Civil registration and vital statistics systems
Civil registration provides important public health information through universal recording of the vital events and legal requirements of a country, such as births, deaths and changes in marital status.
The civil registration system has a number of advantages over other methods of obtaining vital statistics. Critically, it provides universal and continuous registration of vital events, enabling the routine production of vital statistics at all geographic levels essential for monitoring health outcomes. Because the resulting statistics are a by-product of an administrative process, civil registration is relatively inexpensive to maintain.
Although the primary purpose of civil registration is the establishment of legal documents required by law, the system generates continuous data on births and deaths at all levels of a country – national, regional, district and subdistrict. In addition to crucial information on vital events (births and deaths), the civil registration system may also be able to supply additional data, for example on:
- birth weight
- place of delivery (home, maternity centre or hospital)
- medical assistance during childbirth
- maternal age and parity
- medical attention received prior to death.
When civil registration of deaths is coupled with medical certification of cause of death using the principles and standards set out in the International statistical classification of diseases and related health problems, it is possible to generate accurate and timely data on causes of death in the population.
Such information permits the study of mortality differentials by age and sex and other stratifiers, and provides the key input for constructing life tables and estimated probabilities of death at various ages. Information on the number of live births over time, classified by maternal characteristics, is essential for analysing reproduction dynamics. The vital statistics generated through the civil registration system enable regular updating of population size and structure, which are the denominator data needed to calculate population indicators.
In the absence of functional civil registration systems, data on births and deaths can be generated through alternative strategies, including household surveys (for births and child deaths), the census, or demographic surveillance.
For the majority of the countries in the WHO African Region, the reported birth registration rate is calculated on the basis of mothers’ responses to questions in household surveys about their most recent births; it is likely that the true coverage for the general population is much lower.
With regard to mortality data (see figure), of the 46 countries of the Region, only four – Algeria, Mauritius, Seychelles and South Africa – have coverage rates of 75% or higher.