29 October 2007A new initiative backed by the United Nations World Health Organization (WHO) aims to help countries know how many people are born and die each year and the main causes of their deaths – key information for well-functioning health systems. The programme was launched today by the Health Metrics Network, a global, WHO-hosted partnership established to address the lack of reliable health information in developing countries. The lack of civil registration systems – by which governments keep track of births, deaths and marital status of their citizens – means that every year, almost 40 per cent – or 48 million – of 128 million births worldwide go unregistered. The situation is even worse for death registration: globally, two-thirds – or 38 million – of 57 million deaths a year are not registered. In addition, WHO receives reliable cause-of-death statistics from only 31 of its 193 Member States. According to WHO, governments cannot design effective public health policies or measure their impact when deaths go uncounted and the causes of death are not documented. Information on births and deaths by age, sex and cause is the “cornerstone of public health planning,” the agency said. “No single UN agency is responsible for ensuring that births and deaths are registered, so it has fallen between the cracks. That is why we have failed to establish, support, and sustain civil registration systems over the past 30 years in the developing world,” WHO Director-General Dr. Margaret Chan said today at the Global Forum for Health Research in Beijing. “Without the statistics that these systems produce, we can only have a partial view of the impact of $120 billion spent annually in official development aid.” The drive to encourage countries to improve civil registration is launched today with a series of papers published in the medical journal The Lancet, entitled “Who counts?” The papers show that most developing countries have rudimentary or non-existent civil registration systems. They also underscore the challenges of establishing civil registration, including new legislation and governance structures. The Health Metrics Network has already started working with Cambodia, Sierra Leone and Syria to improve their civil registration systems, and three other countries are expected to be identified for assistance by the end of the year.