Birth registration: a child's passport to protection
Authors: Claudia Cappa, Kendra Gregson, Tessa Wardlaw, Susan Bissell
Journal: The Lancet Global Health (2013)

On Dec 11, 2013, UNICEF celebrates its 67th birthday. On that day, an estimated 380 000 children will be born worldwide.1United NationsWorld population prospects: the 2012 revision.http://esa.un.org/wpp/Google Scholar Only six out of ten of these births will be recorded with civil authorities.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar Article 7 in the UN Convention on the Rights of the Child3United NationsThe United Nations convention on the rights of the child.http://www.unicef.org.uk/Documents/Publication-pdfs/UNCRC_PRESS200910web.pdfGoogle Scholar regards birth registration immediately after birth as one of the fundamental human rights of children. If such formal recognition by the state does not occur, a child might be unable to obtain a birth certificate and thus be denied health care or education. The lack of registration might mean that a child enters into marriage or the labour market, or is recruited into the armed forces, before the legal age. If accused of a crime, unregistered children might be prosecuted as adults. Registering children at birth is the first step in securing their recognition before the law, safeguarding their rights, and ensuring that any violation of these rights does not go unnoticed. To raise awareness of the importance of birth registration and to discuss strategies to promote it, UNICEF is launching two related publications on the anniversary of the organisation's founding. Every child's birth right: inequities and trends in birth registration2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar is a statistical analysis spanning 161 countries and presenting the latest available country data and estimates on birth registration, at both global and regional levels. A passport to protection: a guide to birth registration programming4United Nations Children's FundA passport to protection: a guide to birth registration programming. UNICEF, New York2013Google Scholar is a handbook for those working on birth registration, providing background information, general principles, and the programming process. Globally, only 65% of all children younger than 5 years are registered.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar This means that there are nearly 230 million children worldwide who do not officially exist. More than half of them (59%) live in Asia.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar In sub-Saharan Africa, 44% of children younger than 5 years have been registered, with levels ranging from 3% in Somalia to 95% in South Africa.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar Birth registration stands at only 39% in south Asia, the region with the largest overall number of births and children younger than 5 years. India is home to around one in three of all unregistered children worldwide.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar Between 2000 and 2010, global birth registration levels rose only slightly, from 58% to 65%, but they increased by more than 30% in least developed countries.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar During the same period, the global number of unregistered children decreased by about 30 million. Faster progress in raising birth registration levels is needed, however, particularly in sub-Saharan Africa as its child population continues to increase significantly. If current levels persist, the number of unregistered children in east and southern Africa, currently 44 million, will reach 55 million in 2050, and will almost double in the same time period in west and central Africa. There are many reasons why a child might not be registered at birth. Although available data show that there are no gender differences in birth registration, in general, unregistered children come from the poorest households, live in rural areas, and have mothers with no or little formal education.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar In some countries, certain ethnic or religious minorities have lower birth registration rates than the national average. In terms of national wealth, most countries with a per capita income above US$6000 have birth registration rates of more than 80%.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar However, in lower-income countries, both high and low rates of birth registration are found. These differences underscore the fact that the registration of children can be realised even in the face of economic challenges. All of these findings suggest that interventions to accelerate progress in birth registration should be given priority, especially in the poorest countries, in rural areas within a country, and in minority and socially disadvantaged groups. Experience shows that such interventions can achieve maximum coverage by combining them with services that children and their parents are likely to come into contact with, particularly those related to health and education.4United Nations Children's FundA passport to protection: a guide to birth registration programming. UNICEF, New York2013Google Scholar Substantial disparities indicate that targeted action must be taken to ensure that all population groups are covered. Such action necessitates careful review of the legislation that regulates registration procedures and requirements, and of the operation of the civil registry. Since many poor children are not registered, to ensure that birth registration is available to everyone, it must be free of charge, whether for regular or late registration (ie, registration that does not take place at or shortly after the birth of a child). In countries where a fee for registration and penalties apply, interventions could be targeted at policy and legal reforms to eliminate fees. All people who are born in a country must have access to birth registration—without exclusion or discrimination. The data indicate that, in almost all countries, children living in rural areas are less likely to be registered than those living in cities and towns.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar Programmes need to take this into account, and make a special effort to reach rural areas where warranted. In Uganda, UNICEF and a private-sector partner, Uganda Telecom, are piloting mobile and web-based technology to digitise birth records, making the birth registration process faster, more accessible, and more reliable. Data also convey both a lack of awareness about what the registration process entails, and of the benefits of registering.2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar Working with community leaders—including religious leaders—on communicating the importance of registration, and facilitating access, are ways to increase demand. Information in the registry is personal and sensitive. For this reason, access to the registry must be strictly controlled. In certain situations, especially involving conflict or ethnicity, mistrust over confidentiality might be the reason why people choose not to register their children. To ensure that confidentiality is guaranteed in such contexts, programmes should review the structure of the registration system, legislative acts that govern it, and the protocols for data transmission. Accordingly, the design of birth certificates is important, and should include only the minimum necessary personal information to protect individuals from unnecessary risk. Seeking to increase birth registration rates also requires improving the reliability of the civil registration system as a whole. In many countries, the use of mobile and digital technology provides new avenues for making information permanent and easily retrievable. In Afghanistan, digital technology is now being instituted and is replacing decades of paper files, ensuring that data can be available in real time. Ideally, having a civil registry that is coordinated centrally allows for data to be retrievable within civil registrar offices across a country. International efforts have intensified in recent years, accompanied by high-level regional and global commitments to birth and civil registration. The evidence presented in Every child's birth right2United Nations Children's FundEvery child's birth right: inequities and trends in birth registration. UNICEF, New York2013Google Scholar suggests that such efforts have begun to yield results. It also shows that much more is needed to reach the goal of universal birth registration and to improve civil registries such that achievements are sustained. If commitment is sustained and programmes strengthened, the progress underway will gain momentum, and the promise of fulfilling every child's birth right will be achieved. We declare that we have no conflicts of interest.