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Linking communities with civil registry services - Experience of Senegal

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Presentation by Laetitia Bazzi (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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Linking communities with civil registry services - Experience of Senegal

  1. 1. Linking Communities with Civil Registry services Experience of SENEGAL Presented by UNICEF Country Office Ottawa, 27-28 February 2018
  2. 2. Key Figures 70 % U5 Children BR rates (DHS 2016) Population: 13.5 Mo - 55% Rural Under 18 years old : 6.5 Mo (49%) Under 5 : 1.99 Mo % U5C Registered % U5C Unregistered 90.5% of pregnant women make at least 2 prenatal visits 76% of birth in a health facility 69.8 22.9 Immunization Rate Children 12-23 months % (DHS 2016) % who received all vaccins % who received some vaccins % who received no vaccins at all 3084 HF689 CRC Children in rural areas have 1.4 fewer chances than those in urban areas to be registered Poor Children twice fewer chances than richest
  3. 3. Saint Louis Louga Dakar Matam Thies Tambacounda Diourbel Kaffrine Kaolack Sedhiou Ziguinchor Kolda Kedougou Fatick 50 37 37 30 51 58 361910 37 37 28 29 19 High disparities among regions % Children U5 unregistered 2015-2016 Nbr hbts/CRC (2014) ≤ 10.000 ≤ 15.000 ≤ 20.000 ≤ 30.000 + 30.000 ≤ 50% ≤ 70% ≤ 90 % % Institutional birth (2014)
  4. 4. • Upon the law : Mandatory, Free, No restrictions • A system based on one’s voluntary declaration (Francophone)  Can be done by either : father, mother, relative, health staff/agent, household head where the child was born  Has to be done (by default) by : Traditionnal chiefs (sanction) • In practice : High burden on parents / discriminatory practices against women • The broader agenda of State’s authority, and the relation population have with state services 3/17/2018 Key caracteristics
  5. 5. Key components of the CRVS reform in Senegal Developing tools / Trainings Rolling out new process (physical/digitalized) National Civil Registry Management Strengthening M&E systems HEALTH SYSTEM Institutional framework Legal Framework Reform HMISMIH Services National Standards for civil registration Human & Material resources for CRVS Digitization /HERA DEMAND FOR CIVIL REGISTRATION Surveys / Awareness Raising Campaigns & Community mobilization Alert System - Citizen Control DHIS2Health agents facilitate CR CIVIL REGISTRY SYSTEM Support to data collection on Health and CR at community level (CHA) Developing tools / Trainings Rolling out new process/systems Agreements between sectors M&E Baseline and Final Evaluations Real Time Monitoring (RapidPRO) Data generation
  6. 6. UN CONTEXTE FAVORABLE • Awareness raising / Community mobilization • Through Health facilities • Innovations : Rapid PRO Building the bridge between demand and services
  7. 7. UN CONTEXTE FAVORABLE • National Communication Plan for Civil Registration (CNEC) • Community mobilization for Child Protection : CP Committees at district, city, village and urban areas levels • Building on religious leaders’ influence Raising awareness - Community mobilization
  8. 8. Health Contribution to Birth Registration In house MCH Services Institutionnal Birth Delivery of BC Immunization Nutrition Care Outreach MCH Interventions Child Health Days Notify/Declare Identify Child Health Booklet Special BR Registry Book Monitor Take a census and transmit Info Census sheet Inform / Advise DCPC
  9. 9. Identification of children less than one year of age without a birth certificate Entering of child’s personal data in a health register Community Health Worker Transmission of information to the head nurse (Infirmer chef de poste) Transmission of the list of information to the mayorHead Nurse Verification of the quality of the information Issuance of 3 copies of the birth certificate Mayor Transmission of the first copy, volet 1 to the head nurse Transmission of the first copy, volet 1 to the Community Health workerHead Nurse Transmission of the first copy, volet 1 to the parents Community Health Worker End of each day End of the campaign Child Health Days
  10. 10. • Monitoring and reporting on vital events ; • Facilitating communication and collaboration between civil registry agents, health agents, and community actors 3/17/2018 RAPID PRO Perspectives
  11. 11. Civil Registry Desk Functioning
  12. 12. UN CONTEXTE FAVORABLE
  13. 13. UN CONTEXTE FAVORABLE • Electoral agenda. Politization of civil registration • Decentralization • Lack of MOU between Health & Civil Registry. Cooperation at decentralized level based on pilot tools/process • Vision of health actors roles : – Reluctance of some CR Officers on emerging Health agents’s roles for BR – Health agents not envisionned to be civil registrar officers – Need for health agents to preserve the relation of trust between population and health services • Limited knowledge of health agents, community leaders and actors on CR. • Evidence & data. Beyond MICS and DHS, no data available on CR demand. Insuffisiant research / Analysis on social dynamics around CRVS. Limits and constraints
  14. 14. 0 10 20 30 40 50 60 70 80 90 100 Bounkiling Velingara Kolda Medina Yoro Foulah BR rates trends in targeted areas (Under 1) Taux d'enregistrement des naissances 2013 Taux d'enregistrement des naissances 2015
  15. 15. Birth Registration – The Good NewsBirth registration and MNCH –Take away Messages • Multi-pronged interventions mutually reinforcing // CP agenda reinforce CRVS agenda & vice versa • Health’s role is central for results on the ground • More investment needed on building evidence on demand • Innovations do not replace needed changes in human work processes • Joint Planning / Funding strengthen collaboration between Child Protection & Health, and bring together both sectors’ counterparts comparative advantages, expectations, fears, constraints • Multisectors training : an opportunity to build capacities & cooperation between sectors/actors • Start pilot linking both systems at operationnal levels enables testing approaches and provides an opportunity to make the case for decision makers

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