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Why do CRVS systems underperform?

Status of CRVS systems globally

In all advanced economies and in many middle-income countries, every birth and every death is officially registered; and information about the characteristics of the event is compiled, analysed and disseminated as vital statistics and used to guide policy making and planning, particularly in the health area. This seamless process from the occurrence of a death to its official registration and certification, the production of mortality statistics and their use in informing policy dialogue, is far from common in most low-income and many middle-income countries. 

The facts

Birth registration

  • 100 countries in the world do not accurately count births and deaths
  • The births of nearly one-quarter of children under the age of five – 230 million children – have never been registered. Particularly low levels of birth registration occur in sub-Saharan Africa. Around the world, birth registration is lowest among the poorest households. 
  • In 2012 alone, 57 million births were not registered with civil authorities – that is, 4 out of 10 babies delivered worldwide.
  • Furthermore, 1 in 7 registered children do not have a birth certificate*. 

*This can happen when the event was registered by the family, but they did not collect the certificate (perhaps because this may require another visit to the registry office), or the certificate was lost, damaged, or misplaced.

Death registration

  • Recent estimates show that globally, there are 55 million deaths annually, 50% of which are not registered. 
  • Although some countries have achieved progress in registering births and deaths, globally progress has been painfully slow, with global death registration increasing by only 17% in the 43 years between 1970 and 2013, that is an annual increase of 1%.
  • Only 40 of 194 countries in the world report high quality cause-of-death data to WHO
  • According to WHO, 65% of the world’s people live in countries where cause of death data quality is inadequate to permit monitoring progress towards the Sustainable Development Goals and evidence-based health decision making. 
  • In general, the countries with the weakest CRVS systems are low and middle-income countries in Africa, Asia and the Pacific. Only four countries in Africa have cause-of-death data of sufficient quality to underpin health decisions. 


AbouZahr et al (2015). Civil registration and vital statistics: progress in the data revolution for counting and accountability.

GBD 2016 Mortality collaborators (2017). Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet.

Health Data Collaborative

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