Need of Multiple Policy Approaches for the Accurate Estimation of Mortality by Civil Registration Data in Low- and Middle-Income Countries

Mohd Shannawaz, Amity University

Accurate mortality measurement is a challenge in low- and middle-income countries (LMICs), with civil registration and vital statistics (CRVS) systems data due to incomplete registration, poor data quality, limited coverage, and delayed reporting. This paper presents a systematic review and meta analysis of 41 studies from 27 countries. Results shows that combination of two or more components provided improved registration rates. A strong legal identity framework and ensuring equal access to civil registration services for every gender specifically women and girls were found to be critical. A combination of policy strategies tailored to the need of their specific health systems, governance structures, and sociocultural contexts. Finally, aligning capacity building efforts synchronized with other policy implementations is key to improving the skills and resources of local institutions and implementer. CRVS data estimated excess deaths during COVID-19, consistent with seroprevalence and COVID-19 fatality rates. Which emphasis for the robust CRVS systems to accurately estimate excess mortality in pandemics. Data quality will be better if death counts and mortality rates are presented by abridged life table ages up to age 85. Model life tables may be good alternate to estimate mortality rates, especially where CRVS data were incomplete.

Keywords: Civil Registration and Vital Statistics, Mortality and Longevity, Inequality, Disadvantage and Discrimination, Population Policies

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