It’s 2017 and we’re amid a Data Revolution. Wearable technology tells us everything we’ve ever wished to know. In the age of data, we believe that the more information our fitness tracker gives us, the more we know about our health, and what we can do to improve it. What if I told you that many nations around the world don’t have the population health data equivalent of fitness tracker? How can countries that lack basic data about births and deaths formulate plans for improvement?News
“The implications of not having your birth registered is huge,” says statistician and BD4H Tanzania CRVS Fellow Chris Sanga, “yet as little as 1 in 4 Tanzanian children under the age of 5 have had their birth registered.”News
Welcome to the first edition of the More than Numbers newsletter, which will share information about the exciting work being done by the global civil registration and vital statistics (CRVS) team at the University of Melbourne Bloomberg Philanthropies Data for Health Initiative along with our collaborators.News
In rural Myanmar, the local midwife is at your side at the start and end of your life. Not only is she responsible for delivering babies and registering them, she is also responsible for registering deaths and cause of death. And it’s all done the old-fashioned way, using scribbled notes that are sent back to the bureaucrats on bicycles or by mail.News
The Swiss Tropical and Public Health Institute at the University of Basel is the University of Melbourne’s collaborator for the BD4H Initiative, developing CRVS tools and filling knowledge and methods gaps in order to provide technical assistance to countries.News
In 2007, the global ‘scandal of invisibility’ was revealed in the Who Counts? series in The Lancet journal. The ‘scandal’ was caused by a lack or inadequacy of civil registration systems for counting births, deaths and causes of deaths. Before we had accurate data of what people were dying from, allocating resources into research, prevention, management and treatment of diseases was unmanageable. There was no roadmap. Luckily with the increasing capabilities of technology to bring together scientists who were once separated geographically or by different disciplines, we now have the ability to track and estimate disease, injuries and risk factors down to the specifics, and with a level of accuracy that we couldn’t have imagined before.News
View profile in ChineseIn order to build capacity to strengthen civil registry vital statistics (CRVS) systems in countries involved in the Bloomberg Philanthropies Data for Health Initiative (BD4H), six to eight fellows from the project's countries are trained a year on CRVS systems and work on a project with direct application to BD4H activities in their country.News
Access to reliable and timely mortality and cause of death statistics is essential for monitoring trends in diseases, injuries and risk factors, and critically important to guide good public health policy and prevention. Training in ANACONDA will build this capacity in the Philippines, enabling them to identify inconsistencies and errors in their mortality datasets and subsequently improve the quality of their mortality statistics.News
Country coordinators from Bangladesh, Brazil, Ecuador, Ghana, Indonesia, Malawi, Myanmar, Peru, Philippines, Papua New Guinea, Solomon Islands, Tanzania and Zambia attended a civil registration and vital statistics (CRVS) boot camp organised by Bloomberg Data for Health (BD4H) partners the University of Melbourne and Vital Strategies.News
Professor Alan Lopez says the use of big data can revolutionise global health policy.News
One hundred and forty countries with 80 per cent of the world’s population do not have reliable cause of death data, which makes it difficult for policy makers to identify mortality trends and make informed decisions for the benefit of the population.News
Strengthening CRVS Design
In May, the Bloomberg Data for Health (BD4H) Initiative joined with several countries in Bangkok to develop country-specific process models for the registration of births and deaths, both inside and outside health facilities.News
- Myanmar: Strengthening Data Read more
Riley, an undergraduate at the University of Virginia, joined Alan Lopez and the Bloomberg Data for Health Initiative team while on his summer break.News
Midwives in Myanmar undergoing verbal autopsy training as part of Data for Health. Read more.
A bold vision to make deaths count
"Improving the availability and accuracy of global health data is one of the greatest opportunities we have to help people live longer, healthier lives. The more we know about causes of death and illness, the better we can target resources and measure progress," Michael R. Bloomberg, Founder and WHO Global Ambassador for Noncommunicable Diseases.
One of the biggest contributors to preventable deaths isn't a health problem but a record-keeping problem - and it is one that can be solved.
Bloomberg Philanthropies Data for Health Initiative is a global initiative that has partnered with 20 low and-middle-income countries to dramatically improve health data, including improving understanding of the leading causes of premature death with the ultimate goal is to save more lives by ensuring countries have more accurate public health information.
With more accurate public health information, governments, public health leaders, and aid organisations can be guided with better health data through improved collection systems and tools. These new systems and tools include improving the recording of births and deaths and better collection methods for public health surveys.
Data for Health aims to help more than one billion people in 20 countries across Africa, Asia, and Latin America live healthier, longer lives.
"The biggest misconception is that it’s too hard and can’t be done. The Bloomberg project is about countering that myth. That it actually can be done; we’ve developed new, more cost-effective measurement methods we’re starting to exploit. IT advances that are 1000 times faster than they were when I started in this field 30 years ago. We’re making use of these innovations, these methodological advances, packaging them, talking to countries, getting countries interested to see that this is possible, that they can benefit from these scientific and technological advances," Laureate Professor Alan Lopez, University of Melbourne, Technical Director of the Bloomberg Philanthropies Data for Health Initiative.
The Data for Health Initiative is country-driven and committed to capacity building and the sustainability of improvements made.
The University of Melbourne is working with partners including the CDC Foundation, Johns Hopkins University, the World Health Organization, Union North America until 2019.
What is the problem?
Globally, two in three deaths, or around 30 million each year, go unrecorded without a documented cause. For deaths with a recorded cause, many records do not provide medically accurate or specific information.
Record keeping is necessary to tackle public health problems, but 150 nations cannot reliably track what kills their citizens. In addition, non-communicable diseases (NCDs) such as heart disease and diabetes are becoming increasingly important drivers of poor health and premature deaths.
What is CRVS?
A functional civil registration and vital statistics (CRVS) system is the best source of continuous data on how many babies are born, how many people die, and what people are dying from.
Civil registration is the continuous, permanent, compulsory and universal recording of the occurrence and characteristics of vital events of the population in accordance with the law.
Information on these events, as well as cause of death, is important for public health, population planning, and development policies.
Why does CRVS matter?
Very few low-income countries currently have functioning CRVS systems, which is the foundation of public health systems.
This means that that the registration of births and deaths in their population, including the accurate recording of cause of death doesn’t exist or isn’t reliable. Without this information, government officials cannot make informed decisions on priorities including how and where to direct public health resources.
Neglect of these systems have been described by Richard Horton, editor of The Lancet, as the "single most critical failure of development over the past 30 years".
“The more I got involved in the Global Burden of Disease study the more I realised we were dependent on creating ever more sophisticated mathematical modelling methods. But the solution to getting better information for governments was not so much in better modelling, but in better quality cause of death data, about better understanding who dies of what,” Professor Alan Lopez.
CRVS performance coincides with good health worldwide, irrespective of income and other factors likely to affect health status.
To help countries improve public health and save lives, the Data for Health Initiative is helping countries build and strengthen their CRVS systems. See more
With better data, public health leaders will be able to identify risk behaviours. With this information, related illnesses caused by day-to-day behaviours such as smoking and poor nutrition can be targeted, addressed and prevented with better understanding. Additionally, CRVS system data is needed to meet more than one-third (45) of the United Nation’s Sustainable Development Goals.
Civil registration also has a range of benefits for individuals in terms of legal status, and the protection of economic, social, and human rights.
How is the University of Melbourne helping?
Improving national capacity, skills and knowledge is a critical component of any strategy to strengthen a civil registration and vital statistics system.
Interventions include technical assistance to increase the registration of births and deaths, improve the quality of cause of death information at hospitals, apply verbal autopsy to better understand probable causes of death in communities, and to produce high-quality data sets and data analysis skills for policy and program analysis.
With this information and training in data analysis participating countries and cities in Latin America, Asia, and Africa will be able to turn insights from data into public policy, and direct resources to specifically targeted issues affecting public health.
Where is BD4H being implemented?
“Greater innovation in development assistance will allow us to do a better job of tackling the world’s most daunting problems, such as a lack of credible health data," Hon Julie Bishop MP, Minister for Foreign Affairs.
Below are the countries and cities BD4H is implementing in, and the performance of their vital statistics systems (using publicly available data) before the initiative began in late 2017.
- Keep up-to-date
University of Melbourne
- Professor Alan Lopez, Director
- Tim Adair, Principal Research Fellow
- Deirdre McLaughlin, Deputy Director
- Hafiz Chowdhury, Research Fellow
- Sonja Firth, Technical Manager
- Saman Gamage, Research Fellow
- Rajitha Jayasuriya, Research Fellow
- Gulshan Ara Khanom, Research Fellow
- Rohina Joshi, Research Fellow
- Rasika Rampatige, Research Fellow
- Nicola Richards, Technical Manager, Capacity Building
- Claire Brolan, Manager, Knowledge Management Centre
- Ali Hickerson, Manager, Communications and Marketing
- Avita Streatfield, Product Development Officer
Technical Advisory Group
- Ian Riley, Consultant
- Tim Moore, Senior Techical Adviser
- Lene Mikkelsen, Consultant
- Carla AbouZahr, Consultant
- Sam Notzon, CDC
- Don de Savigny, Swiss TPH
- Fatima Marinho, Ministry of Health, Brazil
- Juan Cortez, Consultant
- Margarita Ronderos, Technical Advisor
- Alvin Onaka, Registry Office of Hawaii
- Steven Schwartz, Registry Office of New York City
- Jeff Montgomery, The Department of Internal Affairs Te Tari Taiwhenua, New Zealand
Data for Health aims to help more than one billion people in 20 countries across Africa, Asia, and Latin America live healthier, longer lives.
Bloomberg Philanthropies, in partnership with the Australian government, have launched Data for Health, a $100 million initiative that will enable 20 low- and middle-income countries to vastly improve public health data collection.
The Data for Health initiative seeks to provide governments, aid organizations, and public health leaders with tools and systems to better collect data – and use it to prioritize health challenges, develop policies, deploy resources, and measure success.
The CDC is one of the major operating components of the Department of Health and Human Services, United States of America. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.
The International Statistics Program leads CDC work in CRVS.
The department’s purpose is to help make Australia stronger, safer and more prosperous by promoting and protecting our interests internationally and contributing to global stability and economic growth.
The department provides foreign, trade and development policy advice to the government. They work with other government agencies to ensure that Australia’s pursuit of its global, regional and bilateral interests is coordinated effectively.
The Asian and Pacific CRVS Decade (2015-2024) was proclaimed at the Ministerial Conference on Civil Registration and Vital Statistics (CRVS) in Asia and the Pacific, which was held in November 2014 in Bangkok. At that meeting Governments also adopted the Ministerial Declaration to “Get Every One in the Picture” in Asia and the Pacific and made a commitment to focus their efforts to improve CRVS systems. Through the declaration of the Asian and Pacific CRVS Decade, governments gave a timeframe of 2015-2024, for all people in Asia and the Pacific to benefit from universal and responsive CRVS systems that facilitate the realization of their rights and support good governance, health and development.
The Economic and Social Commission for Asia and the Pacific adopted resolution 71/14 on the Asia and Pacific Civil Registration and Vital Statistics Decade, 2015-2024 in May 2015.
Johns Hopkins will support staff to develop mobile phone risk factor surveys and evaluate the impact of surveys.
The Swiss TPH vision is to achieve significant improvements of human health and well-being through a better understanding of disease and health systems and acting on this knowledge.
Vital Strategies brings global expertise to build large-scale health programs in the following functional areas: project management; strategic communication; research and evaluation; workforce development; policy advocacy; and surveillance and epidemiology.
World Health Organization
The World Health Organization, utilizing their expertise, will provide technical assistance to support existing risk factor surveys in order to provide gold-standard expertise to support mobile phone surveys.
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