CRVS stakeholders, structures and coordination
Harnessing the availability of health sector resources to facilitate registration of births and deaths
A proactive approach involves siting outreach registration offices in health facilities, particularly large referral hospitals, where many births and deaths occur. For example, in Kenya registration offices have been established in hospitals to facilitate immediate registration of vital events. In some countries, health workers at the community level are responsible for reporting vital events occurring outside health facilities.
Community leaders and outreach health workers can be valuable allies in efforts to improve registration. They are close to their communities and generally aware of all births and deaths, especially in small and close-knit communities. For example, in Ethiopia, in addition to the existing obligation of health facilities to notify births occurring in facilities, health extension workers are required to notify births occurring outside of health facilities.
In the case of deaths, official funeral homes are sometimes responsible for reporting deaths to the registration authorities and, in some cases, issuing death certificates, as is the case in South Africa and in the United States of America. This approach can work well in places where funeral homes are officially regulated, but can be problematic where there are many unlicensed, private entities offering funeral services so that it is difficult to ensure common standards of reporting and data quality.
When there are multiple sources of notification to the civil registrar (eg health authorities, community leaders, funeral homes, families), it is important to establish mechanisms to avoid duplication and double counting of deaths. This is why it is essential to have correct information on the decedent and the declarant. Countries with unique identification systems for the population are less likely to face this problem if the identification number is included in all records.