(Freetown, Wednesday 27 October 2021) – The National Civil Registration Authority (NCRA) with support from the Government of Sierra Leone, has conducted a one-day strategic stakeholder engagement meeting with the Ministry of Health and Sanitation (MOHS) officials at the Sierra Palms Hall, Lumley Beach, Freetown.
The purpose of meeting was to critically look at issues that affect births and deaths registration and to discuss the way forward in strengthening births and deaths registration services at health facility levels in the country.
In attendance at the meeting were the Honorable Minister of Health and Sanitation, Dr. Austin Demby, the Deputy Minister of Internal Affairs, Lahai Lawrence Leema, who doubles as chairman of the meeting, the DG NCRA, representatives of UNICEF, WHO and UNFPA, District Medical Officers (DMO) across the country; NCRA Regional Registration Officers (RROs), District Registration Officers (DROs) and cross section of Senior staff of NCRA.
In his opening remarks, the Deputy-Minister of Internal Affairs, Lahai Lawrence Leema thanked participants especially District Medical Officers for leaving their various posts in their respective districts across the country to attend such an important meeting that speaks directly to national development.
He said that over the years, births and deaths registration have been very low due to low awareness and commitment of Health Workers to support the process as a routine service. He added that a Memorandum of Understanding (MoU) had been signed between MOHS and NCRA to promote strong collaboration especially in the area of strengthening births and deaths registration services in Sierra Leone.
The Honorable Minister further noted that government and its Development Partners will continue to rely on the NCRA for accurate and reliable information on Vital Statistics emanating from Civil Registration particularly on Births and Deaths records. These records will be used to inform the design, implementation and the evaluation of various health related interventions.
He reported that poor data collection and submission persist despite efforts by NCRA to improve Births and Deaths Registration in the country as according to the NCRA Vital Statistics Report of 2020, Births and Deaths registration were 34.2% and 16.2% respectively. He therefore called on DMOs through the Ministry of Health and Sanitation to continue to supporting each other especially in the area of strengthening births and deaths registration in the country.
The Minister of Health and Sanitation, Austin Demby said that Births and Deaths are the two most important vital events in our lives and the most profound and personal records that define a person with a true sense of belonging and that the absence of such records will be unfathomable at both the individual and at national level.
“We would all agree that perhaps two of the most important events in each of our lives is the documentation of our arrival on this earth and our exist from it; the registration of Births and Deaths,” he said.
He disclosed that Births and Deaths records are initiated mostly from health facilities manually and has been delayed and inefficient as alluded by the 2020 statistical report on Births and Deaths registration in Sierra Leone by the Deputy Minister of Internal Affairs.
The Minister of Health and Sanitation added, “such inefficiencies of birth records has major implications for effective care and monitoring of babies during the very critical stages in their lives; issues like vaccination schedules, monitoring developmental milestones and timing critical medical interventions in the life of a child are all compromised in the absence of these vital records.”
He also stressed, “the importance of such vital records for macro level planning involving quantification and forecasting of health program needs cannot be overemphasized.”
Dr. Demby said that through an MoU, MOHS and NCRA have arrived at a mutually supportive solution to strengthening births and deaths registration. He assured the NCRA DG of his ministry’s commitment in supporting the process. “In the hands of healthcare workers at the front lines recording these events, I am very confident that we will bring efficiencies, effectiveness, completeness and timelines to this important service to the nation and to every individual,” the Minister assured.
The Child Protection Specialist of the United Nations Children’s Fund (UNICEF), Stefano Schwarz commended the NCRA for inviting his organization to such an important meeting and to engage in discussions that are critical towards strengthening births and deaths registration in the country.
In his submission, the Coordinator Health Systems of the World Health Organization (WHO), Dr. Selassi Amah D’Almeida said CVRS is very important to WHO as reflected in World Health Assembly Resolution WHA67.14 of 24 May 2014 in which member states were urged in the context of development agenda beyond 2015 to recognize the importance of accountability by strengthening CRVS and health information systems to be used for monitoring health equity by providing dis-aggregated data.
“More related to today’s meeting is the World Health Assembly Resolution WHA67.10 which endorsed the strategic objective that every new-born needs to be registered, and new-born and maternal deaths and stillbirths need to be counted. This is an agenda towards “Every new-born: an action plan to end preventable deaths,” he mentioned.
He disclosed that WHO as the secretariat of Ministry of Health of member states is mandated to support the strengthening of Civil Registration and Vital Statistics of which registering births and deaths is part of the continuum.
Making a statement, the Director-General of NCRA, Mohamed Mubashir MASSAQUOI stated that NCRA recognizes MOHS in the administration and management of Births and Deaths Registration services, especially frontline health workers that have to do with the collection of data particularly guiding and supporting the management of births and deaths registration in the country. He said that the essence of the meeting was for NCRA and MOHS to sit together and agree on or carve ways that can improve or strengthen births and deaths registration.
“As a government, we want to have a reliable and accurate data on the events that characterized everyone’s existence in the country,” the DG said
He revealed that the low Births and Deaths Registration records is a prerequisite to strengthen the collaboration and coordination with MOHS at National and District levels to improve Births and Deaths Registration, management and administration to be able to produce a reliable Vital Statistics.
“ It is in view of the aforementioned that NCRA has decided to engage the leadership of the Ministry of Health both at Political, Technical/Professional and Operational levels also at National and District levels to discuss and come up with realistic way forward that will improve Births and Deaths registration services at all levels of healthcare deliveries and also in communities where there are no health facilities in a sustainable manner that guarantees the production of accurate Vital Statistics consistent with Section 26 of the NCR Act, 2016 for the good of all,” he emphasized.
He further noted that the meeting was also an opportunity for NCRA to present to the Ministry of Health and Sanitation the mobile application that health workers and NCRA staff are going to use to support the notification and registration of births and deaths. He informed participants that with support from the government of Sierra Leone and UNICEF, the NCRA has commenced a week-long training of Health Workers across the country on the use of the Mobile Application.
“As we speak, a week-long training session on the use of the Technology is ongoing in all Districts in the country targeting NCRA staff, MOHS staff and Community Health Workers designated to serve as Births and Deaths Focal Persons at health facilities and communities where health facilities do not exist,” he said.
He also said, “the Technology directly links Births and Deaths Registration with the Civil Registration Systems with a unique Identifier “National Identification Number” assigned to every Registrant at the point of registration. This number is tied to the child’s parents and syncs with the antenatal and postnatal care services.”
He disclosed that in 2018, he signed an MoU with MOHS because of its strategic relevance to Births and Deaths registrations which has been managed by the former.
“The indisputable relevance of MOHS was envisaged by the NCR Act, a reason that informed the inclusion of the Chief Medical Officer as a statutory member of the Board of Authority of the NCRA,” he said.
The Director-General of NCRA acknowledged Birth Registration is a fundamental human right of a child as enshrined in the United Nations Convention on the Right of the Child to which Sierra Leone is a signatory.
He added Birth Registration establishes a child’s right to legal identity necessary to enjoy as stipulated in International and National Legal documents such as the Child Rights Act of 2007 and National Civil Registration Act of 2016 respectively.
Mr. Massaquoi further acknowledged the importance of Deaths registration, details of mortality and causes of death in order to adjust and update the Civil Register for public health and disease surveillance reasons and for the production of Vital Statistics.
“It is also used as a permanent legal record through the issuance of Death Certificate,” he affirmed.
“Birth registration is a fundamental right of the child as enshrined in the United Nations Convention on the Rights of the Child, to which Sierra Leone is a signatory. Birth Registration establishes a child’s legal identity necessary for the enjoyment of other rights provided for international and national legal frameworks. This legal provision has been domesticated in the Child Rights Act of 2007 and in the National Civil Registration Act of 2016. Death registration on the other hand is important for the purpose of adjusting the civil register, details of mortality and causes of death surveillance, for legal and personal reasons and for the production of vital statistics. It is also used as a permanent legal record through the issuance of death certificates,” he confirmed.
The Director-General of NCRA maintained both births and deaths registration provide information on Fertility and Mortality profiles for the country, a useful information for health policy formulation and planning as well as providing legal and administrative data for variety of purposes including governance, social security, financial services, etc.
He said Births and Deaths registration is mandatory according to the NCR Act of 2016, as they are required to be registered within the statutory deadline (0-90 days) and it is FREE OF COST, noting that registration after the statutory deadline goes with cost.
Mr. Massaquoi further acknowledged the role of health care facilities in the provision of health delivery in Sierra Leone for which he said they are the main hubs for collecting information and registration of births & deaths which is why as part of their collaborative efforts, NCRA has conducted series of trainings for designated health care workers especially those that provide births and deaths registration services in their respective Primary, Secondary and Tertiary health care facilities.
He added, “amidst these gains made, the Authority’s report on Vital Statistics shows that completeness rate for births and deaths registration for 2020 were 34.2% and 16.2% respectively. This evidence has shown the need for strengthening collaboration and coordination at National and District levels for improved births and deaths administration and registration with the ultimate goal of having real time and reliable vital statistics for evidenced based decisions and policy actions,” he stressed.
The Director-General of NCRA informed with support from the European Union the upgrade of the CRVS and IDMS Infrastructure is at an advanced stage where Registration of all Vital Events namely Births, Deaths, Marriages, Divorces, Adoptions and Nullities will be done and transmitted to the central system to support data sharing with other MDAs in order to produce a reliable and accurate Vital Statistics annually as provided by Section 26 of NCR Act.
“This CRVS System upgrade is in addition to the establishment of a Primary Data Centre to ensure data on our country’s population is stored in a secured environment to prevent threat, damage or loss,”Mr. Massaquoi assured.
He confirmed the New Direction Government of President Julius Maada Bio believes in CVRS and Identity Management System that accounts for the entrance, existence and permanent legal exit of all residents.
Mr. Massaquoi noted that CRVS can support government to take informed-decision in public administration and good governance that is driven by precise and reliable data instead of relying on estimation of the country’s population.
He reiterated the importance of Civil Registration and Vital Statistics in public administration and good governance and called on participants to come up with actionable plans for improved service delivery.
PowerPoint presentations were made by the Acting Director of ICT of the NCRA, Henry Swaray, on the use of ICT to improve on the recording of births and deaths events and the issuance of certificate including the Mobile Application for Births and Deaths Notification and Registration and the status of Births and Deaths Registration by the Director of Vital Statistics Dr. Sahr Yambasu.
The meeting was climaxed by group presentations from participants on challenges and recommendations to improve births and deaths registration, reporting and certification.
IEC DIRECTORATE, NCRA