - this is critical to ensuring efficiency and accountability," Were added.

Trustworthy statistics on levels and trends in mortality and causes of death helped to identify emerging health threats and high risk groups.

Civil registration systems and the improved statistics they generate also supported the health sector in determining needed interventions and required resource allocation, she said.

When supported by the right elements, civil registration and tracking resources helped reaching the most vulnerable and it was the responsibility of the State to ensure this happened.

With births and deaths in most instances, taking place under the eyes of healthcare officials, the health sector, also needed to get involved in the drive to improve civil registration systems.

Speaking to SAnews, Dr Mark Amexo, a senior technical officer at Health Metrics Network, which is a partnership dedicated to strengthening national health information systems hosted by WHO, stressed the need for the health care sector, its systems and infrastructure to support CRVS improvement efforts.

"The health sector needs to play a more active role. Departments that work with vital statistics and civil registration must work closely with the health sector. Linkage and collaboration between the two much be enhanced," he said.

Despite the hard work that lay ahead in improving civil registration systems, which will include infrastructure and human resources development, progress was already being noted.

"We are very hopeful. Even though the recent push for African countries, governments and people to improve their civil registration is only about three years old, already we see very palpable signs of the right steps to improve their systems."

Building on the current weak or even non-existent systems would happen overnight and would likely only happen over two to five years.

"It will take a long time to build but the good thing that a lot of countries have grasped the issues and understand the need to do something about improving their systems," he added.

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