Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, CH-4002, Switzerland.
University of Basel, Petersplatz 1, Basel, CH-4002, Switzerland.
BMC Med. 2020 Mar 9;18(1):67. doi: 10.1186/s12916-020-01522-z.
Despite attempts to apply standard methods proven to work in high-income nations, nearly all civil registration and vital statistics (CRVS) systems in low- and middle-income countries are failing to achieve adequate levels of registration completeness or produce the high-quality vital statistics needed to support better health outcomes and monitor progress towards the 2030 Sustainable Development Goals. This suggests that, rather than simple technical issues, these countries are facing additional or different systemic challenges, including duplication of roles and responsibilities, inefficient methods of data collection, and a reluctance to change.
Process management is a valuable tool that strengthens the production of vital statistics by providing a visualisation of data flow from start to finish. It helps identify gaps and bottlenecks in the process, allowing stakeholders to work collaboratively to find solutions and target interventions. As part of the Bloomberg Philanthropies Data for Health Initiative at the University of Melbourne, 16 countries were supported in mapping the varied processes required in registering a birth or death. Comparative analysis exposed several limitations in the design of CRVS systems that hinder their performance - from 'passive' systems, to overly complex and fragmented system design, through to poor collaboration and duplication of efforts.
The experiences from Myanmar, Papua New Guinea and Rwanda reported in this paper illustrate the benefits of process management to improve CRVS. While these three countries are at different stages of system development, each uniquely benefited. Process management is a useful tool for all CRVS systems, from the most rudimentary to the most developed. It can strengthen CRVS systems and improve the quality and completeness of vital statistics, resulting in more robust, reliable and timely vital statistics for health planning and better monitoring of the 2030 Sustainable Development Goal agenda.
尽管尝试应用在高收入国家行之有效的标准方法，但几乎所有中低收入国家的民事登记和人口动态统计系统都未能达到充分的登记完整度，也未能生成高质量的人口动态统计数据，无法支持改善健康结果和监测 2030 年可持续发展目标的进展。这表明，这些国家面临的并非单纯的技术问题，而是额外的或不同的系统性挑战，包括角色和责任重叠、数据收集方法效率低下以及不愿改变。
流程管理是一种有价值的工具，通过可视化数据从开始到结束的流程，加强了人口动态统计数据的生成。它有助于识别流程中的差距和瓶颈，使利益相关者能够协作寻找解决方案并针对干预措施进行定位。在墨尔本大学彭博慈善基金会数据促进健康倡议的支持下，16 个国家被支持绘制了登记出生或死亡所需的各种流程。比较分析暴露了人口动态统计系统设计中的几个限制因素，这些因素阻碍了系统的性能——从“被动”系统到过于复杂和碎片化的系统设计，再到协作不佳和努力重复。
本文报告的缅甸、巴布亚新几内亚和卢旺达的经验说明了流程管理在改善人口动态统计系统方面的益处。尽管这三个国家处于系统发展的不同阶段，但每个国家都独特地受益。流程管理是所有人口动态统计系统的有用工具，无论是最基本的还是最发达的系统。它可以加强人口动态统计系统，提高人口动态统计数据的质量和完整性，从而为卫生规划提供更稳健、可靠和及时的人口动态统计数据，并更好地监测 2030 年可持续发展目标议程。
