1. 1 1 Disclaimer: The boundaries shown on the above map do not imply official endorsement by the World Health Organization (This Disclaimer applies to the entire presentation) By Jyotsna Chikersal Regional Advisor HST WHO/SEARO Innovative approaches to strengthen Mortality Statistics from routine CRVS systems in the South East Asia Region Barcelona, Spain 16 October 2014 1

2. 2 “To make people count, we first need to be able to count people” (LEE Jong-Wook, WHO Director-General, 2003–06) Most people in Asia are born & die without leaving a trace in any legal record or official statistic. Scandal of invisibility Absence of reliable data for births, deaths, & COD are at the root of making most world’s poor as unseen, uncountable, and hence uncounted Most fundamental of all, civil registration is a proof that a state recognizes & respects lives of those it has a responsibility to defend & develop. 2

3. 3 For 97% of children dying, scientists are forced to make sophisticated guesses for Cause. “ In 2010 7.6 million children under age 5 died. But fewer than 3% of those deaths were medically certified- assigned a cause by a health worker & recorded in an official database.” (Science, June 2012.) 3

4. 4 Every woman dying has a story to tell… Every minute, at least one woman dies from complications related to pregnancy or child birth. Verbal Autopsy can be used to capture the story behind the death 4

5. 5 Completeness of Death Registration: 4 countries high ; 2 medium; 5 low- Need for innovative approaches for strengthening mortality statistics from CRVS > 80% 70-80% 60-70% < 60% 5

6. 6 ECODIRS as an enabler to mobilize community health workers to notify births, deaths & conduct Verbal Autopsy for most probable COD 6

7. 7 To provide unified direction & galvanize political commitment for strengthening mortality statistics from routine CRVS system, a “Regional Strategy for Strengthening the role of the health sector in Improving CRVS (2015-2024)” developed Strategic Area 1: Legal and Organizational Framework for CRVS Strategic Area 2: Political commitment and intersectoral collaboration for National Capacity Building, Partnerships, Advocacy & Outreach Strategic Area 3: Birth and Death registration- completeness and coverage Strategic Area 4: Recording Cause of Death, ensuring completeness and quality Strategic Area 5: Creating demand for health and vital statistics, enabling service delivery and planning through: (i) use in evidence- based decision making and (ii) linkage to other activities 7

8. 8 To strengthen mortality statistics from routine CRVS systems in the SEAR, eCODIRS & the Regional strategy offers a way forward to : Galvanize political will and multi-stakeholder engagement in strengthening mortality statistics from routine CRVS as a critical development agenda Generation of reliable vital statistics from civil registration data and their use in policy and decision-making Use ICT as an enabler for community mobilization and building the capabilities of Community Health Workers for collecting quality CoD data using Verbal Autopsy, as well as notification of births and deaths and reporting of ICD coded Medically Certified Cause of Death (MCCD) Create demand for health and vital statistics, enabling service delivery and planning Engage Development partners for aligned and sustainable support for improving cause specific mortality data, based on nationally representative COD data 8

9. 9 Thank you “ Every mountain top is within reach if you just keep climbing.” ― Barry Finlay, Kilimanjaro and Beyond …… 9