Most People In Africa And Asia Die Without Ever Having Appeared In Any Legal Record Or Statistic

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Main Category: Public Health
Also Included In: Aid / Disasters
Article Date: 29 Oct 2007 - 0:00 PDT

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The majority of people in Asia and Africa come to this world, and leave it, without details about their existence ever having appeared in any statistic, document, or legal record. In numerous poor countries civil registration systems have simply stagnated, writes Dr. Philip Setel in the Who Counts? series appearing in the latest issue of The Lancet. Dr. Seter is from the Carolina Population Center, University of North Carolina, USA.

Official development assistance around the globe totaled $80 billion in 2004 - a huge sum. However, the authors explain that without vital statistics it is extremely hard to find authoritative evidence that these funds have had the right impact on poverty reduction and mortality.

Both individuals and society benefit significantly from a system which includes civil registrations, including the medical certification of deaths and causes of deaths, as well as statistics. Legal documents, apart from aiding the citizen in acquiring state benefits and entitlements, also establish his/her property ownership, inheritance, and protect him/her from exploitation or protracted hardship in times of emergency.

"The persistent failure to establish, support, and sustain civil registration systems over the past 30 years, and to ensure that causes of death are accurately known in the world's poorest countries is a scandal of invisibility, for which affordable remedies exist and need to be implemented," the authors explain.

The paper gives numerous examples of how such information is crucial to policy formation. In the industrial world, data on increased road traffic deaths up to the 1970s helped form laws regarding speed limits, seatbelts, alcohol use, and driving in general. This was followed by drastic falls in traffic mortality.

Population progress is monitored in India thanks to clearer birth monitoring data. Some unpleasant data has also been revealed, such as the extent to which female fetuses are selectively aborted.

"Unless identities are protected, this powerful instrument can be - and has been - used to do great harm to individuals and vulnerable minorities," the authors write. The writers give as examples how the Nazis used Dutch population registers to seek out Jewish families for extermination - as well as the role of ID (identity) cards in the Rwanda Genocide.

While awareness of the global AIDS epidemic shows that visibility demands accountability, say the authors, there seems to be no worldwide urgency to make unregistered people more visible. "Far from advancing into this century, the inadequate state of civil registration in developing countries remains mainly as it was three decades ago," they write.

"Overcoming decades of stagnation will need countries to make a principled long-term commitment to comprehensive civil registration, and to make pragmatic use of complementary or alternative registration systems and sources of data for vital events and cause of death in the short term and medium term. The continued cost of ignorance borne by countries without civil registration far outweighs the affordable necessity of action," they conclude.

www.thelancet.com

Written by: Christian Nordqvist
Copyright: Medical News Today
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