Evaluating the Completeness of the Civil Registration System

1. Evaluating the Completeness of the Civil Registration System

2. Civil registration – Quality control • Level of registration completeness - All local registration areas carried the procedures - Every vital event has a record on the system - All local offices transmit the records up the ladder

3. Direct methods • Direct methods • Matching – Using civil registration records as independent source • Matching – Using administrative and social records • Matching – Using population censuses and surveys lists • Dual records system

4. M1. Civil registration records as independent source • Evaluating birth register using death register • Consists of matching the death record with the birth record • Up to 30 years of age • Not really a good measure – mobility of population • Useful for infant deaths • Accuracy increases if births occur in medical facilities

5. M1. Civil registration records as independent source • Hand matching • If the number of infant deaths is small • If both events (birth and death) occur in the same health facility • In the local registrar office, given the small numbers, a feasible option

6. M1. Civil registration records as independent source • Electronic matching • Fast, effective approach • Having a PIN - advantage • Requirements • Computerized records • Developing applications • Hardware

7. M1. Civil registration records as independent source • Edit method • Identify, for example, record with low birth-weights • Match with death record • If not found, check with the facility to confirm child is alive

8. M2. Administrative and social records • Involves other organizations • Matching birth and death records with: • School enrolment • Hospital records • Baptism • Burial records • Newborn screening programs • Reporting of HIV

9. M3. Population census and survey records • Lists of births and deaths • Census enumeration areas • Census questions • Matching with civil registration records

10. M4. Dual record system • Matching civil registration system (CVS) and periodical retrospective survey (PRS) • When information from two sources are matched, four mutually exclusive sets of records emerge: • Events recorded by both exercises • Recorded by CVS but not PRS • Recorded by PRS but not CVS • Not recorded by either source:

11. M4. Dual record system • Not recorded by either source: • N=C+N1+N2+((N1xN2)/C) • Where • C = the number of vital events recorded by both methods • N1= the number of events recorded by the first method but not the second • N2= the number of events recorded by the second method but not the first • Thus, the events omitted by both: • Y=((N1xN2)/C)

12. Advantages and limitations of direct methods • Advantages • Two sources for matching • If both are quality sources and independent – accurate • Pointing to the cause • Feasible at all levels • Limitations • Really independent? • Population movements undermine accuracy • Costs

13. Indirect methods • These methods were developed to assess the completeness and quality of vital statistics • Statistics is coming from civil registration • Statistics of low quality  most likely consequence of errors in registering events • Comparison of trends

14. Indirect methods • These methods were developed to assess the completeness and quality of vital statistics • Statistics is coming from civil registration • Statistics of low quality  most likely consequence of errors in registering events • Comparison of trends • Delayed registration • Patterns in the sex ratio of births • Comparison with census data • Comparison of rates observed in similar population or previous periods • Incomplete data methods: indirect techniques

15. Comparison of trends • At small area level • Expected values established by previous trends • Unexpected current values • Large proportion of “unknown” answers

16. Delayed registration • Monitoring difference between date of occurrence and date of registration • % of events not registered in prescribed period of time – indicator of possible deficiency • Excessive proportion of delayed registration in health facilities indicates overburden – inadequate infrastructure

17. Comparison with census data • Quality of the census itself • Census content • If all basic components of population are accurately captured by census – birth, deaths, immigrants, emigrants, then • Intercensal population growth of population equals the sum of intercensal births and immigrants minus intercensal deaths and emigrants • Major obstacle – reliable migration statistics

18. Comparison of rates • Useful, but requires caution • Many factors, not necessarily linked to registration errors • Differences in age structures • Population estimates • Skewed population

19. Indirect techniques • Technical approach • Long history of use • Complex • Require specific training

20. Summary • Checks and balances - crucial • A list of techniques • Best approach – a combination of direct and indirect assessment • Computerization increases checking opportunities