Progress and challenges with CRVS in Africa
at the DEMOSTAF Conference

Paris/Aubervilliers, France, 16-18 October 2019

Organizing committee:  Romesh Silva (UNFPA), Karen Carter (UNICEF), Bruno Masquelier (Louvain University), Everton Lima (NEPO - UNICAMP), Philip Setel (Vital Strategies), Irina Dincu (IDRC), Sofia Gruskin (University of Southern California).

The IUSSP Scientific Panel on Population Perspectives and Demographic Methods to Strengthen Civil Registration and Vital Statistics (CRVS) Systems organized two sessions on CRVS focusing on the determinants of under-registration of vital events, and progress made in improving coverage in Africa, at the three-day international conference organized by DEMOSTAF [Demography Statistics for Africa] on “Demographic Challenges in Africa: The Contributions of Census and Civil Registration Data” on the new Campus Condorcet in Paris-Aubervilliers (France) on 16-18 October 2019 (read report on the Conference here). These sessions were sponsored by the International Development Research Center (IDRC), Canada.

Heads of government and state declared 2017-2026 to be “A decade for repositioning CRVS in Africa’s continental, regional and national development agenda” at the African Union Heads of State and Government summit held in Kigali, Rwanda in July 2016. Yet, despite major increases in political and financial commitments to strengthen CRVS systems in sub-Saharan Africa, CRVS systems across the continent remain largely incomplete and deficient. 

These sessions explored the role of demographic and social scientific methods in providing insight into the challenges and opportunities that lay ahead for African countries to move towards universal registration of births and deaths. One of the sessions showcased recent analyses of the proximate determinants of under-registration of births and deaths in various sub-Saharan African contexts (Zimbabwe, Rwanda, Senegal, Burkina Faso), while the second session covered progress in the coverage of the registration of vital events in Burkina Faso, Botswana (Neo Sebolao, University of Botswana), and Tunisia (Nadia Touihri, INS).

The authors used a diverse array of data sources and evidence – ranging from recent population and housing census data, small-scale and nationally-representative household surveys, health and demographic surveillance sites, and qualitative evidence. These analyses each employ formal social scientific methods of analysis and provide guidance to policy makers and practitioners seeking to improve the completeness and quality of birth and death registration across the continent. Neo Sebolao (Botswana) and Louis Niamba (Burkina Faso) chaired the sessions, while Michel Guillot (INED) and Patrick Gerland (UN) discussed the various contributions.

The analysis of the determinants and predictors of birth registration in Zimbabwe (Kudzaishe Mangombe, University of Zimbabwe) and Rwanda (Patrick Nshimiyimana, National Institute of Statistics of Rwanda) shows that while some progress has been made in recent years (especially through the health sector), a number of challenges remain to ensure that all newborns and children are registered at birth or as soon as possible, in particular in low-income settings. While more progress with vital registration has been achieved, especially in urban areas (e.g., high registration of deaths in Dakar, Senegal as shown by Atoumane Fall, ANSD/UC Louvain based on census data – but large differences in coverage remain depending on age at death), rural areas still face many more obstacles as highlighted in Nouna HDSS experience (Louis Niamba and Irina Dincu, IDRC). The authors find very low levels of coverage for deaths (2.7%) and marriages (1.9%) in this rural area of Burkina Faso. Coverage of birth registration is higher (~50%) but remains nonetheless substandard. The authors point out a number of barriers to registration, including negligence, financial considerations, administrative delays and distance to CRVS offices as explanations for low registration. To explain low registration, they also point out the importance of incentives for registration, including whether certificates are actually needed to complete certain administrative procedures. Increased incentives represent indeed an important leverage for CRVS improvements in this context. Despite these pending challenges, substantial improvements are also possible, especially for birth registration as seen in Burkina Faso with the Bravo! Program promising scaling up in some rural regions.

The focus on individual factors across these studies is particularly useful for finding concrete solutions to improving CRVS coverage, but the individual approach is useful for two other reasons: (1) it allows key actors to identify target populations that would particularly benefit from CRVS interventions; (2) it allows researchers to understand the impact of under-registration on mortality levels and social differentials.

Neo Sebolao (University of Botswana) and Nadia Touihri (INS) presented the experience respectively of Botswana and Tunisia, and how these two African countries have improved their vital statistics in recent periods through the expansion and strengthening of their civil registration systems, the modernization, streamlining and computerization of their existing administrative processes, but also through improvements and the integration of the institutional framework with other administrative authorities involved with civil registration, notably the health sector. For instance, births and deaths records in Botswana are now kept centrally (under uniform and standardized archival practice), records can be accessed by field offices for registration and issuance of certificates, and records on vital events occurring in health facilities are transferred to Statistics Botswana annually for processing, production and dissemination of vital statistics. Based on comparison with census and survey data, birth registration completeness now represents 90% or more of the events occurring in the specified year while desired death registration level is about 80%. Five key factors have facilitated this increase in the completeness rates: (1) high-level political and executive leadership commitment, (2) compulsoriness of registration in all the geographical areas within the country, (3) highly decentralized institutional network – in 2017, 98% of births had occurred in health facilities, (4) a robust outreach programme to remote areas, and (5) a vigorous birth and death registration campaign also supported by development partners. In addition to ensure timeliness, various quality checks have been built while processing civil registration and vital statistics (including automatic matching of births and deaths records using a unique identification number). Finally, like in Tunisia, training and raising awareness of civil registrars and municipalities on the importance and use of the collected data has been instrumental in improving the quality and reporting rate for some vital statistics. 

See also:

• Detailed programme and all DEMOSTAF Conference presentations.
• Videos of the presentations in the 2 sessions on Civil Registration and Vital Statistics. (Videos will be added progressively, in December and in January)

Publication Plan: A selection of papers will be submitted for publication as a special collection in a peer-reviewed journal.

Sessions on CRVS in Africa at the DEMOSTAF Conference:

CIVIL REGISTRATION AND VITAL STATISTICS 1: DETERMINANTS

Chair: Neo C. Sebolao (University of Botswana)

Discussant: Michel Guillot (INED)

• Kudzaishe Mangombe (Univ of Zimbabwe) et al., Predictors of birth certificate possession among children aged 0-17 years in Zimbabwe: An analysis based on the 2012 Population Census
• Patrick Nshimiyimana (National Institute of Statistics of Rwanda), Study on knowledge, attitude and practices of parents towards birth registration in Rwanda
• Atoumane Fall (ANSD/UCLouvain), La déclaration des décès à l’état civil à Dakar : une exploration des facteurs explicatifs à l’aide des données de recensement
• Louis Niamba (CRDI) et Irina Dincu (CRDI), Enregistrement des naissances et des décès à l’état civil dans l’observatoire de population de Nouna, Burkina Faso : États des lieux, obstacles et perspectives

CIVIL REGISTRATION AND VITAL STATISTICS 2: COVERAGE

Chair: Louis Niamba (CRDI)

Discussant: Patrick Gerland, UNPD

• Nadia Touihri (INS, Tunisie), Recent Advances and Current Challenges in Vital Statistics Production from Incomplete Civil Registration data in Tunisia
• Neo C. Sebolao (University of Botswana), Botswana success story of completeness of civil registration system?A case study