STAKEHOLDER S MEETING ON BIRTHS AND DEATHS REGISTRATION UNDER THE GHANA HEALTH INFORMATION SYSTEM DATE; 27 TH JULY, 2008 ACCRA

Transcription

1 STAKEHOLDER S MEETING ON BIRTHS AND DEATHS REGISTRATION UNDER THE GHANA HEALTH INFORMATION SYSTEM DATE; 27 TH JULY, 2008 ACCRA 1

2 Overview of the Births and Deaths Registration System Presented By Kingsley Asare Addo 2

3 BACKGROUND OF BIRTHS AND DEATHS REGISTRATION IN GHANA Vital registration started in the Gold Coast in when the cemeteries ordinance was passed to regulate the interment of deceased persons in certain areas of the colony Birth registration was introduced following enactment of Births, Deaths and Burials Ordinance Birth registration introduced.( registration placed under Medical department) 3

4 Background cont d 1965 the Registration of Births and Deaths Act, 1965, (Act 301) was passed to replace the ordinance of 1926 and The Births and Deaths Registry was established to handle and develop the vital registration system in the country. The Act 301 makes provision for the compulsory registration of births and deaths in all parts of the country and is applicable to the entire population of Ghana, irrespective of race, or country of origin. The Act also provides for the registration of foetal deaths and seeks among other things to: Promote public health in the country. Extend births and deaths registration facilities to the entire population of the country Establish an efficient system of births and deaths registration records for the citizenry Obtain vital statistics data which are adequate and efficient enough for deriving reliable demographic estimates to support public health planning, and for policy formulation at various levels of governance and for development planning in the country. 4

5 1888- not assigned to any specific government agency attached to the sanitary branch of the department of medical services placed under the Medical Department Registrar General s Department Births and Deaths Registry established within the Ministry of Local Government to handle data collection aspects of registration while the Central Bureau of Statistics (CBS) handled data processing Registry assigned to the Ministry of Finance and Economic Planning under the direct supervision of the Government Statistician. 1984*- in line with govt decentralisation programme Registry reverted to the Ministry of Local Government. 5

6 Operational Structure Central Registry Office- Accra Regional Registration Offices- 10 District Registration offices- 138 Registries and centres

7 7 NUMBER OF REGISTRIES NUMBER OF REGISTRIES U/WEST U/EAST NORTHERN B. AHAFO ASHANTI VOLTA EASTERN GT. ACCRA CENTRAL WESTERN ALL REGIONS REGION

8 STRENGTHS 1 Mandate derived from legislation Births and Deaths Registration Act, 1965( Act 301) 2 Presence in 10 regions and 138 districts in Ghana 3 Stock of information on registered births and deaths dating back to 1912 Weaknesses 1 Inadequate staff 2 Ineffective monitoring and supervision 3 Inability to publish timely reports 4 Late capture of events 5 Redundancy of data due to multiple registration of events 6 Low coverage of events especially in rural areas 8

9 Opportunities 1. Increasing public awareness about importance of registration 2. Increased collaboration with stakeholders including the DA s, MOH, GHS, Unicef, Plan Ghana, UNFPA, GSS the GIS and others 3. Enforcing demand of registration documents by agencies such as the Passport office, GES, SSNIT, DVLA, EC, NIA, the Banks etc 4. Linking births and deaths registration to the National Identification System 9

10 Threats 1. Inability to attract and retain highly qualified staff 2. Absence of required logistics and equipment ( Need for permanent office buildings and vehicles for Head, regional and district offices) 3. Poor remuneration sometimes engendering corruption 4. Fraudulent acquisition and use of birth certificates 5. Burials without registration 10

11 Efforts to Strengthen Registration System In a bid to expand and achieve universal coverage, series of activities have been undertaken. The main areas of concern are: Building Partnerships Awareness Creation/Public Education Capacity Building 11

12 Building Partnerships Collaboration with partners to collect and disseminate information about births and deaths registration. Key partners include; GHS, MOH, GSS, DAs, MOWAC, Unicef, Plan Ghana, UNFPA, GIS CHNs trained to administer births and deaths registration forms out of 1250 volunteers trained with unicef support (rest to be trained this year) -792 unit committee members trained in Ashanti, Brong Ahafo, Northern ( MLGRD&E support) Participation in annual CHPW with GHS since 2004 and in the IMCH campaign 12

13 Pilot of Community Population Register (partnership with Plan Ghana, GSS, GHS, DAs, Unfpa) The Community Population Register is designed to serve as a population register at the local level. It makes provision for the continuous recording and updating of information on every individual in the population of a community. It is a system of data collection in which details of names, sex, date of birth, educational level, marital status, immunization status, occupation, literacy status etc. of persons residing in the community are recorded and regularly updated with the occurrence of births, deaths and movements. Its efficient implementation would : Facilitate the timely reporting of births and deaths for registration in the various communities. Generate community- based data that would prove beneficial for planning at the community level during inter-censal periods. Provide records that can be used as checks in the review of electoral registers and of social security records. Facilitate the issuing of National Identity Cards. Provide an effective means for the evaluation of decennial censuses. 13

14 CPRP cont d CPRs piloted in Central region- 12 communities - Mfantsiman district( Essarkyir, Ebiram, Krofu, Ekumfi-Twa) - Awutu Effutu Senya( Fianko) - Agona (Kwesitwikwaa, Mensakrom) - Twifu-Heman-Lower Denkyira (Denkyira Wawase) - Kommenda-Edina- Eguafo-Abrem (Amissano) - Ajumako-Enyan-Essiam (Owane) - Abura-Asebu-Kwamankese( Kwamankese) Eastern region- 4 communities - Atiwa district (Kwabeng), Birim-South district (Ayirebi), Akuapem North (Twum Guaso), Manya-Krobo (Asesewa) Upper West region- 5 communities Wa Municipal (Boli), Wa West( Lassia-Tuolu), Wa East (Kundugu), Sissala East(Bugubelle), Sissala West( Fielmuo) The programme will be scaled-up to cover more communities with availability of funds. 14

15 Capacity Building Refresher training for all staff on new SOP ongoing Client service units have been established to improve service delivery New service charter Community volunteers engaged in areas with weak official presence to capture events There is the urgent need for Recruitment of new staff to fill various categories in t he Registry Training internal and external for existing staff. (ICT, Computer literacy, Statistics & Demography, Management) Setting up of well equipped statistics and data processing units at h qrs, regional offices Construction of office accommodation for regional and district levels Vehicles for all regions and districts, motor bikes/bicycles for local level operatives. Construction of a new headquarters building. 15

16 Awareness Creation/ Public Education Launch of public Education Campaign- June 2003 Production and airing of TV adverts, Participation in radio and television discussion programmes (9 media programmes btn August and December last year) Community Durbars (held in Denkyira Wawase (THLD), Mensakrom (Agona), Amissano(KEEA), Owane(AEE), Ekumfi-Twa (Mfantsiman), Kwamankese(AAK, Kokrobite, Bortianor Madina (Greater Accra) Institution of Annual BDR Day celebration (2004) Annual Press briefing sessions by Minister Publicity Road Shows by UBR Goodwill Ambassador (Mr. David Dontoh )(Visited all regional capitals and 4 districts in the northern Volta region) Free Registration of infants 16

17 Partnerships- Results - Involvement of CHNs and Community Volunteers in data collection has enhanced registration in hither-to hard-toreach areas - Participation in CHPW and IMCH campaigns have led to significant increases in birth registration coverage - CPRP - Community Population Registers working successfully in 21 communities across three regions in the country - Enabled the early reporting and registration of births and deaths. - Community level population information available to facilitate planning and other uses at the local level 17

18 Results cont d Verification of documents between BDR,the Passport Office and some Embassies helped to reduce the use of fraudulent registration documents( a lot more will be achieved under the AENEAS Programme with the GIS). Situational analysis conducted as part of HMN programme has enabled the review and improvement in content of registration forms. 18

19 Results cont d AWARENESS CREATION There is a gradual but notable level of awareness about the importance and benefits of births and deaths registration among the general public Significant increase in birth registration coverage 19

20 Registered birth (0-12 months only) REGION POPULATIO N EXPECTED BIRTHS REGISTERED BIRTHS % COVERED ,912, , , ,422, , , ,947, , , ALL REGION S ,485, , , ,038, , , ,606, , , ,190, , , ,789, , , ,404, ,355 20

21 Trend of infant birth registration(0-12 months only) Registered Births 0-12 months , , , , , , , , , , , , , , , , , , , , , , , , , EXPECTED BIRTHS REGISTERED BIRTHS 21

22 REGISTERD DEATHS IN GHANA YEAR POPULATION EXPECTED DEATHS REGISTERED DEATHS % COVERED ,912, ,422, ,947, ,485, ,038, ,606, ,190, ,789, ,894 54,

23 No of Deaths Trend of Registered Deaths in Ghana Trend of Registered Deaths , , , , ,000 50, YEAR Expected deaths Registered deaths 23

24 Computerisation of registration system To facilitate the capture, storage, processing and retrieval of information on births and deaths in the country, computers have been introduced into the operations of the Registry A server which will hold the database information has been installed at the headquarters. Registration forms have been redesigned to make them machine readable. Information on registered events will now be scanned into the database to facilitate processing, storage and retrieval Scanning will be done at the headquarters until such time that the regional and district offices will be properly housed, equipped and linked through WAN to the national server. Information will then be fed directly from the districts into the central database. Interface between Registry and major stakeholders The Registry will launch its website by the close of 2008 to provide information and relevant material to the general public. 24

25 Major challenges include: challenges Limited Access to registration facilities Low public knowledge about importance of registration Inadequate staff Inability to attract and retain highly qualified personnel due to low remuneration and poor service conditions Inadequate funding for the Registry, Difficulty in motivating registration volunteers Lack of logistics including accommodation, vehicles, requisite statistical software and programmes. Absence of training opportunities for sector staff Weak monitoring and supervision mechanisms. 25

26 The Staff Situation REGION POPULATION (2000 POPN. CENSUS) NO. OF REGISTRIES NO OF STAFF REQUIRED MINIMUM STAFF ALL REGIONS 18,912, H/ OFFICE WESTERN 1,924, CENTRAL 1,593, GT. ACCRA 2,905, EASTERN 2,106, VOLTA 1,635, ASHANTI 3,612, B/AHAFO 1,815, NORTHERN 1,820, U/EAST 920, NO. OF VEHICLES U/WEST 576,

27 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION MINISTRY OF LOCAL GOVT. RURAL DEV. &ENVIRONMENT GHANA STATISTICAL SERVICE GHANA HEALTH SERVICE CENTRE FOR HEALTH INFORMATION MANAGEMENT MOH, HMN PROGRAMME MIDWIVES/TBAs Policy issues, Technical guidance, supervision Technical support, Analysis of data collected, Training CHNs- Notification of births, assist with data collection Medical Officers- Collect and complete Medical Certificate of Cause of Deaths from BDR Annual CHPW, IMCH campaigns Accommodating Births &Deaths registration offices in all health facilities Analysis of Medical Certificates of Cause of Deaths Technical and logistic support Improve generation of mortality statistics Pilot of verbal autopsy system Notification of births /deaths 27

28 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION Passport office/national Identification Authority/SSNIT/Electoral Commission/ DVLA GHANA EDUCATION SERVICE UNICEF demand birth/death certificates to access services Make birth certificate enrollment requirement right from KG to tertiary level Technical and logistic support, advocacy PLAN GHANA Technical and logistic support, advocacy EMBASSIES MINISTRY OF PUBLIC SECTOR REFORM MINISTRY OF WOMEN AND CHILDREN S AFFIARS/DEPT OF CHILDREN Technical and logistic support. Birth/death cert. requirement to access service Verification of documents with BDR Logistical support, assist to improve service delivery, support computerization programme Advocacy, sensitization of public, Dissemination 28

29 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION GIS/AENEAS PROGRAMME DEPARTMENT OF SOCIAL WELFARE CHRISTIAN COUNCIL/ISLAMIC COUNCIL Cooperate to counter document fraud Logistic support, Training, support for computerization On legal issues concerning adoptions, registration of abandoned children etc Public education GHANA POLICE SERVICE SEXTONS LA/ OSU/ AWUDOME CEMETERIES ACCRA METROPOLTAN ASSEMBLY Registration of unnatural deaths Coroner inquest cases Deaths occurring outside medical facilities Collect and use Burial Registers Demand Burial Permits before burial Submission of burial returns to Registry Registration of all burial grounds Control of burial grounds PRIVATE FUNERAL HOMES Demand proof of registration before release of corpses. 29

30 Way forward- what we expect from various partners PARTNER AREA OF COLLABORATION CONTROLLER AND ACCOUNTANT GENERAL S DEPATMENT MINISTRY OF FINANCE AND ECONOMIC PLANING Provision of registration material (Value Books), Budgetary support Budgetary support 30

31 THANK YOU 31