What is the status of CRVS in GFF supported countries?

The Global Financing Facility (GFF) has prioritized the strengthening of civil registration and vital statistics (CRVS) systems with the aim of improving data sources for tracking and ultimately improving the health and well-being of women, children and adolescents. The recognizes the importance of CRVS as a component of a country’s health information system through which progress made in ending preventable maternal, newborn, child and adolescent deaths can be monitored. The priority vital events for the GFF are births and deaths, including causes of death, as well as the registration of marriages.

Globally, 25% of the births of children under 5 are not registered; and 40% of deaths are not registered and most of the deaths registered are listed without a clear cause, or no cause at all. Many low- and lower-middle income countries do not have adequate CRVS systems in place, with progress much slower with the registration of deaths and their causes.

Based on the most recent Demographic and Health Surveys (DHSs) or Multiple Indicator Cluster Surveys (MICS), birth registration among children aged below five years ranges 3% in Ethiopia to 96% in Guatemala and Vietnam.

Fig. 1 Birth Registration Among Children < 5

Currently none of the GFF supported countries have complete death registration and only 18 of the 36 (50%) of countries collect cause of death data.

Fig. 2 Death Registration Completeness among GFF Countries

GFF’s approach to strengthening Civil Registration and Vital Statistics systems

The GFF is mainstreaming its support to CRVS systems as part of its new strategic direction of sustaining a relentless focus on results and promoting gender-responsive monitoring and data systems, prioritizing the reform of policies in the health sector to ensure life events are captured timely and at the place of occurrence; advancing equitable and gender-responsiveness in all CRVS systems; building electronic systems for sustainable and efficient delivery of CRVS services; and using CRVS data for decision-making; while advocating for more domestic resources for CRVS; and continuing to mobilize partner resources.

The GFF supports the strengthening of CRVS systems by ensuring that CRVS components are included in countries’ investment cases for the provision of timely and accurate health-related. In collaboration with other partners, the GFF supports countries to develop strong CRVS components in their investment cases (IC) through gaps analysis, and pinpointing of key interventions required to strengthen the CRVS system. The prioritization of CRVS activities within the IC is informed by Reproductive, Maternal, Newborn and Child Health (RMNCAH) priorities as well as priorities set in the national CRVS strategic plan.

The preparation of the CRVS component of the investment case is a consultative process that includes key RMNCAH stakeholders, as well as representatives from CRVS stakeholders, particularly officials from the ministries or agencies responsible for civil registration (e.g. Ministry of Home Affairs, Ministry of Justice, and Ministry of Local Government); and agencies responsible for vital statistics (National Statistics Offices).

Through World Bank projects, countries can leverage financing from the GFF TF and lending facilities from The International Development Association (IDA) / International Bank for Reconstruction and Development (IBRD) to specifically fund CRVS activities. Several GFF partner countries have received financing from the GFF TF, linked to IDA, specifically for strengthening CRVS systems as well as allocations to support advisory services and analytical work.


Country level support for CRVS strengthening

Theory of Change for GFF’s support on CRVS

What is Civil Registration and Vital Statistics (CRVS)?

Civil registration and vital statistics (CRVS) refers to the continuous, permanent, compulsory and universal recording and collection of data on the occurrence and relevant characteristics of vital events [e.g., births, deaths (and their causes), fetal deaths, marriages, adoptions] pertaining to the population, in accordance with the legal requirements in each country. A well-functioning CRVS system registers all vital events with their characteristics, and records causes of death, issues vital events certificates and produces and disseminates vital statistics in a timely manner. It is a tripartite collaboration between the health sector, the civil registration agency and the national statistics agencies. Among GFF partner countries, currently only 28% (10 of 36) produce vital statistics from their civil registration system.

Why is CRVS important?

Birth registration establishes a child’s identity and family relations and facilitates access to health care, education and other social benefits. It is also the foundation of other systems, including identity management systems and national population registers. Coupled with marriage registration, birth registration can protect of young girls from early marriage, as it reveals the age of the child. Early marriages often leads to early pregnancy and childbearing, heightening risks of adverse health outcomes for adolescent mothers and their children. Death registration is important for documenting the rights to inheritance, and benefits linked to widowhood or orphanhood, which are often associated with vulnerability and poor health outcomes.

Vital statistics derived from a well-functioning civil registration system is the ideal source from which to derive accurate, complete, timely and continuous information on vital events useful for planning, monitoring and evaluating reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH-N) programs. These data can be used to measure progress made in reducing maternal mortality ratio, under 5 mortality rate, neonatal mortality rate and adolescent birth rate regularly and at sub-national level.

At the local and national levels, vital statistics is not only important for public health but also a crucial factor for social, political, and economic policies. Vital statistics is a tool for estimating the size and growth of a population; implementing and evaluating public, maternal and child health and other programs; understanding the economic and social dimensions of a population; and producing development indicators . Vital statistics is therefore a crucial instrument for governments to plan for the current and future needs of the population through developing and implementing evidence-based policies and programs.