Legal and regulatory frameworks
Common issues and challenges with CRVS legislation
The need for legislative review has been identified in several countries as part of CRVS system assessments using tools such as the WHO Comprehensive Assessment Tool, the Civil Registration and Vital Statistics Legal and Regulatory Review Tool, and the Legislation for Civil Registration and Vital Statistics in the Pacific Guidelines. Common problems with CRVS legislation include:
Outdated legislation
In many countries, legislation is not recent and the laws which govern registration practices have been in place for many years. Where the laws underpinning the system have not been revised to reflect changes in society, and modern technology not introduced to facilitate registration and allow records to be easily transferred, the completeness and quality of registration data are likely to decline.
Insufficient attention to at-risk groups and populations
Civil registration law may leave out certain population groups altogether – for example, refugees and other displaced persons are often not covered by existing laws and cannot register their vital events. As a result, children born to refugees may become stateless because without a legal identity they cannot prove their origins. Both UNHCR and UNICEF have reported that unregistered children are at increased risk of sexual exploitation, early and forced marriages, slavery and trafficking, illicit adoptions and other human rights abuses.
UNHCR has released a number of short videos on the impact of statelessness on the lives of children and young adults.
The registration process should not discriminate against any child, and the right to be registered should be completely separate from the establishment of paternity, marital status of parents, nationality or origin.
Women and girls are more likely to encounter situations where they cannot easily register or where registering a birth is problematic – for example, because they are unmarried, cannot name the father (for example, in the case of rape) or are unaware of their own place of origin. Laws can also be particularly discriminatory towards children born outside of marriage, who may receive a maternal or even fictitious family name. In some countries, the birth certificates issued to such children are a different colour and format, resulting in a stigma that can stay with the individual throughout their lives.
Advocacy by civil society groups in many countries has played an important role in raising awareness of these and other issues. This has led to reform and to new or updated laws on civil registration in many countries, including Albania, Angola, Argentina, Bangladesh, Bulgaria, Chad, the Democratic Republic of the Congo, the Dominican Republic, Indonesia, Madagascar, Morocco, Niger, Peru, Thailand and Timor-Leste.
Persons deprived of civil-status and identity documents (2010). This report is a summary of all the available information on the presence of people without identity and/or civil-status documents in International Commission on Civil Status (ICCS) member states.
This study focuses on good practices in integrating birth registration and health services at the national level, focusing on four case studies from Bangladesh, Brazil, Gambia and India: Muzzi M (2010). UNICEF good practices in integrating birth registration into health systems (2000–2009). UNICEF, New York.
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This handbook provides information on how to set up registration activities for refugees and asylum seekers, what data should be collected, and how to manage and protect the information gathered: UNHCR (2003). UNHCR handbook for registration.
Unclear roles and responsibilities
In many countries, there are different, often conflicting, legal frameworks governing each of the agencies involved in CRVS, such as the health system, civil registry and national statistics office. Roles and responsibilities around obligations to notify or share data between departments, and for the analysis and reporting of data, are often unclear.
Legislation can help by establishing the authority and duties of the office of the registrar-general and other agencies and departments in the civil registration system. It can also ensure there are standard processes to follow around the entire country, such as what forms people need to complete and what types of evidence are required for registration.
Similarly, in many countries there is no legislation that obliges hospital and health facilities – especially in the private sector – to report vital events to authorities. As a result, many events are not being included in official counts. This is a major concern in countries where the private sector is growing and providing a sizeable share of health services.
In addition, although public hospitals and health facilities usually report deaths and births to the Ministry of Health, these are not always subsequently reported to the civil registration authorities. Wherever there is a lack of close collaboration between government agencies, inconsistencies in the vital registration process can arise.
In the development of a legal framework for civil registration, steps must be taken to ensure that regulations exist which make it obligatory for all hospitals and health facilities to report vital events, and for this information to be shared with the civil registration service. Experience from several countries indicates that registration coverage can be significantly increased when civil registration offices are established within health facilities.
In Latin America, for example, registry offices have been set up in maternity hospitals in Argentina, Bolivia and Uruguay. Other countries in the region, including Brazil and Colombia, are now introducing similar approaches. As the proportions of births and deaths that occur in health facilities are increasing, this strategy can yield significant and rapid improvements in registration coverage.
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The investment plan, written by the World Bank and WHO, provides an overview of the common issues and challenges with CRVS systems and opportunities for improvement: World Bank (2014). Global civil registration and vital statistics. Scaling up investment plan 2015–2024. World Bank, Washington DC.
This study focuses on good practices in integrating birth registration and health services at the national level, focusing on four case studies from Bangladesh, Brazil, Gambia and India: Muzzi M (2010). UNICEF good practices in integrating birth registration into health systems (2000–2009). UNICEF, New York.
This discussion paper reviews the status and evolution of vital statistics systems in Latin America and makes recommendations for improving their coverage, quality and timeliness: Danel I et al (2008). An assessment of LAC’s vital statistics systems. World Bank, Washington DC.
International Statistics Program (2016). Training course on civil registration and vital statistics systems (Section 2: civil registration systems). Centers for Disease Control and Prevention, Atlanta.
United Nations Department of Economic and Social Affairs Statistics Division (1998). Handbook on civil registration and vital statistics systems: Preparation of a legal framework. United Nations, New York.
Poor data security
Data security is an important aspect of any civil registration system.
The nature and range of information collected under civil registration may raise concerns about the potential for abuse if strong privacy protections are not included as part of the legal and regulatory environment. The information on civil registers may include personal information that is sensitive, or information that could lead to harm if it is disclosed or combined with other personal data.
Where there is a perception that data confidentiality measures are inadequate and personal data are not kept private, then trust in the civil registration system will be lost and people may be reluctant to register. Civil registration law should protect the confidentiality of all personal information in registration records and safeguard it from unlawful access.
There should be enforceable penalties for any breaches or data misuse that involves civil records. The United Nations Principles and Recommendations for a Vital Statistics System (2014) outlines the following cases where penalties should be established for failure to comply with the law, rules, and regulations:
“The civil registrar, as a public servant, is expected to faithfully carry out the provisions of the law and all applicable rules and regulations. Therefore, there must be penalties prescribed in the civil registration law for failure to do so. In criminal cases, the highest registration authority (e.g., the registrar-general) is accountable to the competent law enforcement authorities. Penalties should be established in the law in cases where the registrar:
- Fails to register a vital event or its characteristics, as reported by the informant
- Loses, damages or alters any registered records or permits such loss, damage or alteration to occur
- Fails to provide registrants with adequate protection of privacy and confidentiality
- Has been found guilty of violating the provisions of the civil registration law or its rules and regulations
- Fails to fill out and submit statistical documentation.
While it is essential for the system to provide penalties for failures of compliance, it is equally important for local registrars to be encouraged, through the provision of incentives, to do their best in supporting and improving the system. Such incentives as the granting of permanent civil service status, career development and training opportunities, merit-based promotions, and special awards and other forms of recognition for outstanding work, are considered important contributors to the development of a corps of expert, reliable and dependable local registrars.”
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The investment plan, written by the World Bank and WHO, provides an overview of the common issues and challenges with CRVS systems and opportunities for improvement. Section 2 contains information on privacy and personal information: World Bank (2014). Global civil registration and vital statistics scaling up investment plan 2015–2024. World Bank, Washington DC.
This discussion paper reviews the status and evolution of vital statistics systems in Latin America and makes recommendations for improving their coverage, quality and timeliness: Danel I et al (2008). An assessment of LAC’s vital statistics systems. World Bank, Washington DC.
United Nations Department of Economic and Social Affairs Statistics Division (2014). Principles and recommendations for a vital statistics system. United Nations, New York.
Poor data confidentiality
It is important that there are laws, policies and mechanisms governing data security. Important issues include confidentiality, safe storage and disposal and the release and use of an individual's data. Only the close family of a deceased person should have access to information on the death record or to private information on the birth certificate. The strict application of such laws is also necessary to avoid identity fraud of various types.
Confidentiality is particularly important in the accurate certification of causes of death, because social insurance schemes often exclude or pay less for certain causes. Medical physicians may also hesitate to report certain causes of death if they fear the information could be used against them or their institutions.
To preserve confidentiality, some countries include two sections on the same death form – the ‘death certificate/notification’ requires a medical signature and has legal value, while the ‘statistical report’ that provides the foundation of the vital statistics system does not. In Argentina, as in many other countries, the statistical report does not include identifying information such as names or ID numbers. After the combined death certificate/notification is received at the office of the civil register the two elements are separated and follow independent processes.
At the same time, it is important that confidentiality restrictions do not impede government departments in legitimately sharing individual records for statistical or administrative purposes. Where appropriate, such sharing might involve a formal agreement outlining the security procedures to be followed and specifically listing all the restrictions on data use.
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United Nations Department of Economic and Social Affairs Statistics Division (1998). Handbook on civil registration and vital statistics systems: Preparation of a legal framework. United Nations, New York.
Lack of recognition of statistical functions
The United Nations advocates that civil registration has two basic functions – a legal function that provides identity and registers vital events, and a statistical function that generates national vital statistics data. These two functions should be viewed as being of equal importance. However, it is often the case that the latter function is not properly defined in law, resulting in confusion concerning who is responsible for generating the vital statistics from the registration records.
Making the statistical function of civil registration very clear in law, and setting out the cooperative processes required between civil registration agencies and other public administrations for compiling and disseminating the data are both very important. This aspect of the civil registration system should be fully recognised in legislation, and resources made available to ensure that required activities are sustainable and properly implemented.
Vital statistics are a highly valuable resource for governments in implementing or evaluating ongoing social and economic development programs. The dynamic nature of data from civil registration arises because they are collected at the time of the event rather than being derived afterwards as is the case with other data sources.
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United Nations Department of Economic and Social Affairs Statistics Division (2002). Handbook on training in civil registration and vital statistics systems. United Nations, New York.
Limited or no enforcement of the law
The need for civil registration systems to register all vital events and ensure both the quality and completeness of information means that birth and death registration must be made legally compulsory, and linked to some form of penalty for those who do not comply. Linking registration to incentives as well as penalties is likely to achieve even better outcomes as in itself the existence of a law will not guarantee full compliance, and penalties may be difficult to administer. While there is a range of incentives that can be used to encourage people to register, the existence of a law will make it more likely that local authorities will be persuaded to collaborate in enforcing and promoting registration in the populations they administer.
A legal framework can also support the registration process by broadening the responsibility for registration. For example, regulations in many countries oblige health services and funeral authorities to begin the registration process. By linking death registration with permission to transport the deceased to the burial place or with a funeral permit, there is a strong incentive to register the death quickly, while reducing the burden of paperwork on the family. Similarly, obliging physicians and midwives to forward copies of birth and medical death certificates to the local civil registration office or health department proactively encourages registration.
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United Nations Department of Economic and Social Affairs Statistics Division (2002). Handbook on training in civil registration and vital statistics systems. United Nations, New York.
United Nations Department of Economic and Social Affairs Statistics Division (1998). Handbook on civil registration and vital statistics systems: Preparation of a legal framework. United Nations, New York.
Lack of clear definitions
The legal framework should clearly define the important concepts underlying CRVS systems, including key terms and concepts. Having clear definitions helps to clarify the scope of data collected, and how indicators are calculated. Without standard definitions, it is impossible to use data to reliably calculate basic indicators such as neonatal, perinatal and infant mortality rates, which are needed to assess population health trends. In addition, it is not possible to generate statistics that are internationally comparable or consistent over time.
In many countries, deaths which occur within a short time of birth are inadequately dealt with in the civil registration system. For example, early neonatal deaths (deaths occurring within the first week of life) are sometimes classified as stillbirths to avoid having to register both a birth and a death within a few days of each other. This distorts the resulting statistics and prevents public-health authorities from identifying and addressing important issues in perinatal health. It is therefore important that civil registration laws include clear definitions of terms such as ‘fetal death’, ‘stillbirth’ and ‘live birth’ and that these accord with international standards. It is also important to clarify other terms relating to registration, including if the ‘place of occurrence’ relates to the place where the event took place, or the place where the event was registered.
Another common problem in many countries is a lack of clarity concerning the scope and population coverage of civil registration laws. For example, it can be unclear if the law refers to all national citizens, or to citizens living in the country, or to all residents in the country. The situation is further complicated by the issue of inclusion or otherwise of transient populations such as refugees. Where there is doubt about the population covered, the calculation of reliable rates becomes impossible due to the lack of a clear denominator. The United Nations recommends that all people residing in a country, including refugees, be given the right to register vital events, irrespective of whether they are citizens or not. This is also considered to be the best solution at a local level, where it is particularly important that all individuals living in an area appear in the system in order to guide the planning and allocation of resources.
Civil status and perinatal death (1999) compares the different registration processes among ICCS member countries in regard to the registration of lifeless children (that is, children dead at the time of the declaration of birth). As discussed, the medically observed situation of life or death is apprehended under the legislations of ICCS member countries in a variety of ways, with the result that the registration of the child entails legal consequences that vary according to the legislation concerned.
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United Nations, New York. This document provides recommended definitions for vital events as part of a civil registration: United Nations Department of Economic and Social Affairs Statistics Division (2014). Principles and recommendations for a vital statistics system. (Section 304).
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This document provides comprehensive guidance on how to systematically evaluate the quality and functioning of CRVS systems: World Health Organization (2010). Improving the quality and use of birth, death and cause-of-death information: guidance for a standards-based review of country practices. WHO, Geneva.
Secretariat of the Pacific Community (2016). Legislation for civil registration and vital statistics in the Pacific: Best practice guidelines and examples. Secretariat of the Pacific Community, Nouméa.