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MCN. American Journal of Maternal/Child Nursing. 2010 Jan-Feb; 35(1):63.The purpose of this article is to describe recent initiatives designed to improve outcomes for Bolivian women and children. It discusses the high infant and maternal mortality rates of Bolivia and stresses the importance of the international community partnering with the Bolivian government and healthcare personnel to provide support and assistance in a coordinated fashion to make a difference in the health and well-being of women and children.
Lancet. 2007 Nov 24; 370(9601):1744-1746.The four papers in this Series called Who Counts? describe the state of the world's vital statistics, and the fact that few countries derive these from routine compulsory measures through civil registration. However, every country in the world has the capacity to produce useful economic data. Because of its particular interest in, and requirements for, demographic and epidemiological data, the health sector should raise similar expectations of national capacity to produce vital statistics. Unrepresentative, biased, incomplete, and often out-of-date, the world's vital statistics compare poorly with the detailed information available on every country's economy. The effort and expense of gathering and interpreting data on national income and trade balances are accepted costs of monitoring economic prospects in an international market. Health is arguably as important as economics, and establishing their mutual interdependence has made a big difference to the funding and attention that health attracts.Sen proposes mortality as an indicator of economic success or failure, but many countries are still making patchy and incomplete efforts to count lives and deaths, and to document how their people die. (excerpt)
New York, New York, UNICEF, 2005 Feb. 32 p.The objective of this study is to present available empirical evidence obtained through household surveys in order to estimate levels of registration and to understand which factors are associated with children who obtain a birth certificate, and thus realize their right to a name and legal identity. The paper presents a global assessment of birth registration levels, differentials in birth registration rates according to socio-economic and demographic variables, proximate variables and caretaker knowledge, as well as a multivariate analysis. Statistical associations between indicators regarding health, education and poverty can reveal potential linkages in programming to promote the registration of children. By analysing levels of birth registration in the context of other health, education and poverty indicators, the study points to opportunities to integrate advocacy and behaviour change campaigns for birth registration with early childhood care and immunization. By linking birth registration to early childhood programmes, a legal hurdle can become a helpful referral to promote improved health, education and protection for disadvantaged children and their caretakers. (excerpt)
The progress of nations, 1998. The nations of the world ranked according to their achievements in fulfillment of child rights and progress for women.
New York, New York, UNICEF, 1998.  p.The Progress of Nations is a clarion call for children. It asks every nation on earth to examine its progress towards the achievable goals set at the World Summit for Children in 1990 and to undertake an honest appraisal of where it has succeeded and where it is falling behind. This year’s report highlights successes attained and challenges remaining in efforts to register each child at birth, to immunize every child on earth and to help adolescents, particularly girls, as they set out on the path towards adulthood. With its clear league tables, The Progress of Nations is an objective scorecard on these issues. Commentaries by leading thinkers and doers stress the need for an approach to development based on child rights, calling on governments to fulfill the promises they made in ratifying the Convention on the Rights of the Child. The Progress of Nations reminds us annually that rhetoric about children must be backed up with action. I would commend it to anyone concerned about the status of our most vulnerable citizens. (excerpt)
POPULATION AND DEVELOPMENT REVIEW. 1998 Sep; 24(3):659-64.Choosing the topic of birth registration as one of the main themes addressed in its recent report "Progress of Nations 1998," UNICEF presents a well-reasoned argument about why such registration is important, offers a critical description of the deficiencies of birth registration in developing countries, and calls for improvement. Although the quantitative assessment of the degree of completeness of birth statistics is difficult to accomplish when a large percentage of births remain unregistered, UNICEF's report concludes that approximately 40 million births per year are not registered. This means that about one-third of all births go unregistered. Excerpts of the report are presented. The first section of the paper discusses the deficiencies of birth registration and presents UNICEF's rough regional and country estimates of the incompleteness of birth registration. The second section consists of an excerpt from an incisive commentary on the topic by Unity Dow, a High Court judge in Botswana.
AFRICA HEALTH. 1998 Jul; 20(5):39.This brief article voices a concern about unregistered births and the recent decline in immunization coverage, especially in developing countries. A recent report by UNICEF, "The Progress of Nations, 1998" reports that 1 in 3 newborns, or about 40 million births, are unregistered. Some developing countries lack a registration system. UNICEF is concerned about unregistered births because of the implications for receipt of services. In Kenya, for example, unregistered children may not be eligible for immunization. In the past 20 years, immunization coverage rates have increased from 5% to 80%. This progress may be further improved with the possibility of vaccine coverage for diarrheal diseases and acute respiratory infections. It is predicted that soon it may be possible to save the lives of 8 million children yearly. However, there is a declining trend in immunization at a time when new vaccines are about to enter the market. In addition, 2 million children's lives could be saved if every child were vaccinated. Only 50% of the children in sub-Saharan Africa receive immunization against diphtheria, whooping cough, and tetanus. Measles kills over 800,000 children yearly, but measles immunization is often not performed. Measles immunization varies widely by country in Africa. In Uganda, all children are vaccinated against measles, while only 20% in Kenya are protected against measles. In developed countries, only 89% of children in the US were vaccinated against measles. Adults need vaccination against hepatitis B, which kills about 1 million/year. Yellow fever is reoccurring in Africa and Latin America.
The Kenya Civil Registration Demonstration Project (CRDP): a strategy for a rapidly developing country in Africa.
Nairobi, Kenya, Dept. of the Registrar-General, . xxiv, 568 p.Compulsory registration of births and deaths of all ethnic groups in Kenya began with independence in 1963. Nevertheless only 42% of all expected births and 22% of all expected deaths were being registered by 1979-1980. Recognizing the shortfalls, the Kenyan government began its Civil Registration Demonstration Project (CRDP) with the help of UNFPA in 1981. After the establishment of working committees and tours of targeted areas, the Committee for Improvement of the Registration System (IRS) established the head office in November 1981. It also devised a plan to address the issues of field organization and operations, registration of documents, registration processes, training of CRDP staff and personnel from other ministries, management, evaluation, and statistical data processing. The Committee for Civil Registration Enlightenment Campaign (CREC) set the strategy to secure the cooperation of both adults and primary school children (via its Civil Registration Education Programme) by launching a media campaign and introducing incentives to get people to register births and deaths. To reach all the population, CRDP enlisted the help and cooperation of all ministries. For example, assistant chiefs (employees of the Provincial Administration), village leaders (e.g., village elders and traditional birth attendants), and health personnel (employees of the Ministry of Health) reported and completed registers of birth and death within each smallest administrative unit. They did this along with performing their normal duties. To establish and efficient registration system, staff randomly selected demonstration districts to test the 2 schemes (those of IRS and CREC), and upon successful completion of the experiment, other districts would be added over a 7-10 year period.
Report on the evaluation of UNFPA assistance to the civil registration demonstration project in Kenya: project KEN/79/P04.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Dec. xi, 36 p.Kenya established a compulsory vital statistics and civil registration system in 1963 and it was extended nationwide in phases until it covered the whole country by 1971. Serious under-registration of births and deaths however, has persisted. In order to improve registration coverage, the government submitted a proposal to UNFPA to support experimentation with ways to promote registration in some model areas. The original project document included 4 immediate objectives: the strengthening of the civil registration system in the model areas including the creation of a new organizational structure, the training of project personnel and the decentralization of registration activities; the improvement of methods and procedures of registration through experimentation; the collection of reliable vital statistics in the model areas; and, the establishment of a public awareness program on the need for civil registration to ensure the continuation and extension of the new system. Of the 4 objectives of the project, 2 have been achieved--the strengthening of civil registration in the model areas and the improvement of methods and procedures of registration. The major deficiency during the project period was the lack of required staff in the field. The primary feature which distinguishes the project is that traditional birth attendants and village elders become key persons at the village level and act as registration informants after receiving training. The strong points of the project are the high quality of technical assistance provided by the executing agency, the close collaboration among various government departments, and the choice of project strategy and model area. Recommendations have been made to correct the problems of a lack of key personnel at the head office and in the field, and the expansion of registration to new areas before consolidation was completed in the old areas.
Report on the evaluation of UNFPA assistance to the strengthening of the civil registration and vital statistics system in Sierra Leone: project SIL/79/P03.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Dec. x, 28 p.While Sierra Leone has a long tradition in registering births and deaths, dating back to the mid-1880s, registration has remained low. In order to improve registration coverage, the original project formulated in 1979 by the government included 3 immediate objectives; the strengthening of the civil registration system in a model area, the experimentation with field organization procedures most suitable for the registration system in the country, and the production of estimates of demographic variables in the model area and in the rest of the country. In the Tripartite Project Review held in 1981, 2 additional objectives were added to the project; the unification of the civil registration laws, including the provision of a uniform and universal legislation for the entire country, and the reorganization and training of the registration hierarchy. While the strategy to use a model area for the development was a sound one, without the law being enacted, new forms and registers could not be printed and thus few of the planned activities could take place. Of the 5 immediate objectives of the project, only one has been achieved--the passage of the Act of 1983 which provides the legal framework for registration to take place nationwide under the new system. Little progress has been made in the achievement of the 4 remaining objectives. The Evaluation Mission made recommendations concerning the need to reformulate the extension document early in 1985, taking into account the results of the Evaluation Mission, the concentration of government action on registration in the non-model areas, and thereafter the gradual expansion of registration to adjacent areas where more complete coverage is possible.