Minutes of CRVS Regional Core Group Meeting

Minutes of CRVS Regional Core Group Meeting

11-12th July, 2015

Harare, Zimbabwe

Purpose of the meeting

The Core Group met on 11-12th July in order to summarize recent progress and activities undertaken by Group members, review the intermediate work plan for APAI-CRVS as well as discuss and decide on future strategies for its implementation.

Participants list:

·  Maurice Mubila (African Development Bank)

·  Jean-Paul Alaterre (Direction de la Coopération Internationale)

·  Annina Wersun (Plan International)

·  Edward Duffus (Plan International)

·  Lucky Ngwenya (Statistics SA)

·  Raj Gautam Mitra (UNECA)

·  Yacob Zewoldi

·  Mirkka Mattila (UNICEF)

·  Milen Kidane (UNICEF)

·  Andrew Brooks (UNICEF)

·  Anneke Schmider (WHO)

·  Peter Mbondji Ebongue (WHO)

·  Arash Rashidian (WHO)

·  Mohamed Ali (WHO)

·  Gloria Mathenge – Rapporteur

·  Malgorzata Cwiek (UNECA) – Rapporteur

Report on the status against commitments of the Medium Term Plan 2010-2015 and Conferences of Ministers

The list of all the activities included in the Medium Term Plan 2010-2015 and the First and Second Conferences of Ministers Responsible for Civil Registration, and their status were presented in the meeting.

Conclusion:

·  For the purpose of planning and evaluation, the matrix of activities should be expanded to include more detailed description of activities and indicators for evaluation ;

·  For the purpose of communication with the public, the list should also include activities which initially were not included in the plan but were carried on by Core Group members

Report by sub-regional core group mechanism for French speaking countries

There were four main activities reported in the current work plan of the sub-regional core group mechanism for French speaking countries:

·  A sub-regional coordination group was established in Abidjan in February 2015 to support and coordinate the implementation of APAI-CRVS in French speaking countries

·  A visit to Europe with the purpose of meeting key partners and donors supporting development of CRVS systems in French-speaking Africa took place;

·  Planned: pre-assessment missions to countries which expressed interest in starting the assessment process: Mauritania, Madagascar, Cameroon and Cote d’Ivoire.

·  Planned: workshop in October officially launching the programme for French speaking countries, including training CR and VS officials, which will take place in Yaoundé, Cameroon. The workshop is planned to be joined with UNSD training on the Principles and Recommendations on Vital Statistics (3rd revision) for French speaking countries in Africa.

Current challenges:

·  Many countries in the sub-region have a very complex internal situation, which may require a wider expertise and experience than experts in the existing pool currently have.

·  There is a general challenge in the acceptance of the French speaking experts trained to support countries in undertaking comprehensive assessments

Conclusions:

·  Engaging government officials who have demonstrated expertise in CRVS could be considered as a way of expanding the current pool of experts on the condition that respective governments would agree to release them;

·  The African Development Bank may assist in finding an expert for comprehensive assessment in Madagascar;

·  If the current pool of experts is not sufficient, an expert from outside of Africa could be considered. They should be accompanied by a national consultant thus enabling capacity building within the country/region;

·  Formal letter informing about comprehensive assessment should be updated with information on pre-assessment mission and re-sent to countries through ECA Sub-regional Office for West Africa;

·  Even countries that have weak or that do not have CRVS systems at all should conduct comprehensive assessments, as this is an important learning experience and a vital step in developing countries’ capacity in either improving or establishing a CRVS system. The APAI-CRVS Assessment Toolkit can be tailored to the particular country and used as the basis for undertaking assessments.

Report on important activities and events undertaken within the last six months (by Agencies)

Plan International

·  Development of methodology for technical assessment helping to identify the right technologies for CRVs system and conducting these assessments in Kenya and Pakistan

·  Conducting a workshop in Kenya on digital birth registration

·  Engagement in Malawi and planning of conducting a technical assessment

·  Publications:

o  “Identifying and addressing risks to children in digital birth registration systems”

o  Edward Duffus (Plan International), Mark Landry (WHO), Lori Thorell (UNICEF): “Smart ICT Investment for CRVS: A Global Business Case”

WHO EMRO

·  All countries of the sub-region conducted comprehensive assessments

·  Continued advocacy for development of mortality statistics currently compiled only by Egypt and in small extent, Tunisia

·  Invitation to Core Group members willing to provide editorials or other inputs concerning CRVS to WHO Eastern Mediterranean Health Journal

UNICEF

·  Bilateral, regional and sub-regional work with the government, partners and donor community across majority of 21 countries covered by ESARO

·  Recently concluded a major EU grant covering 8 countries across ESAR/WCAR and EAPR

·  Under negotiation with the EU for another Phase II grant covering 4 African countries

·  Near the final stages of completing an evaluation report, which is already raising key findings, lessons learned and recommendations including:

o  Interoperability between CR and health is a game changer from development of CRVS systems in countries – example of Uganda.

o  ICT innovations based on sound business processes accelerate progress

o  There is a big technical knowledge gap on ICT in the assessment process and this is an area where UNICEF country offices require significant technical support

o  UNICEF HQ together with IDB have developed a Guidebook on ICT4BR

o  UNICEF will continue with its efforts to make UN agencies come together on the country level – example of cooperation between UNICEF, WHO and UNFPA in Mozambique

WHO AFRO

·  Country support:

o  Nigeria – strategic plan for CRVS

o  Gabon – preparations for comprehensive assessment

·  Contributions to the meeting on building resilient health systems in Ebola-affected countries showing how CRVS can help improve mortality and morbidity statistics

·  Compilation of country focal persons on child mortality and maternal mortality at the global level of WHO

AfDB

·  Processing to provide support for comprehensive assessment in Madagascar

·  Recruitment of Yacob Zewoldi to support AfDB and APAI-CRVS Secretariat at ECA

·  Support of development of CRVS Digitization Guidebook

WHO HQ

·  Development simplified lists of diseases

·  Development a five year mortality strategy

·  Involvement in discussion around GFF

·  Involvement in setting up of a global fund for mortality statistics

Status of comprehensive assessments – country by country account based on matrix prepared by the secretariat

The matrix presenting the current status of comprehensive assessment in countries was presented.

Key issues discussed:

·  As soon as comprehensive assessment is completed and endorsed by governments, it should be made available to the Secretariat which in turn should circulate it among other core group members. Matrix needs to be updated to account for recent developments (in a more detailed way)and include the full list of countries in alphabetical order

·  Matrix should be expanded to include information on:

o  If APAI-CRVS tools were used and if not what tool was used;

o  outcome of comprehensive assessment;

o  involvement of Core Group members as well as other development partners and donors;

o  status and content of countries strategic plans;

o  Birth and death registration coverage.

·  There are three types of monitoring needed:

o  Monitoring of the APAI-CRVS;

o  Monitoring of the progress of comprehensive assessment and planning;

o  Monitoring of the progress in development of CRVS systems in countries;

Conclusion:

·  There is a need for a stock taking exercise consisting of convening the countries, conducting a peer review of their strategic plans which ultimately should take place on annual basis. The current tools should also be reviewed based on the experiences gained in different countries

Report on on-going activities

Digitization handbook

Digitization Handbook is currently being developed by Jembi Health Systems under the guidance of Plan International, African Development Bank and ECA.

Next steps:

·  Gather inputs from core group members and country experts in the Expert Group Meeting on CRVS digitization handbook.

·  Incorporate the contributions and prepare a final version of the guidebook by September 2015

·  Launch the Guidebook at the11thASSD, which will take place in Gabon 25-28 November 2015.

Mortality Statistics

In response to the declarations of the Conference of Ministers responsible for CR the WHO in collaboration with ECA is developing a 5-year strategy for improvement of mortality statistics. This will be done under the framework of APAI-CRVS for improving the registration of fact of death and recoding causes and compiling mortality statistics.

Next steps:

·  Mortality statistics group is being established

·  Africa Mortality Statistics Strategy Meeting will be held in Addis Ababa, Ethiopia, in August 2015

·  A workshop on training of mortality experts will be held in September 2015

Vital statistics

·  There is need to develop a technical document that can guide countries on the production of VS. Statistics Norway have offered to support APAI-CRVS in this respect

·  More countries need to be supported in compilation of vital statistics

·  A pool of African experts be developed for supporting countries in this area.

APAI-CRVS portal –knowledge sharing and monitoring

The secretariat presented the outline of the CRVS portal. The portal will in addition to being a knowledge sharing platform will also serve as a tool for monitoring of APAI-CRVS and progress made by countries in CRVS.

The secretariat will share the country annual monitoring form with the core group. Core group members are requested to provide their inputs once the matrix is circulated. The assessment of completeness of registration coverage will be included in the first section of the matrix (by 20th August 2015)

Future strategies and activities

Review of assessments and plans

·  Revise the regional CRVS assessment tools and guidelines and include specific guidance on:

o  How to manage the human resources available for the assessment

o  How to ensure engagement and collaboration of different CRVS actors i.e. partner organizations and government ministries

o  Costing of the CRVS plans- Anneke will share with the secretariat samples of costing templates that have been used elsewhere in similar exercises

o  How to develop CRVS business processes from the findings of the assessments. This should be included in Chapter 4 of the planning guidelines. A template for development of the CRVS strategic plan should also be provided

o  The importance of conducting political landscaping to ensure alignment and harmonization of the new CRVS plan to that of the national government i.e. the ministry responsible for civil registration).

·  Some of the Key lessons learnt from countries that have undertaken the assessment include:

o  The cause of death section of the assessment tool currently focuses on medical certification and verbal autopsy; without looking into other multiple sources of mortality data existing in countries (the tool should be revised accordingly)

o  Strategic planning experts are often engaged at the end of the process yet their participation from the onset is very vital to the output of the entire process

o  The assessment road map is very critical in enabling the senior advisor to understand the national context, getting the right people involved, and identifying other important prerequisites for the assessment

o  The assessment tool doesn’t comprehensively cover the technology aspect of CRVS development

o  A comprehensive briefing of the consultants/ senior advisors selected to support country assessment processes is very important. The secretariat should ensure that such briefing is undertaken prior to their engagement

o  The assessment tool should be periodically reviewed to incorporate emerging needs, and the lessons learnt based on country experiences

o  There is need to document case studies of the comprehensive assessments that have been conducted in different countries in the region-UNICEF will provide leadership in the development of this compilation

o  A comprehensive communication plan that covers various stages of the assessment and planning processes is essential

o  Pre-assessment missions are very important in handling potential challenges in in-country political mobilization.

o  Countries should be encouraged to review their CRVS systems on a periodic basis e.g. every five years post-assessment

o  Despite the differences in the legislative framework and organization of CRVS systems between the Anglophone and francophone countries, there is need to provide forum where both convene to exchange knowledge and share experiences

o  A review of the country’s development partners coordination model should be covered within the assessment tool

Implementation of plans

·  The regional office should play a strong role in facilitating a quality check for existing country CRVS plans in view of the Global financing facility (GFF) process. In this respect, the secretariat is requested to submit a letter briefing the responsible officials (of the GFF) about this arrangement.

·  There is need to strengthen advocacy at the country level, especially with the ministry of health and to ensure the engagement of health in CRVS development –Some of the essential activities that should be undertaken to facilitate this include:

o  Conducting proper briefing for ministers of health -Explore the possibility of using the upcoming Regional coordination meeting in Chad (where ministers of health will convene) to conduct such advocacy. This could be through organizing a side session or working with a few countries to have the issue raised from the plenary

o  Explore different avenues for Sensitizing WHO representatives

o  Advocate for the production of health statistics among NSOs-Conduct a session on health statistics at next ASSD

o  Have a regional strategy (for CR based health statistics), which identifies core indicators and provide guidance on how to compute them

·  Need to develop methodology on verbal autopsy-provide guidance to countries on the collection of cause of death data for events occurring outside health facilities

Sustainable capacity development

·  Encourage south to south learning within the continent for example as formally conducted by the Republic of South Sudan and the Republic of Botswana. Have countries that have completed their assessments and plans support those that are at the initial stages