Monitoring the Indicators of Monitoring the Indicators of The Millennium Development Goals The Millennium Development Goals Through the Civil Registration and Through the Civil Registration and

Vital Statistics SystemVital Statistics System

CRVS in MDGsCRVS in MDGs

Goal 4. Reduced mortalityGoal 4. Reduced mortality• Under-five mortality rateUnder-five mortality rate• Infant mortality rateInfant mortality rate

Goal 5. Improved maternal healthGoal 5. Improved maternal health• Maternal mortality ratioMaternal mortality ratio• Proportion of births attended by skilled health Proportion of births attended by skilled health

personnelpersonnel Goal 6. Combat malaria and other diseasesGoal 6. Combat malaria and other diseases

• Death rates associated with malariaDeath rates associated with malaria• Death rates associated with tuberculosisDeath rates associated with tuberculosis

CRVSCRVS

Systems of OperationsSystems of Operations• Civil Registration Civil Registration

• Administration and Management of Administration and Management of DocumentsDocuments

• Compilation and AnalysisCompilation and Analysis

•Birth: Birth: hospital/clinic administrator, hospital/clinic administrator, attendant, attendant, either parents, oreither parents, or owner of the document, if of age owner of the document, if of age

Civil Registration SystemCivil Registration Systemwho shall reportwho shall report

•Death: Death: hospital/clinic administrator, hospital/clinic administrator, attendant, attendant, person who performed the burial person who performed the burial rites,rites,

nearest relative, or nearest relative, or any interested party who knew any interested party who knew about the occurrence of the eventabout the occurrence of the event

Civil Registration SystemCivil Registration Systemwho shall reportwho shall report

Civil Registration SystemCivil Registration Systemwhom to reportwhom to report

1975 / 19971975 / 1997• The death shall be reported to the The death shall be reported to the

local health officer within 48 hours local health officer within 48 hours after death and the death after death and the death certificate shall be forwarded to the certificate shall be forwarded to the local civil registrar concerned local civil registrar concerned within 30 days after death for within 30 days after death for registrationregistration

Registrant/ Informant/ Attendant/

Health Officer

Civil RegistrarCivil Registrar

Death/Fetal death

Birth

CRVSCRVSFlow of DocumentsFlow of Documents

(Within 48 hours)

(Within 30 days)

(Within 30 days)

Death/Fetal death

NSO-PONSO-PO

10 days after reference 10 days after reference monthmonth

NSO-CONSO-CO

6th week after 6th week after ref. mo.ref. mo.

ObjectivesObjectives

To provide measures of:To provide measures of:• G4 Reduce MortalityG4 Reduce Mortality

Under-five mortality rate (UMR)Under-five mortality rate (UMR) Infant mortality rate (IMR)Infant mortality rate (IMR)

• G5 Improve Maternal HealthG5 Improve Maternal Health Maternal mortality ratio (MMR)Maternal mortality ratio (MMR) Proportion of births attended by skilled health Proportion of births attended by skilled health

personnel (%SHP)personnel (%SHP)• Goal 6. Combat malaria and other diseases Goal 6. Combat malaria and other diseases

Death rates associated with malaria (CSDRM)Death rates associated with malaria (CSDRM) Death rates associated with tuberculosis Death rates associated with tuberculosis

(CSDRT)(CSDRT)

Illustrative ExampleIllustrative Example

Data source: Data source: • 2000-2004 vital statistics from CRVS2000-2004 vital statistics from CRVS• Projected population based on Census 2000Projected population based on Census 2000• Level of completeness of births and deaths Level of completeness of births and deaths

based on 2000 (secondary data)based on 2000 (secondary data)

MethodsMethods

Factors in the estimation of IMR, UMR, Factors in the estimation of IMR, UMR, MMRMMR• adjusted number of births and maternal, infant adjusted number of births and maternal, infant

and under five mortality dataand under five mortality data

MethodsMethods

Factors of other measures:Factors of other measures:• Unadjusted number of births by skilled health Unadjusted number of births by skilled health

personnel: physician, nurse and midwifepersonnel: physician, nurse and midwife• Unadjusted deaths due to malaria and Unadjusted deaths due to malaria and

tuberculosistuberculosis

MethodsMethods

Measures: Measures: • IMR = adj. [infant deaths / live births] * 1,000IMR = adj. [infant deaths / live births] * 1,000• UMR = adj. [under five deaths / live births] * 1,000UMR = adj. [under five deaths / live births] * 1,000• MMR = adj. [maternal deaths / live births] * 100,000MMR = adj. [maternal deaths / live births] * 100,000

• %SHP = [births%SHP = [birthsPNW PNW / live births] * 100/ live births] * 100

• CSDRM = [deaths due to malaria / mid-year CSDRM = [deaths due to malaria / mid-year population] * 100,000population] * 100,000

• CSDRT = [deaths due to tuberculosis / mid-year CSDRT = [deaths due to tuberculosis / mid-year population] * 100,000population] * 100,000

ResultsResults

Table 1. CRVS for MDG Indicators:

Philippines, 2000-2004

MDG Indicators 2000 2001 2002 2003 2004P

G4 - Reduce Mortality  

UMR

52.8

50.9

47.6

45.8

43.3

IMR

38.9

36.8

34.1

33.0

31.8 Secondary data

ResultsResults

Table 2. CRVS for MDG Indicators:

Philippines, 2000-2004

MDG Indicators 2000 2001 2002 2003 2004P

G5 - Improve Maternal Health  

MMR

123.5 132.5

138.3

138.4

137.7

%SHP

65.3

65.9

68.5

67.3

67.6

Secondary data

ResultsResults

Table 3. CRVS for MDG Indicators:

Philippines, 2000-2004

MDG Indicators 2000 2001 2002 2003 2004P

G6 - Combat Malaria and Other Diseases  

CSDRM

0.4

0.4

0.3 0.3

0.2

CSDRT 35.8

34.8

35.5

32.7

31.0

Figure 1. Trends in Child Mortality

80

67

52.843.3

26.7

0

1020

3040

50

6070

8090

100

1990 1995 2000 2004 2015

Year

Rate

-4.4

-3.5

-4.8

-4.8

Figure 2. Trends in Infant Mortality

5749

38.931.8

19.00

10

20

30

40

50

60

70

80

90

100

1990 1995 2000 2004 2015

Year

-3.0

-4.6-5.0

-4.7

Figure 3. Trends in Maternal Mortality Ratio

209

180

123.5137.7

51.0

0

50

100

150

200

250

1990 1995 2000 2004 2015

Year

-9.0

-3.0

-7.5

2.7

Figure 4. Trends in Proportion of Births Attended by Skilled Health Personnel

58.862.7 65.3 67.6

100.0

0102030405060708090100

1990 1995 2000 2004 2015

Year

1.3 0.80.9

3.6

Figure 5. Trends in Death Rates Associated with Malaria

1.50

0.90

0.40

0.20

0.01

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1990 1995 2000 2004 2015

Year

-10.2

-27.2-17.3

-16.2

Figure 6. Trends in Death Rates Associated with Tuberculosis

39.10 39.4035.80

31.00

0.01

0

5

10

15

20

25

30

35

40

45

1990 1995 2000 2004 2015

Year

0.2-1.9

-3.6

-73.1

Table 4. Average Annual Rate of Reduction / Growth to Achieve MDGs

Indicators 1990-1995 1995-2000 2000-2004 2004-2015

Goal 4        

UMR -3.5 -4.8 -5.0 -4.4

IMR -3.0 -4.6 -5.0 -4.7

Goal 5        

MMR -3.0 -7.5 2.7 -9.0

%SHP 1.3 0.8 0.9 3.6

Goal 6        

CSDRM -10.2 -16.2 -17.3 -27.2

CSDRT 0.2 -1.9 -3.6 -73.1

Conclusion/RecommendationConclusion/Recommendation

Some resulting estimates from CRVS Some resulting estimates from CRVS can be used for MDG monitoringcan be used for MDG monitoring

More information from CRVS should More information from CRVS should be evaluated and provided to be evaluated and provided to identify whom and where to focus identify whom and where to focus interventions to fast track interventions to fast track achievement of MDGsachievement of MDGs

Conclusion/RecommendationConclusion/Recommendation

Regular assessment of CRVSRegular assessment of CRVS Death certificate should be properly Death certificate should be properly

filled-upfilled-up• By informantBy informant• By Health OfficerBy Health Officer

Insurance agencies shall require Insurance agencies shall require properly filled-up and registered properly filled-up and registered death certificatedeath certificate

Conclusion/RecommendationsConclusion/Recommendations

Enhanced interagency coordination Enhanced interagency coordination to include commitment to improve to include commitment to improve civil registration, especially among civil registration, especially among entities involved in the entities involved in the accomplishment of certificates of accomplishment of certificates of death, registration of deaths and death, registration of deaths and those requiring information on those requiring information on deathsdeaths

Maraming Salamat Po!Maraming Salamat Po!