CRVS assessments: Know your system
The rapid assessment tool
The rapid assessment tool was developed at the University of Queensland to help make the case to policy makers of the need for a full and comprehensive assessment of the functioning of their CRVS system in order to better serve the needs of planners. It was designed to cover the key aspects of a CRVS system and included a scoring system for each of 25 CRVS components.
Like the comprehensive assessment, the rapid assessment was designed to be carried out by a small group of knowledgeable stakeholders who were required to agree on the response that most closely described their country’s situation on each of the 25 indicators. Application of the rapid assessment tool will help decision-makers to rapidly gauge the functionality of their current systems, and to identify feasible and realistic options for moving forward.
The tool is particularly relevant for senior decision-makers, and in settings where systems are dysfunctional or weak and resources are limited, as it helps to generate the evidence needed to advocate for strengthening CRVS systems. The rapid assessment tool consists of 25 questions on the functioning of CRVS systems grouped into the following 11 component areas:
- Legal framework for CRVS
- Registration infrastructure and resources
- Organisation and functioning of the vital statistics system
- Completeness of birth and death registration
- Data storage and transmission
- ICD-compliant practices and certification within and outside hospitals
- Practices affecting the quality of cause-of-death data
- ICD coding practices
- Coder qualification and training, and quality of coding
- Data quality and plausibility checks
- Data access, dissemination and use.
Conducting the rapid assessment:
The assessment should be conducted by a group of knowledgeable individuals with responsibilities for various aspects of their CRVS systems. Critical respondents generally come from:
- The Ministry of Health
- The Civil Registrar’s Office or the Ministry overseeing registration
- The National Statistical Office.
Question responses should be agreed-upon and selected following thorough group discussion.
For each of the 25 questions, respondents must select from one of four possible scenarios, choosing the scenario they believe most closely reflects the country situation.
How the rapid assessment is scored:
- A numerical value (0–3) is assigned to each scenario to indicate how well this aspect of the system functions- See the first diagram below.
- Adding together the numerical scores for each of the 25 questions gives the total score.
- This overall score is then expressed as a percentage of 75, the maximum possible score. This provides a reasonable measure of the broad functionality and quality of the national CRVS system- see the second diagram below
- Percentage scores can also be calculated for each of the 11 component areas listed above.
Extracts showing how the rapid assessment is calculated and categorised:
Strengths and weaknesses of the rapid assessment
The rapid assessment can be helpful in quickly highlighting the main strengths and weaknesses of CRVS systems and demonstrating to senior decision-makers the need for a more comprehensive assessment. However, it is not able to identify detailed development priorities and feasible improvement strategies.
The rapid assessment should be seen as a precursor to the more comprehensive assessment made against international standards. The comprehensive assessment involves a wider array of country stakeholders and comprises a detailed analysis of all CRVS system components. Such an assessment helps identify the precise elements that need to be developed, strengthened or adjusted.