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Civil Registration in Sultanate of Oman

Civil Registration in Sultanate of Oman. Its Development and Potential Implications on Vital Statistics. Dr. Medhat K. ElSayed. Objectives. Health System in Oman – Brief Development of Civil registration – birth and death notifications

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Civil Registration in Sultanate of Oman

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  1. Civil Registration in Sultanate of Oman Its Development and Potential Implications on Vital Statistics Dr. Medhat K. ElSayed

  2. Objectives • Health System in Oman – Brief • Development of Civil registration – birth and death notifications • Reporting on Vital Events before and after Civil registration • Status of Vital Events Data • Implications on Mortality & Fertility Estimates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  3. Health System in Oman • Total area is 309.5 thousands Km2 • 3% Plans • 15% Mountains • 82% Wadis & Desert • 8 Governorates / Regions (now 9) with 60 Wilayates (61) • 10 Health Regions (now 11) • Upper Middle Income • Total Government Expenditure millions RO 4469.8 (≈US$11,579.8 millions) • Per Capita GDP RO 5321.5 (≈US$13,786) • Total Health Expenditure 3% of GDP • Per Capita Health Expenditure RO 84 (≈US$214) Source: Monthly Statistical Bulletin, Ministry of National Economy, volume 18(4), April 30, 2007 Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  4. Health System in Oman … cont • Population is about 2.6 millions; of whom 1.9 millions are Omanis (27% Expatriates) • About 95% of enumeration areas are less than 1000 and present only 17.6% of the total Population Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  5. 80 + 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-09 0-04 10% 8% 6% 4% 2% 0% 0% 2% 4% 6% 8% 10% Males Females Health System in Oman … cont • Relatively young • 38.9% below 15 years of age • 11.9% below 5 yeas of age • Relatively high fertility • TFR 3.14 per women 15049 • CBR 24.75 per 1000 population • Low Death Rates • CDR 2.53 per 1000 population • Life Expectancy at Birth 74.3 years • IMR 10.28 per 1000 Live Births • Natural Increase Rate 2.2% • Expected to double in 30 years Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  6. Health System in Oman … cont • Public Health System • Government finance and provide health care and health services • Public health expenditure accounts for 80% of total health expenditure • Public inpatient services 98%, public dental services 41% and public outpatient services 81% • Government provides 93% of hospitals and 97.6% of hospital beds • Public health services has 78% of doctors 92.5% of nurses and 85% of other paramedics • Ministry of Health is the main health Care provider(49 H, 4549 B, 145 HC) • Other health care providers: • Armed Forces Medical Services (AFMS) (3 H, 260 B, 31 C) • Royal Oman Police Medical Services (ROPMS) (1 H, 48 B, 3 C) • Sultan Qaboos Hospital (SQUH) (1 H, 307 B, 1 HC) • Diwan Medical Services (Diwan MS) (1 C) • Petroleum Development Oman Medical Services (PDOMS) (9 C) • Private Sector (5 H, 732 C) H: Hospital, B: Beds, HC: Health Center, C: Clinics Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  7. Health System in Oman … cont • A modern state started with the Omani Renaissance in 1970 • Interests to document births and deaths started gradually after 1970 • During early 80’s age estimation for public employees • Age may not be accurate for a considerable proportion of people above the age of 25 years Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  8. Health System in Oman … cont • Estimates for fertility and mortality indicators were based on surveys and studies with indirect statistical methods and models • Events taking place were notified and certificates issued but no compulsory registration • Public Health Institutions: Issue certificates • Private Health Institutions: Notification of event to MOH • Home events: Notification of event by community leader (Sheikh – Wali) to MOH • Well established information system capturing service events • Deaths: hospital deaths, dead on arrival, A&E deaths • Births: hospital births, born before arrival Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  9. Health System in Oman … cont • Coverage of events registered could not be properly assessed • Estimates could not be segregated by important parameters as age and sex • Mortality Estimates • Age –sex specific death rates to allow for a life table analysis • Infant mortality Rate, Under 5 mortality Rate • Life expectancy • Fertility Estimates • Age specific fertility rate for male and female births separately to allow estimating reproduction rates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  10. Mortality Estimates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  11. Fertility Estimates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  12. Development of Civil Registration • A Royal Decree (66/99) to develop a civil status was made in October 1999 but implementation took place only in May 2004 • The law has established the Directorate General of Civil Status (DGCS) at Royal Oman Police (ROP) • Develop the implementing regulations of the Law • Register civil status events • Events: birth, death, marriage, divorce, citizenship, residence • Issue certificates • Issue ID Cards Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  13. Notification of Births and Deaths • Registration is based on notifications of events • Establishment of a System of notification of vital events • Identification of all possible sources of notifications • One notification system • Birth & Death Notification Forms :Consider requirements of CS Law and health sector • Notification path • Birth and Death Notification forms were developed by a body established by Minister of Health • Notifications considered needs: administrative needs, health needs Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  14. Notification of Births and Deaths … cont Possible sources of Notifications Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  15. MOH SQUH AFMS Prvt HI ROPMS C L O M Copy of notification forms from places other than MOH Client DG CS Flow of Notifications Notification of Births and Deaths … cont MOH: Ministry of Health; AFMS: Armed Forces Medical Services; Prvt HI: Private Health Institutions; ROPMS: Royal Oman Police Medical Services; CL: community leaders; OM: Omani Missions Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  16. Assessment of 2006 Data from Vital Events Notification • Missing segregation information • Pattern according to age • Completeness (coverage) Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  17. Assessment of 2006 Data from Vital Events Notification … cont Segregation of information Gender unknown for 30% of notified deaths Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  18. Assessment of 2006 Data from Vital Events Notification … cont Segregation information … cont Unknown age of notified deaths Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  19. Assessment of 2006 Data from Vital Events Notification … cont Segregation information … cont Sex of newly born un reported Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  20. Assessment of 2006 Data from Vital Events Notification … cont Segregation information … cont Un-reporting age of mother for newly born Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  21. Assessment of 2006 Data from Vital Events Notification … cont Pattern according to Age and Sex Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  22. Completeness or Coverage Assessment of 2006 Data from Vital Events Notification … cont Using Brass’s Growth Balance Method (preliminary analysis) Males Coverage 98% Females Coverage 97% Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  23. Mortality Estimates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  24. Mortality Estimates … cont Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  25. Fertility Estimates Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

  26. Obstacles and challenges • Notifications by Community Leaders • Need to assess completeness • Data on notification forms need to be completed especially health related data • Cause of death is an issue to consider • Burial permit • No burial permit is required • Can affect completeness of death registration • Cultural believes and attitudes for registration • Age estimation has been practice for a long time • Changes in believes about importance for registration • Cause of death data • Physician and coders need training • Deaths outside health facilities: DOA, A&ED, Notified by CL Gender Statistics from Administrative Data: Civil Registeration & Vital Statistics

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