The document discusses the challenges of civil registration and vital statistics (CRVS) systems in the Pacific region. It notes issues like isolated populations, fragmented systems, lack of awareness, and inaccurate cause of death data. Improving CRVS is important for health planning, government services, identity/security, and land rights. The overarching aim is to help Pacific countries improve birth and death registrations to provide better evidence for decision makers. This will help address issues like rising non-communicable diseases and mortality rates. A multi-sectoral approach is encouraged through a Pacific Vital Statistics Action Plan.

1. The Pacific Counts.
Improving civil registration
and vital statistics
Policy and planning uses of
CRVS in the Pacific
Audrey Aumua
Technical Advisor
WHO Pacific
HIS Knowledge Hub
University of Queensland
Karen Carter
Vital Statistics and Civil Registration
Specialist
Statistics for Development Division
Secretariat of the Pacific Community

2. • Isolated islands and territories
• Small pockets dispersed of populations
• Complex and fragmented CRVS systems
(collection and legislation
• Lack of awareness of registration
• Significant problems with accuracy of cause-
of-death data
• Lost data due to events occurring offshore
• Limited analysis and use of data
• Duplication of responsibilities for vital
registration
• Poor cause-of-death certification practices.
• Limited data sharing between agencies
The Challenge of CRVS in the Pacific

3. The importance of CRVS in the Pacific for
Policy and Health
HEALTH PLANNING
• Identifying Priorities – NCD’s / Maternal and Child health
• Targeting Health Programs – Populations at risk
• Service Delivery - Immunisations / Population s / Midwives etc
• Monitoring and Evaluation – funding / international agreements
GOVERNMENT SERVICES
• Education – planning for number and location of teachers
• Social Security – i.e. age of retirement
• Population Statistics
IDENTITY AND SECURITY
• Passports
• Electoral Rolls
• Disaster Planning (populations at risk and follow up)
LAND RIGHTS and INHERITENCE

4. Drivers for better information in the
Pacific
• Priorities articulated in the Pacific Plan of regional Heads of
Governments
• Ten Year Pacific Statistics Strategy (TYPSS) 2011-2020.
– The TYPSS has been endorsed by statistical agencies from all
Pacific Islands and subsequently also endorsed by:
• SPC’s 40th CRGA meeting and subsequent Ministerial conference, and
• PIFS’ Finance and Economic Ministers Meeting (FEMM)
• Donor initiatives to improve health systems through improving
knowledge about health information systems, (WHO, AusAID)
• Global initiatives such as the Millennium Declaration and MDGs and
maternal and child health

5. The overarching aim of the plan
is to assist Pacific countries
to improve their statistics on
birth, deaths, and cause-of-
death through routine
collections and thereby
provide decision-makers with
the evidence needed for
effective planning.
The Pacific Vital Statistics Action Plan
Policy
Use
Data
accessibility
and
interpretation
Data
collection
and quality

6. • Non-communicable diseases (NCDs) are the leading cause-of-
death in Pacific Island Countries and Territories and are
responsible for over 70% of all deaths
• Life expectancy in several Pacific Countries has not improved in
many years with Life expectancy in some countries less than 60
years of age.
• Improvements in maternal and child health have been offset by high
premature adult mortality – hence high mortality rates remain in
some countries
• While health professionals all have a “sense” of the issue – CRVS is
important for EVIDENCE – monitoring changes and obtaining
resources
NCDs – a critical emerging health issue
Ministers of Health Meeting Solomon Is;
28 – 30 Jun 2011

7. Example: Age-standardized rates showing increase in
NCD’s over time
Carter KL, Hufanga S, Rao C, Akauola S, Lopez AD, Rampitage R, Taylor R.
Causes of death in Tonga: quality of certification and implications for
statistics. Popul Health Metr. 2012 Mar 5;10(1):4.
Age-standardized mortality for males (selected causes) for Tonga, 2001–2009 (plausible range
based on upper and lower mortality scenarios).

8. • Good quality data is important to ensure that other important health issues
are not lost in the push to address NCD’s
For example –
• when calculated by age, the leading cause of death for adult males 15-59
years in Niue is external causes (mostly suicide) – not NCD’s
• Infant and child mortality remains an issue in places like Kiribati where
protein malnutrition remains a leading cause of death in children
• Infectious diseases such as Malaria continue to be an issue in several
countries and need to be monitored
• Septicemia is an important cause of death in several countries and is not
always linked to diabetes - important in monitoring infection control
• TB is re-emerging in a number of populations as a disease of public health
importance.
There is more than one story….

9. • The Pacific Vital Statistics Action Plan encourages a national approach –
across sectors
• Drives governance and accountability
– Country voice in international discussions ie the post 2015
development agenda
– Population statistics- size / distribution and representation
– Funding and accountability (i.e. Compact of association)
• High adult mortality (and morbidity) in working age adults affects
development / family structure / the economy / dependency ratios etc
– Mortality data is critical in addressing reasons and responses to this
high adult mortality.
• Workshops / assessments based on a multi-sectoral approach and BAG
agencies agree to support TA to a national plan / set of priorities
Good civil registration and vital statistics
supports development

10. Thank you
ON BEHALF OF THE BRISBANE ACCORD
GROUP OF PARTNERS