CRVS process mapping
Ten CRVS milestones
The ‘Ten CRVS milestones’ is a framework to help understand and analyse CRVS processes in a systematic and structured way. Although it can be used with processes related to any vital event, we have tailored this framework for births and deaths that occur in health facilities and in the community.
The Ten CRVS milestones represents a set of requirements that every CRVS system must fulfil to achieve its objectives (eg produce vital statistics or provide legal documents). In other words, all these 10 milestones must happen for a CRVS system to be functional.
This framework is the backbone of the process mapping exercise. CRVS stakeholders must understand, map, analyse and redesign (if needed) every CRVS milestone during the mapping exercise.
Country examples: Ghana
One example of the benefits of the application of this framework to a CRVS system comes from Ghana. During a process mapping exercise in the country with all relevant stakeholders, the group was mapping the process for death registration when deaths occur outside of health facilities. They realised that whereas the process from the point of registration (Milestone 3 in the diagram above) was clear and well defined, the way the death was notified was not defined (Ghana did not have a death notification form at that point). This led to a situation in which, although vital events were known by local authorities, they were not notified to the CRO. During this same process mapping exercise, a notification form and procedures to notify a death were identified, agreed on and approved by all relevant stakeholders. The new process then became the recommended practice in the country.
How Ghana revolutionised their CRVS system using process mapping
Interview with Professor Don de Savigny from the Data for Health Innovations Hub and the Swiss Tropical and Public Health Institute about how Ghana has been able to undertake process mapping to document the entire 'as is' and 'as desired' civil registration and vital statistics processes and the effect process mapping has had.