Inequality Assessments in the Asia and the Pacific region
In 2014, in recognition of the role that CRVS plays in supporting development, governments and civil society partners came together at the first Ministerial Conference on CRVS in Asia and the Pacific to concentrate efforts on improving CRVS systems.
As part of that they articulated the shared vision that by 2020, all people in Asia and the Pacific benefit from universal and responsive CRVS systems that can facilitate the realization of their rights and support good governance, health and development. To achieve this vision, governments committed to improving their national CRVS systems by adopting a ministerial declaration and 2015-2024 was declared as the Asian-Pacific CRVS decade — as a timeframe to accelerate efforts and achieve this vision.
A regional action framework to support the improvement of CRVS systems was endorsed. The regional ambition was set through the regional action framework, and the goals and targets of the framework offer measurable outcomes that reflect progress towards the achievement of the shared vision over the course of a decade.
The 3 goals relate first to universal registration of births and events, second to the provision of legal documentation of these events in order to facilitate documentation of legal identity. And finally, the production of vital statistics from civil registration records, including on causes of death.
There are 8 implementation steps conceived as essential tools for achieving quality and universal civil registration systems, and to ensure that improvements are sustainable. Of the 8 implementation steps, one is inequality assessments. The low visibility and inclusion of some groups in the civil registration system at the national level is why the Regional Action Framework on CRVS goes beyond the measurement of civil registration completeness to include inequality assessments as one of the steps.
While in the Asia-Pacific region in particular, the Regional Action Framework on CRVS includes assessing inequalities in CRVS as a critical implementation step, in the more recent context, the COVID-19 pandemic has highlighted the importance of mortality statistics and universal death registration and recording of causes of death, reinforcing the need for thorough identification of those likely to be left behind. As we know, the impact of COVID-19 has not been equal across different population groups. The impact of the pandemic has differed by factors such as sex and gender, and has been compounded by factors such as income and ethnicity, which overlaps with inequalities in death registration. In order to truly understand the impact of the pandemic, we need to ensure that everyone is being included, we need to know who is being left out, and also to be able to quantify that.
Inequality Assessments with a Gender Lens
We know that assessing inequalities in civil registration is a crucial part of the “leave-no-one-behind” agenda. There are marginalized and hard to reach groups that face barriers to civil registration, which need to be understood.
Certain population groups or geographical areas are more likely to have lower civil registration rates. Factors such as gender, citizenship, ethnicity, religion, geographical location, income and education can be barriers to civil registration.
These factors can be further exacerbated by external/institutional factors such as non-institutional births, distance to registration center or cost of registration, alongside legislative barriers.
Disadvantage is further intensified when multiple factors and vulnerabilities intersect (intersectionalities multiply disadvantage). Consequently, certain population groups may lose out on the benefits of civil registration, including for instance people, and even more so women and girls, living in rural, remote and isolated areas; belonging to a certain indigenous group; having migrant status; who are asylum-seekers, refugees or stateless; or living with a disability, to name a few.
While this affects the community through the lack of information on the community’s vital events, it greatly impacts the individual through the lack of a legal identity, which can disproportionately affect women and girls.
Thus, inequality assessments are important from a gender perspective as it is essential to know if and why there are differences in civil registration by sex, and other gender-related barriers to registration, especially for different sub-groups in the population. Further, vital statistics are gender-relevant particularly for indicators such as the maternal mortality ratio, child mortality rates, adolescent fertility rates, age at first birth and to understand mortality differentials by age and sex and the different causes of death women may be dying from compared to men. Improving these statistics would obviously strengthen the evidence base for policies and programmes to address gender-specific issues and to target interventions to improve the lives and well-being of marginalized populations more broadly.
Equity Lens and Exclusion
Assessing disparities in birth and death registration involves assessing differences in coverage and completeness by sociodemographic characteristics. While coverage is about the population for which registration is actually possible (say due to geographical reach of the CRVS system), completeness is a measure of the proportion of vital events in that population which have been captured.
It is critical to keep in mind that inequality assessments are not just for less developed CRVS systems, but they are of relevance even in countries with well-functioning or rapidly improving CRVS systems – since there could still be population groups with lower rates of civil registration. Many countries don’t know who is being left out, and it’s critical to find out, in order to put in place policies to ensure their inclusion in CRVS systems.
As CRVS systems improve, and as more people are covered through these systems, there’s a greater effect on the “individual” of being excluded. For someone from a country where most births aren’t registered and if his/her birth is not registered, then the effect on the person is less as compared to a situation where someone comes from a country where the expectation is that births are generally registered and related documentation is needed to access most services and benefits, then if the person’s birth is not registered, he/she is likely to be excluded. This impacts the individual through the lack of a legal identity, which can disproportionately affect women and girls. Therefore, the impact of exclusion can increase as coverage and completeness increase, and it is important to understand in varying contexts, who is being left out.
Hard-to-reach and marginalized populations include:
-People living in rural, remote, isolated or border areas
-Minorities
-Indigenous people
-Migrants
-Non-citizens
-Asylum seekers
-Refugee
-Stateless people
-People without documentation
-People with disabilities
Top Three Things to Remember when Conducting Inequality Assessments
1) The first thing to keep in mind is that inequality assessments are not just for less developed CRVS systems, but they are of relevance even in countries with rapidly improving or well-functioning CRVS systems since there could still be population groups with lower rates of civil registration. So, it’s not just an issue for low capacity countries, because as CRVS systems improve, and as more people are covered in these systems, there’s a greater effect on the “individual” of being excluded. So Impact of exclusion can increase as coverage and completeness increase.
2) Successful inequality assessments require not only data availability at the country level, but also access to the data. Since multiple data sources may be required and different national agencies could be custodians of these data sources, effective inter-agency data sharing is required.
3) An inequality assessment makes sense only if linked to actions and targets to reduce the gaps between the identified groups and the rest of the population. Therefore, it is not enough to conduct the assessments, but countries should plan to use the results to make appropriate policy recommendations. For this it is imperative that all relevant stakeholders (data producers, users as well as decision-makers) are involved from the start of the inequalities assessment process, so that there is buy-in and ownership. In countries where the assessment reveals significant variability in civil registration completeness or coverage by e.g. geography or level of social and economic development, it may be necessary to establish special procedures for civil registration to ensure that progress is inclusive and universal.
Further Resources
ESCAP blog: Getting everyone in the picture through assessing inequalities, Sharita Serrao and Petra Nahmias https://unescap.org/blog/getting-everyone-picture-through-assessing-inequalities#
Inequality Assessments of CRVS systems in Asia and the Pacific: Challenges and Opportunities: Video start at 21:28 Petra Nahmias, Statistics Division, UN ESCAP
Project website: Implementing Inequality Assessments in Asia and the Pacific
