At the first Ministerial Conference on Civil Registration and Vital Statistics (CRVS) in Asia and the Pacific in 2014, governments committed to ‘Get every one in the picture,’ through strengthening CRVS systems and progress towards universal civil registration. Similarly, a central promise of the 2030 Agenda for Sustainable Development is ‘to leave no one behind.’ The only way we can get everyone in the picture or ensure no one is left behind is if vulnerable and marginalized people, including women and girls, are included. However, due to a lack of data, we do not know if they are being included. If groups such as these are not counted, vulnerable and marginalized people will remain invisible, thereby compounding the inequality they face.
The lack of reliable data hinders policies from targeting inclusion and inhibits us from assessing if policies designed to foster inclusive, sustainable development and reduce marginalization and vulnerabilities are working. Vulnerable and marginalized people need to be front and centre in any data collection.
COVID-19 has further highlighted inequalities, and the need for accurate, timely, granular, and reliable mortality data has become more critical than ever. Knowing where and how many people are dying is essential to tracking the impact of the virus. While seemingly straightforward, COVID-19 has exposed deep and widespread gaps in death registration systems in Asia and the Pacific, especially in low-income countries. Based on a recent Lancet Public Health article, we know that the pandemic is disproportionately affecting the most marginalized and vulnerable populations, as well as differential impacts by sex. We also know from the Knowledge Brief on Gender and CRVS that these people are the least likely to have their deaths registered and the cause of death recorded. Thus, we may never know the true impact of COVID-19 on mortality without understanding how inequality differentially affects death registration.
Recognizing the importance of the issue, countries in the region are assessing inequalities related to CRVS experienced by population subgroups (such as people living in rural, remote, isolated or border areas, minorities, indigenous people, migrants, noncitizens, asylum-seekers, refugees, stateless people, and people without documentation) as an implementation step in the Regional Action Framework (RAF) for the Asian and the Pacific CRVS decade from 2015-2024. The midterm review of implementation of the RAF showed that only a few countries had implemented inequality assessments despite commitments. Clearly, more support in implementing inequality assessments for CRVS systems is needed.
However, it is hard to assess the inclusion of those most at risk. The same factors that lead to their exclusion from CRVS systems place barriers to their inclusion in any assessment. These pervasive challenges are not amenable to any quick fixes. Nonetheless, just because something is hard does not mean it is not worth doing - quite the opposite. While many countries expressed willingness to undertake inequality assessments, guidance is lacking, and there is little uniformity or common understanding of what is involved. Difficulties are heightened in places where capacity is weak. Therefore, ESCAP launched the initiative ‘Let’s really get every one in the picture,’’ which seeks to support countries in conducting inequality assessments of CRVS systems. As an initial step, ESCAP recently held a three-seminar series on keytopics where gaps exist.
The first seminar looked at qualitative assessments based around the Bali Process Civil Registration Assessment Toolkit, designed to assess the civil registration of refugees, asylum-seekers, stateless persons and persons of undetermined nationality. Country experiences in piloting the toolkit were discussed as well as other qualitative assessments. The key message was that the pilots showed that qualitative assessments based on the toolkit were generating useful information, and the underlying methods and approaches of the toolkit could be expanded on to be relevant for other marginalized and vulnerable groups.
The second seminar examined secondary data sources such as surveys, censuses, or administrative data in inequality assessments. Experts shared their experiences and perspectives on the relative advantages and disadvantages of these different sources, the criteria for determining which source should be used, assumptions made, and how these sources might be improved to better assess inequality. For example, including a question in a census on birth or death registration could provide much-needed information, especially for smaller populations.
Finally, the third seminar explored indirect demographic methods which can be used in inequality assessments. These methods are used to produce estimates of the actual number of births and deaths compared to numbers registered. The experts discussed how these methods could be applied in low-capacity countries where it is often the only approach available. They also made recommendations on guidance, making implementation more straightforward, especially since these methods and approaches are often complex.
But the work does not stop there. The expert groups will continue developing clear and practical recommendations, guidance, and tools for implementing inequality assessments. Additionally, ESCAP is exploring ways to support implementing the ensuing recommendations in countries and assisting them in conducting inequality assessments and achieving their commitments outlined in the RAF. This work will fully embody the initiative - ‘Let’s really get every one in the picture.’
Photo credit: https://getinthepicture.org/sites/default/files/inline-images/Regional-Picture-Cover-Photo_1.jpg