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Vital registration in South Africa

Vital registration in South Africa. Angela Smith. Global HIV/AIDS Surveillance Meeting, Bangkok 4 March 2009. Outline. Introduction to vital and civil registration Vital registration in Africa Vital registration in South Africa History Current situation and challenges

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Vital registration in South Africa

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  1. Vital registration in South Africa Angela Smith Global HIV/AIDS Surveillance Meeting, Bangkok 4 March 2009

  2. Outline • Introduction to vital and civil registration • Vital registration in Africa • Vital registration in South Africa • History • Current situation and challenges • Examples of data use • Summary and conclusions

  3. Vital registration • All sanctioned modes of registering individuals and reporting on vital events, including complementary systems not part of a formal registration system and not producing legal birth/death certificates.

  4. Civil registration • Continuous, permanent, compulsory, universal recording of the occurrence and characteristics of vital events in a population as provided by decree/law/regulation in accordance with legal requirements in each country, and establishing and providing legal documentation of such events.

  5. Components of civil registration systems • Law • Incentives • Personal • National • Infrastructure • Central • Peripheral

  6. Vital registration in Africa Mathers CD, Ma Fat D, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Org 2005;83:171-7.

  7. Civil registration in Africa Setel PW, McFarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, AbouZahr C. A scandal of invisibility: making everyone count by counting everyone. Lancet 2007; 370: 1569-77 .

  8. History of civil registration in SA • 1992 – Promulgation of new law: Births and deaths registration act 51 of 1992 • 1996 – consultation with stakeholders (DoH, DHA, StatsSA) • 1998 – New notification form instituted (WHO standard); training and information dissemination done • 1999 – evaluation of new form • 2005-8 – publication of statistics

  9. Current status of civil registration in South Africa Achievements: Challenges: • National coverage of death reporting • +/- 80% completeness • ICD-10 coded cause of death data • 2½ year lag time • Published statistics freely available • Completeness less than optimal, although has improved • Poor quality cause-of-death data • Data available only down to provincial level, not district

  10. Current status of civil registration in South Africa Strengths: Weaknesses: • Co-operation between involved departments • Good initial training and information dissemination • Lack of follow-up after initial assessment • Lack of continued monitoring and training

  11. Mortality vs ARV coverage in SA

  12. Summary • Existing infrastructure can be used as framework for implementation of civil registration • Stakeholder involvement NB • Development is continuous process • Even limited data has value for surveillance purposes – implications for phased civil registration system implementation

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