The ‘What’ and ‘Why’ of Vital statistics Data Analysis and Report Writing workshop 21-31st May, Nadi, Fiji

Outline What are Vital statists? Why we need Vital statistics Sources of Vital statistics data Civil Registration as a source of vital statistics

What do we mean by vital statistics? Definition: The collection of statistics on vital events in a lifetime of a person as well as relevant characteristics of the events themselves and of the person and persons concerned. Vital events: are events concerning life and death of individuals, as well as their family and civil status The UN recognises 10 Vital events for which data are to be collected: Live births, Deaths, foetal deaths, marriages, divorce, Annulment, Separation, adoption, legitimation, Recognition

Priority events The UN provides three classifications of vital events : Vital events proper Dual events Vertical Family events Because they pertain to individuals existence and survival, vital event proper (Live births, deaths and foetal deaths) are ranked to be of highest priority among other events. A governments timely knowledge of the occurrence of these critical events can save a life, family, a village, a community and a country!

Why we need vital event data Vital Statistics provide a bulk of the data needed for monitoring of social and economic development in countries. Accurate data on births, deaths, and cause‐of‐death are essential for: Monitoring the health of a population; Identifying health priorities and evaluating health and program impacts; Providing access to real‐time information on population size and structure; and Providing the necessary data for the calculation of all population‐based development indicators Used to track development progress. SDG indicators

Uses of vital statistics Vital Event Rates and indicators Numerator (Civil registration) Denominator by source i) Live Births Crude Birth Rate Live births Mid-year population* Sex ratio at birth Live births (Male) Live births (Female) General Fertility rate Mid-year female population (15-49) * Age specific fertility rate Live births to women of a particular age group). Mid-year population of female of same age-group* % of low birth weight births Low birth weight infants born alive Live births in one year  % of live births to unmarried women Number of children born alive to unmarried women ii) Death Crude Death rate Deaths in one year Infant mortality rate Deaths of infants (< 1 year) Child Mortality rate Deaths of infants (< 5 years) Neonatal mortality rate Neonatal deaths   Post-neonatal mortality rate Post-neonatal deaths Maternal mortality ratio Maternal deaths Age specific mortality rate Deaths in a particular age group Mid-year population of same age-group* Cause-specific mortality rate Number of deaths from a specific cause Total population* * Requires data from other source in the absence of population register

Example: 2013 Ebola Outbreak in Liberia https://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_Liberia#Hidin g_of_Ebola_infected_and_dead

What are the sources of vital event data? There are two main categories of data sources for which vital statistics data can be drawn from: Periodic collections– Censuses, household sample surveys conducted say 5 yearly, 10 yearly which collect retrospective info about the number and characteristics of birth and death Administrative (routine collections)—Civil registration systems, health information systems, police records (for events of unnatural deaths), other operational admin databases Key difference in these sources is : (i) the frequency for which the are undertaken i.e. “stock” vs “flow”(ii) their scope of coverage

Key features of these data sources Periodicity Sample frame Period of interest Data collection (mortality level data) CoD Data Collected? Census Periodic – 5-10 years Whole Population Retrospective Direct and indirect No Survey DHS ~ 5 years Selected sample – representative of whole population Direct – complete birth history MICS ~ 5-10 years 2 stage clustered sample – representative of whole population Indirect - partial birth history (CEB/CS) Routine Admin records Civil Registratio n Continuous Whole population (depending on coverage) Current Direct reporting of event Yes Health databases Whole population / Hospital cases only Demographic surveillance Sites Selected areas – usually not representative of whole population over time.

Civil registration as a source of vital statistics The continuous, permanent , compulsory and universal recording of occurrence and characteristics of vital events occurring to a popn in accordance with the laws of a country The UN recognises civil registration as being the most reliable source of vital event data and statistics. Key features of the system: Universal Continuous (incidence vs. prevalence statistics) Permanent Compulsory However, civil registration systems are often weak and incomplete in most developing countries. Therefore, it has been necessary to use alternate data sources This method should be distinguished from other methods of gathering data about the population because it is mandated by law to be continuous and permanent. [Para 280 U.N P&R

Civil registration as a source of vital statistics In some instances data collected through health information systems/ through health databases are found to be more complete than civil registration data With the incompleteness of CR systems, censuses have been used as the primary sources of vital event data and statistics in the Pacific. The increasing need to report against key population health indicators ( as required by SDGs) calls for strong Administrative collections

Where does your data come from? Think about the data you brought to the course and where it comes from… Why was it collected? How was it collected and by whom? What are the strengths and weaknesses of that data collection? What impact is that likely to have on your data?