The status, challenges and opportunities of civil registration and vital statistics in Ethiopia: a systematic review

INTRODUCTION

Civil registration is a process by which major vital events, such as births, marriages, divorce, deaths and cause of deaths of citizens is recorded. It is taken place pertaining to the population as provided through decree, law or regulation in accordance with the legal requirements of a country.¹

It is intended primarily for the sake of forming the lawful documents delivered by the law. These records are the best foundation of vital statistics because they produce information on a constant basis and for the entire country, at all levels. Complete coverage, accuracy and timeliness of civil registration are essential for quality vital statistics.² In most countries, a civil registration system is used to record statistics on vital events such as births, deaths, marriages, divorces and fetal deaths. The records derived from civil registration systems have a lot of advantages. Such documents are personal legal documents required by citizens as proof of facts (e.g., age and identity) surrounding events and are used to establish family relationships and inheritance rights, provide proof of age and establish rights based on age (e.g., school entry, driving privileges), provide proof of marriage or divorce and the right to marry and provide evidence of death.³

Vital statistics systems also derive the vital demographic and epidemiological actions that are required in determining the planning of policies and programs in multiple sectors, such as education, labour and health of a nation.⁴ Then again, these systems are the basis of a country’s health information system. If there is a lack of accurate information regarding the number of births, deaths, marriage, divorce, cause of deaths in sex and age group, it is challenging to attain real improvement towards the ultimate goal of any health system, which is to enable individuals to stay alive and healthy for longer. Thus, it is possible to track the strategies such as health-sector reform, poverty reduction and development efforts; and assist planning, monitoring and evaluation in dispersed health systems of a nation, by giving updated information on health conditions at various levels of the health care system.⁵

The sustainable development Agenda 2030 adopted by the world heads of states in 2015 implicitly recognizes the importance of civil registration and vital statistics (CRVS) systems. Without these systems, it is almost impossible to eliminate poverty and hunger in each corner of the world; to struggle disparities within and among nations; to bring peaceful and inclusive societies and to guard human rights that we initiate no one will be left behind. Therefore, It is only through building feasible, collective and inclusive CRVS systems that we can really eliminate the humiliation of inconspicuousness and make certain that no one is left behind.⁶ Recently, attention is being given to strengthen CRVS and a number of universal and regional initiatives are leading by development organizations in co-operation with non-governmental institutions, academia and the supporter community. Countries are progressively taking action to strengthen their CRVS systems, with initiatives from United Nations agencies, WHO, health metrics network (HMN), the pan American health organization (PAHO), secretariat of the pacific community, and the health information systems knowledge hub at the university of Queensland (HIS Hub).⁷

Civil registration is not new in Africa. The system and practice dates back to colonial period. It was a substantial project in several colonial African states. The colonial governments efficiently employed data from civil registration and statistical to rule their various territories. However, the trend was changed during the post-independent era in most of the African union member states.⁸ Currently, many countries cannot draw upon a reliable and continuous flow of accurate vital statistics and their CRVS systems are weak or dysfunctional. Millions of people in Africa are born and die without leaving any trace in legal records or official statistics.⁹ Such systems are often weak or incomplete in these countries.¹⁰ To tackle development obstacles in Africa, a well recorded civil registration, vital statistics and effective public sector control and service provision need to be prioritized in all the African development programs.

HISTORICAL BACKGROUND OF CRVS IN ETHIOPIA

The first tentative and largely symbolic efforts to establish a civil registration system in Ethiopia was started in 1900 proclamation by emperor Menelik II to institute a registration system. This was well-intentioned but failed to materialize. Then after, the law for registration was again included in 1960 Civil Code. This too was not implemented for lack of institutional support and enforcement. A 1980 proclamation stipulated that the central statistical authority (CSA) will begin to undertake registration of vital events. All of the preliminary efforts and attempts to lay the groundwork for a national registration system were not successful. The 1983/88 proclamations by the Derg to register births, deaths, marriages and population numbers did not come to fruition. The 1995 FDRE constitution considered the naming of a child and record of his/her birth a fundamental right, but the law on civil registration has not come into effect.¹ In August 2012, the federal democratic republic of Ethiopia (FDRE) issued the registration of vital events and national identity card proclamation No. 760/2012, referred hereafter as the 2012 law, which is a comprehensive and compulsory law on registrations of vital events in Ethiopia.⁴ This law repealed articles 47 to 153 of the 1960 civil code, which were provisions on civil registration that had been suspended indefinitely and therefore never put to any use.¹¹ Meanwhile, the central statistical agency(CSA) is taking the responsibility for collecting, compiling and disseminating official statistics, including vital statistics from population and housing censuses and household surveys. The agency is also given a mandate by law to coordinate the country’s statistical activities to ensure the use of uniform statistical concepts, definitions and classifications nation-wide. According to the CR law of 2012, the information gathered by the vital events registration agencies on births, marriages, divorces and deaths are compiled for statistical purposes and disseminated by CSA.³

THE STATUS OF CRVS IN ETHIOPIA

Ethiopia has one of lowest levels of birth registration in the world at just 7 per cent. With the new system, however, registration of vital events in Ethiopia has been modernized. From regional up to federal and city level administration, UNICEF is supporting standardization of registration and certification services, which has been officially launched nationwide.¹²

The central statistical agency (CSA) is the main agency for collecting, compiling and disseminating official statistics, including vital statistics from population and housing censuses and household surveys. It is also charged by law to coordinate the country’s statistical activities to ensure the use of uniform statistical concepts, definitions and classifications nation-wide. According to the civil registration (CR) law of 2012, the information gathered by the vital events registration agencies on births, marriages, divorces and deaths are compiled for statistical purposes and disseminated by CSA.⁹

The federal ministry of health (FMoH) is responsible for notifying the concerned civil registration office of births and deaths, including cause of death information, occurring in health facilities. The kebeles record the events along with the particulars of the events in the civil registers. CSA is tasked with compiling vital statistics and cause-of-death information from the copies of registers they receive from the vital events registration agencies at federal and regional levels. CSA has setup a vital statistics division in 2017 with 5 professionals as the core team that would process and disseminate vital events information. Although over 18,000 registrations centers are operational, the registration is still slow since it started nation-wide in mid-2016, mainly because of low demand. It plans to expand the vital statistics activities in many of its branch offices in the regions as the registration coverage increases.

The enhancement of the CRVS system is funded by external agencies. In December 2016, The Italian agency for development cooperation funded UNICEF with a total contribution of €500,000 to strengthen the civil registration system for children’s rights to identify in two regions of Ethiopia. The support is crucial as it represents the preliminary condition towards the creation of a fully functional civil and vital registration system of birth, death, marriage and divorce. The funding aims to improve and standardize the CRVS system and contribute to children’s right to identity to protect them from abuse and exploitation, as well as ensure their access to basic services. The support comes at a critical time in light of Ethiopia’s creation of a fully functional nationwide civil and vital registration system of birth, death, marriage and divorce in August. The funding aims to improve and standardize the CRVS system and help protect children from abuse and exploitation, as well as ensure their access to basic services.¹³

CHALLENGES OF CRVS IMPLEMENTATION IN ETHIOPIA

Ethiopia faces a number of challenges with regard to CRVS, including a large, mainly rural population, and highly decentralized administrative structures. Prior to 2012, there was no legal framework for CRVS. Other challenges to be addressed include. ¹⁰

Infrastructure

The lowest administrative structures require registration equipment and supplies, including safe storage for registration records.

Information, education and communication

The public has to be effectively informed and educated on the benefits of registration of vital events and the obligation to do so. This will require creative, effective and sustained advocacy.

Capacity building

Building institutional capacity in vital events registration and vital statistics systems in all regional states and city administrations and lower administrative levels is needed to ensure sustained delivery of services and quality and continuous flow of data.

CONCLUSION

CRVS systems plays a vital role in providing information to track identity of individuals of one country and being source of valuable information about the population for the government and other concerned bodies to make policies related to health, economic and social welfares. It is mainly intended to meet legal necessities of individuals, such as documentary confirmation of identity; legal status and consequential rights; proof of age and letting access to rights based on age; supporting the legal transmission of property, inheritance, social protection or insurance and other paybacks.

In spite of its prior recognition and abundant advantages, the country is not still maintained and implemented comprehensive CRVS system that is fulfilling international standards and the one that can contribute to construct an emerging public administration and supporting national development initiatives. Therefore, the country is being suffered from lack of reliable and valuable population statistics and its consequences. Many individuals in Ethiopia are born and die without any legal official statistics. It is difficult to get well organized reliable data about birth, death, cause of death, marriage and divorce. This has also resulted in inadequate use of national census data and paucity of trustworthy statistics for the designing, implementation and monitoring of development policies and programs in the country.

Hence, the requirements that should be in place for implementing CRVS successfully are a civil registration law, well-furnished vital statistics and civil registration organization as well as commitment of the government. Moreover, capacity building, awareness creation and establishment of necessary infrastructures are among the solutions which need to be carried out soon. The financial aid provided from international donors and the developments of technologies are also the opportunity to improve the status of CRVS system of the country.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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