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A Case Study of Thailand REVIEW OF NATIONAL CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS: A case study of Thailand By Thai Health Information Standards Development Center (THIS) Health Systems Research Institute March 2013 Review of National Civil Registration and Vital Statistics Systems: A case study of Thailand By Thai Health Information Standards Development Center (THIS) Health Systems Research Institute March 2013 CREDIT PAGE THAI HEALTH INFORMATION STANDARDS DEVELOPMENT CENTER 3rd floor National Health Building 88/39 Tiwanon Rd. , Bangkok 11000 Tel: +66 (2) 832 9290 Emai: [email protected] http://www.this.or.th Preface Vital statistics is important indicators for monitoring the progress of countries towards United Nation Millennium Development Goals (MDGs). Well-functioning and reliable civil registration and vital statistics systems (CRVS systems)are not only needed for the countries development’s monitor and evaluate system but also used by countries’ organizations to plan and manage their operation and developmental programs. It is evidence that well-functioning civil registration system is the best data source for the reliable vital statistics. However, more than half of the countries around the world don’t have CRVS systems or have, but not well function. United Nation (UN) and World Health Organization (WHO) recognize and aware of this important issue. They are facilitating countries to evaluate their CRVS systems and helping the development of well-functioning CRVS systems to their member countries. In 2011, WHO and the University of Queensland, Australia had developed a standard tool called, “Strengthening practice and systems in civil registration and vital statistics: A Resource Kit”, in order to help country strengthening their CRVS systems. WHO and many UN organizations e.g. UNESCAP encourage and facilitate member countries to use the tool to guide the development of well-functioning national CRVS systems. CRVS systems had been implemented in Thailand for many decades, but haven’t been systematic evaluated. Therefore, the country should access it CRVS systems to understand status of the systems and find the way to improve them. Thai Health Information Standards development center (THIS) and country’s CRVS systems stakeholders such as Ministry of Public Health, National Statistics Office, and Ministry of Interior have come together to evaluate the systems using the WHO’s Rapid Assessment of National Civil Registration and Vital Statistics Systems tool. This report contains three main contents. Chapter one describes background and history of Thailand CRVS systems. Chapter two describes the assessment objectives, the tool and evaluation process. The final chapter is the assessment results, including the recommendations. We hope that the assessment will help inform Thai policy makers, administrators and people who are involve in CRVS systems understand the system strength and weakness which will help them improve the systems. Thai Health Information Standards Development Center (THIS) Affiliated organization of Health Systems research Institute (HSRI) Review of National CRVS systems: A case study of Thailand, March 2013 i Acknowledgements This report is result from rapid assessment on national Civil Registration and Vital Statistics (CRVS) system of Thailand. Valuable inputs and comments to each questions in the tool were provided by key stakeholders in the CRVS, e.g., Ms. Apinya Ounruen, Ms. Tippawan Jitrat, and Mr. Susorod Pungboon from The Bureau of Registration Administration (BORA) of the Ministry of Interior (MOI), Ms. Chujit Nacheewa, and Ms. Orapin Saprhon from The Bureau of Policy and Strategies (BPS) of the Ministry of Public Health, and Ms. Pattama Amornsirisombul, and Ms. Orawan Suthangkul from the National Statistics Office (NSO) of the Ministry of Information Communication and Technology, Dr. Kanitta Bundhamcharoen from The International Health Policy Program (IHPP). Important contributions were also provided by participants from other institutes, i.e., The Thai Health Information Standards Development Center (THIS) of the Health System Research Institute (HSRI), the National Health Security Office (NHSO), The Institute for Population and Social Research of Mahidol University, and The Office of the National Economic and Social Development Board (NESDB). This report is not the end of the assessment. It is recommended to continue with the comprehensive assessment tool. We, therefore, are going to continue to participate with all stakeholders. We also hope to promote our network and collaboration on CRVS system in Thailand in order to improve our CRVS system to be a better effective source for national health policies and plans. Review of National CRVS systems: A case study of Thailand, March 2013 iii Acronyms CRVS Civil registration and vital statistics ICD-10 International statistical classification of diseases and related health problems, 10th revision MOI Ministry of Interior MOPH Ministry of Public Health NHSO National Health Security Office UNESCAP United Nation Economics and Social Commission for Asia and the Pacific WHO World Health Organization Review of National CRVS systems: A case study of Thailand, March 2013 v CONTENT Preface i Acknowledgement iii Acronyms v List of Table ix List of Figure x CHAPTER 1 1 Introduction 1 Overview of Civil Registration and Vital Statistics System of Thailand 2 CHAPTER 2 15 Reviewing the country civil registration and vital statistics system 15 Objectives 15 Overview of the WHO assessment tool , 15 Overview of Rapid Assessment Tool and its application 19 Overview of Comprehensive Assessment Tool and its application 22 Thailand’s Assessment Process 23 CHAPTER 3 27 Results and recommendations 27 Comprehensive assessment results and recommendations 28 Component A – Legal basis and resources for civil registration 29 Component B – Registration practices, coverage and completeness 37 Component C – Death certification and cause of death 49 Component D – ICD mortality coding practices 56 Component E – Data access, use and quality checks 60 Conclusions and Recommendations 68 Review of National CRVS systems: A case study of Thailand, March 2013 vii List of Table Table 1: Related history of civil registration system in Thailand 10 Table 2: Related responsible organization or position in CR in Thailand 11 Table 3: Vital events and regulation practices in Thailand 12 Table 4: Related history of vital statistics system in Thailand 16 Table 5: Related responsible organization or position in VS in Thailand 17 Table 6: Number of births and deaths in Thailand 19 Table 7: Roadmap of actions and outcomes of the review 24 Table 8: Scoring of scenarios for rapid assessment 27 Table 9: Scores, ratings and actions required for rapid assessment 28 Table 10: Inputs, processes and outputs 29 Table 11: WHO assessment framework 29 Table 12: Average scores from the Rapid Assessment by 11 main areas 35 Review of National CRVS systems: A case study of Thailand, March 2013 ix List of Figure Table 1: Related history of civil registration system in Thailand 10 Table 2: Related responsible organization or position in CR in Thailand 11 Table 3: Vital events and regulation practices in Thailand 12 Table 4: Related history of vital statistics system in Thailand 16 Table 5: Related responsible organization or position in VS in Thailand 17 Table 6: Number of births and deaths in Thailand 19 Table 7: Roadmap of actions and outcomes of the review 24 Table 8: Scoring of scenarios for rapid assessment 27 Table 9: Scores, ratings and actions required for rapid assessment 28 Table 10: Inputs, processes and outputs 29 Table 11: WHO assessment framework 29 Table 12: Average scores from the Rapid Assessment by 11 main areas 35 x Review of National CRVS systems: A case study of Thailand, March 2013 INTRODUCTION 1 Civil registration systems are used to record vital events – including births, deaths, and marriages – and have the potential to serve as the main source of national vital statistics. However, in many developing countries, civil registration and vital statistics systems are weak or nonexistent; as a result, key demographic, fertility and mortality statistics are not available on a continuous basis and do not cover large segments of the population. Vital statistics are the cornerstone of a country’s health information system. Figure 1 shows the huge gap that exists between the estimated deaths versus reported deaths in the SEAR region of the World Health Organization (WHO), 2007. If continuous and complete information on the number of births and deaths, and on sex, age and “cause of death”, is not available, achieving real progress towards the fundamental goal of health systems of keeping people alive and healthy for longer is out of reach. A first step in addressing such weaknesses is to undertake a review of current status with a view to identifying areas requiring improvement and prioritizing actions. WHO and the University of Queensland (UQ) together developed a framework that provides countries with comprehensive guidance on how to evaluate how well their civil registration and vital statistics systems are able to generate useful vital statistics (Improving the quality and use of birth, death and cause-of-death statistics generated by Civil Registration).1 Figure. 1 Reported deaths versus EsTimated deaths, 2007 Number of Deaths 16,000,000 14,000,000 12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 ESTIMATED 2,000,000 REPORTED EmrA Amr Eur Afr Sear Wpr WHO Region Review of National CRVS systems: A case study
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