What can be done to rapidly improve CRVS systems?
Infrastructure, skills, and resources
When registration services are insufficient, inadequate, under-resourced or unwelcoming to clients, users are less likely to access them. These supply-side barriers need to be addressed in order to improve registration and the resulting vital statistics generated from them.
Registration points should be within a reasonable distance for the whole population. When certain populations or those living in remote areas do not have access to registration facilities, the coverage of the CRVS system is deficient, and the utility of the resulting vital statistics is diminished. In these cases, measures, such as digital registration options, need to be undertaken to facilitate civil registration in remote areas on a routine basis, including for hard-to-reach and marginalised populations.
In terms of human resources, CRVS systems depend on a sufficient number of qualified staff. Governments need to consider mechanisms for career development as well as ongoing training to enhance the skills of and retain staff. Training should include not only the technical aspects of vital events registration, but also the skills needed to provide a service to families and communities that is sympathetic, understanding and user-friendly.
Example activities include:
- Introducing measures to ensure availability of registration infrastructure, staffing, and equipment and supplies, including mobile registration for hard-to-reach communities.
- Building a respected professional cadre of registration officials, ensuring careful recruitment and offering pre-service and in-service training.
- Posting registrars to places where births and deaths occur and where people are likely to congregate, such as hospitals, health centres and busy market places.
- Optimising opportunities for notification and registration of vital events by delegating responsibilities to health sector programs such as immunisation outreach programs.
- Training registration staff in correct registration and certification procedures and practices, possibly through online qualification systems along with periodic retraining.
- Providing staff in the national statistical system with training on using administrative data to produce statistics.
- Introducing courses in medical schools and continuing training for physicians in certification of COD and for statistical clerks in ICD coding procedures.
- Analysing business processes within CRVS systems with a view to identifying options for improved cost-effectiveness as well as resource gaps.
- Allocating national financial resources adequate for the implementation of national comprehensive CRVS strategies.
- Investigating the appropriateness of private partnerships to address infrastructure gaps.