PAHO Regional Perspective: Strengthening CR-VS in the Americas Alejandro Giusti. Regional Advisor in Vital and Health Statistics s (PAHO) Strengthening Civil Registration World Bank, Washington, June 9, 2009
Outline 1. Quick overview on the Regional situation (based in a 2005 assessment) 2. Actions taken by PAHO At the Governing Bodies level At the technical level 3. PAHO s PoA for the Strenghtening Vital and Health Statistics current situation
1. Vital Statistics Situation in the Americas (assessment circa 2005 based in PAHO's tools )
VITAL STATISTICS (Deaths and Births) COVERAGE at the national level (c. 2005) HAI HON PER BOL BEL PAR RDO NIC VEN ECU ELS COL MEX PAN GUA BRA BAH SVC TRI CRI BAR ARG CHI URU CUB EUA DEF NAC 0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00 80.00 90.00 100.00 Source: PAHO, 2005
VITAL STATISTICS COVERAGE at the sub-national level MEX. Births. Differences between estimations and registration. By State. C 2005. Zacatecas Yucatán Veracruz Llave Tlaxcala Tamaulipas Tabasco Sonora Sinaloa San Luis Potosí Quintana Roo Querétaro de Arteaga Puebla Oaxaca Nuevo León Nayarit Morelos Michoacán de Ocampo México Jalisco Hidalgo Guerrero Guanajuato Durango Distrito Federal Chihuahua Chiapas Colima Coahuila de Zaragoza Campeche Baja California Sur Baja California Aguascalientes Estados Unidos Mexicanos Source: PAHO, 2005 0.0 20.0 40.0 60.0 80.0 100.0 120.0
VITAL STATISTICS COVERAGE at the sub-national level PAR. Deaths. Differences between estimations and registration. By Departement. C. 2005. 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Total del Pais CONCEPCION SAN PEDRO CORDILLERA GUAIRA CAAGUAZU CAAZAPA ITAPUA MISIONES PARAGUARI ALTO PARANA CENTRAL ÑEEMBUCU AMAMBAY CANINDEYU PDTE. HAYES ALTO PARAGUAY BOQUERON ASUNCION EXTRANJERO Source: PAHO, 2005
70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 VITAL STATISTICS QUALITY. PARAGUAY. Unspecified child birth-weight Total del Pais CONCEPCION SAN PEDRO CORDILLERA GUAIRA CAAGUAZU CAAZAPA ITAPUA MISIONES PARAGUARI ALTO PARANA CENTRAL ÑEEMBUCU AMAMBAY CANINDEYU PDTE. HAYES ALTO PARAGUAY BOQUERON ASUNCION EXTRANJERO Source: PAHO, 2005
VITAL STATISTICS QUALITY. COLOMBIA. Unspecified child birth-weight 70.0 60.0 50.0 40.0 30.0 20.0 10.0 Total ANTIOQUIA ATLANTICO BOGOTA D. C. BOLIVAR BOYACA CALDAS CAQUETA CAUCA CESAR CORDOBA CUNDINAMARCA CHOCO HUILA LA GUAJIRA MAGDALENA META NARIÑO NORTE DE SANTANDER QUINDIO RISARALDA SANTANDER SUCRE TOLIMA VALLE ARAUCA CASANARE PUTUMAYO SAN ANDRES Y PROVIDENCIA AMAZONAS GUAINIA GUAVIARE VAUPES VICHADA 0.0 Source: PAHO, 2005
VITAL STATISTICS QUALITY. ARGENTINA. Unspecified child birth-weight 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Total del país Ciudad de Buenos Aires Buenos Aires Catamarca Córdoba Corrientes Chaco Chubut Entre Ríos Formosa Jujuy La Pampa La Rioja Mendoza Misiones Neuquén Río Negro Salta San Juan San Luis Santa Cruz Santa Fe Santiago del Estero Tierra del Fuego Tucumán Source: PAHO, 2005
2. Actions taken by PAHO Governing Bodies level Technical level
Governing Bodies level 2007. Strategy for the Strengthening Vital and Health Statistics in the countries of the Americas approved by 27 th Session of the DC (WDC, October 2007). http://www.paho.org/english/gov/csp/csp27.r12-e.pdf 2008. A Regional Plan of Action (PoA) for the Strengthening Vital and Health Statistics approved by 28 th Session of the DC (WDC, October 2008. http://www.paho.org/english/gov/cd/cd48.r6-e.pdf The PoA aims at providing a more effective assistance to the countries, promote horizontal cooperation, establish a collaboration mechanism between areas of the Organization, and coordinate actions with other IOs. 2008. PoA was included in the PAHO/WHO SP 2008-2013, Strategic Objective 11 ( To strengthen leadership,governance and the evidence base of health systems. ) http://intranet.paho.org/dpm/pps/strategic_plan0812_intranet-esp.doc
Technical level Three initiatives support the assessment of the situation in vital and health information systems: 1. PAHO s INITIATIVE. The Strategy for the Strengthening Vital and Health Statistics presented in the meeting of Directors of Statistics held in Buenos Aires in 2005 (RD-2005). (25 countries) 2. The Health Metrics Network (HMN) INITIATIVE. PAHO adhered to goals, objectives and framework of HMN. (6 countries: BLZ, ELS, GUA, NIC, BOL, PAN) 3. PAHO/USAID INITIATIVE. Developed by PAHO and MEASURE Evaluation under the umbrella agreement between PAHO and USAID (HMN and PRISM tools). (6 countries: DOR, ECU, HON, MEX, PAR, PER)
100 90 80 70 60 50 40 30 20 10 0 Countries participating in the PAHO initiative articulated with HMN or PAHO/USAID initiatives by VS coverage index HMN Initiative SP Assessment Beginning PAHO/USAID Initiative SP Assessment Beginning Barbados Costa Rica Trinidad y Tobago St Vicent Bahamas Brasil Guatemala Panama Mexico Colombia El Salvador Ecuador Venezuela Nicaragua Rep. Dominicana Paraguay Belice Bolivia Peru Honduras Chile Argentina Uruguay Cuba Estados Unidos
PoA current situation At the national level Being implemented in all the countries of the Region: All countries are linked to the PoA trough the WHO/PAHO SP, SO 11. Giving technical cooperation to 12 countries in critical situation in alliance with HMN, USAID, MEASURE Evaluation and CIDA (BLZ, BOL, DOR, ECU, ELS, GUA, HON, MEX, NIC, PAN, PAR, PER. Following activities with PWR s FP in COL and VEN. Designing strenghtening activities at the subnational level (HON, PAR). At the subregional level Coordinating activities in BWP of MERCOSUR and ANDEAN subregions. Participating in the Red Mesoamericana, HMN TSP initiative with JSI and the IMSP (México). Meeting in MEX next July for disseminating HMN s SP tool. Participating in HMN meeting for the Caribbean countries in Belize, next August. At the regional level Designing a network with countries in alliance with Red Mesoamericana (HMN TSP), USAID, MEASURE and RHINO. Meeting next October.
Way forward for PAHO and IOs Promote, coordinate and make a sustainable plan at the national level? Define activities at the subregional level? Finance and promote horizontal cooperation between countries? Go forward with strengthening activities at the local level where the process begin?
Thank you giustia@chi.ops-oms.org