Hong Kong: Many people in Africa and Asia are born and die without leaving a trace in official records, which leaves countries unable to track and cater to the health needs of their populations, experts say.
In a series of articles published in the latest issue of The Lancet, they urged governments to collect reliable data for births, deaths and causes of death.
“If vital statistics of births and deaths are combined with accurate cause-of-death data, their usefulness for health decision-making is greatly increased,” wrote Philip Setel of Measure Evaluation at the University of North Carolina.
Nearly 50 million infants in Africa and Asia are not registered each year. Barely a third of countries outside North America and Europe have the capacity to obtain usable mortality statistics, and half the countries in Africa and Southeast Asia record no cause of death data at all.
Calling it a “scandal of invisibility”, Setel and his colleagues wrote that poor records over the past 30 years had prevented affordable remedies from being implemented.
Such data are central to policy making, they said, citing how road traffic fatalities up to the 1970s led to laws creating speed limits, requiring use of seatbelts and limiting alcohol consumption among drivers in developed countries.
Although there are programmes to fight hunger, poverty, childhood mortality and diseases such as HIV/AIDS and malaria, their effectiveness may only be assessed by the reduction of deaths due to specific causes -- hardly possible in the absence of reliable data on mortality and causes of death, they added.
In the second article in the series, Prasanta Mahapatra of India’s Institute of Health Systems said only 125 of 193 member countries had reported cause-of-death statistics to the World Health Organisation at least once since 1950.
“Countries with large populations such as India and China have rarely sent reports on cause of death to the WHO,” Mahapatra’s team wrote. Worse, 68 countries, representing 24% of the world’s population, had never furnished such information.
Such a situation calls for urgent redress because “it is in such settings that premature mortality is most severe and need for robust evidence to back decision-making most critical,” wrote Carla AbouZahr of the WHO’s Health Metrics Network.
“It is a fundamental principle of human rights that every life counts, that every individual matters. If we are to give life to such principles, it is time to start counting everyone.” AbouZahr proposed more technical and financial assistance be given to help governments strengthen civil registration.