Jordan Civil Registration System Overview

The Civil Registration and Vital Statistics System in Jordan Dr Majed Asad / Ministry of Health Jordan CRVS 2018 Casablanca

Background of CRVS Ministry of Health established in 14-Dec-1950 and it was responsible for vital statistics registration until 1-7- 1977.during this period mortality data (Causes of death) were available. After that the responsibility of vital registration were transferred to the Civil Registration Department established in 1977

Infrastructure and resources We have adequate number of civil registration points in Jordan All points connected together with one data base Every citizen has one unique ID number Refugees and foreign worker birth and deaths tabulated separately from the national population

Importance of vital statistics: The Vital Statistics has an important role in determining estimates of Population growth rate Age structure of population and their geographical distribution. Provide a dynamic picture of demographic changes. Detect trends in birth and death rates, marriage and divorce Contribute to the planning of social and economic development. Contribute in the setting of health strategies and the implementation of specific health programs continue

Importance of vital statistics Contribute to the planning educational strategies according to gender. Contribute to the completion of various official files such as population records ,personal cards, social security lists and election tables.

Civil registration and passport Bureau functions and duties 1. Issue a unique national number for every Jordanian citizen and family book for each Jordanian family. 2. Registration and storage of vital events (births, deaths, marriage, divorce) to citizens wherever they occur and vital events for foreigners residing in the Kingdom 3. Issuance and renewal of passports. 4. Issuance of identity cards for citizens. 5. Registration and preparation of the electoral tables

Death notification form

Personal Information National Identification number 10 digits Nationality Name as in the National Identification Card Place of death Date of death Mother s name Date of birth 34 Lesso n 3: Co m pl et i n g t h e f o r m

Form Components Cause of Death Period between Onset and Death .. .. .. .. .. Immediate cause is always Row A Time periods should increase Part one: 1. Immediate cause of death 2. Conditions that lead to the immediate cause a. .. Result of: b. .. Result of: c. .. Result of: d. .. .. Part two: - Diseases or conditions contributing to death but not resulting in the underlying cause stated in Part I - If the deceased is a woman in the reproductive age (15-49), did the death happened during: Pregnancy Delivery After Delivery(within 42 days) Others The death happened at: - Hospital - Health Center - Private Clinic - Home - Others - Did they advise the legal authority - Yes - No - The form was filled according to my medical knowledge: - checking the deceased before dying - Seeing the body after death - Autopsy - Filing & medical report Dr s Name .. Signature Official Stamp .. Often used with chronic disease Lesson 3: Completing the form

Additional Information Lesson 3: Completing the form

Previous death notification form

Persons required and allowed to report death notification by law Assets ,branches or deceased husband. Attended the death of relatives of the deceased adults. The doctor in charge of proving death. The store owner or manager or the person who administered if death occurs in a hospital or place intended for nursing or a shelter or a hotel or a school or a prison or any other entity. Mukhtar .

Mortality System

Review of mortality system for the period (1995 2000) shows Inaccuracy in writing the cause of death: Died suddenly Heart stopped Old age Other heart disease Diarrhea Heart & lungs stopped The selection of the cause of death was based on direct cause of death and not on the UCOD Incomplete information on death notification form Underreporting of deaths

Interventions to improve the system (2001 2003) A national meeting was held to raise awareness about the importance of mortality system A national committee was formed from all related bodies, reviewed the system and recommended the following : Death notification form should be modified according to international standard A copy of the death notification form should be sent to the ministry of health Ministry of health should take a leading role in the coding and selecting the UCOD . Physicians should be trained on how to fill death notification form Exchange of data between ministry of health and civil registration department

Achievements in 2003 Death certificate has been modified according to international standard Guidelines on how to fill the death notification form have been developed and distributed to all physicians A group of physicians were sent to Australia to get training on ICD-10 mortality and morbidity coding. A software has been developed to facilitate storage, retrieval and analysis of mortality data Focal points has been trained on how to fill the death notification form and appointed in all hospitals and health directorates to help in improving the quality of data and to enforce the reporting system. The system began working on June 2003.

Other important steps 2004-2006 Third National meeting (2005) Mortality and Morbidity systems were embedded in the national health agenda and in the strategic plan of the ministry of health Three national training workshops were conducted on mortality and morbidity coding using ICD_10 , another workshop is planned to be conducted on May 2007 Two national workshops were conducted on how to fill the death notification form for the focal points and they will be provided with a training curriculum to train other physicians in their regions

Other important steps/cont 2004-2006 Participation in Strengthening Dissemination &Utilizations of Vital Statistics workshop organized by UNFPA and Civil Registration Department Dec. 2005 . Participation in the meeting of World Health Organization Family of International Classifications Network Oct. 2006 . Participation in the Round table discussion on Strengthening Dissemination &Utilizations of Vital Statistics Organized by UNFPA and Civil Registration Department Dec. 2006

Death Notification Flow Death Physician determines cause of death Issue Death Notification Form Give to Family Focal Points Information Directorate MOH Civil Registration Department

Legal Requirements Deaths are reported to Civil Registry Office or the Mokhtar within a week Specific individuals are required to report the death Cause of Death is a required field on the reporting form Hospitals provide relatives with notification forms (birth forms or death forms)

ICD practices We use ICD-10 for mortality coding We distribute guidelines how to fill death notification form We do many workshops for physicians how to fill death notification form Mortality coding centrally coded Coders received training by NCHS in Australia The proportion of births taking place in hospitals is 99%(DHS2012)

Completeness Estimated completeness of births above 95% and deaths around 75% 2012 Last decade births was above 90% and deaths around 70% Civil registration offices cover all country. Social benefits for birth registration; obligatory for school registration, medical insurance for under 5 years how have National Number (ID) Benefits for death registration; inheritance wrights and allocation

Coverage All areas are covered (urban and rural) all population are covered Births 99 % 2010 Deaths 75 % 2010 Special registration point (refugee camp)

Challenges in CRVS Under Reporting of Deaths lack of high-level awareness of the importance of civil registration and vital statistics and the consequent lack of political support, and lack of awareness of the benefits of registration among the general public; incompleteness of death certificates; challenges due to war, conflict and resulting humanitarian crises which adversely affect the functioning of registration systems and impede the progressive realization of the basic human rights of all individuals.

Road Map Establishing Electronic reporting system from hospitals to civil registration offices Rise of public awareness regarding of civil registration importance Improve cause of death certification and coding and the compilation of mortality data

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