Why do CRVS systems underperform?
The provision of registration services can be adversely affected by many factors. For example:
- Shortage of registration infrastructure and poor distribution of registration offices, which are often located in urban areas, may limit physical access to registration services.
- Registration facilities may not be available on a continuous basis in areas where religious rites require rapid burial.
- There may be a lack of outreach to communities and awareness-raising of the importance of birth and death registration (especially on the need to declare fetal deaths).
- There may be insufficient financial and human resources for CRVS.
- Lack of transport infrastructure and geographic barriers such as seas, mountains, rivers, or problems due to climatic conditions at certain periods of the year may intervene.
- Registration officials usually have multiple responsibilities and may not always prioritise registration, so people may face long delays at registration offices.
- Registration forms are complex, hard to understand and not available in local languages.
- Registration may require multiple visits (eg to register and to collect the associated certificate).
- There may be costs associated with registration, such as registration fees, additional costs of late or delayed registration.
- In some settings, there may be complex registration requirements – eg the need to be accompanied by witnesses to the vital event.
- There may be inadequate collaboration across departments or agencies involved in aspects of registration. For example, between the health sector and the registration and statistical agencies.
- Those responsible for aspects of registration, for example determination of cause of death, may not have the necessary knowledge or skills.