Civil Registration and Vital StatisticsCivil Registration and Vital Statistics
In Sultanate of OmanIn Sultanate of Oman
Dr. Medhat K. ElSayed
Decemebr 3-6, 2007 Civil Registeration & Vital Statistics 2
IntroductionIntroduction
� A modern state started with the Omani Renaissance in 1970
� Interests to document births and deaths started gradually after 1970
� During early 80’s age estimation for public employees
� Age may not be accurate for a considerable proportion of people above the age of 25 years
� Vital Registration was implemented in may 2004
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Birth & Death Certificates
� Before May 2004� Ministry of Health (MOH) and other public hospitals issues
certificates
� Private Health Institutions: Notification of event to MOH
� Home events: Notification of event by community leader (Sheikh – Wali) to MOH
� Age estimation by MOH
� Royal Decree (66/99): Civil Status Law� October 1999
� Implementation in May 2004
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Birth and Death Certificates … Cont
� October 1999
� Establishment of Directorate General of Civil Status (DGCS) at Royal Oman Police (ROP)
� Develop the implementing regulations of the Law
� Register civil status events
� Events: birth, death, marriage, divorce, citizenship, residence
� Issue certificates
� Issue ID Cards
Civil Status LawCivil Status Law
Decemebr 3-6, 2007 Civil Registeration & Vital Statistics 5
Birth and Death Certificates … Cont
� Committee to instituted by “The Inspector General of Police and Customs”� Chaired by Director General of Civil status� Members represent the following ministries:
� Ministry of National economy� Ministry of Interior� Ministry of Foreign Affairs� Ministry of Health� Ministry of Social Affairs, Labour & Vocational Training� Ministry of Justice� Ministry of education
� Streamline the course of work in the Civil Register and contribute to its development
Civil Status Law … cont
Decemebr 3-6, 2007 Civil Registeration & Vital Statistics 6
Birth and Death Certificates … Cont
� Birth and Death Notification forms to be developed by a body established by Minister of Health
Civil Status Law … cont
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Birth and Death Certificates … Cont
� Notification of all births� Notification should be made to registrar in the Sultanate (or the
Omani Mission in the country if outside the Sultanate) � Notification within 2 weeks (if inside the Sultanate or after arrival)
or 3 months if births takes place outside the Sultanate� Informants with legal responsibility to notify birth (in order)
� Father if he was present� Any adult (relative - closest) present at delivery� Any adult occupant of the same house as the mother of the newborn� The doctor or authorized person who delivered the baby� Directors of institutions (e.g. hospitals, maternity centers, prisons,
quarantines, others) where birth takes place� Community leader (headman or chief of district – Sheikh – wali)� Mother
Civil Status Law … cont
Chapter 3: BirthsChapter 3: Births
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Birth and Death Certificates … Cont
� Notification of birth should include the following:
� Day, date both Georgian and Hijri (in numbers and alphabetical), time and place
� Sex of newborn (male – female) and name
� Both parents: name, civil number, tribe, nationality, religion, address, occupation
� In case of twins each should have an individual notification
Civil Status Law … cont
Chapter 3: Births … cont
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Birth and Death Certificates … Cont
� Minimal set of health related data for births (not required by law)� Live birth or Still birth� Age of mother and father� Cause of death for stillbirth; in fetus and in mother� Mode of Delivery� Birth weight� Consanguinity� Gestational period� Number of twins, order among twins� Educational level of mother� Delivery (birth) attendant� Birth interval� Gravidity, previous stillbirths, previous live births, still living
Civil Status Law … cont
Chapter 3: Births … contHealth related data Health related data
Decemebr 3-6, 2007 Civil Registeration & Vital Statistics 10
Birth and Death Certificates … Cont
� Notification of all deaths� Notification should be made to registrar in the Sultanate (or the
Omani Mission in the country if outside the Sultanate) � Notification within 7 days (if inside the Sultanate or after arrival)
or one month if death takes place outside the Sultanate� Informants with legal responsibility to notify death (in order)
� Ascendants, Descendants or spouse of deceased� Any adult (relative - closest) present at death� Any adult occupant of the same house as the deceased� Community leader (headman or chief of district – Sheikh – wali)� The doctor who checked the deceased� Directors of institutions (e.g. hospitals, maternity centers, prisons,
quarantines, others) where death takes place
Civil Status Law … cont
Chapter 5: DeathsChapter 5: Deaths
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Birth and Death Certificates … Cont
� Notification of birth should include the following:� Place, time, day, date both Georgian and Hijri (in number and
alphabetical)
� Deceased: name, tribe, sex (male – female), nationality, religion, address & occupation
� Deceased: age, place & date of birth, civil number, place of registration if known
� Name and tribe of father and mother, if known
� Informant: name, address and relation to deceased
� Unidentified dead bodies are to be notified by ROP describing age, sex, description of deceased and cause of death
� General Prosecution should notify death of persons executed within 24 hours of the execution
� Permission of burial only if criminal or suspected death
Civil Status Law … cont
Chapter 5: Deaths … cont
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Birth and Death Certificates … Cont
� Minimal set of health related data (not required by law)
� Cause of death (underlying, direct, other diseases)
� Maternal death
Civil Status Law … cont
Chapter 5: Deaths … contHealth related data Health related data
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Notification of Births and DeathsNotification of Births and Deaths
� Establishment of a System of notification of vital events
� Identification of all possible sources of notifications
� One notification system
� Birth & Death Notification Forms :Consider requirements of CS Law and health sector
� Notification path
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Possible sources of NotificationsPossible sources of Notifications
Nearest health institution –with ROPFactors, companies, roads, transportation
Omani mission in country where event Outside Oman
Community leader (Sheikh – Wali)Home
Private health institutionPrivate hospitals & clinics
SQU hospitalSQU hospital & HC
ROP health institutionsROP Hospitals and dispensaries
AFMS health institutionsAFMS Hospitals and dispensaries
MOH health institutionsMOH Hospitals & HC
Source of notificationsPlace of birth or death
Notification of Births and Deaths … cont
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Notification of BirthNotification of Birth
� A Notification of birth form was developed
� Satisfying law requirements
� Adding health related data
Notification of Births and Deaths … cont
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Notification of DeathNotification of Death
� A Notification of death form was developed
� Satisfying law requirements
� Adding health related data
Notification of Births and Deaths … cont
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Flow of NotificationsFlow of Notifications
Notification of Births and Deaths … cont
MOH
SQUH
AFMS
Prvt HI
ROPMS
C L
O M
DG CS
Client
Copy of notification form
s from places other than M
OH
MOH: Ministry of Health; AFMS: Armed Forces Medical Services; Prvt HI: Private Health Institutions; ROPMS: Royal Oman Police Medical Services; CL: community leaders; OM: Omani Missions
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Notification databaseNotification database
� MOH has a database parallel to that of DGCS
� MOH database was installed in SQUH, AFMS, and major private health institutions
� Send data electronically directly to MOH database
Notification of Births and Deaths … cont
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Flow of NotificationsFlow of Notifications
Notification of Births and Deaths … cont
MOH
SQUH
AFMS
Prvt HI
ROPMS
C L
O M
DG CS
Client
Copy of notification form
s from places other than M
OH
MOH: Ministry of Health; AFMS: Armed Forces Medical Services; Prvt HI: Private Health Institutions; ROPMS: Royal Oman Police Medical Services; CL: community leaders; OM: Omani Missions
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Assessment of 2006 Data Assessment of 2006 Data
from Vital Events Notificationfrom Vital Events Notification
� Missing segregation information
� Pattern according to age
� Completeness (coverage)
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Segregation of informationSegregation of information
32%30%
0%
10%
20%
30%
40%
Omani Expatriate
Assessment of 2006 Data from Vital Events Notification … cont
Gender unknown for 30% of notified deaths Gender unknown for 30% of notified deaths
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Segregation information … cont
12.2%
9.6%
27.0%
5.8%
0.0%
10.0%
20.0%
30.0%
Omani Expatriate
Males Females
Assessment of 2006 Data from Vital Events Notification … cont
Unknown age of notified deaths Unknown age of notified deaths
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Segregation information … cont
0.3%0.8%
0.0%
10.0%
Omani Expatriate
Assessment of 2006 Data from Vital Events Notification … cont
Sex of newly born un reportedSex of newly born un reported
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Segregation information … cont
13.6%
5.0%
0.0%
10.0%
20.0%
Omani Expatriate
Assessment of 2006 Data from Vital Events Notification … cont
UnUn--reporting age of mother for newly bornreporting age of mother for newly born
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Pattern according to Age and SexPattern according to Age and Sex
Assessment of 2006 Data from Vital Events Notification … cont
Natural log (ln) of ASDR for Males 2006
-1.000
0.000
1.000
2.000
3.000
4.000
5.000
6.000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Natural log (ln) of ASDR for Females 2006
-2
-1
0
1
2
3
4
5
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
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Completeness or CoverageCompleteness or Coverage
-
0.0200
0.0400
0.0600
0.0800
0.1000
0.1200
0.1400
0.1600
- 0.0200 0.0400 0.0600 0.0800 0.1000 0.1200
Dx+/Nx+
Nx/Nx+
Assessment of 2006 Data from Vital Events Notification … cont
Males Coverage 98%
Using Brass’s Growth Balance Method(preliminary analysis)
Females Coverage 97%
-
0.0200
0.0400
0.0600
0.0800
0.1000
0.1200
0.1400
- 0.0100 0.0200 0.0300 0.0400 0.0500 0.0600 0.0700 0.0800
Dx+/Nx+
Nx/Nx+
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Mortality EstimatesMortality Estimates
OverallFemalesMalesOverallFemalesMales
8.17.1910.19.211IMR (/1000 lb)
81.681.281.972.674.970.4e0 years
12.9613.512.811.813.8U5MR (/1000 lb)
1.21.11.22.92.33.4CDR (/1000 pop)
ExpatriatesOmanis
CDR: Crude Death Rate, IMR: Infant Mortality Rate, U5MR: Under 5 Mortality Rate, e0: Life expectancy at birth
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Fertility EstimatesFertility Estimates
101.7105.8Sex ratio (/100 females)
OverallFemalesMalesOverallFemalesMales
1.033.19TFR (/women 15-49)
0.501.51NRR (/women 15-49)
0.511.55GRR (/women 15-49)
5.713.43.724.223.724.6CBR (/1000 pop)
ExpatriatesOmanis
CBR: Crude Birth Rate, TFR: Total Fertility Rate, GRR: Gross Reproduction Rate, NRR: Net reproduction Rate
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Obstacles and challengesObstacles and challenges
� Notifications by Community Leaders� Need to assess completeness
� Data on notification forms need to be completed especially health related data
� Cause of death is an issue to consider
� Burial permit� No burial permit is required
� Can affect completeness of death registration
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Obstacles and challenges … cont
� Cultural believes and attitudes for registration� Age estimation has been practice for a long time
� Changes in believes about importance for registration
� Cause of death data� Physician and coders need training
� Deaths outside health facilities: DOA, A&ED, Notified by CL