Completeness of birth and death registration in a rural area of South Africa: the Agincourt health and demographic surveillance, 1992–2014

Abstract

BackgroundCompleteness of vital registration remains very low in sub-Saharan Africa, especially in rural areas.ObjectivesTo investigate trends and factors in completeness of birth and death registration in Agincourt, a rural area of South Africa covering a population of about 110,000 persons, under demographic surveillance since 1992. The population belongs to the Shangaan ethnic group and hosts a sizeable community of Mozambican refugees.DesignStatistical analysis of birth and death registration over time in a 22-year perspective (1992–2014). Over this period, major efforts were made by the government of South Africa to improve vital registration. Factors associated with completeness of registration were investigated using univariate and multivariate analysis.ResultsBirth registration was very incomplete at onset (7.8% in 1992) and reached high values at end point (90.5% in 2014). Likewise, death registration was low at onset (51.4% in 1992), also reaching high values at end point (97.1% in 2014). For births, the main factors were mother's age (much lower completeness among births to adolescent mothers), refugee status, and household wealth. For deaths, the major factors were age at death (lower completeness among under-five children), refugee status, and household wealth. Completeness increased for all demographic and socioeconomic categories studied and is likely to approach 100% in the future if trends continue at this speed.ConclusionReaching high values in the completeness of birth and death registration was achieved by excellent organization of the civil registration and vital statistics, a variety of financial incentives, strong involvement of health personnel, and wide-scale information and advocacy campaigns by the South African government.

An Empirical Analysis of the Socioeconomic and Demographic characteristics influencing Birth Certification in Nigeria

“…It thus confirms the use of multilevel modeling techniques. This finding was consistent with the study conducted by [60], and justified by the existence of differences in coverage, social norms, cultural beliefs, geography, quality of health services and distribution of registration centers. One can thus conclude that 2.52% of the variation in BC is attributed to differences between states and 25.98% to differences between communities nested within the states.…”

“…This finding of the negative effect of distance to registration centers on BC has not been noted elsewhere for Nigeria, however, [5,29,30] reports similar findings for children living in Indonesia and selected countries in Latin America and the Caribbean. The findings of higher birth order, longer birth intervals and father's work status as significant obstacles to BC are also in line with other studies of birth registration [60][61][62][63].…”

“…during post-natal visits and vaccinations), where their parents can be reminded of the need for BC. Children whose mothers are separated or divorced are less likely to be certified which has also been noted by [21,60] on birth registration in Nigeria. Mothers in a union may have the assistance from a spouse or partner to care for the child(ren), while they deal with the process of BC.…”

“…Seven characteristics were included as measures of the child's demographic information: gender (0=female, 1=male), age-in-months, collapsed into five cohorts (1=<12, 2=12-23, 3=24-35, 4=36-47, 5=48-59), birth order (1=1 st child, 2=2 nd child, 3=3rd child, 4=4 th or higher order birth), size-at-birth (1=small, 2=average, 3=large) 10 , birth interval (years), skilled birth attendant (SBA, 0=No, 1=Yes) and vaccination status (0=0, 1=1+).…”

Incentives for Improving Birth Registration Coverage

“…Further, Lesotho's Child Grants Program increased birth registration by 37 percentage points (Benjamin et al 2015). South Africa's Child Support Grant is a nationwide cash transfer to households under the government-determined income threshold, and the study's authors cited the grant as a significant contributor to increasing South Africa's birth registration from 21.2 percent in 1992 to 84.1 percent in 2012 (Garenne et al 2016).…”