1. Authors: Jané Joubert, Debbie Bradshaw
WHO - FAMILY OF INTERNATIONAL CLASSIFICATIONS NETWORK ANNUAL MEETING 2016
Reviewing progress in civil registration and vital statistics (CRVS) in selected countries of the Southern African Development Community (SADC).
8-12 October Tokyo, Japan
Poster Number
WHO/CTS to insert
Authors: Jané Joubert, Debbie Bradshaw
Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
Abstract
Valid and reliable vital statistics from a well-functioning civil registration system are key input for public health policy and development programs. Valid cause-of-death data, in particular, are critical for public health prioritization. However, few low- and middle-income countries have such data. African countries, in particular, have been facing fundamental problems standing in the way of improving CRVS systems. This poster aims to review the status and progress of CRVS systems in selected countries of the Southern African Development Community region.
Introduction
Results
Table 1 below contains 5-yearly average VSPI scores for each SADC country over a 32-year period, allowing the opportunity to assess progress over time extracted from Mikkelson et al (2015). South Africa has made substantial progress over the period, showing the possibility of substantial system improvement in short periods of time. However, South Africa, Mauritius and Seychelles are exceptions in the region. Most SADC ccountries show limited or no improvement in CRVS system performance in the past 30 years, with scores for Madagascar and Zimbabwe pointing to performance decline over time.
While global progress with CRVS systems in the past 30 years has been reported as “disappointingly slow” (Setel et al, 2007; AbouZahr et al, 2015), and slow and limited progress, generally, are seen in the SADC region too, South Africa’s situation gives reason for optimism about the prospects of rapid progress with CRVS systems in low- and middle-income countries.
Although common problems impact CRVS systems in the SADC region, there is considerable diversity among countries in system performance, e.g. in completeness levels of death registration, and in the reporting and quality of basic and cause-of-death data. Regional capacity to support countries in improving CRVS coverage and completeness; and in compiling, processing, and critically evaluating vital-event data, are essential for CRVS improvement in the region.
Conclusions
Valid and reliable vital statistics from a well-functioning civil registration system are key input to inform health and development programmes. Valid cause-of-death data, in particular, are critical for public health prioritization.
Recognizing the need for reforming and improving CRVS systems in Africa, the Africa Program on Accelerated Improvement of Civil Registration and Vital Statistics (APAI-CRVS) has emerged, aiming to provide management and programmatic guidance to improve CRVS systems on the continent.
This poster aims to review the status and progress of national CRVS systems, including cause-of-death information, in the Southern African Development Community (SADC) countries as listed in Table 1 below.
United Nations Study
All 13 SADC countries have a centralized civil registration system, with legal responsibility for the registration of births and deaths assumed by specific ministries, such as the Ministry of Home Affairs, Ministry of Justice, Office of the President, and Ministry of Local Government.
While all 13 countries have centralized vital statistics system, only Botswana, Mauritius and South Africa compile statistics from civil registration. The remaining
countries rely on population
censuses and sample
surveys for basic vital
statistics. For Mauritius and
South Africa, data had been
provided to the UN
Demographic Yearbook for
34 and 26 tables (out of 42),
respectively, for the period
1997 – The DRC
and Tanzania did not
provide any data for this
period, while the remaining
countries provided some
data on live births, deaths
and infant deaths from
national projections or
population censuses.
Coverage and completeness of death registration varied considerably and was not assessed for half the countries.
Vital Statistics Performance Index
In contrast to the situation of the best performing CRVS systems in Europe, the Americas, and Australasia (Map 1), Mikkelson et al (2015) found Africa had the majority of low-scoring countries, or countries with no relevant data.
In the SADC region, with the exception of South Africa and Mauritius, the map illustrates that for most SADC countries, mortality data were either reported sporadically and for a fraction of all deaths, or CRVS systems were so weak that data were not compiled or reported.
Table 1: Five-year annual VSPI scores, for SADC countries,
Methods & Materials
Data Sources:
In a United Nations (UN) study (2010), CRVS information was collected for 13 of the 15 SADC countries (not for Angola and the Seychelles) via country-completed questionnaires and proceedings of a UN workshop held in Malawi in December CRVS system status, and data produced by these systems, were reported for selected years up to 2008 (UN, 2010).
Methodological research by Phillips et al (2014) proposed a single composite metric, the Vital Statistics Performance Index (VSPI) to reflect the status of CRVS. Extracted from the mortality database of the Global Burden of Disease 2010 and 2013 Studies, the VSPI was computed on a continuous scale from 0 to 1 for each calendar year of vital statistics data that are publically available for 1980 to A value of 1, or close to 1, signifies that the data for that country in that period are suitable for policy use. A value of 0 indicates that the data are of little or no policy use. The VSPI comprises six components, each capturing a different aspect of vital data accuracy or utility:
completeness of
death reporting,
2. quality of death
reporting,
3. level of cause-
specific detail,
4. internal consis-
tency,
5. quality of age &
sex reporting,
6. data availability
or timeliness.
Mikkelsen et al
(2015) reported the
global status of
CRVS based on the
VSPI estimates.
Conclusions
Map 1: Typology of CRVS systems on the basis of VSPI scores for the best available year between 2005 and Source: Map extracted from Mikkelsen et al, 2015.
References
AbouZahr C, de Savigny D, Mikkelsen L, Setel PW, Lozano R, Nichols E, et al. Civil registration and vital statistics: progress in the data revolution for counting and accountability. Lancet Online /S (15)
Mikkelsen L, Phillips DE, AbouZahr C, Setel PW, de Savigny D, Lozano R, et al. A global assessment of civil registration and vital statistics systems: monitoring data quality and progress. Lancet. 2015; 386(10001): Epub 2015/05/15.
Phillips D, Lozano R, Naghavi M, Atkinson C, Gonzalez-Medina D, Mikkelsen L, et al. A composite metric for assessing data on mortality and causes of death: the vital statistics performance index. Popul Health Metr. 2014; 12(1): 14.
Setel PW, Macfarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, et al. A scandal of invisibility: making everyone count by counting everyone. Lancet. 2007; 370(9598):
United Nations. Status of civil registration and vital statistics in the SADC region. New York, USA: United Nations, 2010.