GlobalIn response to the deficiencies in CRVS information systems and particularlytheir impact on the reporting and monitoring of progress against theMillennium Development Goals, growing global attention is being given toimproving CRVS, especially through region-centric approaches, which seek toimprove the coverage of both the count of births and deaths as well as thequality of causes of death data produced.
ESCAPIn Asia and the Pacific, since 2008, the UNESCAP Committee onStatistics has recognised the need for CRVS improvement and in 2010tasked ESCAP with the development of an improvement plan:Recognizing the importance of reliable vital statistics for producingtimely and accurate population estimates and other demographic andhealth statistics, including the Millennium Development Goals, whichare some of the most basic requirements for evidence-based planningand efficient resource allocation, the Committee supports thedevelopment of a regional programme for improving vital statistics inthe Asian and Pacific region and recommends that the secretariat,under the guidance of the Bureau, continue to develop the regionalprogramme fully in close collaboration with development partners.Ref: UNESCAP Committee on Statistics (2010) ‘Report of the Committeeon Statistics on its second session Second session’ Second session,Bangkok, 15-17 December 2010
Brisbane Accord GroupAt the same time in the Pacific, the urgent need for CRVS strengtheninghas been formalised. A Ten Year Pacific Statistics Strategy 2011-2020.The CRVS component was given further prominence and impetus withthe formation of the Brisbane Accord Group (BAG). Pacific VitalStatistics Action Plan focused on coordination of partners to supportcountries improve the completeness and quality of their CRVS data.The Pacific Health Ministers meeting in Solomons in July 2011welcomed the formation of the Brisbane Accord Group and its goal tosupport Pacific countries to improve their CRVS systems. The meetingrecommended that CRVS should be a regional priority.
Pacific Action PlanThe action plan for strengthening CRVS in the Pacific systematicallyaddresses the following specific objectives:1. Establish mechanisms for the coordination of all in-country personneland development partners to work with countries to develop acountry strategy for improving vital statistics2. Support country specific strategic plans that can be carried out withinthe framework of the Ten Year Pacific Statistics Strategy3. Encourage and assist all countries to undertake assessments of theirCRVS systems4. Promote both community awareness and government commitment toimprove and sustain CRVS systems5. Enhance understanding of the importance of vital statistics6. Strengthen training of personnel involved in civil registration and theproduction, analysis and interpretation of vital statistics7. Promote the use and dissemination of vital statistics8. Establish with countries mechanisms for regularly reviewing progresswith CRVS systems
4 GroupsThe Pacific Vital Statistics Action plan groups countries into 4 groupsbased on geographic and population considerations and proposestailored strategies for each group, including technical assistance andtraining:• Group 1 countries: Small island states in South and Central Pacific(Cook Islands, Nauru, Niue, Tokelau and Tuvalu)• Group 2 countries: Small island states in North Pacific (The Republicof Marshall Islands, the Federated States of Micronesia (5), theCommonwealth of the Northern Mariana Islands and Palau)• Group 3 countries: Larger countries with more developedadministrations (Fiji, Tonga, Samoa)• Group 4 countries: Larger countries with less developedadministrations and history of civil registration (PNG, Kiribati,Solomon Islands and Vanuatu).
Leadership and Governance• Lead by example• Policy Unit, Policy Commission – think tank• Donor Coordination• Multi-sector engagement• Development of decrees, policies, strategic plans, guidelines• Best Buys, Reduce Salt, Health Promotion, Bula 5:30, Walk forHealth• Wellness Framework• NCD Strategic Plan
Health Workforce• Increase number of doctors and nurses• Allied health workers• Training• Professional Development• Specialist training• Shaydri Atachment• ICD 10 Training• COD Training• CRVS Short Courses
Information• Health Information Unit• Health Indicator M&E (MDGs, CHIPSR)• Disease Registries• Birth and Death Databases• Analysis of Death Certificates using ICD10• Quarterly Feedback bulletin• Development of HIP and HISSP• Data Analysis on a monthly basis• Clinical Service Network
Medicinal Products &Technologies• Introduction of new vaccines• New technological equipment (MRI, CT, Echo, etc)• ICT (PATIS, LIMS, PHIS)• Hi Speed Internet (Skype - telemedicine)
Financing• National Health Accounts• Healthcare costing study• Donor/Development partner Harmonisation• FHSSP (MDG 4, 5, NCD, CHW, HSS)• GF (TB, HIV and HSS - PHIS)• NGOs• Outsourcing?
Leadership outside Health• Other government departments• Cabinet• Regional (advocacy at various seminars, forums etc)• Global (various summit - ??)• Development Partners
Messages for others• Walk the talk• Quick wins• Provide support• Proactive• Use information