Globally, only 34 countries have high-quality, easily accessible data on something as important—and basic—as the causes of death of their citizens. In Africa, only Mauritius has a good-quality civil registration and vital statistics (CRVS) system.
How is it possible that low- and middle-income countries have made enormous progress across the development spectrum—but they have no record of the life events of their people, like births, marriages, divorces, adoptions and deaths? Because countries lack the well-functioning CRVS systems that provide real-time data for measuring progress and for better targeting of health and other development programs.
Part of the problem lies in outdated, inaccurate definitions. For example, the current definition of registration “at birth” is children registered by age 5. Only 10% of births are registered in the first year, which means that most stillbirths and neonatal deaths go unregistered. This means that those lives are not counted.
“Policymakers can’t plan and allocate resources effectively without accurate data on the health and welfare of their citizens,” said Samuel Mills, a Senior Health Specialist at the World Bank Group. “Due to deficient CRVS systems, millions of people in developing countries are being denied basic health, education, social protection services, and are missing out on humanitarian responses to emergencies and conflicts, trade, and security.”
Mills led a multi-sectoral working group to develop the Global Civil Registration and Vital Statistics Scaling Up Investment Plan 2015-2024, which the World Bank Group and the World Health Organization recently launched in partnership with several global health agencies and country governments, including Canada’s.
A CRVS system is a keystone of any country’s development infrastructure—and benefits all sectors (see box). For example, marriage and divorce registration contribute to women’s ability to inherit property, and registering girls at birth and recording their marriages help prevent early and forced marriage. Or, by providing people with legal proof of identity, they can get passports, open bank accounts, obtain driver’s licenses, vote, and access education and social security services.
“We have the technology, human resources and know-how to register these vital events. Now, we need to close the estimated CRVS financing gap of US$200 million a year, which, if filled, will finance country-led, costed plans,” said Mills.
The plan to scale up outlines what it will take to develop sustainable CRVS systems that are integrated across the government and that serve the needs of the public and private sectors—and most importantly, citizens. The World Bank Group is developing a framework for engaging donors to establish a global CRVS program.
In late May, at Canadian Prime Minister Stephen Harper’s Maternal, Newborn and Child Health Summit, World Bank Group President Jim Yong Kim stressed the importance of CRVS. During the summit, Canada committed CAD$3.5 billion for maternal, newborn and child health, including CRVS, from 2015-2019.
"Civil registration and vital statistics systems are critical for delivering results for mothers and children,” said Christian Paradis, Canadian Minister for International Development and for La Francophonie. “We are encouraged by the growing global momentum to support countries to improve CRVS so children have a legal identity at birth, and there is better and more accurate information on where people live, and on their health status, including causes of death, so that we are able to direct resources to where they are most needed. This is important for the realization and protection of human rights, and for increased accountability so our support can make the greatest difference."
President Kim outlined the vision to register every pregnancy and every birth by 2030.
“Every country should have a 21st century, active, digital, and truly ‘vital’ system.” President Kim said at the summit. “To stop mothers and young children from dying, we first need to know who is dying, from what causes, and where.”
The World Bank Group has the breadth of expertise—in diverse areas such as health, ICT, identity systems, statistics, economics and finance—required to work across regions and with countries to strengthen CRVS systems.
“Thanks to new knowledge and innovation, we are developing and deploying some of the tools we need to help countries build CRVS and national identification systems, which will yield substantial benefits across the development spectrum,” said Tim Evans, World Bank Group Director of Health, Nutrition and Population.
Robust CRVS systems and national identity systems contribute to the goals of ending extreme poverty and boosting shared prosperity, and benefit all sectors.
Agriculture – to accurately identify poor farmers, women producers, and people living below the poverty line
Education – for early childhood education, primary, secondary and tertiary education planning
Energy & Extractives – identifying the poor and where they live is necessary for achieving universal access to affordable, reliable, and sustainable energy
Environment & Natural Resources – identifying the poor and where they live contributes to sustainable management of biodiversity and natural resources for the social safety net of the poor
Finance & Markets – for robust banking systems that give the poor access to bank accounts and loan services; companies are better able to identify their customers and banks and insurance companies will have the information they need to provide services
Gender – marriage and divorce registration contribute to women’s ability to inherit property, and to registering girls at birth and recording their marriages to help prevent early and forced marriage
Governance – forms the basis for the development, implementation and monitoring of government policies, programs, and services; provides the means of holding governments accountable for their policies, and determining the extent to which services meet economic and social needs
Health, Nutrition & Population – provides accurate vital statistics to monitor many global health targets, including new commitments to universal health coverage and tackling the global epidemic of non-communicable diseases.
Macro & Fiscal Management – provides database for a solid macroeconomic framework and improves the efficiency of resource allocation for ending poverty and boosting shared prosperity
Poverty – contributes to national systems for tracking poverty
Social Protection & Labor – for effective and efficient social protection programs for the poor
Trade & Competitiveness – for targeting the unemployed and for efficient taxation systems
Transport & ICT – provides database for digital IDs
Urban, Rural & Social Development – provides database for addressing the rural poor’s vulnerability and marginalization
Water – provides database for providing water and sanitation services to the poor