Monitoring the Indicators of The Millennium Development Goals

Monitoring the Indicators of The Millennium Development Goals Through the Civil Registration and Vital Statistics System

CRVS in MDGs n Goal 4. Reduced mortality • Under-five mortality rate • Infant mortality rate n Goal 5. Improved maternal health • Maternal mortality ratio • Proportion of births attended by skilled health personnel n Goal 6. Combat malaria and other diseases • Death rates associated with malaria • Death rates associated with tuberculosis

CRVS n Systems of Operations • Civil Registration • Administration and Management of Documents • Compilation and Analysis

Civil Registration System who shall report • Birth: hospital/clinic administrator, n attendant, n either parents, or n owner of the document, if of age n

Civil Registration System who shall report • Death: hospital/clinic administrator, n attendant, n person who performed the burial rites, n nearest relative, or n any interested party who knew about the occurrence of the event n

Civil Registration System whom to report n 1975 / 1997 • The death shall be reported to the local health officer within 48 hours after death and the death certificate shall be forwarded to the local civil registrar concerned within 30 days after death for registration

CRVS Flow of Documents Health Officer Death/Fetal death (Within 48 hours) Registrant/ Informant/ Attendant/ Death/Fetal death (Within 30 days) NSO-CO 6 th week after ref. mo. Birth (Within 30 days) Civil Registrar 10 days after reference month NSO-PO

Objectives To provide measures of: • G 4 Reduce Mortality n n • G 5 Improve Maternal Health n n • Under-five mortality rate (UMR) Infant mortality rate (IMR) Maternal mortality ratio (MMR) Proportion of births attended by skilled health personnel (%SHP) Goal 6. Combat malaria and other diseases n n Death rates associated with malaria (CSDRM) Death rates associated with tuberculosis (CSDRT)

Illustrative Example n Data source: • 2000 -2004 vital statistics from CRVS • Projected population based on Census 2000 • Level of completeness of births and deaths based on 2000 (secondary data)

Methods n Factors in the estimation of IMR, UMR, MMR • adjusted number of births and maternal, infant and under five mortality data

Methods n Factors of other measures: • Unadjusted number of births by skilled health personnel: physician, nurse and midwife • Unadjusted deaths due to malaria and tuberculosis

Methods n Measures: • • • IMR = adj. [infant deaths / live births] * 1, 000 UMR = adj. [under five deaths / live births] * 1, 000 MMR = adj. [maternal deaths / live births] * 100, 000 %SHP = [births. PNW / live births] * 100 CSDRM = [deaths due to malaria / mid-year population] * 100, 000 • CSDRT = [deaths due to tuberculosis / mid-year population] * 100, 000

Results Table 1. CRVS for MDG Indicators: Philippines, 2000 -2004 MDG Indicators 2000 2001 2002 2003 2004 P G 4 - Reduce Mortality 5 UMR 2. 8 5 4 0. 9 7. 6 4 5. 8 4 3. 3 3 8. 9 3 6. 8 4. 1 3 3. 0 3 1. 8 IMR Secondary data

Results Table 2. CRVS for MDG Indicators: Philippines, 2000 -2004 MDG Indicators 2000 2001 2002 2003 2004 P G 5 - Improve Maternal Health MMR 12 1 1 1 3. 5 32. 5 38. 3 38. 4 %SHP 6 6 5. 3 65. 9 68. 5 67. 3 7. 6 Secondary data 13 7. 7

Results Table 3. CRVS for MDG Indicators: Philippines, 2000 -2004 MDG Indicators 2000 2001 2002 2003 2004 P G 6 - Combat Malaria and Other Diseases CSDRM 0. 4 0. 3 0. 2 3 CSDRT 35. 8 34. 8 35. 5 32. 7 1. 0

-3. 5 -4. 8 -4. 4

-3. 0 -4. 6 -5. 0 -4. 7

-3. 0 -7. 5 2. 7 -9. 0

3. 6 1. 3 0. 8 0. 9

-10. 2 -16. 2 -17. 3 -27. 2

0. 2 -1. 9 -3. 6 -73. 1

Table 4. Average Annual Rate of Reduction / Growth to Achieve MDGs Indicators 1990 -1995 -2000 -2004 -2015 Goal 4 UMR -3. 5 -4. 8 -5. 0 -4. 4 IMR -3. 0 -4. 6 -5. 0 -4. 7 Goal 5 MMR -3. 0 -7. 5 2. 7 -9. 0 %SHP 1. 3 0. 8 0. 9 3. 6 Goal 6 CSDRM -10. 2 -16. 2 -17. 3 -27. 2 CSDRT 0. 2 -1. 9 -3. 6 -73. 1

Conclusion/Recommendation n n Some resulting estimates from CRVS can be used for MDG monitoring More information from CRVS should be evaluated and provided to identify whom and where to focus interventions to fast track achievement of MDGs

Conclusion/Recommendation n n Regular assessment of CRVS Death certificate should be properly filled-up • By n informant Health Officer Insurance agencies shall require properly filled-up and registered death certificate

Conclusion/Recommendations n Enhanced interagency coordination to include commitment to improve civil registration, especially among entities involved in the accomplishment of certificates of death, registration of deaths and those requiring information on deaths

Maraming Salamat Po!