24/11/2014 08:45 GMT | Updated 23/01/2015 05:59 GMT

Get in the Picture!

This week sees the first Ministerial Conference on Civil Registration and Vital Statistics in Asia and the Pacific - which the organisers have wisely branded under the much snappier slogan Get In The Picture. So what's it all about?

Most citizens in Asia (and Africa for that matter) live lives that are not officially documented or counted. That's not good for them - because if you are not known to your national authorities, how can they provide the services that you need? And it's not good for countries - if you don't know who your citizens are, how is it possible to plan schools, hospitals and other services for them? The World Health Organization has a map that shows huge areas of Asia and Africa where counting citizens' deaths (often call civil registration) just doesn't happen. This graphic from getinthepicture shows the global conseqeunces:


One important issue is how to decide what someone's cause of death is, because often doctors aren't available to do that. So a technique called verbal autopsy has been developed, where families are interviewed after a death. An article in The Lancet Global Health points out that it is time to use verbal autopsy in routine civil registration. We know this works - the INDEPTH Network recently published the biggest ever dataset (over 110,000 deaths) across Africa and Asia to prove the principle.

The wealth of detail from INDEPTH points to the substantial potential of using the same methods routinely within CRVS procedures. Child deaths are of course a special concern. Non-communicable diseases were shown to not yet be the largest cause of adult mortality in Africa and Asia, but are a worry for the future. Deaths from accidents and injuries revealed particular issues of childhood drowning in Bangladeshi Delta areas, high rates of assault among men in eastern and southern Africa, and hazardous road travel in western Africa. Pregnancy-related mortality is much easier to understand if all deaths in women of reproductive age are documented. Malaria and HIV/AIDS continue to be important problems in some areas.

Mobile apps have even been developed to make the cause of death interviews faster and easier. Here one of these is being tested at the Agincourt site in South Africa.


So this week's meeting for the Asia Pacific region in Bangkok, and a similar meeting planned for Africa in 2015, present a unique challenge and opportunity. We have the methods and tools for universal civil registration of births and deaths on a worldwide basis - let's make it happen! We need every global citizen to get in the picture.