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Human-centred design in CRVS - An example from Tanzania

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Presentation by Bhaskar Mishra (UNICEF) at the international conference on innovations in Civil Registration and Vital Statistics (CRVS) systems - Ottawa on 27-28 February 2018. See more at http://crvsinnovations.net

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Human-centred design in CRVS - An example from Tanzania

  1. 1. Human-Centred Design in CRVS An example from Tanzania CRVS Innovations Conference Ottawa, Canada February 27–28, 2018
  2. 2. From the perspective of the user (human) Human Centred Design in CRVS – UNICEF | for every child What does CRVS entail? Notification Declaration Registration Certification Universal coverage
  3. 3. DISTANCE: Registration points closer to the community COST: Affordable to all; direct costs and indirect costs NOTIFICATION: An alert about the occurrence of an event REGISTRATION AND CERTIFICATION: A Siamese twin; ‘One step, One visit’ process Drivers of a human-centred CRVS process Human Centred Design in CRVS – UNICEF | for every child
  4. 4. Legal framework: One of the statutory requirements Awareness: A key to demand creation Interoperability with other systems: Benefits all, the community the most Quality vital statistics: Aids evidence-based planning Drivers of a human-centred CRVS process
  5. 5. DISTANCE: Average distance to district HQ between 80 – 140 kilometres; difficult and mountainous terrain; weak public transport system COST: Prohibitively costly exercise; one of the costliest systems NOTIFICATION: Cumbersome, limited coverage REGISTRATION AND CERTIFICATION: ‘Two-step, two-visit’ process Existing Tanzanian CRVS system Human Centred Design in CRVS – UNICEF | for every child
  6. 6. Existing Tanzanian CRVS system Human Centred Design in CRVS – UNICEF | for every child Legal framework: Outdated; doesn’t address the basic issues of ‘distance’ and ‘cost’ Awareness: A big challenge across the board Interoperability with other systems: Centralized CRVS system hinders effective interoperability with other systems Quality vital statistics: No vital statistics generated from the CRVS system due to poor coverage
  7. 7. CRVS situation in Tanzania Consequently, unregistered U5 children account for: 16.4% Eastern and Southern Africa 8.3% in Sub- Saharan Africa 4.1% across the world More than 75% outside purview of CRVS system Human Centred Design in CRVS – UNICEF | for every child Less than 13% have a birth certificate Under-5 children: Another 11% only have a notification Huge differentials: Urban 28.1% Rural 7.3% Poorest households 3.1% Richest households 41.3% Only 637 of the 5,542 births each day get registered.
  8. 8. Tanzania at a glance Human Centred Design in CRVS – UNICEF | for every child Total population U5 Population U18 Population % Urban Population Annual no. of births CBR CDR U5MR IMR TFR NNMR % Institutional births 55 million 9.6 million 28.7 million 32 2.1 million 38 7 57 40 5 22 62.6 % population living below $1.90 per day GNI per capita (US$) National electricity rate % HHs using mobile phones %HHs with a computer Internet users Males Females % Adult Literacy rate 47 920 34 77.6 3.8 Internet users 8% 18.70% 78
  9. 9. • Piloted in Temeke District in Dar es Salaam in 2012 • First launch took place in Mbeya region in 2013 • Current coverage: 9 regions; 58 district councils, 1214 wards, 1859 HFs • Four more regions to be covered in 2018 New birth registration system
  10. 10. • Decentralization • Fee waiver • ‘One step, One visit’ Registration and Certification Process • Innovation: - Data capturing using mobile phones - A dashboard to depict the progress in real-time - An online data validation platform • Public-Private Partnership: Government of Tanzania, UNICEF, Government of Canada, and TIGO Five pillars of the new system Human Centred Design in CRVS – UNICEF | for every child
  11. 11. Distance: Registration closer to the community • Registration points: Health Facilities and Ward Executive Offices 3,000 + against 41 district headquarters • Registration officers: 5,500 + against 41 district registrars • Average distance: 5-6 KMs from 80-140 KMs; Cost: Fee and fine waived; the first copy of the birth certificate is given free of cost • Fee and fine waiver: USD 3.6 million • Savings on account of 2 visits to the district registrar: USD 18 million What does the new system bring about? Human Centred Design in CRVS – UNICEF | for every child
  12. 12. Notification: Formal notification process done away with • Mother and Child health cards used as proof of birth – more than 98% of mothers have this card • Recommendation letter from the VEOs for others Registration and Certification process : ‘one step, one visit’ • Registration and certification happen simultaneously at the nearest HF/WEO Legal Framework: An MOU among the three key ministries governs the new process • Learnings fed into the national CRVS strategy and the legal review work What does the new system bring about? Human Centred Design in CRVS – UNICEF | for every child
  13. 13. Awareness: A well-chalked out strategy followed • Mix of modern and traditional methods – Social media to out reach • Involves community leaders, FBOs, elected leaders Interoperability with other systems: A good beginning • Declaring HFs as registration points a game-changer • Real-time registration data an important input for the ID ecosystem Quality vital statistics: Dashboard and data validation turning points • Depicts progress at regional, district, ward, and health facility levels • Yields disaggregated numbers by age, sex, place of birth, place of registration, and other variables • Data validation module makes data error free What does the new system bring about? Human Centred Design in CRVS – UNICEF | for every child
  14. 14. Progress over four and a half years 175,000 225,000 455,152 858,711 1,986,640 2,018,536 childrenregistered Under-5 children registered through Decentralised Birth Registration (DBR) initiative Human Centred Design in CRVS – UNICEF | for every child
  15. 15. 2012: Census; 2018: DHS and Dashboard Certification rates in nine regions Regions Mbeya Songwe Mwanza Iringa Njombe Geita Shinyanga Lindi Mtwara All 2012 11.0 11.0 12.1 11.4 8.7 8.6 9.4 11.4 9.4 10.5 2018 71.7 81.0 42.9 100.0 98.2 99.3 99.7 100.0 97.6 80.4 Human Centred Design in CRVS – UNICEF | for every child
  16. 16. Certification rate for under-5 children – Tanzania Mainland Human Centred Design in CRVS – UNICEF | for every child
  17. 17. Capturing birth registration data Human Centred Design in CRVS – UNICEF | for every child Internet Android app SMS SMS Gateway SMS Dashboard
  18. 18. http://u5bri.rita.go.tz/ud/index.php Tanzania under-5 birth registration dashboard Registration insolvency and Trusteeship Agency (Rita), Government of Tanzania Thursday 15 February 2018 Human Centred Design in CRVS – UNICEF | for every child Registrations by gender 50.5% 49.5% Place of registrations 39.1% 59.7% Registrations by region Registrations by age (%) Total birth registrations 2,019,418
  19. 19. Search/Selection of a record Data validation screen Records with OK status Red shows records are yet to be validated A scanned image Uploaded data Green shows records have been validated with OK status Online data validation module Human Centred Design in CRVS – UNICEF | for every child
  20. 20. Five Pillars Decentralization Fee waiver 1 step, 1 visit process Innovation PPP
  21. 21. Thank you Father & Son with birth certificate Geita, Tanzania

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