Chapter 4 Recommendations
B. A flow chart to guide selection of indicators for delivery of civil registration services for birth registration
Chapter 4 Recommendations
Figure 5 Use of a flow chart to develop indicators for the delivery of civil registration services for birth registration
Figure 5 shows a simple example of a mapping of the end processes involved in the delivery of birth registration services. More detailed flow charts of both the supply and demand sides adapted to both rural and urban areas and different population sub-groups would facilitate the design and implementation of a more effective, efficient and gender-sensitive system of delivering birth registration services. For example, a detailed supply-side flow chart might include provision of budget, provision of staff, design of the public awareness campaign, design and delivery of training for delivery staff, design of forms, identification of distribution points and distribution of forms, and training (including gender training) for registration staff. Similarly, a detailed demand-side flow chart might elaborate the creation of demand through stages from hearing about birth registration, understanding its importance, knowing the requirements for registering a birth, knowing where to obtain the necessary forms, through to details of the distance, time and other financial, social and cultural costs of access for various groups of women and the likelihood that women with new babies would have the resources needed to follow through on the required process. Analysis of the detailed supply and demand flow charts might help improve service delivery. For example, if the majority of women attend at least one ante-natal visit or have their babies immunised, the local health centre might be the most effective distribution point for birth registration forms, as well as information about the importance of birth registration and the processes involved.
Process
Issues/gender issues
Supply side
Demand side
Training for hospital staff & midwives on importance of birth registration and distribution of registration forms
Public awareness campaign on benefits of birth registration targeting women of reproductive age & their husbands
Language for campaign Literacy of women of reproductive age
Midwife
Registration form provided to mother
Proportion of target group sample by sex aware of benefits of birth registration
Proportion of hospital staff/midwives aware of benefits of birth registration
Delivery
Hospital
Indicators
At home
Parent (Mother? Father?) gets form from post office or other readily accessible location
Parent brings form to registration office
Possible cultural & communication barriers between mothers & medical staff Empowerment/motivation of mothers to obtain form
Number/proportion of mothers delivering in hospital receiving form
Motivation of fathers or other family
Number/proportion of mothers delivering with midwife receiving form
Distance, time, other costs of access and whether women with new babies have the necessary resources for access
Number/proportion of mothers delivering at home obtaining form (directly or through father or family)
Possible differences in motivation by sex of child
Form checked Parent assisted to fill out if necessary Form submitted
Possible cultural or communication barriers between parents & registration officers Potential for bribery by officials
Number/proportion of parents by sex submitting completed registration forms Number of birth certificates issued
Birth certificate issued
36
Possible differences in registration by sex of child
Proportion of children by sex with birth certificate (at immunisation or school entry etc)
37