For individuals, documents from vital events such as birth, death, and marriage certificates are crucial to unlocking rights to education, access to healthcare, inheritances, and voting. For governments, information collected when these events are registered provide critical insights into their populations’ health and needs. This information also enables countries to measure their progress toward achieving many of the U.N. Sustainable Development Goals. Robust civil registration and vital statistics (CRVS) systems are the roots of good governance, yet today 40% of deaths and 25% of births of children under age 5 are still not registered.
The newly launched CRVS Systems Improvement Framework aims to help increase registration globally. The Framework offers governments a guide to examine their current CRVS processes, to identify gaps and to determine areas needing improvement, and address them. The goal is to broaden the equitable and inclusive coverage of registration, which will support individuals and also strengthen data and data use for more effective planning and priority setting by governments. This has become even more important during the COVID-19 pandemic.
We sat down with three of the Framework’s contributors, Martin Bratschi, Technical Director, at Vital Strategies; James Mwanza, Regional Deputy Director, Africa at Vital Strategies; and William Muhwava, Chief, Demographic and Social Statistics, African Centre for Statistics at the United Nations Economic Commission for Africa to learn more about this foundational document.
What is the CRVS Systems Improvement Framework? What inspired its creation?
The CRVS Systems Improvement Framework encompasses a package of materials developed to support countries in strengthening their CRVS systems. The new Framework includes all the elements of the previous version of the tool (called the Comprehensive Assessment), and adds a process-centric and iterative approach to assessing, planning, implementing and monitoring improvements in a country’s CRVS system. This innovative approach will significantly improve civil registration systems’ performance and support the generation of vital statistics data.
The Framework is a next-generation tool developed to improve CRVS systems. The Framework emphasizes a client-centric approach and focuses on improving business processes, or the chain of events, decisions, and activities, leading to the generation of vital statistics within the CRVS system.
The Framework enables governments to pinpoint weaknesses in their CRVS systems and provides guidance for sustainable solutions. This assessment is particularly useful in Africa, where CRVS systems are at different levels of maturity across the continent. The Framework serves to engage stakeholders and create ownership among governments, enabling leaders to coordinate in a way that minimizes CRVS system fragmentation.
What processes can be improved by using the CRVS Systems Improvement Framework?
Civil registration should be seen as a business that has both service providers and customers. The Framework ensures that both the engagement on the demand side outreach (people and communities) and the supply side (our registration offices and systems) are lean, efficient, and fit for purpose. The performance of the civil registration office depends on how well its business processes are designed and executed. The approach of measuring, analyzing, and redesigning business processes to accomplish significant performance improvement is known as business process improvement. The Framework helps governments work toward these improvements.
Through our experience supporting governments to improve their CRVS systems, including within the Blomberg Philanthropies Data for Health Initiative, we discovered how transformative it can be to analyze business processes in CRVS systems in the way laid out in the Framework . This encourages stakeholders to identify and understand gaps and undertake coordinated actions around the system’s very complex inter-agency processes. To harness the potential of business process analysis and develop a methodology on how to translate weaknesses into concrete steps toward improvement seamlessly, we teamed up with partners to build the CRVS Systems Improvement Framework.
Civil registration is made up of a series of processes by multiple government institutions. The CRVS Improvement Framework provides an end-to-end structured approach to understand the complexity of systems to solve some of the performance challenges needed to expand and accelerate CRVS improvement. It elaborates how to describe in a simplified way the processes within a CRVS system and to identify actions for improvement.
How has COVID-19 affected CRVS systems? How can countries use this Framework to maintain CRVS systems during and after the pandemic?
The pandemic has impacted civil registration services, including birth, marriage and death registrations. An assessment by the Economic Commission for Africa in mid-2020 shows that the pandemic affected almost 90 percent of Africa’s civil registration offices. Services have been disrupted or discontinued, and this has both short- and long-term effects on individuals’ rights to access services. It is imperative that during emergencies, civil registration systems continue to function because they are essential services. Countries in Africa need to develop disaster-resilient civil registration systems that can continue to operate under precarious circumstances. One way to do that is through developing and implementing digital civil registration systems. Countries with automated systems of registration had minimum disruptions as the online tools facilitate notification and registration of vital events as they occur, allowing for continuity. The CRVS Systems Improvement Framework can support countries with the improvement and digitization of civil registration processes.
COVID-19 has put a strain on many CRVS systems while at the same time highlighting the tremendous importance of these systems. The pandemic has illustrated the importance of total mortality and cause-of-death information, which only a fully functional and complete CRVS system can provide. At the same, time lockdowns have affected the performance of already strained systems – particularly those that require in-person interactions between individuals and the civil registrar. The pandemic has highlighted the importance of fully functional CRVS systems and shone a light on particular system challenges during the pandemic; the Framework provides the potential to revise systems overall and improve processes specifically to facilitate the civil registration of all events.
COVID-19 exposed the vulnerabilities of well-functioning civil registration systems and illustrated the need to build resilient CRVS systems that remain functional despite public health emergencies or other natural disasters. The Framework is a critical tool to help governments build resilient systems and track performance for continuous improvement.
How can governments apply the Framework to their existing CRVS systems?
Martin Bratschi & James Mwanza:
The Framework is a flexible guide that can be applied to provide value to any country regardless of their CRVS system maturity level. Countries in the middle of implementing improvement efforts will be able to use the Framework to continuously evaluate their current system’s performance. For countries in the planning stage of their CRVS improvement strategies, the Framework can be applied in full to assess, redesign, and develop strategic action plans. Additionally, the Framework can be used for individual components of a CRVS system—for example, the registration and certification of selected vital events—or the entire system overall.
How can the Framework help countries track and achieve progress toward U.N. Sustainable Development Goals (SDGs)?
Stronger CRVS systems and higher demand from communities for services are essential to achieve many of the Sustainable Development Goals (SDG) and other development commitments, such as the African Union Agenda 2063: The Africa We Want. These efforts strive for universal civil registration to generate vital event statistics for governmental planning and reporting. Complete, current and accurate civil registries foster good governance by ensuring equity, inclusiveness, and transparency in service delivery. The Framework can help countries develop CRVS systems that are capable of tracking progress toward these global and regional goals.
The Framework will support countries to strengthen their CRVS systems, all the way from the notification of vital events to the production of vital statistics (including on cause of death). This will help countries directly achieve SDG Target 16.9: “By 2030, provide legal identity for all, including birth registration,” as well as many other targets, such as achieving 80% death registration.
The CRVS System Improvement Framework will help CRVS authorities analyze and redesign existing CRVS processes and develop strategies and an action plan to improve the coverage and completeness of vital statistics, essential to monitoring SDGs. The same information will help governments implement development interventions that address critical issues identified as problems based on the SDG indicators.
The CRVS Systems Improvement Framework was developed in collaboration with experts convened by the Economic Commission for Africa’s Africa Programme for Accelerated Improvement of CRVS (APAI-CRVS). Vital Strategies co-led the development, working alongside APAI-CRVS, the IDCR Centre of Excellence for CRVS Systems, the Pacific Community and the Economic and Social Commission for Asia and the Pacific with support from the Bloomberg Philanthropies Data for Health Initiative.
To access The Framework, visit: http://www.vitalstrategies.org/CRVSFramework
To learn more about Vital Strategies’ Data for Health Initiative, please visit vstrategystage.wpengine.com/programs/data-for-health/ and follow us on Twitter @VitalStrat.
The Data for Health Initiative is a global effort supported by Bloomberg Philanthropies and the Australian Department of Foreign Affairs and Trade. It provides technical assistance to low- and middle-income countries worldwide to improve public health data systems at the national level, including improving civil registration and vital statistics systems, maximizing the use of data to enhance public health policymaking and decision-making, establishing and strengthening national cancer registries and more. Vital Strategies serves as an implementing partner.