CRVS system in Egypt By Dr. Abd el shakour M.A. Farghaly Health Officer responsible Ministry of Health and Population Egypt Legal Framework for Civil Registration, Vital Statistics and Identity Management Systems Manila, Philippines 17 - 19 July 2017

Introduction Civil registration is “The continuous, permanent, compulsory, and universal recording of the occurrence and characteristics of vital events (live births, deaths, fetal deaths, marriages and divorces) and other civil status events pertaining to the population as provided by decree, law or regulation, in accordance with the legal requirements in each country. Civil registration establishes and provides legal documentation of such events. These records are also the best source of vital statistics” Civil registration records are the best source of vital statistics because they generate data on a continuous basis and for the whole country, at both national and local levels. “Vital statistics” are used to derive the fundamental demographic and epidemiological measures that are needed in national planning across multiple sectors, such as education, labour and health. They are also critical for a wide range of government activities (e.g. “population registers” and other administrative registers) and commercial enterprises (e.g. life insurance and marketing of products).

Introduction cont., In the health sector, vital statistics form the core of a country’s health information system, because they: permit understanding of the prevalence and distribution of mortality due to diseases and injury, identification of health inequalities and priorities, monitoring of trends and evaluation of the impact and effectiveness of health programs; provide (when timely and complete) a reliable method for measuring baseline levels and monitoring progress towards global goals, such as the United Nations (UN) Millennium Development Goals (MDGs); they are also important in understanding emerging health challenges due to, for example, non-communicable diseases, and injuries enable tracking of national strategies such as health-sector reform, poverty reduction and development efforts; Support planning, monitoring and evaluation in decentralized health systems, by providing information on health conditions at a regional and local level.

Introduction cont., Brief history of CRVS system in in Egypt Egypt introduced the first registration system in the world in 1250 B.C. early in the reign of King Ramses II. In the modern era, the registration of births and deaths in rural as well as urban areas dates back to 1839; it was made obligatory toward the end of the last century. However, in spite of the early beginnings of compulsory registration of vital events Egypt is the 1st Arabic Country that had civil registration records and civil registration system in Egypt is one of the strongest systems in the world. Civil registration and vital statistics system is used in Egypt to record the statistics of births, deaths, and marriages, and divorce.

Introduction cont., Registration has begun for these vital events (births - deaths) since the beginning of the last century, relying on the manual system by enrolling in paper notebooks where he is recording the facts of birth and death to citizens offices of Health and local units and property taxes in the governorates and is saved the books after the end of the year in Dar public archives in Cairo This is the record of the birth of Egyptians abroad by the consulates of Egypt in these countries and then send the books to save the Ministry of Health, Department of birth 0 The registration of the facts of marriage and divorce were pens book in the Egyptian courts, which holds the record these facts Then successively to pass laws that regulate these events and facts registration .

Major developments (in terms of law, process, etc.) in CRVS system Civil registration was first organized by the decree No. 23 promulgated in 1912 that made notification of birth and death events occurring in Egypt compulsory for both Egyptians and foreigners living in Egypt. Law No.25 of 1922 year. Law No.130 of 1946 year for births and deaths (notification of births in Egyptian Kingdom within 8 days in the place of birth and notification of death within 24 hours in the place of death in health offices as there’s no civil status . That Law No. 260 of 1960 year ( Egypt and Syria ) issued in respect of Civil Status, which regulates the specialized receiving notifications and constraint and the time limit for reporting and registration - and the people in charge of reporting and data to be reported and session Documentary statistical and notifications and communications models and notifications

Current state of CRVS System 1- Main Features of the CRVS Laws : Notification of births in Arab Republic of Egypt within 15 days in the place of birth and notification of death within 24 hours in the place of death in health offices . Marriages and Divorces are to be registered within 15 days after the marriage contract or the divorce notification is issued.

Current state of CRVS System 2- Main Organizational Structure for CR and VS Responsibilities: - The civil registration system in Egypt is centralized. - In Egypt there are 27 governorates, These governorates are further divided into centers/towns and villages .There are 4571 local health units in the country registering births, deaths. There are 284 health district that reviewed the forms of births and deaths. - Registration of marriages and divorces is the responsibility of Family Affairs Courts (a total of 231) and Real Estate Publicity Department (2 of them, located in Cairo and Alexandria).

Current state of CRVS System 2- Main Organizational Structure for CR and VS Responsibilities: - All the information collected at the local registration office is eventually sent to Department of Civil Status (under the Ministry of Interior) through the provincial lev. - The National Information Center for Health and population (NICHP) is responsible- in collaboration with preventive sector- for the compilation and annual publication of national statistics on causes of death based on information reported on Death notification form . - CAPMAS is the source of Population data that is needed to calculate the mortality indicators.

Data Flow of Births & Deaths

Data Flow of death registration at health offices for either Hospital or home deaths

Data Flow of Marriage & Divorce

Current challenges and bottle necks in birth and death registration processes No direct automated connection with civil status and CAPMAS ( Data is taken by USB ) The automated system in Egypt is online application ,but some areas has no coverage . Registration of births and deaths ( Ministry of Health and Population ) , Registration of marriage and divorce ( Ministry of Justice ) . Lack of training of doctors lead to Incompleteness and inaccuracy of the direct and indirect causes of death. Assessment and follow-up for quality of data of cause of death ( direct and indirect ) . There is duplication of data of births and deaths( Ministry of Health and Population in preventive sector and information center

Improvement of the quality of services and the production of vital statistics Establish high committee responsible for CRVS . Connection with civil status to use: ID NO, for Father , Mother , Notifier ( births ) ID NO, for Notifier and dead person ( deaths )to save time, effort and accuracy of data . ID NO, for the new borne in coverage in immunization . There is offline desktop application for areas which has no coverage .

Next step Improvement of the quality of data : - Training and capacity development are urgently needed. Although cause of death certification is a key responsibility of physicians, they rarely receive the training they need to do so effectively, either during medical education or subsequently when in service. Using IRIS to increase quality of cause of death . Strengthen the role of verbal autopsy . Establish the ICD10 curriculum in the University . TOT training ( governorate ,district ) . Revision of direct and indirect cause of death( central ,governorate ,district ) .

Stakeholders Ministry Of Health and Population ( preventive – Information center ) Ministry Of Planning Civil Status Organization ( Ministry of Interior )

Manual & Automated Birth Notification Form

Birth Data

Birth Registration ( Health Information for live birth )

Death Registration

cause of death

Smoking Data

Accidents Data

Female Deaths during Reproductive Period

Reports

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