civil registration study tour in uganda

Breaking with Broken Systems: EU/UNICEF Partnership for the Legal Identity of African, Asian and Pacific Children

Civil Registration Study Tour in UgandaKampala, Uganda, 1-6 September 2013

Meeting Summary and Recommendations 1

Executive Summary 1

Background 4

Why focus on CRVS, and particularly on Birth Registration? 4

The Broader African CRVS Agenda: APAI-CRVS 5

“Like Siamese Twins” 6

Barriers to Birth Registration 6

Using Technological Innovation to Close Gaps in Registration 6

Integration and Technology: Strategies for Improving CRVS Efficiency 7

Identifying the Business Process 8

A Model for Using Innovations in Technology to Improve Registration: Uganda’s Mobile VRS 9

Other Country Experiences 12

Innovations in Technology Also Require Innovations in Partnerships 14

The Way Forward and Recommendations 14

Appendix “A” 16

Uganda Study Tour 16

Appendix “B” 21

Uganda Pan-African Study Tour Conference 21

Appendix “C” 24

Illustrative Model of CRVS System and Multi-sectoral Linkages 24

Appendix “D” 25

“The Know Me Systems” Africa Awakened 25

Page

Contents

Cover Photo: UNICEF Uganda/2013/Michele Sibiloni

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Civil Registration Study Tour in Uganda

Meeting Summary and Recommendations1 Executive SummaryBirth registration, a component of civil registration and vital statistics (CRVS) systems, enables a child to obtain a nationally and globally recognized permanent legal identity, and is the foundation forp rotecting children from exploitation, abuse and neglect and to securing their future, particularly their health and education. In many parts of the developing world, children’s births are not registered. In fact, nearly half of the world’s children and 54% of Africa’s children are unregistered.2 Those children in Africa and other parts of the world whose births are not captured by CRVS systems are subject to increased vulnerability that comes with not having a legally recognized identity.

In this context, as part of pan-African initiative called the Africa Programme on Accelerated Improvement of Civil Registration and Vital Statistics (APAI-CRVS)3, UNICEF, the European Union and the Uganda Registration Services Bureau (URSB) organized a Study Tour held 1-6 September in Kampala Uganda. About 60 UNICEF country and regional staff, implementing partners, government officials and experts in CRVS, technology and child protection met to look at how innovations can improve CRVS systems, particularly birth registration.

A key aspiration of the APAI-CRVS initiative is contributing to country efforts to improve their CRVS systems, particularly by providing guidance and support for analyzing CRVS business processes and developing tools, guidelines and standards for using technological innovations to improve efficiency and increase registration.

Participants heard about various country experiences and visited registration sites in the city of Kampala and in a rural district to see firsthand how one particular technological innovation, Mobile VRS (Vital Records System), is being implemented and its potential for improving registration. These country experiences and site visits demonstrated a number of critical elements for using similar innovations in technology to improve CVRS systems elsewhere:

1 Special thanks and acknowledgement go to the World Health Organization (WHO) and Plan International, both of which provided substantial input into this Report, and to Study Tour note takers, Gloria Mathenge, Fidelia Dake, Nkiru Madueschesi, Roseleen Akinloye, Neidi de Carvalho and Innocent Mofya.

2 State of the World’s Children (2013). In real numbers, 66 million of the world’s children and 40 million of all of Africa’s children are unregistered. This translates into 3 out of every 5 unregistered children live in Africa. (Id.)

3 APAI-CRVS emerged from the necessity of bringing together various CRVS initiatives in Africa into a common and consolidated policy and advocacy framework. The overall objective of APAI-CRVS is to provide management and programmatic guidance to the regional agenda of reforming and improving CRVS systems.

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1. Emerging country experiences show that CRVS systems tend towork most effectively and efficientlywhen integrated holistically with the systems of other sectors including health, education and social transfers.

2. It is critical to map and understand the underlying business processes and where bottlenecks existin order to determine the appropriate technological innovations to address those bottlenecks. This involves including stakeholders from multiple sectors at the beginning of the entire assessment and planning process, and Investing up front in detailed feasibility assessments.

3. While technologyshould be led by programmatic needs, it is generally possible to use existing technology and adapt that technology for a particular purpose and context.4 There is no reason to “reinvent the wheel”.

4. Technology, when used, should go hand in hand with the system, as CRVS is a dynamic entity that evolved over time. Accordingly, technology should aim at systematically strengthening allcomponents of CRVS: registration of vital events, delivery of certificates, and the generation of vital statistics.

5. In identifying and analyzing bottlenecks in CRVS systems and how technological innovations can improve CRVS outcomes,it is imperative to assessin detail the role of the enabling environment, including laws, policies, infrastructure, culture and tradition (e.g. naming of children, gender) at each step in the business process.

6. Systems should be designed always with the intent that they will ultimately be integrated, scaled and sustained at the national level.

7. Using innovations in technology and integrating systems of different sectors require innovative partnerships. Memorandums of Understanding for working together should be obtained with the Minister of Health and any other relevant Ministry whose functions can relate to registration (e.g., education, social transfers). Partnerships with the private sector, particularly mobile operators also play a role, and must be integrated with other sectors to be economically viable. Lastly, partnerships with community organizations such as faith-based organizations serve in organizing outreach in communities, particularly in rural areas.

Key recommendations in moving forward in promoting technological innovations included:

1. The APAI-CRVS Regional Core Group should continue its mandate to provide support to countries requesting assistance on comprehensive assessments and developing reform action plans.5

4 This is contrasted to those situations in which an existing technological solution is brought in and effort is made to see how the technology can fit into a program simply for the sake of using technology.

5 The country support has been intensified since developing the standardized assessment and strategic planning tools in May 2013. The initial countries supported included Mozambique, Burkina Faso, Zambia, Kenya and others. The number of countries is currently being expanded.

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2. The APAI-CRVS Regional Core Group should move forward with its mandate to develop standards and guidance for countries to use ICT to improve CRVS systems.

3. Establish a clear evidence base that demonstrates impact using rigorous research methodologies and strong monitoring and evaluation frameworks for using innovative technologies. Invest in building the evidence particularly around the impact of integrating CRVS with health systems. Invest in operational research to determine how to do the intervention. Reference can be made to the growing evidence base for using ICT in health and how functionalities for using technology in health can be compared to functionalities for using technology in CRVS.

4. Through advocacy and demonstrating results, build political commitment to using innovative technologies where appropriate to improve CRVS systems. Political commitment and governance are directly linked. Sovereign states with better governance structures have much better CRVS systems.

5. Work with legislators to ensure that the appropriate legal and policy frameworks are in place supporting the integration of systems and innovations in technology for CVRS.

6. Ensure proper privacy, confidentiality and data security mechanisms are in place to protect individual data.6

7. Proponents of using innovations in technology to improve CRVS (and child protection more broadly) should build relationships with the health sector to sharewith each other experience, lessons learned and strategic direction for best promoting the use of innovations in technology.7

8. Train other national and local stakeholders in analyzing CRVS business processes and determining how technological innovations can improve those processes.

9. Work holistically by continuing to advocate and find ways to work multi-sectorally, particularly with the health sector, in leveraging high coverage events such as immunizations, to increase birth registration. Other sectors that can play a role include the sector include education and the sectors responsible for food aid, social transfers, refugees and family reunification.

10. Continue identifying economically feasible business models for public- private partnerships using technology for CRVS, bundled with other services.

6 APAI-CRVS plans to develop Digitalization Guidelines to address these mechanisms.

7 This includes exploring how CRVS systems can be integrated with health management information systems (HMIS) as a means to promote registration.

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BackgroundThe Uganda Study Tour, hosted by UNICEF, the European Union and the Uganda Registration Services Bureau (URSB) was held 1-6 September 2013 in Kampala, Uganda. The Study Tour brought together 60 UNICEF country and regional staff, implementing partners, government officials, and CRVS experts in technology and child protection from 21 countries, primarily in Africa, but also from India, the United Kingdom, Switzerland, Belgium andthe United States. The Study Tour was part of a an EU funded project, Breaking with Broken Systems. The two-year (2013-2014) project aims to contribute to increasing the birth registration of children under 5 by at least 20% and reduce disparity rates between urban and rural birth registration by 50%. The EU supported project takes into consideration a larger continental initiative called the Africa Programme on Accelerated Improvement of Civil Registration and Vital Statistics (APAI-CRVS). The APAI-CRVS was first created in 2010, jointly be the AU, UNECA, AfDB and other UN partners namely UNICEF, UNFPA, UNHCR, WHO and HMN, with an aim to support governments in building fully functional and comprehensive CRVS systems that are built on strong legislative provisions, efficient operations and management systems.

Organizers designed the Study Tour as a “South-to-South” learning experience. The theme of the Study Tour was “Interoperability and Innovations to enhance civil registration and vital statistics (CRVS) systems in Africa”. There were three clear objectives for the participants:

1. Gain knowledge and understanding of the use of technology and innovations to strengthen CRVS systems in Africa;

2. Identify opportunities to address challenges of promoting interoperability (health and social sectors); and

3. Learn about the use of social mobilization by working with faith-based organizations for mass registrations (i.e. through the “Family Health Days” strategy).8

Why focus on CRVS, and particularly on Birth Registration?In many developing countries, the focus is primarily on birth registration.Having a legal identity that begins with registration at birth is often the starting point for a child to access the support vital to his or her survival, and serves as the window for escaping poverty.9 Without legal identification, children have no institutional protection and are more vulnerable to exploitation, violence, neglect, early marriages, under-age military conscription, sexual trafficking and slavery. Not having a formal legal identity also undermines the ability to assert succession rights and claims. With a legal identity that comes with birth registration, a child is better able to prove age and nationality, as well as access education, social and many health services, including social protection transfers which are the foundation for emerging from poverty conditions. From the government perspective, having clear records

8 Faith-based organizations are just one example of community-based partnerships and engaging with civil society for the purpose of creating awareness of, and facilitating access to registration.

9 However, death registration is just as vital for a functioning CRVS system. Knowing about deaths and causes of death is integral to planning and policies relating to child survival.

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of the number of births (and deaths) is a cornerstone of policy and budgetary planning around the provision of essential services to its citizens. In cases in which children are separated from their families, birth registration and having a legal identity makes it easier to repatriate and reunite those children with family members. Further, statistics generated through birth registration provides an easy and effective tool for countries to develop and monitor social and economicdevelopment policies, including MDGs 4& 5, at all levels of aggregation (sub-county to national) almost on a real-time basis. This sort of efficiency in aggregating large amounts of data is not possible when depending upon sample surveys.

Alarmingly, over ½ of all the world’s children are unregistered. In some areas of Sub-Saharan Africa, approximately 70% of births go unregistered.10 CRVS systems clearly need attention.

The Broader African CRVS Agenda: APAI-CRVSAfrica reinvigorated its efforts to address the poor state of its CRVS systems (which includes birth registration) at a CRVS regional workshop held in 2009 in Tanzania. That workshop was followed in 2010 by the first conference of African ministers overseeing CRVS. At the conference, the African ministers agreed to harness their political commitment to improve CRVS systems in their countries. A second conferenceof the ministers laid out the policy directives, including ministerial declarations, for improving CRVS in Africa. At the second conference, the ministers alsocommitted to meet every two yearsand formally track progress in CRVS systems.

APAI-CRVS is the African regional program created under by directives of the African ministers who are responsible for civil registration. The purpose of APAI-CRVS is to provide systematic and coordinated guidance to African countries for improving their CRVS systems. Country ownership and leadership, along with coordination among counties’ civil registration, health and statistics offices are the operational underpinnings for APAI-CRVS.A regional CRVS Core Group was established to coordinate and implement the APAI-CRVS program. The ministers specifically called upon the CRVS Core Group to conduct a regional assessment study to establish a baseline for measuring progress for improving CRVS systems.

The Regional Core Group conducted the regional assessment and presented its findings at the second conference of the ministers. Influenced by these findings, the ministers called for all countries to conduct assessments of their own CRVS systems. To support country assessments, the ministers called for the regional CRVS Secretariat and Core Group to support countries in conducting their assessments. Accordingly, the Regional Core Group has developed a team of experts to support country assessments through a regional training program, and the development of assessment tools, methodologies and guidelines.

Thus far, approximately 20 countries have requested support and are being guided by the Core Group to conduct their assessments.

10 See, e.g., State of the World’s Children 2012.

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“Like Siamese Twins”Civil registration and vital statistics “are like Siamese twins – they can’t be separated”. While in modern reality, surgery can in fact successfully separate Siamese twins, the underlying sentiment of this quote by one of the Study Tour’s speakers explains the operational framework for a functioning CRVS system. CRVS must be viewed as one functioning system of interrelated and multi-disciplinary processes working together.11 CRVS systems must be functional and be “interoperable” (or integrated) with other systems including national identification, social protection and perhaps most importantly, health.12 This requires a phased-based, holistic and integrated approach with strong partnerships and coordination at regional and country levels.

CRVS has three arms, namely: birth registration, delivery of certificates and generation of vital statistics. A complete and efficient system entails working on all the three fronts in tandem. Registration without the delivery of certificates is ineffective because having a physical certificate is necessary to prove legal identity and access many public services.

Barriers to Birth RegistrationSignificant barriers hinder birth registration in developing countries, particularly in rural areas. Whereas delivery in a health facility is the optimal opportunity to register births, most children in Africa are born at home. For example, in Uganda, 43% of children are born outside health facilities; in all of Africa, 51% are born outside health facilities.13 Many parents are unaware of the importance of registering their children’s births. Even when children are born in health facilities, often the burdensome bureaucracy, paperwork and waiting periods required for officially registering births make the process prohibitive to many parents. Culture and traditional practices also impede timely registration of births. In many parts of Africa, the naming of children is often delayed, or superstition preventsparents from acknowledging children before they reach an age well past the danger period where many infants die. Further, many countries do not have to appropriate legislation and policies in place, along with the accompanying system infrastructure required for a well-functioning birth registration system.

Using Technological Innovation to Close Gaps in RegistrationMany barriers that lead to the gaps in in birth registration and other areas of CRVS in developing countries can be improved with emerging innovations that includes innovations

11 See Appendix “C”: Illustrative Model: CRVS System and Multi-sectoral Linkages

12 See Footnote 9 for distinction between use of the words “interoperable” and “integrated”.

13 State of the World’s Children (2013).

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in technology.14 Technology, particularly information and communications technology (ICT), is being used increasingly with success in developing countriesto improve health, education and economic outcomes for some of the poorest people in rural areas.15

Experiences involving technological innovations from various other countries provide useful guidance to how CRVS systems can be improved to provide better and more efficient coverage in birth registration. It is critical, however, to note that technological innovations can be highly contextual and that “one size does not necessarily fit all”.

Integration and Technology: Strategies for Improving CRVS Efficiency While the state of the evidence for using innovations in technology to improve birth registration (and CRVS generally) is still nascent, country experience has demonstrated that a well-functioning CRVS system cannot function as individual independent units. Birth registration itself is part of a system that also records deaths, marriages, and often adoptions and divorces. In addition, within countries, multiple agencies,such as those dealing with health,may record details of births. In other cases, other sectors may require birth details prior to enrolling in schoolor receiving social transfers (e.g., cash transfers).

Given this, emerging evidence suggests that success, in terms of ensuring complete coverage of birth registrations,is more likely when CRVS be “interoperable” or “integrated” with other systems. Integration means that CRVS is a multi-agency system and that the appropriate interoperable technology exists at each agency.16 In a multi-agency system, coordination and cooperation between and among agencies are required to achieve both interoperability of ICT (information and communications technology) and integration of systems across agencies. Multi-agency coordination means not only that registration, health, education and vital statistics ministries coordinate activities, but also that local administrative offices, courts and health facilities at the district level coordinate with each other. Challenges of a multi-agency system include inter-agency conflicts over customized system designs (“purpose built” systems that are specifically customized for the particular functions of each agency), ownership and sharing issues, and protecting security and confidentiality.17 If these challenges can be overcome though purposeful coordination and pooling of information, the overall system is more efficient, effective and better equipped to validate and confirm data.

14 As understood by UNICEF, “innovation” encompasses: 1) innovations in programs; 2) innovations in products; 3) innovations in processes; and 4) innovations in partnerships. For a further description, see http://www.unicef.org/about/execboard/index_61592.html

15 ICT refers to technologies that provide access to information through telecommunications, focusing primarily on communication technologies. This includes the internet, wireless networks, mobile phones, and other communication mediums. See, e.g., The Transformational Use of Information and Communications Technologies in Africa (World Bank, 2012); 2012 Information and Communications for Development: Maximizing Mobile (IRBD/World Bank, 2012).

16 “Interoperability” has been used to refer to systems working and interacting together. However, “interoperability” has more frequently been used to refer specifically to how the actual underlying software technology work together and “talk to each other”. For purposes of this Study Tour Report, “integration” will refer to systems and sectors working together and “interoperability” will refer to software technologies working together.

17 It is important to ensure that the use of technology to increase efficiencies does not result in the circumvention of any legally mandated processes.

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Elements for Integration

● Mapping ministries and their roles and relationships, identifying where agencies and systems need to “speak” with one another.

● Understanding the core business of each agency and identifying business synergies (i.e. how each agency would benefit from working with another).

● Understanding interlocking business processes and dependencies.

● Examining, understanding and putting into place mechanisms for safeguarding privacy and data security, particularly with respect to personal individual data (compared to aggregate data). This includes negotiating about who “owns” the data, how individual data will be shared (and protected when shared), and third party access and use to individual data.

● Developing formal processes and executing agreements amongst ministries (e.g., Memorandum of Understanding). Participation from all sectors, including IT, at the beginning of the planning process, creates a sense of shared ownership and mutual interest in successful outcomes.

● Employing open-sourced software technologies that have the means to be interoperable with the software technologies used in other sectors and by other agencies in accordance with a set of harmonized standards.

Identifying the Business ProcessRelated to mapping ministry roles is developing a clear business process using a holistic systems approach.18 The business process is simply an events map from the first event that should triggerthe registration process through the final outcome. The business process is typically depicted as a flowchart diagram that shows the start event, intermediate events, decision-making points and the end event.

Developing the business process is often a 2-step process that includes:1) a detailed feasibility assessment, and 2) a solution/program blueprint. The entire business process requires reviewing the current systems (including other sectors), identifying bottlenecks and identifying (and customizing) the appropriate technology that would best operationalize the business process and achieve the long-term vision for an integrated CRVS system.The exercise ideally includes stakeholders from multiple sectors who are involved from the very beginning of the assessment.

18 Some might instead characterize the business process as a workflow. Others, such as Michael Porter from Harvard University and Jim Kin, president of the World Bank, advocate for mapping and understanding the “value chain” to address bottlenecks.

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19 Uganda also used UNICEF’s U-Report mobile phone innovation to assess public awareness around birth registration. U-reporters in Uganda were asked if they knew about birth registration. While most knew about the birth registration requirement, a large majority indicated that they did not know where to go to register births.

20 The death registration component of Mobile VRS has not yet been launched.

Typical Bottlenecks

● Physical and geographic barriers to access

● Complexity of systems

● Inaccurate and manual entry of data

● Cultural barriers (gender, delay in naming)

● Legal and policy impediments (lack of legal framework)

● Lack of human capacity

● Insufficient infrastructure

● Connectivity

● Duplication of activities

● Lack of quality control mechanisms to certify the accuracy and reliability of data due to long processing times.

Developing the solution/blueprint in business process planning involves thinking about how technology can be used to improve or add value to the CRVS system, and therefore the technological and business processes should go hand-in-hand. The ultimate national plan developed to operationalize a business process for improving CRVS should be laid out in phases that include orienting, planning, testing, assessing, re-engineering (lessons learned) and scaling.

A Model for Using Innovations in Technology to Improve Registration: Uganda’s Mobile VRSUganda’s Mobile VRS (Vital Records System) represents a good model exhibiting traits of a functional CRVS system and using innovate technology to improve birth registration.19 Developed by UNICEF, in partnership with URSB, the government partner, and Uganda Telecom, a private sector partner (which also hosts the system), Mobile VRS is a phone and web-based application that uses USSD, SMS and a web-based interface to streamline, simplify and decentralize birth and death registration in Uganda.20 It also has an off-line version that is used to register births and deaths in the absence of internet connectivity, but enables data to be uploaded into the main database as connectivity is restored. Mobile VRS is not only a tool to improve efficiencies and increase the number of births (and deaths) registered, it is also a tool for managing large quantities of information.

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● Web based interface

● desktop computer

● printer

● laptops

● internet access

● Completeness and timliness

● Onsite issuing of registration certificates

● Mobile phones (SMS/USSD)

● Laptop

● Printer

● Solar panel

Birth Registration

Hospital Births

Community Births

A partnership between URSB and the Ministry of Health forms the foundation for using the system. Notably, Mobile VRS was developed after a technical assessment identifying bottlenecks, and was not an already developed technological solution brought in “looking for a problem”. Mobile VRS was designed to work at the community level, as well as within local governments and hospitals mandated to register births. It specifically brings services closer to the people, minimizes forgeries, creates transparency and reduces the time between notification and receipt of birth or death certificates, a critical window where there is often loss to follow-up with traditional paper-only systems. Although the system is primarily web-based when used by hospital and local governments (demonstrated to two Study Tour groups as part of a field visit), it uses basic and easily available mobile phones when used in communities and rural areas. The mobile component (demonstrated to the third Study Tour group which traveled to a rural area) allows community registrars to use simple short USSD codes to access the system and input birth information such as name of child, birth date, names of parents, etc.21 Information is immediately conveyed to a sub-county registrar who validates the information before printing, signing and issuing a short form birth (or death) certificate.22

21 The short code used depends upon the service provider or mobile operator. In those areas where Uganda Telecom is the service provider, the short code is *162#. In areas where MTN is the service provider, the short code is *153 * 162#.

22 See Appendix “D” for Mobile VRS Technical Schematic (Business Process).

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Demonstrated advantages of Mobile VRS compared to paper-based systems

● Real-time transmission of birth records from hospitals and hard to reach areas, to a central repository in URSB. Easy to use and appropriate technology.

● The ease and efficiency in processing birth and death certificates;

● Minimizes forgeries as each record is given a unique registration number, which also makes it easy to search and retrieve specific records from the system;

● More efficient and reliable storage of information, and

● Real-time generation of data

Since its launch in the second quarter of 2011, there have been qualitative improvements in efficiency and data use, resulting in quantifiable increases in the number of birth registrations, and official birth certificates distributed. Challenges, however, still impede more rapid progress and include:● Cultural traditions (delaying in the naming of children)

● Unreliable internet connectivity (addressed with the option of an off-line Mobile VRS)

● High turnover in human capacity

● Logistical issues connected with integrating with existing stand-alone systems

● Limited public awareness about the importance of birth (and death) registration

● Lack of a national Birth and Death Registration policy

● Lack of funds for national scale-up of rollout.

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India

While individual country experiences with CRVS systems are unique according to country context, they do offer guidance for designing functional systems in other countries. India, a country with the world’s 2nd largest population, has a comparative high registration rate of 82% of births (2010) and 66.9% of deaths (2010). There are 14 states (provinces) where the level of registration of births is 100%. Still IndianCRVS misses about 5 million births and 2.7 million deaths every year.

The key factors that continue to affect the system are lack of public awareness of the need for birth registration, the multiplicity of languages, inadequate budgetary provisions, and the failure to link birth registration with basic service sectors such as education etc. and low priority in many provinces. Distribution of certificates and culling out of reliable vital statistics still remain a big challenge.

Improvements in Indian registration since 2002 have resulted from a comprehensive review of the CRVS landscape that included a number of factors that did not happen in isolation. These factors included increased public awareness campaigns, training of doctors, targeting marginalized children (such as street children and urban dwellers), use of technology (the system has been computerized in 6-7 developed provinces) and enhanced partnership with other stakeholders such as UNICEF. Contributing to progress in registration is the linkage with National Rural Health Mission under Ministry of Health, using CRVS for updating the National Population Register and computerization of the Indian civil registration system currently underway that will also support reporting of information in multiple languages as required under the law.

23 Other countries shared similar experiences during the Study Tour. These countries included: South Africa, Zambia, Mozambique, Senegal, Côte d’Ivoire, Burkina Faso, Angola, Tanzania and Switzerland.

Other Country Experiences23

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Nigeria

In Nigeria, the use of Rapid SMS since 2012 as an information tracking and quality control tool has demonstrated early success in capturing non-reported and erroneous birth registration applications for immediate collation, analysis and data correction. Decentralized real-time data generated using RapidSMS reflects both progress and gaps in integrating birth registration into health services. While the system does not actually register births, it does serve as a management quality control tool to provide real-time decentralized data to supervisors to enable them to touble-shoot service gaps. Effectiveness of the system depends upon supervisors valuing the data they receive and taking appropriate action. Technical challenges with using RapidSMS include safeguarding security, resistance from some health workers, technical failures (GSM network), internet connectivity (server occasionally shutting down), and insufficient trained personnel to use the application. Nigeria’s system also serves as an example of using innovative partnerships. Overseen by the National Population Commission (NPopC), the CRVS system is integrated with the health system, formalized by a Memorandums of Understanding. NPopC alsohas a partnership with the private sector, specifically GMS network providers. In some states, NPopC is initiating partnerships with the education sector as well.

Kenya

Kenya’s experience with CRVS also serves as a potential model for using innovations. Like Nigeria, Kenya partners with the health sector, specifically employing a “community strategy” for registration by using community health extension workers as registration agents. The government’s goal is that by linking with the Ministry of Health, and leveraging the high coverage for immunizations, birth registration will increase from 60% (2012) to 100% by 2017. The registration also works through innovative partnerships with faith-based institutions (FBOs) and other religious and cultural stakeholders to reach into communities to promote birth registration.

Kenya is employing innovations in technology to further improve CRVS. Through the MOVE-IT program (Monitoring of Vital Events through Information Technology), community health workers use mobile phones to report births and deaths. The World Health Organization (WHO) and Plan International support the MOVE-IT program.1 MOVE-IT leverages the high immunization coverage in Kenya (90%) to increase birth registration. Further analysis on the use of technology will be conducted as part of a planned Comprehensive Assessment of CRVS in 2013

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Innovations in Technology Also Require Innovations in PartnershipsDuring the course of the Study Tour, it became evident that the model for functional CRVS systems, particularly CRVS systems that integrate innovative technology, must include innovative partnerships that operationalize the integration of multi-sectoral systems. When we speak of “innovative” partnerships, we refer to non-traditional partners that operate outside the CRVS sector. Innovative partners for the CRVS sector that integrate technology into a mult-sectoral system would include the Ministries of Health (and lower administrative health offices) and Education, as well as the ministries which oversee the distribution of social transfer vouchers and the collection of demographic information.

Innovative partnerships that use technology to improve CRVS systems would also include partnerships with the private sector, notably the mobile service providers or operators. Governments need to negotiate deals with operators such as MTN, Uganda Telecom, Airtel, Zain, Tigo, Vodacom and others in obtaining short codes and discounted rates for SMS messaging that are part of CRVS systems that use mobile phone technology.

Further, when linked with health systems, CRVSpartnerships could include negotiations with insurance carriers and mobile money financial institutions that target health insurance products (that require birth registration)to people living developing countries. The presentation from India demonstrated that public-private partnerships (PPPs) that are based solely on CRVS are not economically feasible and sustainable. For CRVS to put part of a sustainable business case for private sector partners it must be bundled with other services, the most obvious being health.

Innovative partnerships are important at the community level, particularly in rural areas where innovative technologies such as mobile phones make registration easier and faster. FBOs and other community groups are becoming increasingly instrumental for sensitizing community members to the importance of birth registration. In Uganda and in other countries, FBOs have become a primary partner in the CRVS system to promote birth registration and are responsible for planning strategic community outreach events (in partnership with the health sector) such as Family Health Days.

The Way Forward and RecommendationsThe Study Tour participants identified a number of steps to take in improving the effectiveness and efficiencies of CRVS systems, particularly birth registration by using appropriate innovative technologies: ● Through advocacy and demonstrating results, build political commitment to

using innovative technologies where appropriate to improve CRVS systems. Political commitment and governance are directly linked. Sovereign states with better governance structures have much better CRVS systems.

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● Work with legislators to ensure that the appropriate legal and policy frameworks are in place supporting the integration of systems and innovations in technology for CVRS.

● Establish a clear evidence base that demonstrates impact using rigorous research methodologies and strong monitoring and evaluation frameworks for using innovative technologies. Invest in building the evidence particularly around the impact of integrating CRVS with health systems. Invest in operational research to determine how to do the intervention. Reference can be made to the growing evidence base for using ICT in health and how functionalities for using technology in health can be compared to functionalities for using technology in CRVS.

● The APAI-CRVS Regional Core Group should continue its mandate to provide support to countries requesting assistance in mapping and assessing their CRVS business processes and systems, including checking the accuracy, transparency and accountability within each system.

● Invest up front in detailed feasibility assessments. Evaluate the business processes used and identify bottlenecks and practical technological innovations that can address those bottlenecks. Do not re-create the wheel: determine how existing technology can be customized for different contexts.

● Think about moving beyond proofs of concept. Design systems always with the intent that they will ultimately be integrated, scaled and sustained at the national level.

● In identifying and analyzing bottlenecks in CRVS systems and in using technological innovations, pay special attention to the role ofthe enabling environment, including laws, policies, infrastructure, culture and tradition (e.g., naming of children, gender) at each step of the business process.

● Ensure proper privacy, confidentiality and data security mechanisms are in place to protect individual data.

● Train other national and local stakeholders in analyzing CRVS business processes and determining how technological innovations can improve those processes.

● The APAI-CRVS Regional Core should continue with its mandate to develop standards and guidelines for countries in the use of technological innovations for CRVS.

● Work holistically by continuing to advocate and find ways to work multi-sectorally, particularly with the health sector, in leveraging high coverage events such as immunizations, to increase birth registration. Other sectors that can play a role include the sector include education and the sectors responsible for food aid, social transfers, refugees and family reunification.

● Continue identifying economically feasible business models for public- private partnerships using technology for CRVS, bundled with other services.

● Proponents of using innovations in technology to improve CRVS (and child protection more broadly) should build relationships with the health sector to share experience, lessons learned and strategic direction for best promoting the use of innovations in technology.

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Appendix “A”Uganda Study Tour2-5 September 2013

Theme: Interoperability and Innovations to Enhance CRVS Systems in AfricaObjectives/Expected Outcomes:

● Gain knowledge and understanding of the use of technology and innovations to strengthen CRVS Systems in Africa

● Identify opportunities to address challenges of promoting interoperability (health and social sector)

● Use of social mobilisation (faith-based organisations) for mass registration (Family Health Days Strategy)

Time Activity Expected Outcome/Learning/Key Take-Aways

Facilitators/Resource Persons

Comments/Notes

Day 1 - Monday 2 September 2013

08:00- 09:00 Registering of Participants

Secretariat Master of Ceremony Eva Kentaro (URSB)

There will be media presence during opening ceremony

09:00 - 09:05 Security briefing Daniel David, Security Officer –UNICEF-Uganda

09:05– 09:15 Welcome Remarks Official Welcome by Government

Bemanya Twebaze, URSB-Registrar General

09:15 – 09:30 Cultural interlude (Ndere dancers etc)

LoC-Uganda

09:30 – 09:40 Statement Overview of General Civil Registration System

Isaac Musumba Isanga, Chairman Board of Directors- URSB

09:40 - 10:00 Statement The State of Affairs of the African CRVS System

Pali Lehohla, Statistician General, South Africa Statistics

10:00 - 10:10 Vote of Thanks Cornelius Williams, UNICEF ESARO

10:10 - 10:30 Official Speech Minister’s statement Major Gen Kahinda Otafiire, Minister

10:30 - 11:00 Coffee Break Press Conference – Photo Op

RG, Minister, URSB Board Chairman, SG-South Africa, UNICEF

11:00- 11:10 Session 1: Overview of EU support to CRVS

Objectives of the Study Tour

Introduction of participants and overview of overall objectives of the Pan-African Study Tour on CRVS

Presenter:Cornelius Williams, UNICEF ESARO

Documentation and Note taking to be coordinated by UNICEF-HQ T4D Consultant and YAS throughout

17





Comments/Notes

11:10 – 11:40 Session 2: Introduction to the Uganda Civil Registration System

Introduction on linkages between URSB and MoH

Presentation/Overview of URSB Reform Process and Linkages with other Social Sectors

Chair: Cornelius Williams, UNICEF ESARO

Presenter(s):Eva Kentaro Mugerwa, Director Civil Registration - URSB

Edward Mukhooya, MoH

Joseph Adreka, FBO

Documentation and Note taking to be coordinated by UNICEF-HQ T4D Consultant and YAS throughout

11:40 - 12:00 Session 3: Introduction of the broader African CRVS Agenda

APAI-CRVS Implementation including: Conceptual and Operational Framework and Assessment and Planning Activities

Chair: Bemanya Twebaze, URSB - RG

Presenter(s):Raj Gautam Mitra, Core Group

12:00 – 12:20 Session 4: Presentation on the National CRVS System in India

Comparison of CRVS System from different region focusing on the importance of creating enabling environments for digitisation of CRVS

Chair:Anneke Schmider, WHO-Geneva

Presenter(s):Deepak Rastogi, Additional Registrar General – India

12:20 - 13:00 Session 5: Plenary Discussions

Panel Group with above presenters and Chairs: RG Uganda, MoH Uganda; ARG – India, Core Group, WHO-Geneva, Statistician General-SSA

13:00-14:00 Lunch

14:00 - 15:30 Session 6:Presentations on use of IT to reform and modernise business processes and service delivery in Civil Registration. (Mobiles VRS, Mtrac and U report)

Participants learn about various options and models (actual examples), pros and cons

Importance of understanding the required CRVS business process

Importance of a structured analysis phase for digitising CRVS systems

Chair: Raj Gautam Mitra, Core Group Secretariat

Presenter(s):Anneke Schmider, WHO-Geneva

Arthur Kwesiga and Hosea Mitala URSB

Caroline Barebwoha, UNICEF-Uganda

Edward Duffus, Plan International and Adam Rowlands, Accenture Development Partnerships

Interactive session with Q&A

15:30 - 16:00 Coffee Break

18

16:00 - 17:30 Session 7:Presentations from countries on their experience and use of ICT/T4D/ Innovations to improve CRVS

Exchange of country experiences

Presentations from Nigeria, Kenya and Senegal

Plenary Discussions

Chair: Sudha Murali, UNICEF-Uganda

Presenters:NigeriaKenyaSenegal

Day 2 - Tuesday 3 September 2013

08:30 - 09:00 Session 8: Reflections of previous day’s session

Participants to share their reflections and key lessons learnt

Gloria Mathenge, YAS

09:00 - 10:00 Session 9: Introduction to interoperability and agreements on what to take forward

Participants learn about various options and models (actual examples), pros and cons

Clarity on business process and standards

How different databases need to be linked to CRVS databases

Chair:Cornelius Williams, UNICEF-ESARO

Anneke Schmider, WHO –Geneva

Edward Mukhooyo, MoH – Uganda


10:30 - 13:00 Session 10: Presentations from countries on their experience with Interoperability to improve CRVS

Exchange of country experiences

Presentations from Zambia, Burkina Faso, Mozambique

Followed by Plenary Discussions

Chair: Anneke Schmider, WHO-Geneva

ZambiaBurkina FasoMozambique

13:00 - 14:00 Lunch Break

14:00 - 15:30 Session 11: Business process mapping and reengineering with technology

Mapping of national CRVS business process (by country)

Facilitator – Anneke Schmider, WHO-Geneva and Edward Duffus – Plan and Adam Rowlands - Accenture

Break out into small working groups (by country)


15:45 - 16:30 Session 12: Strategic Thoughts and Trends on CRVS Systems: A European Perspective

Some European efforts to enhance national CRVS systems

Proposed areas for priority actions for sustainable orientation of national CRVS systems

Chair:Pali Lehohla, Statistics General South Africa Statistics

Presenter(s)Urs Buerge, Independent Consultant

Followed by Plenary Discussion

16:30 – 16:45 Information on Planned Field Trip

Hosea Mitala, URSB – Uganda



Comments/Notes

19



17:00 Cultural Night, Entertainment + Cocktail

Delegates entertained by Ndere Troupe

LoC

Day 3 - Wednesday 4 September 2013

08:30-17:30 Field Visits/Project Sites

Group 1:

Morning:Visit to Mulago Hospital (Mobile VRS in hospital)

Afternoon: Visit to URSB offices

URSB and UNICEF Uganda Transport logistics-cars

Packed lunches to be organised for team visiting Mubende district

Group 2:

Morning:Visit to Mityana Hospital (use of Mobile VRS in hospitals) en-route to Mubende district Local government (use of mobile phones to notify birth

Afternoon: Visit to Mubende Hospital -PM

Group 3:

Morning: Visit to Wakiso District local Government ( Integration of BR into Health services) & a Health Centre 4

Afternoon: Visit to Nsambya Hospital (Mobile VRS in hospital)

Day 4 - Thursday 5 September 2013

08:30 - 09:00 Session 13:Reflections of previous days field visits

Participants to share their reflections and key lessons learnt from field visits

Fidelia Dake, YAS

09:00 - 10:15 Session 14:Business process mapping and reengineering with technology

Participants review mapping develop

Facilitated by Anneke Schmider, WHO-Geneva, Raj Gautam Mitra Core Group and Edward Duffus, Plan International




Comments/Notes

20

10:30 – 12:30 Session 15: (continued)Business process mapping and reengineering with technology

Country delegates present proposals based on mapping and reengineering exercise

Facilitated by Anneke Schmider, WHO-Geneva, Raj Gautam Mitra Core Group and Edward Duffus, Plan International

12:30 - 13:00 Closing Statements

Closing Statements Statement from Cornelius Williams, UNICEF-ESARO

Closing Remarks from Bemanya Twebaze, URSB

13:00 - 14:00 Lunch

15:00 Checkout / Departure of some participants

OFFICIAL END OF STUDY TOUR



Comments/Notes

21



Appendix “B”Uganda Pan-African Study Tour Conference – Speke Resort Muyonyo, Kampala Participants List

No Country/ Agency

Last Name First Name Position/Title Email

Government Delegates

1 Angola Mangueira Vicentina Statistic Clerk – National Central Registration Bureau, Ministry of Justice and Human Rights

[email protected]

2 Angola Carlos Ana Adviser to the Minister of Justice and Human Rights

[email protected]

3 Angola Domingos Arsenio Analyst of Business Intelligence e DateWareHouse - Adviser of the National Bureau of Civil Registration for Information Technology Ministry of Justice and Human Rights

[email protected]

4 Burkina Faso Nignan Sylvain Directeur de l’Informatisation de l’Etat Civil [email protected]

5 Burkina Faso Benon Yatassaye

Nana Directrice du suivi des statistiques de l’Etat Civil [email protected]

6 Cote D’Ivoire Bouakary Berte Ministere d’EtatMinisterre de & Interviewer et de la securite directeur des Affaires Generales

[email protected]

7 Cote D’Ivoire Kouassy Edith Clarisse Ministere de la Sante et de la Lutte contre le SIDA/Directrice Generale Adjointe de la Sante

[email protected]

8 Cote D’Ivoire Cisse Hassan Office National D’Identification/ Directeur Du Departement Etudes, Statistique et Documentation

[email protected]

9 Kenya W. Mugo Joyce Director, Department of Civil Registration [email protected]

10 Kenya W. Kariuki Jane Desk Officer, UNICEF [email protected]

11 Kenya Wanjala Pepela Ministry of Health, Health Information System [email protected]

12 Malawi Chilenga John Assistant District Registrar, National Registration Bureau

[email protected]

13 Malawi Banda Benjamin Bisa Chief Registration Officer, National Registration Bureau

[email protected]

14 Mozambique Sergio Cambaza IT Technician [email protected]

15 Mozambique Carla Guilaze Director of Registry and Notary [email protected]

16 Mozambique Gertrudes Macueve Deputy Director of Information System

17 Niger Deouda Aboubacar Directeur de l’état civil et des réfugiés, Ministère de l’intérieur

[email protected]

18 Niger Housseini Hamidou Consultant de l’UNICEF auprès de la Direction de l’état civil et des réfugiés, Ministère de l’intérieur

[email protected]

19 Nigeria Rano Garba Musa Deputy Director, Vital Registration Dept. NPopC [email protected]

20 Nigeria Ezeife Chinwe Joy Assistant Director, Community Health Services Dept, NPHCDA

[email protected]

21 Senegal Ba Dieh Mandiaye Head of Centre National de l’Etat-Civil of Senegal

[email protected]

22 Tanzania Eliya Lubeja Registration Officer [email protected]

23 Zambia Nyahoda Martin Principal Registrar [email protected]

22

UNICEF

24 Angola Borba Lidia Child protection Specialist, UNICEF- Angola [email protected]

25 Brussels Rivas Pereda Ruben [email protected]

26 Cote D’Ivoire Kambou Sie UNICEF – Child Protection Officer [email protected]

27 ESARO Kidane Milen Child Protection Specialist [email protected]

28 ESARO Ghalain Karim UNICEF Regional T4D [email protected]

29 ESARO Williams Cornelius Regional Adviser – Child Protection [email protected]

30 ESARO Li Kun Communication Specialist [email protected]

31 India Bhaskar Mishra UNICEF Policy, Planning and Evaluation Specialist

[email protected]

32 Kenya Kinuthia Violet Programme Officer, Birth Registration UNICEF [email protected]

33 Malawi Mwale Alexander Child protection Officer, UNICEF [email protected]

34 Mozambique Neidi Carvalho Officer UNICEF [email protected]

35 Nigeria Maduechesi Nkiru Child Protection Specialist. UNICEF [email protected]

36 Nigeria Akinroye Roseleen Child Protection Specialist. UNICEF [email protected]

37 Senegal Kassoka Yves Olivier Protection Specialist [email protected]

38 Tanzania Msangi Mwajuma UNICEF – Child Protection Specialist [email protected]

39 WCARO Mattila Mirkka Child Protection Officer [email protected]

40 Zambia Mofya Innocent Child Protection Officer [email protected]

41 Uganda Sharad Sapra Country Representative [email protected]

42 Uganda May Anyabolu Deputy Country Representative [email protected]

43 Uganda Sudha Murali OIC – Chief Child Protection [email protected]

44 Uganda Harriet Akullu Child Protection Specialist [email protected]

45 Uganda Augustine Wassago Child Protection Officer [email protected]

46 Uganda Harriet Kajubi Child Protection Officer [email protected]

47 Uganda Jackie Atei Program Assistant [email protected]

48 Uganda Rose Kabasomi Program Assistant [email protected]

49 Uganda Marion Negaga Admin Assistant [email protected]

50 New york Crowe Sarah Spokesperson [email protected]

51 JHB Beukes Sue Camera/Producer [email protected]

52 Uganda Barebwoha Caroline Consultant U-Report [email protected]

CRVS Experts

53 WHO-Geneva Schmider Anneke WHO [email protected]

54 Plan-International

Duffs Edward Plan International [email protected]

55 South Africa Statistics

Pali Lehohla South Africa Statistic Director [email protected],

56 Independent Consultant

Bürge Urs Fidel CR IT Expert [email protected]

57 APAI-CRVS Secretariat

Mitra Raj Gautam Chief, Demographic and Social Statistics Section [email protected]

58 India Deepak Rastogi India Registrar General [email protected]

Young African Statisticians

59 Ghana Dake Fidelia Population Scientist/Young Statistician [email protected]

60 Kenya Mathenge Gloria Junior Consultant, CRVS – UNECA/Secretariat Core Group

[email protected]

No Country/ Agency


23



Invited Guests

61 UNICEF-HQ Consultant

Philbrick Bill UNICEF-HQ Innovations Consultant [email protected]

62 Plan-Kenya Sherman Carol Plan-Kenya [email protected]

63 Plan-Kenya Njoroge Anthony Plan-Kenya [email protected]

64 Accenture Development Partnerships

Rowlands Adam Plan International (Accenture Development Partnerships)

[email protected],

65 UNHCR Uganda Nora Ochieng Child Protection Specialist [email protected]

66 UNFPA Uganda Tagoola Florence Team Leader Populations [email protected], [email protected]

67 EU Delegation Meya Rossete Prog. Specialist [email protected]

68 Plan Uganda Adupa Patrick Project Manager Child Protection [email protected]

69 Church of Uganda

Adweka Joseph Programme Coordinator [email protected]

70 Church of Uganda

Kintu Fred Programme Officer [email protected]

Observers

71 de la Rue Taylor Sophie De la Rue [email protected]

72 Researcher Wanzala Peter Research Scientist, Kenya Medical Research institute

[email protected]

Uganda Government Delegates

73 MoJCA Bireije Denis Commissioner [email protected]

74 URSB Mugerwa Eva Director Civil Registration [email protected]

75 URSB Ruta Darius Manager Liq [email protected]

76 URSB Charles Nsimbi Manager Civil Registration [email protected]

77 URSB Lubega Twaha RegistrationOfficer [email protected]

78 URSB Bemanya Twebaze Registrar General [email protected]

79 URSB Kwesiga Arthur Manager ICT [email protected]

80 URSB Mutekanga Isaac DFA [email protected]

81 URSB Anganya Alex SIA [email protected]

82 URSB Katutsi Vincent M, C&E [email protected]

83 URSB David Guma Board Member

84 URSB Baishaki Chetorion Director CL [email protected]

85 URSB Nangobi Provia Public Relations Officer [email protected]

86 URSB Karungi Gloria Client Officer

87 MoJCA Kahini Binebyengo John

Officer

88 MoJCA Sitankya Ismail Officer

89 URSB Winfred Mwogeza F.O - URSB

90 President office Odongo Joseph Liasion Officer

91 MoH Mukooyo Eddie ACHS/RC

92 Member of Parliament

Atiku Benard MP

93 URSB Nassuna Juliet Director IP [email protected]

94 URSB Kasibayo Charles Ag. Administrator General

No Country/ Agency


24

Appendix “C”Illustrative Model of CRVS System and Multi-sectoral Linkages

CRVS Operational Framework

Civil Register

CRVS Stakeholders: National ID, Education etc

Ministry responsible for Civil Registration

Civil Registration Database

Institutional arrangement may vary depending on country context

Migration

Population Register

Ministry responsible for Health

Vital Statistics Compiling National Office

Vital statistics including causes of death

Establishing identity, safeguarding rights and

privileges

Health, education, grant and other social and economic services

National ID database (ID from a certain age)

Passport, election database, driving licence etc

Birth, death and foetal death at home

Birth, death and foetal death in health

facility

Marriage and divorce

Processing complementary vital events

Source: Raj Gautem Mitra, UNECA

25



Appendix “D”“The Know Me Systems” Africa Awakenedby Pali Lehohla, South Africa’s Statistician-General and Head of Statistics South Africa and Waithira Mathenge Young African Statistician

“Civil registration and vital statistics (CRVS) systems are everybody’s business!” CRVS constitute the most pervasive of systems penetrating the thinking, functioning and reporting of human endeavour from conception to the disposal of the mortal remains of individuals including their estate. It constitutes the nervous system of a multi-sectoral, multi-disciplinary and multi layered process of human endeavor. No doubt the CRVS play a crucial role in governance, national identity, national security, justice, health service delivery, measurement of development, upholding human rights, providing vital statistics, providing evidence for prioritising government spending, informing national planning and allocation of government resources and so on. Indeed, there is no one faculty of human development of which civil registration and vital statistics (CRVS) are not pertinent to. Yet often CRVS is the most ignored institution, at least until recently. Home Affairs offices or Ministries of Interior in Africa and possibly elsewhere in the world are always associated with inefficiency, bureaucracies that are simply paper pushers chocking under tons of paper, long queues, dingy offices, dark allays, bribery and lack of governance and respect for the public. Yet increasingly these institutions are now going through a paradigm shift, throwing away the poor label image they had for ages. They are rising to the challenge as central nervous systems for governance, custodians of life records of citizenry, facilitators of conversations amongst institutions, amongst people, and between institutions and people. With technological revolution these institutions can prevail as information institutions of the future.

CRVS - A Global AgendaThe relevance of CRVS in achieving the global development agenda cannot be over-emphasised. In two years time, countries across the globe will make reports on the progress realized on various indicators of the 2015 Millennium Development (MDGs) goals. Such will inform the post-2015 development agenda the vision of which according to Secretary General of the United Nations “inspiring the next generation to believe that a better world is within its reach.” CRVS constitute a central pillar of this vision in that it maps itself neatly on the five priority areas of first, leaving no one behind. In order to know that no one is left behind you first need to know that they exist. Second, place sustainable development at the centre, requires that the human agency as the most significant both as a creator of commodities and culture and consumer of same has to be visibly known. Third, transform the economy for creating jobs and inclusive growth demands that those to be in jobs and included in growth are known. Fourth ensure peace, and create accountable and transparent institutions places CRVS as the maiden hands for such institutions and fifth and finally forging a new global partnership requires people to people systems, governments to governments and governments to people systems. All these are anchored on “know me” systems which must be accurate, current and comparable across countries.

The need to monitor and improve the state of maternal and child health in the developing world and secondly to improve systems of public administration and governance are also priority actions of most countries in this decade. All these are reliant upon continuous and permanent records of the population provided by the CRVS system which are unfortunately in a poor functioning state in most countries. The Commission on Information and Accountability for Women’s and Children’s Health (COIA) convened by the World Health Organisation under the direction of the United Nations Secretary-General in 2010, has as its first recommendation, in a report released in 2011, that countries prioritise increasing their efforts to strengthening CRVS systems.

Global Efforts Towards Improvement of CRVS SystemsSignificant efforts and progress have been made in different parts of the world towards improvement of CRVS systems. The Americas are currently implementing a Regional Plan of Action for Strengthening Vital and Health Statistics since 2008 as part of the efforts to strengthen the health information system in the country. The Pacific Island countries have a Ten Year Pacific’s Statistics Strategy (TYPSS), 2011-2020, which prioritizes improvement of CRVS among its four focus areas. The region also has in place and is implementing the Pacific Vital Statistics Action Plan (PVSAP), 2011-2014, among other achievements towards improvement of CRVS systems. In Africa, the improvement of CRVS systems has been top of the development agenda because Africa’s Agenda on Political, Social and Economic Integration is

strongly rooted upon good governance and statistics that can measure the state and progress, all which are provided by CRVS systems. It is unfortunate that while these systems hold such promise, they have not been functioning properly in most of Africa and for decades if not centuries.

Africa however has made significant strides in creating conditions for institution building for the CRVS. Below are some of Africa’s experiences on “what has worked” and “what has not worked for Africa” in the past two years of implementation of the Africa regional programme for improvement of CRVS (APAI-CRVS).

Africa’s Experience on CRVSIt is worth noting that Africa and the Asia-Pacific share a number of common guiding principles in their programmes for improvement of CRVS systems. These include country ownership and leadership, multi-stakeholder engagement in the improvement processes, a phased approach of programme implementation, consistency with international principles and guidelines, as well as building on local expertise.

The following are some of key strategies and approaches that have worked for the continent in the efforts to improve the state of the CRVS systems in countries:1. African ministers responsible for civil registration have over their first and

second conferences, held in Addis Ababa, Ethiopia, in August 2010, and Durban South Africa in September 2012, declared their commitment and support to the improvement of CRVS systems on the continent. During both conferences, the ministers were engaged in technical discussions on the themes of the meetings. These conferences have served as an awareness raising platform and a means to accrue political support at both regional and country level.

African Heads of States and Governments in their meeting held in 2012 endorsed recommendation that the ministerial conference on civil registration be a standing regional platform that will meet every two years. This decision is one of the significant milestones of the programme, and is expected to yield sustained political support to the APAI-CRVS

2. The African Symposium on Statistical Development (ASSD), an annual statistical forum that convenes heads of National Statistics Offices, has adopted CRVS as the theme for the symposia to be held for the next five years. The symposium has now convened on two occasions on the CRVS theme. Besides convening heads of National Statistics offices, the symposium has also brought on board key stakeholders of CRVS i.e. Director Generals of Civil Registration Authorities and participants from the health sector. This forum has served as an important one in providing a platform for dialogue and interaction between these three key stakeholders

3. Engagement of Young African Statisticians (YAS) in the CRVS agenda as part of capacity building for CRVS and utilization of the available resources. The YAS programme is a development of the 57th session of the International Statistical Institute (ISI) held in Durban, South Africa in 2009. As part of its plan, the programme has a strategy to technically support the implementation of APAI-CRVS.

The programme has, with the support of HMN, attached three young statisticians to support the regional CRVS Secretariat at the Economic Commission for Africa. The three and a few more have also been consistently engaged in relevant forums on CRVS such as the ASSD meetings, the ministerial conferences as well as trainings on CRVS. The young statisticians cohort will also join older experts in supporting the country CRVS assessment process and development of national CRVS plans.

The recent Civil Registration Study Tour to Uganda by African countries on what was termed fixing broken systems demonstrated what is possible. Mothers can acquire registration certificates on the birth of their newly born within minutes, provided the children are born in a health facility. Registrars can, through mobile-devices register births remotely relieving the rural communities of a major barrier to development, even when they are not born in a health facility. Through adapting technology information asymmetry and uneven development can be tackled. Yet, within the same environment, registration can also unfortunately take a very long time, thus depriving infants a promise of a possible better world. The “know me systems” will drive change through transparency, known, responsible and accountable citizenry as well as responsive and accountable institutions.

Pali Lehohla is South Africa’s Statistician-General and Head of Statistics South Africa. He is also Chair of Africa Symposium for Statistical Development (ASSD)

Waithira Mathenge is a Young African Statistician palced at the APAI-CRVS at the Statistics Center of the Economic Commission for Africa.

Photo: UNICEF/Mozambique/2013

civil registration study tour in uganda

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