Country Experiences in Civil Registration Systems Development Health Metrics Network/ World Health Organisation

Transcription

1 1 Country Experiences in Civil Registration Systems Development Health Metrics Network/ World Health Organisation DATE: 1 8 TH- 19 TH MARCH, 2009 G ENEVA G HANA S SITUATION P R E S E N T E D B Y K I N G S L E Y A S A R E A D D O

2 Birth Registration Process Live Births occurring in Hospitals/Health Facilities Public Hospitals Private Hospitals Clinics Maternity Homes Medical Certification ( Road to Health Card) (Doctor/Midwife/ Child Welfare Clinic) 2 PARENTS/ RELATIVE BIRTHS AND DEATHS REGISTRY (Birth Certificate) GHANA STATISTICAL SERVICE Live Births Occurring outside Health Facilities Home TBA Others PARENT/RELATIVE CHN CV Abandoned Children Police Social Welfare Children s Home

3 Death Registration Process Deaths occurring in Hospitals /Health facilities Public Hospitals Private Hospitals 3 Medical Certification (Medical Certificate of Cause of Death) Clinics (Doctor) RELATIVE Cemetery (Burial Permit) BIRTHS AND DEATHS REGISTRY Ghana Statistical Service Deaths occurring outside health facilities Home Police Coroner RELATIVE (Coroner s Inquest Report) Others Community Volunteer Cemetery

4 Result of Rapid Assessment Test Thematic Area Score Interpretation Overall Assessment of system Legal Framework 5 Registration Infrastructure and resources 7 Organisation and functioning of vital statistics system 6 Coverage and Completeness of registration 3 Data Storage and transmission 6 ICD-compliant practices and certification in and outside hospitals 4 Practices affecting the quality of cause of death 3 ICD coding practices 3 Coder qualification and training, and quality of coding 2 Data quality and plausibility checks 1 Data access and dissemination 4 Total 44 Poor Numerous aspects of system need to be improved 4

5 REGION POPULATION (2000 POPN. CENSUS) The Staff Situation NO. OF REGISTRIES NO OF STAFF ADDITIONAL STAFF REQUIRED ALL REGIONS 18,912, H/ OFFICE WESTERN 1,924, CENTRAL 1,593, GT. ACCRA 2,905, EASTERN 2,106, VOLTA 1,635, ASHANTI 3,612, B/AHAFO 1,815, NORTHERN 1,820, U/EAST 920, U/WEST 576, NO. OF VEHICLES

6 Registered birth (0-12 months only) REGION POPULATIO N EXPECTED BIRTHS REGISTERED BIRTHS % COVERED ,912, , , ,422, , , ,947, , , ALL REGION S ,485, , , ,038, , , ,606, , , ,190, , , ,789, , , ,404, ,355 6

7 Trend of infant birth registration(0-12 months only) 7 Registered Births 0-12 months , , , , , , , , , , , , , , , , , , , , , , , , , EXPECTED BIRTHS REGISTERED BIRTHS

8 REGISTERD DEATHS IN GHANA YEAR POPULATION EXPECTED DEATHS REGISTERED DEATHS % COVERED ,912, ,422, ,947, ,485, ,038, ,606, ,190, ,789, ,894 54,

9 No of Deaths Trend of Registered Deaths in Ghana 9 Trend of Registered Deaths , , , , ,000 50, YEAR Expected deaths Registered deaths

10 Major success factors: Building partnerships Public education and sensitization Capacity building i 10

11 challenges Major challenges include: Low utilization of vital statistics for policy decisions Limited Access to registration facilities Low public knowledge about importance of registration Inadequate staff Inability to attract and retain highly qualified personnel due to low remuneration and poor service conditions Inadequate funding for the Registry, Difficulty in motivating registration volunteers Lack of logistics including accommodation, vehicles, requisite statistical software and programmes. Absence of training opportunities for sector staff Weak monitoring and supervision mechanisms. 11

12 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION MINISTRY OF LOCAL GOVT. RURAL DEV. &ENVIRONMENT GHANA STATISTICAL SERVICE GHANA HEALTH SERVICE CENTRE FOR HEALTH INFORMATION MANAGEMENT MOH, HMN PROGRAMME MIDWIVES/TBAs Policy issues, Technical guidance, supervision Technical support, Analysis of data collected, Training CHNs- Notification of births, assist with data collection Medical Officers- Collect and complete Medical Certificate of Cause of Deaths from BDR Annual CHPW, IMCH campaigns Accommodating Births &Deaths registration offices in all health facilities Analysis of Medical Certificates of Cause of Deaths Technical and logistic support Improve generation of mortality statistics Pilot of verbal autopsy system Notification of births /deaths 12

13 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION Passport office/national Identification Authority/SSNIT/Electoral Commission/ DVLA GHANA EDUCATION SERVICE UNICEF demand birth/death certificates to access services Make birth certificate enrollment requirement right from KG to tertiary level Technical and logistic support, advocacy PLAN GHANA Technical and logistic support, advocacy EMBASSIES MINISTRY OF PUBLIC SECTOR REFORM MINISTRY OF WOMEN AND CHILDREN S AFFIARS/DEPT OF CHILDREN Technical and logistic support. Birth/death cert. requirement to access service Verification of documents with BDR Logistical support, assist to improve service delivery, support computerization programme Advocacy, sensitization of public, Dissemination 13

14 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION GIS/AENEAS PROGRAMME DEPARTMENT OF SOCIAL WELFARE CHRISTIAN COUNCIL/ISLAMIC COUNCIL Cooperate to counter document fraud Logistic support, Training, support for computerization On legal issues concerning adoptions, registration of abandoned children etc Public education GHANA POLICE SERVICE SEXTONS LA/ OSU/ AWUDOME CEMETERIES LOCAL GOVT AUTHORITY (DISTRICT ASSEMBLY) Registration of unnatural deaths Coroner inquest cases Deaths occurring outside medical facilities Collect and use Burial Registers Demand Burial Permits before burial Submission of burial returns to Registry Registration of all burial grounds Control of burial grounds PRIVATE FUNERAL HOMES Demand proof of registration before 14 release of corpses.

15 15 THANK YOU MERCI SANTE ME DAA SE