1. Civil Registration & Vital Statistics Palestine Role of MOH
Dr. Jawad Bitar
Epidemiologist
Director of Palestinian Health Information Center (PHIC)
National Focal Person for Health Information & Statistics
Tunis, Tuesday, 27 March 2018

2. Palestine Historical Palestine is about 27,000 km2
Now Occupied Palestinian territories (Opt) about 22% (6020 km2) from Palestine.
West Bank (included East Jerusalem) 5,655 km2
(11 Governorates)
Gaza Strip 365 km2
(5 Governorates)

3. Palestine, 2017 Population 4,952,168 West Bank 3,008,770
Gaza Strip ,943,398
Male / Female Ratio: : 100
Population is young; 39.0% < 15 year (WB 36.7%, GS 42.6%)
Population 65 years & above: 3.1% (WB 3.3%, GS 2.4%)
Fertility Rate 4.1 (4.5 in GS & 3.7 in WB)
99.9% of deliveries are in health institutions.

4. OPt

5. Palestine Population by Age Group & Gender, 2017
According to the most recent estimation 46.3 of the population is under 15 years 2% of the population is above 65 years
The median age in Palestine is 16.7 years 5

6. Distribution of Palestine Population by Locality, 2016
In Palestine 41.9% are Refugees
66.7% in Gaza Strip
26% in West Bank

7. Life Expectancy, Palestine, 1990 - 2016
Life Expectancy among Palestinian males 72.1 years
Life Expectancy among Palestinian females 75.2 years

8. CRVS in Palestinian MOH
The national health information system (HIS) including Vital Statistics (Births & Deaths) (as one of the HIS components) has been identified as one of the priority areas in the Palestinian national health since the end of 1994.
WHO was the technical supporter of HIS in Palestine.

9. Permanent National Committee for Updating and Development of Population Register in Palestine

10. Main Institutions Members of the National Population Register Committee
Ministry of Interior: As responsible for the storage, management, operation and maintenance of the population register.
Ministry of Health: As responsible for the vital events of births and deaths included the cause of death.
Court of Chief Justice: As responsible for the events of marriages and divorces.
PCBS: As user of data for statistical purposes and evaluation of data.

11. Rapid Assessment of National CRVS in Palestine
Done on 3/ 12/ 2012

12. Result of Rapid Assessment of Civil Registration & Vital Statistics, West Bank, Palestine
Score
89%
100%
67% 0%
50%
75%
83%

13. Result of Rapid Assessment of Civil Registration & Vital Statistics, Gaza Strip, Palestine
Score
78%
83%
100%
33% 0%
50%
75%
71%

14. Rapid Assessment of Civil Registration & Vital Statistics

15. Comprehensive Assessment of CRVS in Palestine
Done in Amman- Jordan, April, 2015

16. The Main Recommendations of Comprehensive Assessment of CRVS in Palestine
To activate the direct electronic connection to update and develop the civil registry in order to consolidate all data, ensure availability and flow, including causes of death between the Ministries of Health and Interior.
To strengthen the partnership at the national level through the Permanent National Committee for Updating and Development of Population Register in Palestine.
To raise public awareness of the importance of recording the events of the population registry.
To build and strengthen the national capacities in the field of CRVS registration, statistics and reporting.

19. Role of Palestinian MOH (PHIC) in CRVS

20. Electronic Notification of Live Birth
All maternity and general hospitals in West Bank are electronically connected with Palestinian Health Information Center (PHIC) in MOH for easily, quick and correct notification of newly live births.
MOH looking to complete the cycle with electronic connection with MOI.
Now, MOH working to applied the
electronic notification for deaths
through electronic connection between
PHIC & PHC District Directorate.

21. MOH & Vital Statistics Data & Indicators
Palestinian Health Information Center (PHIC) in MOH
collecting, analyzing and disseminates annually
Vital statistical data and indicators
(birth and death) of Palestine
through the Health Annual Report of Palestine.
PHIC in MOH providing EMRO/ WHO with complete Palestine mortality file including the cause of death according of ICD 10 and all the vital indicators required from WHO.

22. MOH Annual Publishing Vital Statistics Indicators
Number of reported births.
Number of reported deaths
Crude reported birth rate.
Crude reported mortality rate.
Reported Neonatal mortality rate.
Reported Infant mortality rate.
Reported Child (under five) mortality rate.
Maternal mortality rate.
Percentage of low birth weight.
Percentage of deliveries in health institutions.
Percentage of Reproductive age women deaths from the total deaths.
Top ten causes of death in Palestine with
percentages.

23. MOH Annual Publishing Vital Statistics Reports
BIRTH:
Distribution of reported live births and stillbirths by sex & governorates.
Percentage of reported live births by place of delivery and governorates.
Percentage of reported live births weight by sex & governorates (low birth weight, normal & overweight).
Distribution of reported live births by month & governorate.

24. MOH Annual Publishing Vital Statistics Reports
2. Death (1):
Distribution of reported deaths among population by age groups & governorates.
Distribution of reported causes of death (ICD 10) among population by age groups & sex.
Distribution of reported infant deaths by sex & governorates.
Distribution of reported stillbirth cases by sex & governorates.
Distribution of reported cause of death (ICD 10) among infant by sex & region.
Distribution of reported under five years deaths by sex & governorates.

25. MOH Annual Publishing Vital Statistics Reports
2. Death (2):
Distribution of reported causes of deaths (ICD 10) among age group 0- 4 years by sex.
Distribution of reported causes of death among age group 1- 4 years by sex.
Distribution of number, percentage & incidence rates of reported cancer deaths by sex & governorates.
Distribution of reported cancer deaths by site, sex & region.
Distribution of reported causes of cardiovascular diseases death by sex & region.

26. MOH Annual Publishing Vital Statistics Reports
2. Death (3):
Distribution of reported diabetes mellitus deaths by age group, sex & region.
Distribution of reported maternal mortality by death time (during pregnancy, delivery & postpartum period) & governorates.
Distribution of maternal mortality by cause of death (ICD 10), age groups & region.
Distribution of reported reproductive age women deaths by cause of death (ICD 10) & age groups.
Distribution of reported reproductive age women deaths by age group & governorates.

27. Palestine Reported Crude Death Rate\ 1,000 Pop., 1996 - 2016
In Gaza Strip 2.0 / 1,000 of Population
West Bank 2.7 / 1,000 of Population

28. Palestine Reported Infant & Under 5 Mortality Rate\ 1,000 Live Births, 1991- 2015

29. Palestine Reported Maternal Mortality Rate, 2009 - 2016
In Gaza Strip 15.5 / 100,000 Live birth
West Bank 12.4 / 100,000 Live birth

30. Main Cause of Death Problems in Palestine
About 40% of death causes are attributable to undetermined or inadequately defined causes.
About 40% of death causes attributable to how did the death not the cause of death.
The majority of physicians are not aware about ICD 10.

31. Ongoing Projects for Updating & Development of CRVS in Palestine
Enhance cooperation and coordination between all partners of CRVS to control and record all birth and death events and Cause of death.
Training the physicians and medical graduate students to fill correctly the death notification form and correctly to define the cause of death.
Completion of electronic connection between PHIC and PHC directorate and hospitals for notification of death cases and cause of death.
Completion of work on the project of electronic connection between MOH and MOI, that the reporting of the of births & deaths to be electronically from MOH to MOI, not by the citizen.
Continued cooperation between MOH and MOI to monitoring the of completeness reported births and deaths.
Using the census data for 2017, for monitoring of the completeness of reporting births and deaths.

32. Thank you