Timely registration of births and deaths should be ensured as it can contribute to an efficient recording of vital statistics, as well as inform effective planning for development through accurate data, according to the Rwandan Parliamentarians' Network on Population and Development (RPRPD). In Rwanda, timely registration is done within the time stipulated by the law (30 days after births and deaths). From November 24 to November 25, 2023, teams of RPRPD members visited districts in provinces and the City of Kigali to sensitise citizens to have newborns and deceased people recorded in civil status registers. This was in line with supporting the provision of information that contributes to effective planning. The parliamentarians held sessions with district, sector officials, and managers of health centres to understand the state of birth and death registration, and how it affects planning. According to the fifth Rwanda Population and Housing Census, 2022, by the National Institute of Statistics of Rwanda, the percentage of children whose births were registered was 94 per cent, at national level. The president of RPRPD, MP Jeanne Henriette Mukabikino, said that generally, the registration of births was fast-tracked after the law governing persons and family allowed health facilities to register babies born there. However, she exposed that in some instances, after delivery, mothers say they don’t have a ready name to give to their baby, with the Rwandan cultural consideration that a child is named seven days after birth also contributing to that. Again, RPRPD indicated that there were some cases where birth registration was not done at health facilities because of reasons including the fact that some parents do not have identity cards. Mukabikino said that normally, population data is obtained from national censuses (carried out every 10 years), or the demographic Health surveys (DHSs) (conducted every five years). According to the Rwanda Demographic and Health Survey (DHS) 2019-20 by the National Institute of Statistics of Rwanda, the percentage of birth deliveries taking place at health facilities increased over time, from 28 per cent in 2005 to 93 per cent in 2019-2020. She indicated that district planning should have accurate vital statistics including those about births and deaths, which can inform their development agenda, without necessarily waiting for such studies that are conducted once or twice a decade. “We should ensure timely registration of newborns, and people who have died so that we have accurate statistics because if we achieve that and civil registration performs as it should, even the costly population census would not be necessary,” she said, pointing out that a well-functioning civil registration system should give the correct number of population of the country. Low death registration can negatively affect planning Meanwhile, the report of RPRPD showed that there are still cases of deaths, including children who die at birth and mothers who die during delivery, while the registration of deaths was at a low level. Results from the Demographic and Health Survey 2019-2020 by NISR show that infant mortality rate was 33 deaths per 1,000 live births for the 5-year period preceding the survey, while under-5 mortality was 45 deaths per 1,000 live births, which it said implies that about 1 in 22 children in Rwanda die before their fifth birthday. On trends, the survey indicated that the under-5 mortality rate decreased since 2014-2015 (from 50 to 45 deaths per 1,000 live births), pointing out that there was no noticeable change in infant mortality or neonatal mortality. Also, it showed that adult mortality rate was 1.82 deaths per 1,000 population among women, and 3.21 deaths per 1,000 population among men, while the estimated pregnancy-related mortality rate was 226 deaths per 100,000 live births. As 19,797 deaths were registered in Rwanda in 2021, yet 75,603 deaths were expected in the same year, death registration completeness was 26.2 per cent at national level, according to Rwanda Vital Statistics Report 2021 published in July 2022 by NISR. Mukabikino said that the registration of deaths that occur at health facilities is relatively done timely, but pointed to challenges of lack of identification documents for the deceased, sometimes. But she expressed a concern that residents were not interested in registering deaths when people died at home – or outside health facilities – unless relatives want to share property left by the deceased. Lack of registration of births and deaths negatively affects planning as it leads to inaccurate population data, Mukabikino said, pointing out that greater effort was needed to address the low death registration rate. RPRPD held that timely registration of deaths can support evidence-based planning in line with preventing future deaths or addressing the underlying conditions, as the cause of deaths would also be recorded, through means including verbal autopsy – a method used to determine the cause of death through interviews with the deceased person's next of kin or caregiver(s).
