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CRVS assessments: Know your system

Country experiences using the tools

Both the rapid and comprehensive assessments were developed through close collaboration between country and technical partners. They were designed to be self-assessments completed by a suitably broad group of local stakeholders familiar with their CRVS system processes – with technical support if needed.

Broad participation is a crucial factor in the eventual improvement of CRVS systems. Improvement requires effective collaboration between government departments in the health and nonhealth sectors, as well as cooperation with nongovernmental organisations and other civil society groups. The rapid assessment can be completed by the major stakeholders in less than a day. The comprehensive assessment requires more time and involves more participants, but gives a much more detailed diagnosis of the problems and provides clearer guidance on the actions required.

The rapid assessment has been conducted in more than 70 countries. Based on the results, a typology has been developed that classifies country CRVS systems into four groups – dysfunctional; weak; functional but inadequate; and satisfactory. The table below outlines the main challenges that countries face in each of the four groupings, and sets out the level of actions required in each case.

Typology of national CRVS systems according to overall rapid assessment scores

 Score (%)

 Typology

 Description

 Actions required

 <35

 Dysfunctional

 There is very limited registration of births and deaths and medical   certification of cause of death. The systems do not produce vital   statistics.

 Systems require improvements in all areas.

 35–64

 Weak

 There is incomplete or variable registration of births and deaths (with   higher coverage in urban areas, for example), limited medical   certification of cause of death (mainly confined to secondary and tertiary   hospitals), and vital statistics are not generally compiled and analysed.

 Many aspects of the systems do not function   well and multiple areas require attention.

 65–84

 Functional but inadequate

 There is complete registration of births and deaths and medical   certification of cause of death in hospitals, but limited medical   certification for non-hospital deaths. There are concerns about the   compilation, quality and dissemination of vital statistics.

 Systems work but some elements function   poorly and require attention. The   comprehensive assessment should be   completed to identify weaknesses in the   systems.

 85–100

 Satisfactory

 There is complete registration of births and deaths with medical   certification of cause of death. Vital statistics are produced and used, but   there are some concerns regarding data quality.

 Minor adjustments may be required for   otherwise well-functioning systems.

Experiences using the tools in the Asia–Pacific

An evaluation was conducted of the results from rapid assessments of CRVS systems in 26 countries in the Asia–Pacific region. The countries covered a broad income and development spectrum, with overall assessment scores ranging from 11 to 97% (average 73%; median 77%). Countries with the lowest scores (<65%) identified major issues in relation to the completeness of vital statistics, malfunctioning systems, poor cause-of-death certification and coding, and absence of overall data quality. 

Countries in the middle group (average scores 65–84%) identified some weaknesses in completeness, cause-of-death certification, training of ICD coders, transmission of data, intra-governmental collaboration and data dissemination. Countries scoring >85% – generally those in the highest income group – identified different weaknesses, mainly in relation to the quality of mortality coding, coder training and interagency cooperation. The diagram below summaries the average scores for each of the 11 component areas of the tool.

Results of rapid assessment of CRVS systems in 26 Asia–Pacific region countries, 2010

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Source: Rapid assessment of vital statistics systems: Evaluation of the WHO/HIS Knowledge Hub tool in 26 countries in the Asia–Pacific region.

Experiences using the tools in Africa

Based on the original rapid and comprehensive assessment tools, the Africa Program for Accelerated Improvement of Civil Registration and Vital Statistics and United Nations Economic Commission for Africa developed and modified tools for the African region.

These guidelines and tools have been prepared to assist countries in undertaking a comprehensive assessment of their CRVS systems and in the development of a national CRVS strategic plan. The guidelines provide specific steps for assessing a national CRVS system and set out the range of options for organising the exercise, as well as specific issues for investigation.

The assessment tool is developed to guide countries to comprehensively and holistically review their CRVS systems with the objective of generating evidence that will guide the improvement efforts. The tool provides a comprehensive range of management, technical, operational and infrastructural issues against which countries need to review their systems. The issues presented in the tool are based on the international principles and standards on CRVS systems developed by the United Nations.

The output of the assessment is expected to feed into the development of a strategic plan and a costed action plan.



Learn more

Download  the modified guidelines and tools.

Download  additional resources, including a facilitators’ handbook, strategic planning guide and terms of reference for international experts.

Read more

Results from Mozambique’s’ rapid CRVS assessment 

Ethiopia’s indicative CRVS investment plan

Namibia’s CRVS strategic plan

Experiences using the tools in the Eastern Mediterranean region

Countries in the Eastern Mediterranean region (EMRO) have also taken part in the rapid and comprehensive assessments, using the standard tools developed.

Based on this self-assessment by countries, it would appear that approximately one-third of EMRO countries have satisfactory CRVS systems, whereas the remaining two-thirds have systems that are functional but inadequate or weak or dysfunctional. Furthermore, whereas approximately 10 million births are being registered each year (62%), more than two-thirds of deaths (over 3 million) are not being registered (see diagram below).

download

download

Source:  
http://www.emro.who.int/civil-registration-statistics/assesment/crvs-assessments.html



Learn more

Arabic and French versions of the rapid and comprehensive assessment tools are available to  download  from the EMRO website.


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