Session 1:

Civil Registration and Vital Statistics

(CRVS)

Medical Certification of Death

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Objectives:
At the end of the session, the participants will be able
to:

1. Define Civil Registration and Vital Statistics (CRVS);

2. Describe the key features of the Philippine situation
on Medical Certification of Death; and
3. Enumerate issues and concerns identified in the
CRVS system.

Medical Certification of Death

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Civil Registration and Vital Statistics (CRVS)

● Civil registration is the universal, continuous,

compulsory, and permanent recording of vital
events occurring in a country’s population.
● Vital statistics constitute the collection of
statistics on vital events pertaining to the
population.

Medical Certification of Death

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Civil Registration and Vital Statistics (CRVS)
● CRVS system is defined as:

“Those systems which produce births, deaths and

causes of death information which are of
fundamental strategic importance for country’s
development process and governance.”

– Lene Mikkelsen, Dec 2012

Medical Certification of Death

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Civil Registration and Vital Statistics (CRVS)

● A well-functioning CRVS system registers all

births and deaths, issues birth and death
certificates, and compiles and disseminates
vital statistics, including cause of death
information.
● The CRVS underscores the facts of birth and
the causes of death.

Medical Certification of Death

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Legal and Institutional Framework

As a state policy, the CRVS system mandates

the basic and compulsory registration of all vital
events and the accompanying changes in civil
status of every Filipino citizen.

Medical Certification of Death

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Importance of CRVS
1. Provides the legal identity of a person to have
access to government and private services such
as but not limited to education, health & welfare
support, travel documents issuance;
2. Creates permanent factual records of vital
events such as birth, marriage & changes in
status, and death with causes;
3. Establishes family relationships and
inheritance rights;

Medical Certification of Death

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Importance of CRVS
4. Provides basis for proof of age to exercise rights
such as right to vote, to drive, to study, to marry or re-
marry, to insurance claims among others;
5. Establishes evidence on nature and cause of death;
6. Derives the fundamental demographic and
epidemiological measures, such as population levels
and trends, fertility, mortality and related studies;
7. Serves as key information in planning& research
across multiple sectors and industries, such as
commerce, education, labor and health for country’s
programs and policies.

Medical Certification of Death

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Health Picture,
1960-2010

Medical Certification of Death

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 Civil Registration and Vital Statistics
Cause of Death Among Filipinos Males, 15-49 years old.

Medical Certification of Death

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 Uses of Death Certificate

• Prima facie evidence of death

• Claim of benefits, pensions, insurance, or tax
exemption
• Evidence for settlement of estate
• Remarriage purpose of surviving spouse
• To designate a guardian or foster parent for
minor

Medical Certification of Death

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 Uses of Death Certificate

• The information recorded in the death

certificate is used to determine health
priorities for prevention of deaths due to
similar causes in the future.
• The information is also important for family
members so that they know what caused the
death and are aware of conditions that may
occur or could be prevented in other family
members.

Medical Certification of Death

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Problems in CRVS
Low emphasis
Low data
on death
quality
certification

INVESTMENT
Lack of
S
Low data
investments
utilization
in CRVS

Department of Health,
Medical Philippinesof Death
Certification
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 Problems in CRVS

35.6%
of death certificates
in 2018 contains garbage
codes and insufficiently
specified causes of death

Department of Health,
Medical Philippinesof Death
Certification
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 Common problems with Vital Statistics
 Data are not readily available
 Poor communication channels or collaboration
between the different authorities responsible
 Low emphasis on death certification
 Low quality of data (lack of standards, checking
procedures, training of registrars and doctors,
coders)
 Lack of investments (weak infrastructure, lack of
human resource)
 Little use made of the data

Medical Certification of Death

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Most common problems with cause of death data
 Inaccurate cause of death specified on the death
certificate
 High proportion of ill-defined deaths (absolutely of
no value for health policies and programs)
 Confusion between immediate and underlying
cause of death
 Under registration of certain events (e.g. suicide,
homicide, HIV/AIDS)

Medical Certification of Death

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 Implication

Non-registration of deaths as well as

erroneous information in the certificate of
death may present problems for planning of
health services especially among marginal
and poverty affected sectors.

Medical Certification of Death

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 What have we done?

● Developed long term strategic and investment plans

for CRVS
● Enhance the protocols and standards for CRVS. PSA
with DOH is coming up with a handbook on CRVS for
health workers

Medical Certification of Death

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 What have we done?

● Develop the CRVS training program (CRVS

Framework, ICD-10, Cause of Death and Verbal
Autopsy)
● Readying the omnibus CRVS Bill for congress
● Scaled COD with medical societies, associations and
hopefully in the medical curriculum

Medical Certification of Death

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 How are we doing so far? 2024 TARGET CURRENT DATA

Births registered 99% 72% *

Deaths registered 90% 92% *

Medically attended registered deaths 85% 56% **

Reduction of ill-defined or unusable COD

with zero R codes (from registered deaths) 0.45% 1.2% *
Community deaths with underlying COD
determined through standard VA 85% No data
* Philippine Statistics Authority. (August 2021). Philippines’ Response to the UNESCAP Mid-Term Questionnaire 2020.
** Philippine Statistics Authority. (January 31, 2022). Registered Deaths in the Philippines, 2020. https://psa.gov.ph/content/registered-deaths-philippines-2020#:~:text=In%202020%2C%20a%20total
%20of,per%201%2C000%20population%20in%202020.

Medical Certification of Death

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 What do we need from YOU?

● Advocate COD to your fellow doctors and

health workers.
● Capacity building of physicians on COD.
● Increase capacity to critically analyze and use
mortality data

Medical Certification of Death

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 CRVS
begins and ends
in the health sector.

Department of Health,
Medical Philippinesof Death
Certification
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 Be Legible,
Be Careful,
Be Accurate.

Department of Health,
Medical Philippinesof Death
Certification
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 Thank you!

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