Registration of births, deaths and causes of death to inform population and health policies

Michel Garenne
Ceped, Paris

The paper briefly reviews the history of vital registration in Europe and in some other countries prior to the 20th century. It analyses in particular the use of death registration for monitoring epidemics, and to inform public health practitioners. Vital statistics have also been the key to document and understand the demographic transition, both for fertility and for mortality during the 20th century. Further information on causes of death has been fundamental to analyze mortality decline in developed countries.

In developing countries, the completeness of vital registration remains low in many instances. Despite low coverage of death registration, VRS data can still be used to document demographic trends. The paper describes a few case studies showing the use of VRS to document a major mortality decline (such as Sri Lanka) and major mortality crises (HIV/AIDS in Abidjan, famine in Antanarivo). Information on births can also be used to document the effect of family planning programs.

Beyond classic vital registration, other systems have been developed to improve the quality of estimates when VRS was deficient, such as sample registration systems (SRS) like in India and demographic surveillance systems (DSS) like in many population observatories in Africa and South Asia. When causes of death data are not available, verbal autopsies can also produce useful information, both at local and national levels.

The paper advocates for the need to improve current health information systems in developing countries, in particular to improve the completeness of births and deaths registration, and to develop appropriate alternative methodologies in case of deficient data.