DATA EVALUATION AND METHODS RESEARCH Series 2 Number 79 Vital RegistrationSystemsin Five DevelopingCountries: Honduras,Mexico,Philippines, Thailand, and Jamaica This report was prepared under the direction of the World Health Organization through a contract with the Vital Statistics Improve- ment (vISTIM) project of the Office of International Statistics, Nationid Center for Health Statistics (Contract No. BRA 230-76-0293). The Vital Statistics Improvement project is funded by the Agency for International Development through a Resources Support Service Agreement with the National Center for Health Statistics. DHHS Publication No. (PHS) 81-1353 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Office of Health Research, Statistics, and Technology National Center for Health Statistics Hyattsville, Md. October 1980 Library of CongressCataloging in Publication Data I Main entry under title: Vital Registration systems in five developing countries. (Vital and health statistics : Series 2, Data evaluation and methods research ; no. 79) (DHHS publication; no. (PHS) 81-1353) 1. Underdeveloped areas–Registers of births, etc. 2. Underdeveloped areas– Statistics, Vital. 3. Underdeveloped areas-Statistics, Medical. 4. Underdeveloped areas-Public health-Statistical services. I. Series: United States National Center for Health Statistics. Vital and health statistics : Series 2, Data evaluation and methods research ; no. 79. II. Series: United States. Dept. of Health and Human Services. DHHS publication ; no. (PHS) 81-1353, RA409.U45 no. 79 [HA38.A1] 312’.07’23s [350’,81] 79-16799 For sale by the Superintendent of Documents, U.S. Government Printing Otlice, Washington, D.C. 20402 NATIONAL CENTER FOR HEALTH STATISTICS DOROTHY P. PRICE, Director ROBERT A. ISRAEL, Deputy Director JACOB J. FELDMAN, Ph.D., Associate Director for Analysis GAIL F. FISHER, Ph.D., Associate Director for the Cooperative Health Statistics System ROBERT A. ISRAEL, Acting Associate Director for Data Systems ALVAN O. ZARATE, Ph.D., Acting Associate Director for International Statistics ROBERT C. HUBER, Associate Director for Management MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical Statistics PETER L. HURLEY, Associate Director for Operations JAMES M. ROBEY, Ph.D., Associate Director for Pro~am Development GEORGE A. SCHNACK, Associate Director for Research ALICE HAYWOOD, Information Officer OFFICE OF INTERNATIONAL STATISTICS ALVAN O. ZARATE, Ph.D., Acting Director Vital and Health Statistics-Series 2-No. 79 DHHS Publication No. (PHS) 81-1353 Library of Congress Catalog Card Number 79-16799 PREFACE In 1976, the National Center for Health 3. The government of the country to be Statistics (NCHS) entered into an agreement studied must have an interest in the pro- with the Agency for International Development gram. (AID) to conduct a project directed to improv- On the basis of these criteria, and by mutual ing civil registration and vital statistics in se- agreement of VISTIM, AID, and WHO; the five lected AID-assisted countries. The project, countries included in this report were selected known as the Vital Statistics Improvement for study. (VISTIM) project, is under the direction of the Office of International Statistics of the NCHS. The studies were conducted by teams of ex- VISTIM seeks to improve the registration of perts assembled by the Health Statistics Division births and deaths, and the resulting vital statis- of WHO. In order to obtain as clear a picture as tics, so that the data may be used for demo- possible of the present civil registration and vitaI graphic analysis, population growth monitoring, statistics system, the teams interviewed a large health planning, family planning, and economic number of government officials at the national program planning and evaluation. and at the several local levels (depending on the As a first step in the development of the intemzd structure of the country being investi- VISTIM project, it was decided that studies gated). The team had discussions with university should be undertaken to define the problems of and hospital authorities and population officers. several countries, as a preliminary to possible de- Storage facilities for records were viewed. In velopment of specific assistance projects in those addition to the five country reports, Bernard countries, and to gain an understanding of basic Benjamin, professor of actuarial sciences of the problems that might be generic to civil registra- City of London University, has prepared a com- tion in the developing world. Accordingly, parative report identifying ~lommon problems. studies of the civd registration and vitzd statistics Although the major interest of the three agencies involved in these studies is the produc- systems of five developing countries were con- tracted with the Health Statistics Division of the tion of improved data, the legal ramifications of World Health Organization (WHO) in Geneva. deficient registration systems should not be min- imized. Civil registration provides the legal basis Countries w;re selected on the basis of the for proof of age, citizenship, and paternity, and following criteria: the documents are generally needed for school entry, employment, entry into the military or civil service, passports, social security, and 1. The registration of births must be be- property inheritance. Because the need for these tween 50 and 90 percent complete, documents occurs at various points over the life- time of an individual, deficiencies in the present 2. There should be some expectation ;hat have implications for the individual and the the system can be improved. country for some 70 or 80 years into the future. ... Ill CONTENTS ... Preface ...... ................................................................................................................................................ 111 Chapter I. Vitaf and Health Statistics in Hondum ............................................................ .............. 1 Chapter II. The Health and Vital Statistics Systems of Mexico ......................................................... 31 Chapter III. Civil Registration and the Collection of Vkd Statistics in the Philippines ...................... 55 Chapter IV. Analysis of Vital Statistics Services in Thailand .............................................................. 87 Chapter V. Vitaf Registration and the Waf Statistics Systems in Jamaica ........................................ 113 Chapter VI. Vital Registration Systems in Five Developing Countries: Honduras, Mexico, Phtippines, Thailand, and Jamaica-A Comparative Study ............ 147 v ChapterI Vital and Health Statistics Systemsin Honduras Dr. Hans A. Bruch and luis Marchant Caviers World Health Organization Study Mission to Honduras March 6-27, 1977 CONTENTS Introduction ............................................................................................................................................. General Infomation ............................................................................................................................ ; 1972 Demographic Sumey ................................................................................................................... 5 1970-73 Improvement of Vital Statistics Project ................................................................................. 6 Health Guardians ................................................................................................................................. 6 No National Authority ........................................................................................................................ 6 Organization of the Vital and Health Statistics Systems ............................................................................ 7 National Level ..................................................................................................................................... 7 LoCid hVcl . .. ................... 8 Mechanisms of Registration and Certification of Vital Events ................................................................... 9 Bkths ...................o..............................o....................oo........o....................o..............................o............. 9 Deaths ................................................................................................................................................. 13 The Health Statistics System ..................................................................................................................... 16 Objectives ............................................................................................................................................ 16 Functions ............................................................................................................................................ 16 Types of Data ...................................................................................................................................... 17 Organization and Stmcturc .................................................................................................................. 18 Manpower Qutifimtions ..................................................................................................................... 18 Utilization ................................................................................................................................................. 18 Evaluation ................................................................................................................................................