Understanding the complexity of CRVS systems is essential to finding solutions to solving some of the structural problems CRVS system in low and middle-income countries. CRVS process mapping is a tool that gives us the opportunity to look at CRVS systems as a whole.
Methods have been developed using freely available, easy-to-use software, to map separately the CRVS processes of birth in a health facility, birth in the community, death in a health facility, and death in the community.
The act of mapping these processes requires the various stakeholders to work together to understand each other’s roles and challenges. The initial step is to map the current CRVS situation for processes related to births and deaths. This is an essential first step, and is now also being recommended as a first or early step in CRVS comprehensive assessments. The current or ‘as is’ maps start to stimulate thinking and innovation in addressing the future or ‘as desired’ CRVS processes.
CRVS process mapping makes it easier to see:
- how to integrate and anchor new interventions (e.g. verbal autopsy) into the system
- missing processes (eg notification processes or quality control steps)
- duplicated processes (collecting the same information at different levels); redundant and -duplicate databases
- missing or out-dated process specifications, requirements and SOPs
- missing or out-dated legal or regulatory provisions
- key steps in the processes where most events are lost.
The CRVS process maps can become the table of contents for CRVS documentation, a road map for a higher performing CRVS system and are intended to be used longitudinally as the system improves.