Bureau of Vital Statistics
An Assistant Minister heads the Bureau of Vital and Health Statistics with three directors (Research, HIMS, and M&E), a Principal Registrar, and two coordinators (Birth Registration, and HMIS, M&E and Research). The bureau has the mandate to produce birth and death certificates, collect, compile and disseminate health information (data), supervise health research, and monitor health programs in the country.
Monitoring and Evaluation
The Monitoring and Evaluation Policy and Strategy articulate the approach to monitoring and evaluation of the Ten Year Health and Social Welfare Policy and Plan. The M&E Strategy and its three years operational plan are implemented with visible outcomes. The Ministry’s M&E system is developing and getting stronger and better by the day.
The M&E Unit monitors the implementation of the National Health Policy and Plan in line with the M&E Strategy. To measure the performance of key indicators, regular assessment of health programs, projects at the communities and health facilities are conducted quarterly, while health facilities data are analyze monthly. During the period, only USAID and Pool Fund supported health facilities were assessed and performance measured.
Assessments of health facilities data in 2014revealed that data quality is gradually improving. However, there are systems, organizational and individual or behavior issues that contribute to poor data quality. To improve the quality of health facilities data, quarterly supervision and verification exercises are regularly conducted. These exercises are supported by the USAID’s FARA project, the health sector pool fund and global fund. During the year, 222 health facilities’ data on key indicators were verified and validated. Additionally, all County Health Team were supported through an MOU initiated by the M&E Unit to verify data from all health facilities with funding from the Global Fund. These interventions have contributed to improvement in data quality.
The mandate of the Research Unit of the Ministry of Health and Social Welfare is to govern, manage and coordinate the health and health related research in Liberia. During the calendar year (2013), the Research Unit was involved with the following:
The Unit coordinated health related studies in 2014, supported the data collection and analysis aspect of the EVD response, and carried out research capacity building initiatives.
Health Management Information System
Health Management Information System (HMIS) is responsible for the provision of data for decision-making and interventions. The National Health Policy avowed that HMIS will be strengthened in order to better collect, organize and maintain relevant data in a timely fashion. The system will have the capacity to produce reports related to health sector development, including the analysis of trends, in order to understand the progression of the health sector over time. With the introduction of the District Health Information Software Version 2 (DHIS) and the standardization of reporting instruments, the coverage of routine health facility reporting has increased and data quality is gradually improving.
The unit key activities and accomplishments are as follow:
- Enhanced the capacity of M&E Officers and data managers skills and knowledge on data management and analysis
- Trained 50 M&E and data management staff on District Health Information System (DHIS) and Integrated Human Resources Information System (IHRIS) usage
- Harmonized DHIS and DHIS data management on a single platform
- Trained County HR officers and Administrators on IHRIS
- Introduced Community Health Information System and trained county and central level trainers of trainers
- Conducted the Performance of Routine Information System Management (PRISM) assessment
- Conducted quarterly data verification exercise
Birth registration is fundamental to ensuring a child’s legal status, their basic rights and services (UNICEF, 2006; United Nations General Assembly, 2002). Liberia is a signatory to the UN Convention on the Right of the Child (CRC) and the African Charter on the Right and Welfare of the Child. In fulfillment of these legal obligations, the Ministry has decentralized the registration of births to increase access and coverage. However, the registration of births is face with plentiful challenges that require urgent attention to achieve universal coverage within five years.
The Bureau of Vital Statistics has the responsibility to produce and issue birth certificates to persons born in Liberia regardless of their economic and social status. The low registration is a result of theover two decades of highly centralized birth registration system, and limited resources (Human, logistics, and financial) for birth registration. However, with the support of partners there are potential for increase access and coverage.
To achieve universal birth registration coverage, several measures have been instituted that include, routine registration of children at various public health facilities, regular birth registration campaigns, collaboration with other institutions,robust resources mobilization and awareness creation.
In 2014, the Liberia Demographic Health Survey results shows that children under five registration increased from 4% in 2007 to 24% in 2013. It also revealed no disparity between males and females under five registration. The Bureau conducted birth registration campaigns for children below the ages of 13 years in six counties (Bong, Nimba, Grand Bassa, Maryland, Margibi and Grand Gedeh). BR awareness was conducted through the registration campaigns and radio talk shows.
Births certificates production trend at central MOH continues to increase gradually. Though there has been an increase in registration over the past 7 years, Liberia’s progress is diminutive compared to the proportion of unregistered persons in the Country.A total of 199,076 certificates have been produced from 2007 to 2014 at the central level that precludes county level under 13-year registration.
The decentralization of birth registration for children below the age of 13 started in 2010 with three counties; Bomi, Gbarpolu and Grand Gedeh and currently covered all 15 counties. The Ministry made remarkable progress in 2012 by establishing birth registration centers in the 15 counties of Liberia and these centers are registering children less than 13 years. Over the four years, 150,000 children under 13 years have been registered through the decentralized system across the counties. In 2014, the number of children registered reduced by 38.8% from 2013.
The Liberian Public Health Law of 1976 mandates the MOH to register all deaths within 24 hours after their occurrence. This regulation has not been implemented to its fullest by the Ministry due to limited access to death registration services and information on the importance and need for death certification. As a result of inadequate access, the coverage of registration has always been below 5% annually. Apart from the mentioned plausible reasons for low registration of deaths, traditional and religious practices contribute to lower registration in Liberia. Death certificates are usually processed in Liberia with the intent to obtain insurance benefits, to settle inheritance issues and not as a requirement for burial and documentation of cause of death. The registration of deaths continues to fluctuate over the past seven years. In 2007, 548 deaths were registered compared to 624 in 2011 and 549 in 2012. In 2013, 659 deaths were registered compare to 600 in 2014.