Anthrologica Birth Registration in Angola
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Birth registration in Angola Formative research Nell Gray and Juliet Bedford February 2016 Anthrologica Acknowledgements. ! ! We!extend!sincere!gratitude!to!the!stakeholders!who!participated!in!this!research!for!sharing!their! experiences!and!insights,!and!for!giving!their!time!so!willingly.! ! We!would!like!to!thank!the!Government.of.Angola!for!their!support!of!this!research,!particularly!Dr.! Claudino!Filipe!and!his!team!at!the!Ministry!of!Justice,!and!representatives!from!the!provincial!and! municipal!Administrations!who!facilitated!and!supported!the!fieldwork.! ! Thanks!also!to!UNICEF.Angola!for!their!onBgoing!engagement!with!the!research:! Clara!Marcela!Barona! ! ! ! Paulo!Helio!Mendes! Tatjana!Colin! ! ! ! ! Manuel!Francisco! Lidia Borba Amelia!Russo!de!Sa!! Niko!Manos!Wieland! ! ! ! Christopher!Ngwerume! Vincent!van!Halsema! ! ! ! Hammad!Masood! Neusa!de!Sousa!! ! ! ! Mario!Manuel!! Teófilo!Kaingona! ! ! ! Vinicius!Carvalho! ! And!to!UNICEF.ESARO!colleagues,!Patricia!Portela!Souza,!Milen!Kidane!and!Mandi!Chikombero,!and!to! Debra!Jackson!at!UNICEF.Head.Quarters!in!New!York.! Anthrologica!would!like!to!thank!our!two!partner!organisations,!JMJ.Angola!and!the!Scenarium.Group.! ! JMJ.Angola!was!a!valuable!collaborative!partner!at!every!stage!of!the!project,!and!particular!thanks!are! extended!to!the!following!colleagues!for!their!positive!inputs:! João!Neves! ! ! ! ! ! Manuel!Francisco! Margaret!Brown! ! ! ! ! Mateus!Correia!da!Silva! Idaci!Ferreira! ! ! ! ! ! Rui!Pascoal!Figueiredo!Junior!Romeu! Ernesto!Isidro! ! ! ! ! ! Amelia!Tome! Simba!Nevanda!José! ! ! ! ! Martins!Bota! Cristina!Oliveira!! ! ! ! ! Sabrita!Velasco! Helga!Sofia!Borges!da!Silveira! ! ! ! Galdino!Capembe! Amilton!Neto! ! ! ! ! ! Jose!de!Lima!Manuel! Pedro!Teixeira! ! ! ! ! ! Murielle!Mignot! Willy!Piassa! ! ! ! ! ! Pedro!Paposseco! ! From!the!Scenarium.Group,!we!would!like!to!thank!Michael!Thiede!for!supporting!the!management!and! analysis!of!quantitative!data.! ! From!Anthrologica,!we!would!like!to!acknowledge!the!contributions!of!our!colleagues:! Ginger!Johnson!! ! ! ! ! Alejandro!Reig! Julianne!Weis! ! ! ! ! ! Beth!Vale! Katie!Moore! ! ! ! ! ! Sylvia!LIm! Yara!Alonso!Menendez! ! ! ! ! Lars!Larsson!(from!Pronto!Publishing!Services)! Gefra!Fulane! ! Particular!thanks!are!extended!to!Yara!Alonso!Menendez!(Anthrologica)!for!translating!the!report!from! English!into!Portuguese!and!to!Fernando!Pacheco!(JMJ!Angola)!for!finalising!the!translation.! ! ! ! The!front!cover!art!and!all!graphics!included!in!the!report!were!produced!by!the!children!and!adolescent! participants!during!the!workshops!held!as!part!of!the!research.! ! Executive.summary. ! ! Background.and.objectives. ! Birth!registration!is!the!continuous,!permanent!and!universal!recording!of!the!occurrence!and! characteristics!of!birth!within!national!civil!registries.!!As!outlined!in!the!Convention!on!the!Rights!of!the! Child!that!was!signed!and!ratified!by!Angola!in!1990,!a!name!and!a!nationality!at!birth!is!every!child’s!right.!! After!four!decades!of!conflict!in!Angola,!however,!birth!registration!rates!remain!low.!!In!order!to!address! this,!registration!services!were!expanded!into!municipal!and!communal!administrations!in!2007,!and!free! birth!registration!was!guaranteed!for!children!underBfive!years!of!age.! In!2013,!in!recognition!of!the!high!number!of!unregistered!adults!and!children!over!five,!free!registration! was!extended!to!all!Angolan!citizens!until!2016.!!This!was!the!basis!for!the!Government’s!Programa'de' Massificação'do'Registo'de'Nascimento'e'Atribuição'do'Bilhete'de'Identidade'(Programme!for!Universal! Birth!Registration!and!Identity!Cards!Assignment)!that!included!a!range!of!measures!aimed!at!increasing! the!registration!rate.!!In!support!of!these!efforts,!the!Angolan!Ministry!of!Justice,!with!technical!support! from!UNICEF!are!implementing!the!‘Birth!Registry!and!Justice!for!the!Children’!programme.!!This!aims!to! serve!and!protect!the!rights!of!children!in!birth!registry!and!access!to!justice!through!the!modernisation!of! the!birth!registration!systems!and!related!administrative!procedures.!!The!programme!is!based!on!three! main!streams!of!activity:!strengthening!the!legal!and!policy!context!of!birth!registration!in!the!Angolan!Civil! Registration!and!Vital!Statistics;!increasing!technicalBprofessional!skills!and!material!resources!for!local! entities!to!plan,!manage!and!monitor!birth!registration!services!in!target!province;!and!improving! knowledge!about!correct!birth!registration!procedures!in!target!provinces.! UNICEF’s!core!role!lies!in!designing!and!implementing!appropriate!communication!for!development!(C4D)! strategies!to!increase!caregiver!and!community!demand!for!and!utilisation!of!registration!services.!!The!aim! is!to!emphasise!enabling!factors,!incorporating!new!perspectives!that!take!into!consideration!individual! behaviours,!perceptions!and!social!norms,!and!involve!families!and!communities!in!the!design!and! implementation!of!the!programmes.! Formative!research!was!conducted!to!provide!an!evidence!base!to!guide!the!design!and!elaboration!of!the! C4D!plan.!!The!research!had!four!core!objectives:!to!analyse!perceptions,!knowledge,!attitudes!and! practices!in!relation!to!birth!registration!(of!parents!and!caregivers,!children!and!adolescents!(12!to!18! years!old),!key!community!figures!with!influence!and!registration!and!health!staff!involved!in!the!provision! of!services!related!to!registration);!to!analyse!the!dominant!barriers!and!key!drivers!associated!with!birth! registration;!to!identify!the!type!and!quality!of!messaging!and!existing!gaps!in!information!communication! at!different!levels;!and!to!determine!preferences!for!modes!of!communication!and!media!channels.!! This!research!provides!important!new!empirical!data!that!contributes!to!our!understanding!of!knowledge,! attitudes!and!practices!about!birth!registration!in!Angola,!and!related!barriers!and!enabling!factors.!!The! report!is!structured!to!be!of!operational!use!to!UNICEF!and!its!partners!at!local,!national!and!international! levels.!!It!outlines!the!methodology!used!in!the!study,!presents!a!situational!analysis!of!birth!registration!in! Angola,!and!of!the!study!sites!and!participants,!and!details!the!observations!made!at!birth!registration! posts.!!The!four!subsequent!chapters!focus!on:!knowledge,!attitudes!and!practices!related!to!registration;! barriers!to!birth!registration;!enablers!leading!to!birth!registration!and!solutions!to!barriers!identified;!and! communication!and!collaboration.!!The!final!chapter!presents!the!study’s!conclusions!and! recommendations.! ! ! Methodology. Permission!to!conduct!the!research!was!granted!by!the!Angolan!Ministry!of!Justice!and!all!the!relevant! Provincial!Delegations!of!Justice.!!The!‘Birth!Registration!and!Justice!for!Children!in!Angola’!project!has! national!coverage,!but!six!priority!provinces!were!selected!for!inclusion!in!the!research!due!to!their!low! registration!rates:!Uíge,!Luanda,!Moxico,!Huíla,!Bié,!Kwanza!Sul!and!Malange.!!The!study!comprised!two! ! 3! related!components:!a!quantitative!KAP!survey!(of!registration!and!health!staff)!and!observational!data;! and!qualitative!data!collection!using!open,!inductive!and!participatory!methods!(inBdepth!interviews,!focus! group!discussions,!and!workshops!with!children!and!adolescent).!!Key!interlocutors!included!centralBlevel! stakeholders;!demandBside!stakeholders!(parents!and!caregivers,!community!leaders,!traditional!birth! attendants,!children!and!adolescents);!and!supplyBside!stakeholders!(registration!staff,!health!staff,! education!staff).!!Purposive!sampling!was!used!in!each!site!and!across!the!project.!!Saturation!of!findings! was!achieved.!!The!study!comprised!a!total!of!456!activities!involving!1,470!participants:!84!FGDs!(934! participants);!115!inBdepth!interviews!(115!participants);!20!child!and!adolescent!workshops!(213! participants);!208!KAP!questionnaires!(208!participants);!and!observations!at!29!registration!posts.! All!qualitative!data!was!fully!transcribed!and!53%!of!the!material!was!translated!into!English.!!Full!analysis! of!the!qualitative!data!was!conducted!in!three!phases.!!In!the!first!phase!the!English!transcripts!were! analysed!using!thematic!analysis.!!Salient!concepts!were!coded!by!hand!and!labelled!each!time!they! occurred.!!The!emerging!trends!were!critically!analysed!according!to!the!research!objectives.!!Based!on!this,! a!matrix!of!dominant!themes!was!developed!and!used!for!the!second!phase,!deductive!analysis!of!the! remaining!Portuguese!transcripts.!!In!the!third!phase!analysis,!the!complete!qualitative!data!set! (incorporating!all!material!in!both!English!and!Portuguese)!was!reviewed!and!data!triangulated!in!order!to! maximise!validity.!!The!quantitative!data!(from!the!KAP!survey!and!observational!checklists)!were!cleaned,! coded!and!then!analysed!using!Stata!software.!!The!quantitative!analysis!was!largely!descriptive,!using! bivariate!analyses!and!crossBtabulations!to!provide!key!insights.!!The!results!focused!on!supplyBside! knowledge!and!practices,!and!capacityBbuilding!needs!and!preferences,!and!was!disaggregated!by!type!of! respondent.!!The!observational!data!documented!the!infrastructure!and!service!provision!at!selected! facilities!including!computerisation,!data!management!and!storage;!human!resources;!client!organisation;! process!and!efficiency;!and!communication!materials.! ! . Knowledge,.attitudes.and.practices.regarding.birth.registration! ! In!analysing!the!key!themes!emerging!in!both!the!qualitative!and!quantitative!data,!a!high!level!of! corroboration!between!participant!groups!was!noted.!!Previous!studies!have!suggested!‘lack!of!knowledge’!