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Whether you're a CRVS expert of just starting to learn about CRVS systems, you will enjoy exploring the range of resources available here in our library. Discover more about strengthening and innovating CRVS systems, plus learn from other countries challenges and experiences.


A framework for evaluating national CRVS systems at baseline
A framework for evaluating national CRVS systems at baseline

Describes the baseline evaluation framework developed for BD4H, which delivers a concise and up-to-date 'actionable' evaluation of a CRVS system.

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Author: University of Melbourne

Publication date: April 2018

Resource type: CRVS technical outcome series

Related resources: Action guide on process mapping for CRVS system-strengthening


Action guide on process mapping for CRVS systems
Action guide on process mapping for CRVS systems

Outlines the four key steps in process mapping and explains how they can be used to strengthen CRVS system design.

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Publication date: April 2018

Resource type: CRVS action guide

Related resources: Understanding CRVS systems: The importance of process mapping


CRVS and health
Civil registration and vital statistics in health systems

Over the past decades, the health sector has forged a widespread network of health facilities and community health workers who carry out key public health interventions, aiming to reach the most marginalized populations with life-saving interventions. In many countries, health networks offer untapped potential to leverage health services for the notification and registration of births and deaths.

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Authors: Jackson D, Wenz K, Muniz M, Abouzahr C, Schmider A, Braschi MW, Kassam N, Diaz T, Mwamba R, Setel P, Mills S

Publication date: December 2018

Resource type: Journal article

Source: Bulletin of the World Health Organization http://dx.doi.org/10.2471/BLT.18.213090


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Collecting verbal autopsies: improving and streamlining data collection processes using electronic tablets

As countries increase verbal autopsy surveillance, it is important to consider the best way to design sustainable systems for data collection. Electronic data capture has the potential to greatly reduce the time and costs associated with data collection. For long-term, large-scale surveillance required by national vital statistical systems, electronic data capture reduces costs and allows data to be available sooner. This study collected verbal autopsy interviews using paper and pencil, and using electronic tablets at two sites, and measured the cost and time required to process the surveys for analysis.

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Authors: Flaxman AD, et al

Publication date: 2018

Resource type: Peer-reviewed paper

Source: Population Health Metrics. 2018; 16(3) [creative commons attribution license https://creativecommons.org/licenses/by/4.0/]


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CRVS Costing Tool

The purpose of the CRVS Costing & Budgeting Tool is to help planners and managers to determine the costs of implementing CRVS systems. This Tool can be customised to country context and covers all aspects of a CRVS system comprising start-up costs, training costs, community-level service delivery costs, as well as support, supervision, and management costs at all administrative levels. Additionally, the Tool has a budgeting element that can be used to estimate budgets for CRVS systems.

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CRVS Costing Tool Report Template

The purpose of the CRVS Budgeting & Costing Tool is to help planners and managers to determine the costs of implementing CRVS systems.

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CRVS Costing Tool: User guide

This user guide provides program planners and managers with instructions for using the accompanying CRVS Costing Tool. The purpose of the CRVS Costing Tool is to help you to determine the costs of implementing CRVS systems.

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CRVS innovations: Developing and testing a CRVS Costing Tool

This CRVS technical outcome series paper describes the CRVS Costing Tool that has been developed as part of the Bloomberg Philanthropies Data for Health (D4H) Initiative by the Swiss Tropical and Public Health Institute and the University of Melbourne.

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CRVS performance metrics: Assessing the performance of CRVS systems

This CRVS technical outcome series paper describes the CRVS performance assessment toolkit that has been developed as part of the Bloomberg Philanthropies Data for Health (D4H) Initiative by the Swiss Tropical and Public Health Institute and funded by the University of Melbourne.

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CRVS perf metrics tool
CRVS performance metrics: Data collection tool

Having a strong monitoring system is essential for any program to function. CRVS systems are complex adaptive systems and as such they perform hundreds of activities every day to register vital events, to provide legal documents to citizens and to produce vital statistics. To monitor CRVS systems we need to understand their complexity and identify appropriate metrics that can be used routinely to assess their performance.The purpose of this data collection tool is to facilitate the process of data collection in a consolidated and systematic way. The tool consists of 18 worksheets in a single Excel file (.xls). It is formulated specifically to calculate and visualise the performance indicators at each health system level. This tool can be customised to the country’s context and users can decide the level of detail they want to obtain. Depending on the data available, it is possible to input performance data from a sample or from a whole national information system.

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CRVS performance metrics: Indicator guideline

This document presents a clear description of the generic indicators that could be used as metrics to assess CRVS process performance. It also describes the data required, the method of measurement or potential approximations as well as the data sources and alternative if these sources are not available.

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CRVS performance metrics: User guide

This user guide provides program planners and managers with instructions for using the accompanying data collection tool and the CRVS performance dashboard template.

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CRVS-VA sample size calculator tool

The purpose of this package of a two part guidance document and its companion sample size calculator Tool is to assist countries with scale up and rollout planning for the application of verbal autopsy (VA) as a function of a national civil registration and vital statistics (CRVS) system. Users of the package will include those tasked with designing and managing the CRVS-VA system. The package is intended to be used after pre-testing and pilot phases during which the processes, methods and possibly costing of the CRVS-VA system are perfected and established, and before the scale-up and rollout phase.

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Developing a verbal autopsy costing and budgeting tool

This paper describes the Verbal Autopsy Costing and Budgeting Tool that has been developed by the Swiss Tropical and Public Health Institute and the University of Melbourne. The tool estimates the resources needed to implement verbal autopsy (VA) as part of a routine civil registration and vital statistics (CRVS) system. The tool has been piloted in four different countries, representing different stages of implementation of VA activities, and the tool was able to demonstrate the relatively low ongoing cost of conducting routine VA when integrated within a CRVS system.

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Authors: Cobos Muñoz D, Monzon Llamas L, Dayo C, Renggli S, deSavigny D

Publication date: January 2019

Resource type: CRVS technical outcome series

Related resources: Challenges associated with automated VA training and rollout


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Estimating the completeness of death registration: An empirical method

Many national and subnational governments need to routinely measure the completeness of death registration for monitoring and statistical purposes. Existing methods, such as death distribution and capture-recapture methods, have a number of limitations such as inaccuracy and complexity that prevent widespread application. This paper presents a novel empirical method to estimate completeness of death registration at the national and subnational level.

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Authors: Adair T, Lopez AD

Publication date: May 2018

Resource type: CRVS technical outcome series

Related resources: Summary: A new method for estimating the completeness of death registration

Source: PLoS ONE


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How can we accelerate progress on civil registration and vital statistics?

The first in a series of papers published by the WHO Bulletin looking at how the health sector can contribute towards strengthening CRVS systems and increasing birth and death registration coverage.

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Authors: AbouZahr C, Bratschi MW, Cobos Munoz D, Santon R, Richards N, Riley I, Setel P

Publication date: April 2018

Resource type: Journal article

Source: Bulletin of the World Health Organization http://dx.doi.org/10.2471/BLT.18.211086


PopHealthMetrics
How useful are registered birth statistics for health and social policy? A global systematic assessment of the availability and quality of birth registration data

Since 1980, approximately one billion births were registered and shared in public databases. Compared to estimates of fertility, this represents only 40.0% of total births in the peak year, 2011. Approximately 74 million births (53.1%) per year occur in countries whose systems do not systematically register them and release the aggregate records. Considering data quality, timeliness, and completeness in country-years where data are available, only about 12 million births per year (8.6%) occur in countries with high-performing registration systems. This study highlights the gaps in available data.

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Authors: Phillips DE, Adair T, Lopez AD

Publication date: 2019

Resource type: Peer-reviewed paper

Source: Population Health Metrics. 2019; 16(21) [creative commons attribution license https://creativecommons.org/licenses/by/4.0/]


Integrating community-based verbal autopsy into CRVS: System-level considerations
Integrating community-based verbal autopsy into CRVS: System-level considerations

This document provides recommendations for integrating VA processes into CRVS, which involves consideration of system-wide integration issues.

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Authors: de Savigny D, Riley I, Chandramohan D, Odhiambo F, Nichols E, Notzon S, AbouZahr C, Mitra R, Cobos Munoz D, Firth S, Maire N, Sankoh O, Bronson G, Setel P, Byass P, Jakob P, Boerma T, Lopez AD

Publication date: January 2017

Resource type: CRVS technical outcome series

Related resources: Summary: Integrating verbal autopsy into CRVS systems

Source: Global Health Action


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Maximising synergies between Health Observatories and CRVS

This report provides practical guidance about how population and health observatories and CRVS systems can collaborate, to ultimately improve the registration and certification of births, deaths, and causes of death.

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Authors: de Savigny D, Renggli S, Cobos D, Collinson M, Sankoh O

Publication date: March 2018

Resource type: CRVS technical outcome series


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Sampling strategies for national scale CRVS-VA planning: Guidance document and sample size calculator tool

The purpose of this package of a two part guidance document and its companion sample size calculator Tool is to assist countries with scale up and rollout planning for the application of verbal autopsy (VA) as a function of a national civil registration and vital statistics (CRVS) system. Users of the package will include those tasked with designing and managing the CRVS-VA system. The package is intended to be used after pre-testing and pilot phases during which the processes, methods and possibly costing of the CRVS-VA system are perfected and established, and before the scale-up and rollout phase.

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Authors: University of Melbourne, Swiss Tropical and Public Health Institute, Vital Strategies, London School of Hygiene and Tropical Medicine, CDC

Publication date: May 2018

Resource type: CRVS resources and tools

Related resources: CRVS-VA sample size calculator tool


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Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú

Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. However, the quality of cause of death data is poor. In August 2016, the Ministry of Health of Perú decided to make two specific interventions to improve cause of death data: to introduce an online death certification system and to train doctors in standard death certification practices. This study demonstrates how the two interventions improved the correctness of death certificates. The study also provides evidence on necessary changes to the training program to address the poor certification practices that have remained after implementation of the online system.

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Authors: Miki J, Rampatige R, Richards N, Adair T, Cortez-Escalante J, Vargas-Herrera J

Publication date: December 2018

Resource type: Academic journal article

Related resources: Fellowship profile: Assessing the impact of death certification interventions in Peru

Source: BMC Public Health https://doi.org/10.1186/s12889-018-6264-1 


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Summary: A global systematic assessment of the availability and quality of birth registration data

Explains the global birth registration database and quality metric, the Vital Statistics Performance Index for Births (VSPI-B), developed to assess the completeness and quality of birth registration data. The database and index together can help enable the tracking of the performance of registration systems over time and between countries and can be of great use for monitoring progress for global and national development goals.

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Publication date: February 2019

Resource type: CRVS summary

Related resources: How useful are registered birth statistics for health and social policy? A global systematic assessment of the availability and quality of birth registration data


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Summary: A new method for estimating the completeness of death registration

Explains a new method to estimate the completeness of death registration using widely available country data.

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Publication date: May 2018

Resource type: CRVS summary

Related resources: Estimating the completeness of death registration: An empirical method


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Summary: Improving the notification of community deaths

Notification of deaths, particularly deaths in the community, requires special attention and will likely need specific interventions tailored to each country. Two checklists have been developed for countries seeking to audit and improve internal notification of community deaths.

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Publication date: August 2018 (update)

Resource type: CRVS summary

Related resources: Where there is no physician: Improving the notification of community deaths


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Summary: Integrating verbal autopsies into CRVS systems

This document details how to sustainably integrate verbal autopsy into CRVS systems.

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Publication date: April 2018

Resource type: CRVS summary

Related resources: Integrating community-based verbal autopsy into CRVS: System-level considerations


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Summary: Maximising synergies between health observatories and CRVS systems

Outlines six different areas of potential collaboration between health and demographic observatories and CRVS systems, including challenges and successes.

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Publication date: November 2018

Resource type: CRVS summary

Related resources: Maximising synergies between health observatories and CRVS: Guidance for INDEPTH HDSS sites and CRVS stakeholders

Partners: Swiss TPH, INDEPTH Network


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Summary: Understanding the VA costing and budgeting tool

A VA costing and budgeting tool has been developed to help determine the financial and economic costs of implementing routine VA, based on six activity groups: start-up activities, governance activities, program management, supervision, refresher training, VA delivery and analysis.

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The 'Ten CRVS Milestones' framework for understanding CRVS systems
The 'Ten CRVS Milestones' framework for understanding CRVS systems

Describes how CRVS systems function, including key processes that must be accomplished. Provides an understanding of system strengths and weaknesses.

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Authors: Muñoz DC, AbouZahr C, de Savigny D

Publication date: February 2018

Resource type: CRVS technical outcome series

Related resources: Understanding CRVS systems: The importance of process mapping

Source: BMJ Global Health


Understanding CRVS systems: The importance of process mapping
Understanding CRVS systems: The importance of process mapping

Explains how enterprise architecture and its process mapping methodology can be used to describe and improve CRVS systems.

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Authors: de Savigny D, Cobos Muñoz D.

Publication date: April 2018

Resource type: CRVS development series

Related resources: Action guide on process mapping for CRVS systems

Source: Swiss Tropical and Public Health Institute, University of Basel


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VA Costing Tool

The purpose of the VA Costing Tool is to help planners and managers to determine the costs of implementing verbal autopsy systems. The Tool can be customised to the country’s context and covers all aspects of a VA system, including start-up costs, training costs, community-level service delivery costs, as well as governance, supervision, and management costs at all administrative levels. Additionally, the Tool has a budgeting and a modelling component. The former can be used to estimate budgets for VA systems, whereas the latter can be used to model different VA implementation scenarios. NOTE: clicking on the 'download resource' button will automatically save the Excel file to your PC.

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VA Costing Tool: Report template

This template can be used to summarise key outputs from the VA Costing Tool, to assist planners and managers to determine the costs of implementing verbal autopsy systems. The template is based on three key areas of the Tool: total program costs for baseline year by activity and input type; average costs per VA; and key drivers of costs. NOTE: clicking on the 'download resource' button will automatically save the Word document to your PC.

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VA Costing Tool: User guide

This user guide provides program planners and managers with instructions for using the accompanying VA Costing Tool. The purpose of the VA Costing Tool is to help you to determine the costs of implementing VA within CRVS systems, including identifying key cost drivers and estimating total budget requirements.

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Where there is no physician: Improving the notification of community deaths

This paper highlights the importance of community death notification, and provides checklists for countries seeking to audit and improve internal notification of community deaths. Results from applying these checklists as part of a broader process mapping exercise with 16 countries will also be discussed, which influenced the development of seven general guiding principles for the development of death notification forms. These resources are meant to aid countries and their CRVS partners as they move towards improving notification and registration of community deaths, particularly when considering universal digital notification-registration where there is no physician.

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Author: Cobos Muñoz D, de Savigny D.

Publication date: July 2018

Resource type: CRVS technical outcome series

Related resources: Improving registration: Best practice guidelines

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