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Monitoring the Indicators of The Millennium Development Goals Through the Civil Registration and Vital Statistics System. CRVS in MDGs. Goal 4. Reduced mortality Under-five mortality rate Infant mortality rate Goal 5. Improved maternal health Maternal mortality ratio
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Monitoring the Indicators of The Millennium Development Goals Through the Civil Registration and Vital Statistics System
CRVS in MDGs • Goal 4. Reduced mortality • Under-five mortality rate • Infant mortality rate • Goal 5. Improved maternal health • Maternal mortality ratio • Proportion of births attended by skilled health personnel • Goal 6. Combat malaria and other diseases • Death rates associated with malaria • Death rates associated with tuberculosis
CRVS • Systems of Operations • Civil Registration • Administration and Management of Documents • Compilation and Analysis
Civil Registration Systemwho shall report • Birth: • hospital/clinic administrator, • attendant, • either parents, or • owner of the document, if of age
Civil Registration Systemwho shall report • Death: • hospital/clinic administrator, • attendant, • person who performed the burial rites, • nearest relative, or • any interested party who knew about the occurrence of the event
Civil Registration Systemwhom to report • 1975 / 1997 • The death shall be reported to the local health officer within 48 hours after death and the death certificate shall be forwarded to the local civil registrar concerned within 30 days after death for registration
CRVSFlow of Documents Health Officer Death/Fetal death Death/Fetal death (Within 48 hours) (Within 30 days) Registrant/ Informant/ Attendant/ NSO-CO 6th week after ref. mo. Birth (Within 30 days) Civil Registrar NSO-PO 10 days after reference month
Objectives To provide measures of: • G4 Reduce Mortality • Under-five mortality rate (UMR) • Infant mortality rate (IMR) • G5 Improve Maternal Health • Maternal mortality ratio (MMR) • Proportion of births attended by skilled health personnel (%SHP) • Goal 6. Combat malaria and other diseases • Death rates associated with malaria (CSDRM) • Death rates associated with tuberculosis (CSDRT)
Illustrative Example • Data source: • 2000-2004 vital statistics from CRVS • Projected population based on Census 2000 • Level of completeness of births and deaths based on 2000 (secondary data)
Methods • Factors in the estimation of IMR, UMR, MMR • adjusted number of births and maternal, infant and under five mortality data
Methods • Factors of other measures: • Unadjusted number of births by skilled health personnel: physician, nurse and midwife • Unadjusted deaths due to malaria and tuberculosis
Methods • Measures: • IMR = adj. [infant deaths / live births] * 1,000 • UMR = adj. [under five deaths / live births] * 1,000 • MMR = adj. [maternal deaths / live births] * 100,000 • %SHP = [birthsPNW / live births] * 100 • CSDRM = [deaths due to malaria / mid-year population] * 100,000 • CSDRT = [deaths due to tuberculosis / mid-year population] * 100,000
Results Secondary data
Results Secondary data
-3.5 -4.8 -4.8 -4.4
-3.0 -4.6 -5.0 -4.7
-3.0 -7.5 2.7 -9.0
3.6 0.9 0.8 1.3
-10.2 -16.2 -17.3 -27.2
0.2 -1.9 -3.6 -73.1
Conclusion/Recommendation • Some resulting estimates from CRVS can be used for MDG monitoring • More information from CRVS should be evaluated and provided to identify whom and where to focus interventions to fast track achievement of MDGs
Conclusion/Recommendation • Regular assessment of CRVS • Death certificate should be properly filled-up • By informant • By Health Officer • Insurance agencies shall require properly filled-up and registered death certificate
Conclusion/Recommendations • Enhanced interagency coordination to include commitment to improve civil registration, especially among entities involved in the accomplishment of certificates of death, registration of deaths and those requiring information on deaths