Systems Strengthening

As part of the Bloomberg Philanthropies Data for Health Initiative, we have partnered with over 30 governments to strengthen civil registration and vital statistics systems so every birth, death and cause of death is counted, which provides countries with better data to make better decisions.

CRVS Systems Improve Lives, Public Health and Governance

Strong CRVS systems provide legal identity, protect rights and generate the data governments need for effective policymaking and public service delivery.

Civil registration and vital statistics (CRVS) systems record key life events such as births and deaths, and generate vital statistics that governments rely on for planning and policymaking. Birth registration establishes legal identity and helps individuals access health and social services, education, and social protection, and protects their legal rights. Death registration and cause-of-death data help governments understand population health trends, respond to emerging threats and allocate resources effectively.

Yet globally, millions of births and deaths still go unrecorded each year, and many registered deaths lack reliable cause-of-death information. Incomplete or fragmented systems can leave vulnerable populations invisible and limit governments’ ability to make evidence-based decisions.

Strong CRVS systems are increasingly recognized as foundational to digital public infrastructure, linking health systems, national identification, statistics and public administration. When designed effectively, these systems support more inclusive governance, stronger public health systems and better service delivery.

Country-led Systems Sustain CRVS Improvement

Our approach to CRVS systems strengthening is rooted in a commitment to government ownership and leadership, long-term capacity building, capacity strengthening. sustainability and locally tailored technical assistance. We work across sectors — including health, civil registration, statistics, digital government and national identification systems — to help countries strengthen both the registration of vital events, and the production and use of high-quality data and vital statistics.

We support countries to identify their own priorities, assess system gaps and design practical solutions that reflect local context, including governance structures, digital maturity and public health needs. This includes strengthening coordination and collaboration across multiple stakeholders, improving compatibility between systems, supporting digital transformation, building workforce capacity and improving the quality and use of birth, death and cause-of-death data.

The Ingredients for Impact

We rely on over a decade of experience across the full CRVS ecosystem — from governance and registration systems to cause-of-death data, interoperability and the production and use of vital statistics.

Different ministries and agencies often collect overlapping data without talking to each other. We help by:
- Establishing or strengthening bodies that coordinate work across agencies.
- Improving system business processes.
- Supporting legal and regulatory review and reform.
A country can’t act on data it doesn’t have. We help governments count every life by:
- Linking the health sector and civil registration authorities to increase reporting of vital events.
- Including socially or economically excluded populations, who are the most likely to go uncounted.
- Designing and scaling up improved, digitized birth and death registration and compatibility of systems.
When a death happens in a hospital or clinic, the cause recorded needs to be accurate and comparable across facilities and countries. We help by:
- Supporting countries to adopt the international standard medical certificate of cause of death.
- Supporting the transition to ICD-11 (the International Classification of Diseases — the World Health Organization’s global standard for coding cause of death).
- Providing multimodal cause-of-death certification and mortality coding training.
- Promoting sustained quality control of ICD-coded mortality data.
Many deaths happen outside health facilities, in cases where no clinician ever assigns a cause. One solution is verbal autopsy — trained interviewers asking a family about the symptoms and circumstances before a death — helps fill that gap. We help by:
- Introducing, institutionalizing and scaling WHO’s automated verbal autopsy method.
- Integrating verbal autopsy data with civil registration and health information systems.
- Sustaining quality control of verbal autopsy data.
- Exploring new methods to determine cause of death for deaths that occur in the community.
Deaths from injury, violence or other external or suspicious causes require careful, accurate and standardized documentation. We help by:
- Comprehensively assessing this system, including legal and regulatory review and business process mapping.
- Strengthening medical-legal death investigation reporting systems — the systems coroners and forensic examiners use — to capture and certify all “unnatural” deaths and support their reporting in civil registration and health information systems.
Data only matters if it reaches the people making decisions. We help by:
- Producing and using vital statistics reports, including causes of death, for planning and policymaking.
- Training in Data to Policy, CRVS data journalism and leadership communication, in partnership with Vital Strategies’ Data Impact Program.

Using Systems to Guide Reforms

Our CRVS Systems Improvement Framework guides country-led reforms. The framework helps governments assess existing systems, prioritize interventions, and build sustainable approaches to registration, mortality data, compatibility and data use.

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