Some experience in China The Role of Health Institutions in Collecting Vital Information Some experience in China Mr. Liu Qinghai National Health and Family Planning Commission, China Hanoi, Nov. 14th 2017

Basic situation of China Most populous country( 1.38Billion, 19%) Mid-income developing country (GDP per capita ranked 74th) Unbalanced regional development (Urban & Rural) In a transition period (Reform and Opening-up)

China attaches great importance to the population data collecting and statistics, which is essential for population strategic setting and policy making

Births and Deaths Per Year in China, 2010-2016 (millions)

Population Registration System Ministry of Public Security——Household Registration (Hukou), Personal Registration and ID management National Health and Family Planning Commission——Birth certificate, Death certificate Ministry of Civil Affairs——Marriages(divorces), adoptions

Birth Certificate System in China

The certificate contains information on full name of baby, sex, weight at birth, date of birth, place of birth, full name and ID No. of the parents, and the birth certificate No. Birth certificate is required to the Household registration(Hukou) and ID application Parents are responsible for application to the Household registration(Hukou)

No National system of Birth Certificate Before 1996 No National system of Birth Certificate No Nationally unified Birth Certificate Birth Certificate in Local level: Health Institutions issue some kind of certificate if required by the parents

No National system of Birth Certificate Before 1996 No National system of Birth Certificate No Nationally unified Birth Certificate Birth Certificate in Local level: Health Institutions issue some kind of certificate if required by the parents

No National system of Birth Certificate Before 1996 No National system of Birth Certificate No Nationally unified Birth Certificate Birth Certificate in Local level: Health Institutions issue some kind of certificate if required by the parents

No National system of Birth Certificate Before 1996 No National system of Birth Certificate No Nationally unified Birth Certificate Birth Certificate in Local level: Health Institutions issue some kind of certificate if required by the parents

1996-2008 1996, Law of Maternal and Infant Health Care Nationally unified Birth Certificate One should pay the production cost (15- 20yuanRMB) when applying for a Birth Certificate Before 2005, handwritten and printed both valid

1996-2008 1996, Law of Maternal and Infant Health Care Nationally unified Birth Certificate One should pay the production cost (15- 20yuanRMB) when applying for a Birth Certificate Before 2005, handwritten and printed both valid

1996-2008 1996, Law of Maternal and Infant Health Care Nationally unified Birth Certificate One should pay the production cost (15- 20yuanRMB) when applying for a Birth Certificate Before 2005, handwritten and printed both valid

2008- For free (No production cost to be paid)， funded by the central government finance Many normative documents at departmental level(NHFPC & MPS) to standardize and supervise the implementation After 2005, handwritten version is no longer accepted, only printed is valid

Issuance of Birth Certificates Years Births(Millions) Certificates Issued(Millions) Rate(%) 1996 20.67 9.87 47.74 1996-2000 96.53 42.68 44.21 1996-2005 146.01 91.86 51.57 1996-2010 257.81 180.94 70.18 1996-2014 323.46 275.22 85.09 Sources: NHFPC, China The rate of issuance has exceeded 90% in recent years.

Informatization With the development of information technology, most of the information contained in the new birth certificate is transferred to computer databases at local level. A national network has been established, about 40% of the local information was uploaded. The uploaded-rate is growing steadily and it greatly improves the administrative efficiency and the quality of public services.

Death Certificate System in China

Nationally unified Death Certificate since 2014 No National Law on Death Certificate. Only regulations at Departmental level. The certificate is issued by local health institutions. It contains information on age, sex, marital status, place of permanent residence (where Hukou is), place of death, education attainment, occupation and causes of deaths

Characteristics of NRCMS Financing and enrollment Voluntary participation in unit of household Pooling in unit of counties (some in unit of municipalities) Fund raising from households and governments Medical aid for the most vulnerable groups

Nationally unified Death Certificate since 2014 No National Law on Death Certificate. Only regulations at Departmental level. The certificate is issued by local health institutions. It contains information on age, sex, marital status, place of permanent residence (where Hukou is), place of death, education attainment, occupation and causes of deaths

Death certificate information is shared with the local Bureau of Public Security and Civil Affairs. Death certificate is required to cancel the Hukou registration and to bury the deceased person. The related family member is responsible for application to cancel the Hukou registration.

National Diseases Surveillance Points System (DSP) The system was designed since 1978, primarily to collect data on causes of death, and the incidence of infectious diseases in sample areas. By 1989, there were 71 DSPs scattered throughout 29 provinces in the country, with a standard working procedure for data collection, management, analysis and dissemination. However, the system was not representative of the national population. In 1990, a nationally representative population sample of 145 points based on random sampling was established. By 2013, the number of sample points has extended to 605.

Death Registration Reporting System(DRRS) Based on the 605 sample points of the National Diseases Surveillance Points System (DSP), all death registration information is uploaded to the national platform Death registration information from regions other than the sample points is encouraged to report to the national platform In 2016, the national platform collected death cases more than 6.5million, which accounts for 70% of the total deaths in China.

Tasks for the Next Step

Tasks for the Next Step Improve the national-level design (e.g. Law on Death Certificate, Revise of Law and Regulations， Standardize the implemetation, Integration and coordination of multi-departments) Strengthen training, supervision and speed up informatization to improve the quality of information Learn from Global Principles and Recommendations for Vital Statistics System and other countries’ experiences

Thank you!