Opportunities to increase birth registration level in countries

Leveraging existing healthcare programmes as opportunity to improve birth registration coverage

Why is birth registration important? 

Civil Registration and Vital Statistics (CRVS) systems are essential for ensuring legal identity, enabling access to services, and generating vital statistics for policy and planning.  

Birth registration provides documentary evidence of the place, date of birth and filiation of a person. This information is fundamental to determine the accurate age thus preventing fraud, exploitation of minors, such as child labour and marriage. After registration, a birth certificate can be issued allowing multiple legal, social and economic benefits, including identity and/or citizenship. 

There are two indicators in the Sustainable Development Goals (SDGs) related to birth registration:  

  • SDG indicator 16.9.1: “Proportion of children under 5 years of age whose births have been registered with a civil authority”  
  • SDG indicator 17.19.2 (b): “Proportion of countries that have achieved 100 per cent birth registration and 80 per cent death registration“ 

However, in many countries, not all births are registered or may not be registered in a timely manner, leading to significant gaps in population data and access to service.

What are the opportunities in the health sector to improve civil registration?  

Health institutions and health workers occupy a unique position with respect to the collection of data on births and deaths.   

The health system has its first contact with individuals at birth, Globally, 84% of births attended by a skilled professional in 2025, and 77% in the least developed countries. The second contact occurs during immunization of newborns. Globally, 89% of infants receive the first dose of the vaccine protecting  against diphtheria, tetanus, and pertussis (DPT1) in 2024 and 83% in the WHO African Region. Additional contacts follow according to the routine vaccination schedule.

In the case of mortality, vertical surveillance programmes and disease registries can support monitoring and informing the occurrence of deaths in a timely manner in accordance with the International Classification of Diseases (ICD), the international standard for cause-of-death reporting. 

Points of contact with health systems that could improve civil registration

Thanks to global, regional and national investments, immunization programmes,-particularly those targeting infants during the first year of life (for example BCG and DTP1) , can reach a high percentage of the target population.

This presents an opportunity for the health sector to contribute improving birth notification and supporting registration as many low-income countries follow WHO’s recommended routine immunization schedule.

Selected immunization coverage indicator

  • Bacillus Calmette-Guérin (BCG) to protect against severe forms of tuberculosis - given as soon as possible after birth
  • Diphtheria, Tetanus, and Pertussis (DTP) - given firstly at 6 weeks minimum and then at an interval of every 4-8 weeks. The coverage of the third dose of DTP vaccination (DTP3) is the key indicator for Immunization coverage for 1 year-olds. 
  • Measles-containing Vaccine (MCV) - In most countries, the second dose (MCV2) is recommended  at the second year of life or around school entry age.

 

Given the marked improvement in the essential health services and the reiterated moments of contact with health sector, from institutional births and vaccination or newborn growth measurements to death certification, the health sector can continue to play a significant role in ensuring that many more births and deaths are officially registered by national civil registration systems.