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Around half of all deaths worldwide annually, about 45 million, go unrecorded, leading to health policy decisions being made with incomplete information. To address this, a new campaign launched at the World Health Summit, Berlin, seeks to promote investment in Civil Registration and Vital Statistics (CRVS) systems and emphasise the importance of using accurate data to enhance public health and save lives.
Data for Health, an initiative set up in 2015 and funded by Bloomberg Philanthropies and The Gates Foundation, partners with low- and middle-income countries to improve public health data and use of data for policymaking. It focuses on four major areas: civil registration and vital statistics; data use for policymaking; Population-Based Cancer Registries; non-communicable disease risk factor surveys. Last year, Bloomberg Philanthropies announced an investment of $150 million now bringing the total investment committed to the initiative to $436 million.
The initiative includes collaborating institutions like the CDC Foundation, Global Health Advocacy Incubator (GHAI), Johns Hopkins Bloomberg School of Public Health, Vital Strategies, WHO and others. CRVS is the continuous, universal, timely, inclusive and compulsory recording of births, deaths and causes of death in the population. Fully functional CRVS systems also record marriages, divorces and adoptions which are particularly important for women and children. In most countries the registration of a birth creates an individual’s legal identity.
At a panel of top experts on the lifesaving potential of death data; shaping health policies that save lives, experts said without high-quality mortality data, policymakers struggle to understand demographic trends and causes of death and disease, making it difficult to allocate resources effectively. In many cases, even when deaths are recorded, many have vague causes such as “stopped breathing” or “heart failure,” or no cause at all. Even when health data is available, it often remains underutilised, missing its potential to guide critical policy and investment decisions.
According to Betsy Fuller who has worked on the public health team at Bloomberg Philanthropies, approximately 30% of health spending in middle-income countries goes toward NCDs, while in low-income countries it’s about 13%. According to experts 100+ low- and middle-income countries do not have fully functioning CRVS systems and 40% of deaths around the world are not registered.
“Hence even modest investments in data systems can lead to powerful, lasting changes in people’s lives. For every $1 invested in strengthening data systems, countries see $32 in net benefits through better targeted policies and stronger health systems,” Fuller said. The campaign will showcase human-centred stories and technical successes in Bangladesh, the Philippines, Rwanda, Solomon Islands and Zambia.
Chloe Harvey, associate statistician with the United Nations Economic and Social Commission for Asia and the Pacific, highlighted the importance of bringing registration processes to the village level, making them accessible to everyone, including people with disabilities. While internet connectivity remains a challenge in many areas, efforts are underway to simplify registration platforms and make them more user-friendly.
Dr Hafiz Chowdhury, technical advisor / lead, CDC Foundation, who works with governments in low- and middle-income countries, mostly in Asia and the Pacific, to improve CRVS and cause-of-death statistics, referred to the situation in Solomon Islands and said initially there was no organised data collection. “Primary healthcare was not established at the grassroot level and the usability of cause of death is low. Howeverm we started implementing verbal autopsies and other strategies and made progress in improving quality of death data,” e said.
Dr Alain Labrique, Director of the Department of Data, Digital Health, Analytics, and AI at the World Health Organization (WHO) also highlighted that CRVS was the foundational aspect of health systems and it was important to invest in the the system. “Mortality surveillance is often not prioritised within national health information systems. During the Covid 19 pandemic only 73 of 194 WHO member states could produce weekly death counts exposing critical gaps in civil registration and vital statistics, incomplete cause of death certification, fragmented data systems and limited anayltical capacity,” Dr Labrique said.