The Pacific Counts.Improving civil registration and vital statistics

Policy and planning uses of CRVS in the Pacific

Audrey AumuaTechnical Advisor

WHO Pacific HIS Knowledge Hub

University of Queensland

Karen CarterVital Statistics and Civil Registration

SpecialistStatistics for Development Division

Secretariat of the Pacific Community

• Isolated islands and territories

• Small pockets dispersed of populations

• Complex and fragmented CRVS systems (collection and legislation

• Lack of awareness of registration

• Significant problems with accuracy of cause-of-death data

• Lost data due to events occurring offshore

• Limited analysis and use of data

• Duplication of responsibilities for vital registration

• Poor cause-of-death certification practices.

• Limited data sharing between agencies

The Challenge of CRVS in the Pacific

The importance of CRVS in the Pacific for Policy and Health

HEALTH PLANNING• Identifying Priorities – NCD’s / Maternal and Child health• Targeting Health Programs – Populations at risk• Service Delivery - Immunisations / Population s / Midwives etc• Monitoring and Evaluation – funding / international agreements

GOVERNMENT SERVICES• Education – planning for number and location of teachers• Social Security – i.e. age of retirement• Population Statistics

IDENTITY AND SECURITY• Passports• Electoral Rolls• Disaster Planning (populations at risk and follow up)

LAND RIGHTS and INHERITENCE

Drivers for better information in the Pacific

• Priorities articulated in the Pacific Plan of regional Heads of

Governments

• Ten Year Pacific Statistics Strategy (TYPSS) 2011-2020.

– The TYPSS has been endorsed by statistical agencies from all

Pacific Islands and subsequently also endorsed by:

• SPC’s 40th CRGA meeting and subsequent Ministerial conference, and

• PIFS’ Finance and Economic Ministers Meeting (FEMM)

• Donor initiatives to improve health systems through improving

knowledge about health information systems, (WHO, AusAID)

• Global initiatives such as the Millennium Declaration and MDGs and

maternal and child health

The overarching aim of the plan is to assist Pacific countries to improve their statistics on birth, deaths, and cause-of-death through routine collections and thereby provide decision-makers with the evidence needed for effective planning.

The Pacific Vital Statistics Action Plan

Policy Use

Data accessibility and interpretation

Data

collection

and quality

• Non-communicable diseases (NCDs) are the leading cause-of-death in Pacific Island Countries and Territories and are responsible for over 70% of all deaths

• Life expectancy in several Pacific Countries has not improved in many years with Life expectancy in some countries less than 60 years of age.

• Improvements in maternal and child health have been offset by high premature adult mortality – hence high mortality rates remain in some countries

• While health professionals all have a “sense” of the issue – CRVS is important for EVIDENCE – monitoring changes and obtaining resources

NCDs – a critical emerging health issue

Ministers of Health Meeting Solomon Is; 28 – 30 Jun 2011

Example: Age-standardized rates showing increase in NCD’s over time

Carter KL, Hufanga S, Rao C, Akauola S, Lopez AD, Rampitage R, Taylor R. Causes of death in Tonga: quality of certification and implications for

statistics. Popul Health Metr. 2012 Mar 5;10(1):4.

Age-standardized mortality for males (selected causes) for Tonga, 2001–2009 (plausible range based on upper and lower mortality scenarios).

• Good quality data is important to ensure that other important health issues are not lost in the push to address NCD’s

For example –

• when calculated by age, the leading cause of death for adult males 15-59 years in Niue is external causes (mostly suicide) – not NCD’s

• Infant and child mortality remains an issue in places like Kiribati where protein malnutrition remains a leading cause of death in children

• Infectious diseases such as Malaria continue to be an issue in several countries and need to be monitored

• Septicemia is an important cause of death in several countries and is not always linked to diabetes - important in monitoring infection control

• TB is re-emerging in a number of populations as a disease of public health importance.

There is more than one story….

• The Pacific Vital Statistics Action Plan encourages a national approach –

across sectors

• Drives governance and accountability

– Country voice in international discussions ie the post 2015 development

agenda

– Population statistics- size / distribution and representation

– Funding and accountability (i.e. Compact of association)

• High adult mortality (and morbidity) in working age adults affects

development / family structure / the economy / dependency ratios etc

– Mortality data is critical in addressing reasons and responses to this

high adult mortality.

• Workshops / assessments based on a multi-sectoral approach and BAG

agencies agree to support TA to a national plan / set of priorities

Good civil registration and vital statistics supports development

Thank you

ON BEHALF OF THE BRISBANE ACCORD GROUP OF PARTNERS