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CRVS assessments: Know your system

What tools are available?

Generally, the first step in the process is to collaboratively complete a process map that provides an end-to-end description of CRVS processes for vital events. Process mapping involves a detailed review of existing practices, involves multiple stakeholders and gets into considerable detail of actual functioning. Once the tool has been mastered, it can be used in an ongoing way to re-engineer CRVS processes.

Once process mapping is completed, there are other  important assessment tools that can provide you with a detailed understanding of your CRVS system. They can be found in the tables below.

CRVS system-wide tools




Process mapping

-Shows a clear, fairly comprehensive picture of how data flow between users and agencies in a CRVS system

-Good way for smaller group of stakeholders to start a discussion, gain agreement on processes, and highlight areas where processes are unknown or unclear

-Focus is on processes and data flow

-Requires training to use tool

-Does not cover areas such as strength of legislation, accessibility, ease of use for the public or aspects of data quality

-Does not provide enough information to inform a national CRVS improvement plan

WHO/UQ Rapid Assessment*


* Should be used as a precursor to the more comprehensive assessment, using international standards.

-Quick way for a few key stakeholders to assess the strengths and weaknesses of system through a scoring system

-Can be used for baseline analysis and subsequent occasional monitoring as interventions are implemented

-Increases awareness of the need to improve a country’s CRVS system and can generate political will to undertake a comprehensive assessment

- Outcome of assessment intended to be used to make the case to senior decision-makers for a more comprehensive analysis to be conducted

-Is not a detailed assessment of a CRVS system. It only provides directions to inform development priorities and improvement strategies for a national CRVS plan

-Scores influenced by who is involved in grading performance


WHO/UQ comprehensive assessment

-Provides a detailed assessment of a country’s CRVS system

-Is the best method to prioritise areas for improvement and inform a national CRVS improvement plan

-Brings all together a more comprehensive set of stakeholders

-Builds understanding of CRVS standards, providing guidance on: legal and regulatory frameworks; registration practices, coverage and completeness; certification and coding practices; compilation, tabulation and use of resulting data

-Outlines main steps in conducting a review, including an assessment framework template for the review process

-Best completed in a workshop with active participation of key stakeholders, requiring time and many resources

-Requires a large number of stakeholders to set aside time and meet over a period of days

-Has no scoring system (that would enable easy monitoring)

-New electronic tools have been developed for CRVS assessments that are better for specific areas

ANACONDA  -Provides a comprehensive  assessment of mortality and cause of death quality

Identifies gaps in completeness and quality of the input data and informs users of the reliability of the data

-Calculates an overall index of the mortality reporting system that can be used to monitor the impact of improvement actions

-Requires population and mortality data by age and sex coded to ICD-10 (3-4 digits)

-Needs a minimum of 2000 deaths to work well

-Cannot calculate rates without population data

-Full understanding of the tool's usage and correct interpretation of results is best achieved in workshop settings

Legal review tool -Should be central to all assessments (much more complete than what was attempted in the comprehensive and rapid tools)  
Intervention-specific tools

The following tools provide indicators to drive decision-making and implementation, rather than assessing the CRVS system as a whole.



MCCOD quality assessment tool

-Excellent for identifying weaknesses in physician certification.

VA and CRVS costing tools

-Estimates cost of implementing VA systems.

-Can be customised to country context.

-Includes start-up costs, training costs, community-level service delivery costs, support, supervision, and management costs.

VA sampling tool

-For estimating how many VAs are needed to provide policy relevant information on community deaths.

-Should be part of an assessment (will help drive the way VA is operationalised in country).

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