Abstract
BackgroundBirth registration provides the basis for population data. Previous studies have examined that collaboration between the health sector and civil registration can help improve birth registration rate. However, there was a little exploration into health workers’ understanding of civil registration and vital statistics (CRVS) and their perceived role in it. This study aims to fill this gap by focusing on the perspective of both health personnel in a managerial position and those who are involved in direct service provision to the community. Finally, we discussed the opportunities and challenges to strengthen the birth registration presented by health workers’ diverse views.MethodThis study uses a qualitative approach through semi-structured in-depth interviews with 23 provincial to village health personnel in Pangkajene Kepulauan (Pangkep) district of South Sulawesi province. The participants were selected through consultation with the Department of Planning and the head of the Department of Health at provincial and district level based on the relevance of their position with CRVS. At the frontline level, the informants were identified using a snowballing technique and recommendation from community members.ResultsThis study finds that at the village level, health workers perceive CRVS as important since it supports them in delivering healthcare to community members. They see identification document like birth certificate as crucial for healthcare seekers to access the government’s health insurance and with that, proper and affordable treatment. Some health workers have been facilitating birth registration on a discretionary basis. Local health officials agree that accurate birth data lead to effective planning and financing for healthcare services and insurance. Despite the positive perception of birth registration, the majority of health workers do not want the additional burden for registering births. Health officials, however, are more open to taking some responsibilities.ConclusionThis study concludes that the level of health workers’ understanding and appreciation of the CRVS system provides opportunities to engage them systematically in birth registration. It recommends that institutionalizing health workers’ participation in birth registration must consider their current workload, revision of legal instruments, capacity building plan, and operable linkage with civil registration authority.
Highlights
Birth registration provides the basis for population data
This study finds that at the village level, health workers perceive civil registration and vital statistics (CRVS) as important since it supports them in delivering healthcare to community members
Health workers’ understanding and perceived value of CRVS and birth registration Most of the participants were familiar with legal identity documents such as birth certificates, ID card (KTP), and family card (KK)
Summary
Birth registration provides the basis for population data. Previous studies have examined that collaboration between the health sector and civil registration can help improve birth registration rate. In addition to being a national priority, Indonesia commits to an increased birth certificate coverage through the Asia Pacific CRVS Decade 2015– 2024 [2] and the Sustainable Development Goals (SDG) target 16.9 “to provide legal Identity for all, including birth certificates, by 2030” [3]. In the last five years, Indonesia has made several breakthrough policies and has moved toward the digitalization of registration of vital events [4, 5]. It still has the second lowest coverage of birth registration in the region, after East Timor (Kusumaningrum et al: A child’s growth is a nation's growth: children’s wellbeing and inequlity in Indonesia, forthcoming). With a total of 84,6 million children estimated by Susenas 2016, this leads to 28 million Indonesian children without a birth certificate
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