first meeting of national directors of statistics and health statistics for the countries of the...

First Meeting of National Directors of Statistics and Health statistics for the Countries of the Americas, Buenos Aires 21-22 November 2005

The ‘Rights’ Start to Life: a Statistical Analysis of Birth Registration

Claudia Cappa, UNICEF NY

BIRTH REGISTRATION: A FUNDAMENTAL HUMAN RIGHT

- Definition

The permanent and official recording of a child’s existence by the state

- International legal framework

“The child shall be registered immediately after birth and shall have the right from birth to a name, the right to acquire a nationality and as far as possible, the right to know and be cared for by his or her parents” (1989, UN Convention on the Rights of the Child – CRC, art 7).

- Goal

“To develop systems to ensure the registration of every child at or shortly after birth, and fulfill his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments” (World Fit for Children, WFFC).

GLOBAL ESTIMATES

Source: UNICEF estimates based on household surveys and vital registration systems.

OBJECTIVES

Present available empirical evidence obtained through household surveys in order to:

estimate national levels of birth registration analyze differentials in birth registration rates according to socio-

economic and demographic variables, as well as proximate variables identify the factors associated with birth registration

Discuss the results on the relationship between levels of birth registration and other health, education and poverty indicators.

DATA AND METHODOLOGY

• Data sources: MICS2 and DHS (1999-2003)

• Geographical coverage: 64 countries (10 in LA)

• Population: children 0-59 months of age

Indicator Numerator Denominator

Birth registration Number of children aged 0-59 whose birth was declared registered

Total number of children aged 0-59 months surveyed

MULTIPLE INDICATOR CLUSTER SURVEY

• Household surveys designed to collect data on children and women (nutrition, health, education, family environment, child work, etc.)

• Methodology developed by UNICEF to produce data needed to report on agreed indicators (WSC, MDGs, WFFC, etc.)

• Capable of producing internationally comparable estimates of indicators

• Flexible — to suit country requirements: core questionnaires + additional situation-specific modules, and optional modules

• Collaboration with DHS survey programme

• Two rounds completed. Third round (MICS3) is ongoing (2005-2006)

MICS MODULE ON BIRTH REGITRATION

DHS MODULE ON BIRTH REGISTRATION

Variable length (under the section on reproduction)Peru

Nicaragua

NATIONAL LEVELS OF BIRTH REGISTRATION FROM HOUSEHOLD SURVEYS

0

10

20

30

40

50

60

70

80

90

100

OP

T

Kor

ea D

PR

Bos

nia

& H

erze

govi

na

Mol

dova

Aze

rbai

jan

Guy

ana

Trin

idad

& T

obag

o

Per

u

Col

ombi

a

Com

oros

Tog

o

Nic

arag

ua

Bur

undi

Dom

inic

an R

epub

lic

Mal

dive

s

Vie

tnam

Nam

ibia

Sao

Tom

e &

Prin

cipe

Sud

an

Ben

in

Lao

PD

R

Mau

ritan

ia

Sw

azila

nd

Sie

rra

Leon

e

Gui

nea-

Bis

sau

Mya

nmar

Con

go D

R

Equ

ator

ial G

uine

a

Ang

ola

Cha

d

Afg

hani

stan

Tan

zani

a

MICS/DHS DATA ON BIRTH REGISTRATION IN THE AMERICAS

69.7 - 81.4

69.7% – 81.4%

81.5% - 91.8%

91.9% - 94.9%

95.0% - 96.5%

No DHS/MICS data

Guyana 96.5

Suriname 94.9

Trinidad & Tobago 94.9

Peru 92.5

Venezuela 91.8

Colombia 91.4

Bolivia 81.6

Nicaragua 81.4

Dominican Republic 74.6

Haiti 69.7

REASONS FOR NON-REGISTRATION

0 5 10 15 20 25

Cost too much

Must travel too far

Did not know childshould be registered

Late fee

Did not know whereto register Venezuela

Bolivia, Colombia, Dominican Republic, Nicaragua

Guyana, Suriname

DIFFERENTIALS OF BIRTH REGISTRATION: SOCIO-ECONOMIC VARIABLES

• GENDER

Similar rates of birth registration between girls and boys.

0102030405060708090

100

female

male

total

DIFFERENTIALS OF BIRTH REGISTRATION: SOCIO-ECONOMIC VARIABLES

• PLACE OF RESIDENCE

Urban areas have higher birth registration rates

0102030405060708090

100

rural

urban

total

DIFFERENTIALS OF BIRTH REGISTRATION: SOCIO-ECONOMIC VARIABLES

• HOUSEHOLD WEALTH

Poverty is associated with low levels of birth registration

0

10

20

30

40

50

60

70

80

90

100

poor quintile

rich quintile

DIFFERENTIALS OF BIRTH REGISTRATION:SOCIO-ECONOMIC VARIABLES

• MOTHER’S LEVEL OF EDUCATION

Positive correlation between the mother’s educational level and her child’s likelihood to be registered

0102030405060708090

100 no education

primary

secondary

tertiary

DIFFERENTIALS OF BIRTH REGISTRATION:PROXIMATE VARIABLES

Sample birth registration levels, according to received vaccinations

SUMMARY AND CONCLUSIONS

Limited access to health care

Born without support of health professionals

Do not attend childhood education Higher level of

malnutrition and mortality rates

Lower level of vaccination and

vitamin A provision

Mothers with lowlevel of education

Live in rural areas

Poor

UNREGISTERED CHILD

→ Need for an integrated approach:

education, maternal and child health, early childhood development