“My name is Ali. (…) I was not registered until I reached the age of 16, when I realized how important it is. Without my birth certificate, I would have been deprived of my right to identity, my right to education, my right to travel and move locally and internationally, and my right to health”. Ali’s story is not unique to the Asia-Pacific region where 65 million children under the age of five still do not have their birth registered.
“Get every one in the picture” is the slogan embodying the Asian and Pacific Civil Registration and Vital Statistics (CRVS) Decade (2015-2024). It encapsulates the shared regional vision that by 2024, all people in Asia and the Pacific will benefit from universal and responsive CRVS systems, facilitating the realization of their rights and supporting good governance, health and development. To mark the midpoint of the Decade, over 400 participants including ministers, senior officials and stakeholders from 48 countries and 15 international and civil society organizations convened virtually for the Second Ministerial Conference on CRVS, 16-19 November 2021.
The conference celebrated the successes of the first half of the CRVS Decade and served as an interactive platform for identifying the remaining challenges as the region looks towards the second half and seeks to really get every one in the picture. Many diverse side-events were also organized by development partners, including the voices of children and youth, as well as experts focusing on innovations in CRVS.
The culmination of the conference was the adoption of the Ministerial Declaration, which lays out clear actions to achieve universal civil registration, with a particular focus on the critical role that strong CRVS systems play in ensuring resilience during times of crisis.
Stocktake at the midpoint: are we getting every one in the picture?
Birth registration has been rapidly increasing in countries which had low birth registration rates at the beginning of the Decade. Countries have used innovative approaches to ensure that every birth is registered, such as mobile registration campaigns and engagement of frontline workers in communities to increase access among hard-to-reach populations. Nevertheless, universal birth registration has yet to be achieved in the region. This remaining challenge was brought into sharp focus by the Joint Statement of Children and Youth; delivering a powerful set of recommendations advocating for strengthened and inclusive civil registration systems, so that all children can reach their full potential, starting with the right to birth registration.
Although death registration has improved, levels remain below birth registration, likely owing to fewer incentives to register deaths and the large numbers of deaths still occurring outside of health facilities. Furthermore, even when deaths are registered, a medically certified cause of death is often missing. The COVID-19 pandemic sharpens this last point, as more than ever, the quality of information on deaths and their causes have proven critical for assessing the true impact of a public health emergency and planning appropriate response measures.
Samira Asma, Assistant Director General of the World Health Organization, further reflected that “these last two years have been a tragic reminder of our inability to accurately count the human lives we lost during the COVID-19 pandemic.” Discussions during the Conference advocated for integrating verbal autopsy (a practical method for determining probable cause of death at the population level in places where CRVS systems are weak) into civil registration systems to provide information on all deaths, including those occurring without attendance of a medical practitioner.
Low rates of marriage registration across the region, coupled with varying legal definitions of marriage make it difficult to enforce legislation and track national targets to tackle the high levels of child marriage observed in parts of the region. Similarly, significant gaps also exist for divorce registration, which is critical for addressing gender-based violence and ensuring social protection.
The ‘Leave no one behind’ call of the 2030 Agenda for Sustainable Development was also a common theme throughout the Conference, as countries shared their considerable efforts to register the vital events of refugees, asylum seekers, internally displaced people and stateless populations. However, most countries still need to take additional actions to ensure civil registration coverage among all marginalized and hard-to-reach population groups.
What is the outlook for the second half of the CRVS Decade?
- The future is digital: fully digitized CRVS systems have the potential to streamline the collation and transfer of civil registration data; facilitating the production of accurate, complete and timely vital statistics.
- From cradle to grave, embracing a gender-sensitive, life cycle approach to civil registration to better assess population health risks and inequality at all stages of life.
- Prioritizing technical capacity-building to facilitate the production of vital statistics based on civil registration data.
- Maximizing the role of the health sector in reporting live births and deaths occurring in health facilities.
- Expanding the use of inequality assessments to identify existing barriers to civil registration and determine who is being left behind.