Monitoring the Indicators of The Millennium Development Goals Through the Civil Registration and Vital Statistics System

CRVS in MDGs Goal 4. Reduced mortality Goal 4. Reduced mortality Under-five mortality rateUnder-five mortality rate Infant mortality rateInfant mortality rate Goal 5. Improved maternal health Goal 5. Improved maternal health Maternal mortality ratioMaternal mortality ratio Proportion of births attended by skilled health personnelProportion of births attended by skilled health personnel Goal 6. Combat malaria and other diseases Goal 6. Combat malaria and other diseases Death rates associated with malariaDeath rates associated with malaria Death rates associated with tuberculosisDeath rates associated with tuberculosis

CRVS Systems of Operations Systems of Operations Civil RegistrationCivil Registration Administration and Management of DocumentsAdministration and Management of Documents Compilation and AnalysisCompilation and Analysis

Birth:Birth: hospital/clinic administrator, hospital/clinic administrator, attendant, attendant, either parents, or either parents, or owner of the document, if of age owner of the document, if of age Civil Registration System who shall report

Death:Death: hospital/clinic administrator, hospital/clinic administrator, attendant, attendant, person who performed the burial rites, person who performed the burial rites, nearest relative, or nearest relative, or any interested party who knew about the occurrence of the event any interested party who knew about the occurrence of the event Civil Registration System who shall report

Civil Registration System whom to report 1975 / / 1997 The death shall be reported to the local health officer within 48 hours after death and the death certificate shall be forwarded to the local civil registrar concerned within 30 days after death for registrationThe death shall be reported to the local health officer within 48 hours after death and the death certificate shall be forwarded to the local civil registrar concerned within 30 days after death for registration

Registrant/ Informant/ Attendant/ Health Officer Civil Registrar Death/Fetal death Birth CRVS Flow of Documents (Within 48 hours) (Within 30 days) Death/Fetal death NSO-PO 10 days after reference month NSO-CO 6th week after ref. mo.

Objectives To provide measures of: G4 Reduce MortalityG4 Reduce Mortality Under-five mortality rate (UMR) Under-five mortality rate (UMR) Infant mortality rate (IMR) Infant mortality rate (IMR) G5 Improve Maternal HealthG5 Improve Maternal Health Maternal mortality ratio (MMR) Maternal mortality ratio (MMR) Proportion of births attended by skilled health personnel (%SHP) Proportion of births attended by skilled health personnel (%SHP) Goal 6. Combat malaria and other diseasesGoal 6. Combat malaria and other diseases Death rates associated with malaria (CSDRM) Death rates associated with malaria (CSDRM) Death rates associated with tuberculosis (CSDRT) Death rates associated with tuberculosis (CSDRT)

Illustrative Example Data source: Data source: vital statistics from CRVS vital statistics from CRVS Projected population based on Census 2000Projected population based on Census 2000 Level of completeness of births and deaths based on 2000 (secondary data)Level of completeness of births and deaths based on 2000 (secondary data)

Methods Factors in the estimation of IMR, UMR, MMR Factors in the estimation of IMR, UMR, MMR adjusted number of births and maternal, infant and under five mortality dataadjusted number of births and maternal, infant and under five mortality data

Methods Factors of other measures: Factors of other measures: Unadjusted number of births by skilled health personnel: physician, nurse and midwifeUnadjusted number of births by skilled health personnel: physician, nurse and midwife Unadjusted deaths due to malaria and tuberculosisUnadjusted deaths due to malaria and tuberculosis

Methods Measures: Measures: IMR = adj. [infant deaths / live births] * 1,000IMR = adj. [infant deaths / live births] * 1,000 UMR = adj. [under five deaths / live births] * 1,000UMR = adj. [under five deaths / live births] * 1,000 MMR = adj. [maternal deaths / live births] * 100,000MMR = adj. [maternal deaths / live births] * 100,000 %SHP = [births PNW / live births] * 100%SHP = [births PNW / live births] * 100 CSDRM = [deaths due to malaria / mid-year population] * 100,000CSDRM = [deaths due to malaria / mid-year population] * 100,000 CSDRT = [deaths due to tuberculosis / mid-year population] * 100,000CSDRT = [deaths due to tuberculosis / mid-year population] * 100,000

Results Table 1. CRVS for MDG Indicators: Philippines, MDG Indicators P G4 - Reduce Mortality UMR IMR Secondary data

Results Table 2. CRVS for MDG Indicators: Philippines, MDG Indicators P G5 - Improve Maternal Health MMR %SHP Secondary data

Results Table 3. CRVS for MDG Indicators: Philippines, MDG Indicators P G6 - Combat Malaria and Other Diseases CSDRM CSDRT

Table 4. Average Annual Rate of Reduction / Growth to Achieve MDGs Indicators Goal 4 UMR IMR Goal 5 MMR %SHP Goal 6 CSDRM CSDRT

Conclusion/Recommendation Some resulting estimates from CRVS can be used for MDG monitoring Some resulting estimates from CRVS can be used for MDG monitoring More information from CRVS should be evaluated and provided to identify whom and where to focus interventions to fast track achievement of MDGs More information from CRVS should be evaluated and provided to identify whom and where to focus interventions to fast track achievement of MDGs

Conclusion/Recommendation Regular assessment of CRVS Regular assessment of CRVS Death certificate should be properly filled-up Death certificate should be properly filled-up By informantBy informant By Health OfficerBy Health Officer Insurance agencies shall require properly filled-up and registered death certificate Insurance agencies shall require properly filled-up and registered death certificate

Conclusion/Recommendations Enhanced interagency coordination to include commitment to improve civil registration, especially among entities involved in the accomplishment of certificates of death, registration of deaths and those requiring information on deaths Enhanced interagency coordination to include commitment to improve civil registration, especially among entities involved in the accomplishment of certificates of death, registration of deaths and those requiring information on deaths

Maraming Salamat Po!