Birth Register and Statistics. A big challenge for the Pan American Health Organization (PAHO) Dr Fatima Marinho, HDM/HA Coordinator Congreso Mundial de Epidemiología. Porto Alegre, Brasil, September 21-25, 2008 1
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Crude Birth Rate AMERICAS and Sub Regions 2008 Central America Latin Caribbean Non-Latin C aribbean North America South Americ a 10 15 20 25 30 35 Birth rate Source: CEPAL/United Nations 2008 3
Fertility Rate AMERICAS and Sub Regions 2008 Central America Latin Caribbean Non-Latin C aribbean North Am erica South Americ a 1.5 2 2.5 3 3.5 4 Source: CEPAL/United Nations 2008 4
Vital and Health Statistics Situation 2004-2005 Project started evaluation of vital statistics information. 2005 A preliminary report was presented A database was consolidated, and a REGIONAL REPORT was issued identifying strengths and weaknesses in the production of countries statistics. The report also identified differences among countries to facilitate the design of a plan of action, both national and international in scope, that, respecting national differences and needs, would strengthen capacity in the management, operation, and maintenance of health information systems. 5
Regional Situation The Regional Report lists the countries according to their vital and health statistics situation, revealing wide disparities among countries and even within them. This findings make it possible to pinpoint the areas requiring greater attention and targeting (at geographical and sectoral level, in processes associated with health care, vital records systems, etc.). Coverage. Situation was relatively better in 7 of 26 countries, which exhibited broad coverage (over 85%) throughout their national territory. Al the other extreme, however, 7 countries recorded barely 50% of these events. This means: only one out of every two births or deaths are recorded (under recording affects special groups of population). Quality. Affects the countries in a more homogeneous manner, specially at the local level. Lack of information on the mother s age, the child s birth weight, the place of residence, the socioeconomics characteristics of people involved in events, the attribution of ill-defined cause of death or failure to state the cause make it difficult for the countries to know the true levels of risk and burden of disease or to determine the epidemiogical profiles of mortality. 6
1. COVERAGE. Births and deaths. 2005 (c) 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 0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00 80.00 90.00 100.00 7 Death Births
Peru Honduras 100 90 80 70 60 50 40 30 20 10 0 8 Bolivia 2. Regional Situation. Births and Deaths coverage. 2005 (c) Situation of Vital Statistics in the countries. Birth and death coverage. Estados Unidos Cuba Uruguay Chile Argentina Barbados Costa Rica Trinidad y Tobago St Vicent Bahamas Brasil Guatemala Panama Mexico Colombia El Salvador Ecuador Venezuela Nicaragua Rep. Dominicana Paraguay Belice
3. COVERAGE. MEXICO. Births. Occurred vs. Registered. 2005 (c) 90 MEXICO. Porcentaje de nacimientos ocurridos en el año sobre el total de registrados en el año. 2003 80 70 60 50 40 30 20 10 0 9
4. COVERAGE. PARAGUAY. Births. Differences between sources (MOH,VR). 2005 (c) Gráfico 2 Nacimientos. Diferencias debidas a la transmisión (salud y registro civil). 2005. 80,0 70,0 60,0 50,0 40,0 30,0 20,0 10,0 0,0 10 Total del País Concepción San Pedro Cordillera Guairá Caaguazú Caazapá Itapúa Misiones Paraguarí Alto Paraná Central Ñeembucú Amambay Canindeyú Presidente Hayes Boquerón Alto Paraguay Asunción Extranjero
5. COVERAGE. PARAGUAY. Births. Register vs. estimates. 2005 (c) Gráfico 3 Nacimientos. Cobertura (diferencia entre registro y estimaciones). 2005. 200,0 180,0 160,0 140,0 120,0 100,0 80,0 60,0 40,0 20,0 0,0 11 Total del País Concepción San Pedro Cordillera Guairá Caaguazú Caazapá Itapúa Misiones Paraguarí Alto Paraná Central Ñeembucú Amambay Canindeyú Presidente Hayes Boquerón Alto Paraguay Asunción
6. COVERAGE. HONDURAS. Births. Register vs. estimate. 2005 (c) 12
7. COVERAGE. MEXICO. Births. Register vs. estimates. 2005 (c) 100.0 MEXICO. Cobertura de nacimientos según estimación disponible, por jurisdicción y año de ocurrencia. 2003 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 13
8. COVERAGE. BRASIL. Births. Register vs. estimates. 2005 (c) Gráfico 4 Nacimientos. Cobertura, estimaciones varias. Circa 2002. 120 100 80 60 40 Relaciones de supervivencia Estim aciones 1 20 Esrtim aciones 2 0 14
9. QUALITY. PARAGUAY. Births. Unspecified birth-weight of child. 2005 (c) 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 15 Total del Pais CO NCEPCION SAN PEDRO CO RDILLERA GUAIRA CAAGUAZU CAAZAPA ITAPUA MISIONES PARAG UARI ALTO PARANA CENTRAL ÑEEMBUCU AMAMBAY CANINDEYU PDTE. HAYES ALTO PARAGUAY BOQUERO N ASUNCION EXTRANJERO
10. QUALITY. COLOMBIA. Births. Unspecified birth-weight of child. 2005 (c) 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 16 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
11. QUALITY. ARGENTINA. Births. Unspecified birth-weight of child. 2005 (c) 30.0 25.0 20.0 15.0 10.0 5.0 0.0 17 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
Way forward (2008-2009) 2007. PAHO DC approved the Strategy for the Strengthening Vital and Health Statistics in the countries of the Americas in it s 27 th Session (WDC, October 2007) that aims at providing amore effective assistance to the countries, promote horizontal cooperation, establish a collaboration mechanism between areas of the Organization, and coordinate actions with other IOs. 2008. PAHO EC approved a Regional Plan for the Strengthening Vital and Health Statistics in the countries of the Americas (PEVS) (http://www.paho.org/spanish/gov/ce/ce142index-s.htm). 2007-2008. The PEVS is included in the 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 esp.doc 18
Way forward (2008-2009) The RP has led to consideration of lines of action in the following areas: (a) (b) (c) (d) (e) (f) Preparation or expansion of situation analysis in each country. Creation of an interinstitutional team to make a diagnosis and devise a plan in each country. The priorization of greater coverage (thematic, geographical, sectoral), improvements in quality, and timelines of availability and dissemination of data. To prepare a national plan in countries (NP). To harmonize the national plan in the PEVS. To define a corporative multilateral components of the plan. 19