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Evaluation database

Evaluation report

2017 Dominican Republic: Evaluation of the initiative Timely Birth Registration in Prioritized Hospitals in the Dominican Republic

Author: Julia Hasbún

Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 3’ of the report, and the executive feedback summary labelled as ‘Part 4’.


In the Dominican Republic, 12% of all children under the age of 5, or 116,880 children, are not registered. This happens in a context where the birth registration is free, 60 most important public hospitals have civil registry office, and institutional birth is universal.  UNICEF and the Central Electoral Board implemented a successful pilot initiative in 12 hospitals between 2013 and 2016 to increase the timely birth registration for all babies born in public hospitals before they leave the premises. 


Evaluate the scope of the initiative Timely Birth Registration in Prioritized Hospitals in the Dominican Republic for its relevance, efficiency, sustainability, and impact. 


The methodological framework was based on the use and analysis of quantitative and qualitative information, collected through: i) document review, ii) review and comparison of birth records in the hospitals; iii) focus groups discussions and interviews with officials and service users; iv) satisfaction survey of the service users; and v) direct observation of the application of procedures.

Findings and Conclusions:

Highlights of the main findings are:
a) Relevance. The relevance of the initiative was validated by the results and positive impacts observed in the evaluation.
b) Effectiveness. The initiative successfully implemented a results-based management approach, through a monthly accountability mechanism of the civil registry officers in the hospitals.  This approach was supported by the Central Electoral Board to address the concerns and make decisions for improvement.
c) Sustainability. UNICEF only partially funded the project, and remained a technical partner that guided the project with simple and effective guidelines.  The initiative was adopted by the Government who financed most of the costs and personnel.
d) Impact. The initiative had highly significant impact: timely birth registration rate in target hospitals increased from 37% (2012) to 69% in two years. 


The main recommendations are:
a) The initiative is replicable: it should be expanded and include more hospitals and civil registry delegations.
b) The Central Electoral Board should establish a Monitoring Unit as part of its institutional structure to ensure the universalization of timely birth registration.
c) Training should be extended to all hospital staff.  Pregnant women without identification document should be prioritized to obtain it before the child’s birth. 
d) Coordination among the participating Government institutions should be improved.  UNICEF should remain as technical partner.

Lessons Learned:

a) Training of Central Electoral Board should continue, as the staff’s knowledge was limited on relevant laws, administrative resolutions and procedures.
b) The whole hospital staff should be informed and empowerment to promote timely birth registration.  For example, hospitals porters can contribute to control that babies leave the hospitals only with the birth registration. 
c) The certificate of live birth of each hospital should be standardized and improved, to avoid confusion and delay in registration process.  It should be governed by the administrative resolution of the MOH.

Full report in PDF

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Report information


Dominican Republic



Birth Registration

Central Electoral Board -  Dominican Republic



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