Understanding CRVS Indicators and Systems

CRVS CORE INDICATORS

Introduction Civil registration is the continuous, permanent, compulsory and universal recording of the occurrence and characteristics of vital events in the population. Civil Registration and Vital Statistics (CRVS) is important both: As a source of data to measure/ produce key indicators As a means to supporting the achievement of key targets under the SDGs and national development plans

CRVS functions A legal record of identity for both government and individual family use Access to services, social inclusion, citizenship rights, Example: 8.10.2 Proportion of adults (15 years and older) with an account at a bank or other financial institution or with a mobile-money-service provider Tier I Birth and death data on individuals for government processes School enrolment, electoral rolls, name changes (police records etc), citizenship eligibility Example: 10.7.2 Number of countries that have implemented well-managed migration policies Example: 15.6.1 Number of countries that have adopted legislative, administrative and policy frameworks to ensure fair and equitable sharing of benefits Timely vital statistics Population data for planning and response Births, fertility, deaths, mortality ANY indicators that include per capita; proportion of the population; proportion of children etc . Cause of death data Individual Non natural deaths Aggregate public health data

CRVS for data linkage Increasing attention globally to national identity data & systems CRVS provides an important foundation for these ID systems by establishing a legal identity at birth, and a means to close an identity/ record at death Data linkage has significant value for the region Data quality for key indicators Improved baselines Greater ability to interrogate and add value to data

Types of CRVS Indicators System Measures Indicators that measure how well the CRVS system is performing Sectoral Measures Health, Population, Gender, & other indicators which are directly measured using data collected through the CRVS system.

System Indicators These indicators relate to the performance of the CRVS systems In terms of providing LEGAL identity Ability to generate tabulated data for statistical analysis/ generation of other indicators. All Pacific countries (except Tokelau) have committed to the Asia Pacific Regional Action Framework for CRVS in 2015, and the Asia Pacific Decade for CRVS 2015-2024 to get everyone in the picture This includes setting specific national targets and reporting progress back to the regional commission for statistics against 3 goals Goal 1: Universal civil registration Goal 2: All individuals are provided with legal documentation Goal 3: Accurate, complete and timely vital statistics are produced and disseminated.

System Indicators Goal 1: Universal civil registration of births, deaths and vital events Percentage of births in the country that are registered within 12 months of birth Percentage of children under 5 years old who have had their birth registered (Tier 1) Percentage of all individuals in the country who have had their birth registered Percentage of all deaths in the country that are registered within 12 months of the event Percentage of all deaths recorded by the health sector in the country in a given year that have a medically certified cause of death recorded using the international form of the death certificate Goal 2: All individuals are provided with legal documentation of civil registration of births, deaths and other vital events, as necessary, in order to claim identity, civil status and ensuing rights Percent of registered births for which an official certificate is issued including key information (the individual s name, sex, date and place of birth, and name of parent(s) where known) Percent of registered deaths for which an official certificate is issued including key information (the individual s name, sex, date and place of birth, and name of parent(s) where known)

System indicators Goal 3: Accurate, complete and timely vital statistics (including on causes of death), based on registration records, are produced and disseminated Tabulated data on births, disaggregated by age of mother, sex of child, & geographic area (if relevant) are produced from registration records or other valid administrative data sources annually Tabulated data on deaths, disaggregated by age, sex, cause of death defined by ICD code or category (General mortality list 1 104 causes), & geographic area (if relevant) are produced from registration records or other valid administrative data sources annually Percentage of deaths occurring in health facilities (or with the attention of a medical practitioner) that have an underlying cause of death code derived from the medical certificate according to the standards defined by the ICD. Proportion of medically certified deaths coded to ill-defined codes (according to the ICD) Percentage of deaths taking place outside of a health facility and without the attention of a medical practitioner that have an underlying cause of death code determined through verbal autopsy in line with international standards (Only relevant for larger populations where there is no possibility of medical certification of deaths by a doctor). Key summary tabulations of vital statistics on births and deaths using registration records as the primary source, are made available in the public domain in electronic format annually, and within one calendar year Key summary tabulations of vital statistics on causes of death using registration records as the primary source, are made available in the public domain in electronic format annually, and within two calendar years of the reference period. An accurate, complete and timely vital statistics report, using registration records as the primary source, is made available in the public domain at least every two years.

Sectoral Indicators with strong existing commitments Maternal mortality rate (3.1.1) Proportion of births attended by skilled health personnel (3.1.2) Under 5 mortality rate (3.2.1) Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group (3.7.2) Proportion of children under 5 years of age whose births have been registered with a civil authority, by age (16.9.1) Deaths due to NCDs (3.4.1) Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease Global WHO NCD indicator: Unconditional probability of dying between ages 30 and 70 years, from cardiovascular disease, cancer, diabetes, or chronic respiratory diseases Number of deaths, missing persons and persons affected by disaster per 100,000 people (11.5.1/ 13.1.2) 16.10.1 Number of verified cases of killing, kidnapping, enforced disappearance, arbitrary detention and torture of journalists, associated media personnel, trade unionists and human rights advocates in the previous 12 months (16.10.1

Sectoral indicators under discussion Life expectancy Life expectancy at 40 Life expectancy at 60 Neonatal mortality Rate (3.2.2) Infant Mortality Rate Total Fertility Rate Proportion of births with low birth weight Deaths due to homicide/ violence Deaths due to road traffic accidents Other indicators related to specific causes of death Occupational deaths Toxins and air pollution deaths Unintentional poisoning Unsafe water Death registration coverage

The Brisbane Accord Group Brisbane Accord Group formed in 2010 to support improved CRVS in the Pacific and better coordinate partner efforts around this Additional partners added over time Includes Regional & international organisations, national stats partners, universities, etc. - all partners must be active in providing on the ground support Activities coordinated through the Pacific Vital Statistics Action Plan which is a living document driven by country priorities

BAG support for analysis and reporting Reporting guidelines Coding support for cause of death IRIS automated coding Coding support agreements with Australia and New Zealand Spot coding as required for analysis Analysis support Data analysis and report writing workshop Remote analysis support International data sharing off island events Planning - Capacity development National improvement plans Collection and system support (legislation, IT, certification,

Publication of basic tabulations. There is a huge reporting burden from the number of indicators required One means of assisting countries to address this is to focus on a central reporting mechanism for: Measures of coverage and completeness Basic tabulations Births by mothers age, sex of child, place (where relevant) Deaths by sex, age group (<1, 1-4, 5-9 5 yr age groups, 85+), and underlying cause of death (ICD general mortality list) Support can then be provided for indicator analysis and agencies can extract data directly. Building support for CRVS admin data sets to be cleaned and accessible in the same way as the Pacific Survey Catalogue.

Discussion Do we have general agreement on the list of indicators re systems. Any thinking/ questions around the difficult to measure system indicators Any thoughts/ discussion re the sectoral indicators - and the role that CRVS has in collecting these. Resourcing activities such as capture / recapture work to evaluate completeness of CRVS and Census

Thank you