Recording births in Uganda's remote villages

UNICEF is working with the government to boost the rate of birth registration but poor and marginalised communities remain difficult to access.

When data collectors last year came to Daniel Lowal’s village in remote northeast Uganda, the father of four didn’t want to miss out. He gathered his family together and hurried to the market square where data collectors had stationed. 

One-by-one, Lowal presented his children at the registration desks, giving the data collectors the names and birth dates of each. Because he’d never had a birth certificate himself, Lowal always found it difficult to prove his identity and find work. “I didn’t want my children to suffer the way I suffered,” he said.

The youngsters have since been supplied with four clean, white “birth notification cards” from the government’s district office, which they will use to acquire birth certificates that are required to produce before they can sit for primary school exams, obtain identity cards and apply for jobs.

Lowal isn’t alone in wanting the births of children recorded in Uganda. The European Union and UNICEF in 2017 announced a grant worth 6 million euros to support a substantial increase in birth registration in the East African nation and three other African countries. 

The grant, which is being managed by UNICEF, is designed to substantially increase the rate of registration, which until recent years was alarmingly low. Birth registration rates for children under 5 in Uganda have risen from 30 per cent in 2011 (UDHS report 2011) to an estimated 69 per cent at the end of 2016 (Administrative data).

The European Union grant builds on evidence that shows that rapid gains are made when birth registration is linked to the health sector, when births are recorded in the health facilities where they occur.

UNICEF describes birth registration as the official recording of a child's birth by the government, establishing the child’s existence under law and providing the foundation for safeguarding many of the child's civil, political, economic, social and cultural rights.

Low birth registration rates disproportionately affect poor and marginalised communities. Orphans, people with disabilities, victims of natural disaster and ethnic minorities risk missing out on critical education and health services if they don’t obtain birth certificates. People living in rural or remote areas also have limited access to civil registration services.

The European Union Ambassador to Uganda, Attilio Pacifici, said birth registration was crucial for the protection of vulnerable children from abuse such as child marriage and child labour.

In Uganda, newborns can be registered immediately at birth in health facilities, while children born at home can be registered at their respective sub counties. 

While UNICEF is working hard with the national government to increase birth registration rates across the country, the challenges of recording the births of thousands of children born across the country every year are daunting. 

UNICEF child protection officer Diclerk Asiimwe, one of two local UNICEF staff members dedicated to birth registration activities in Uganda, says the infrastructure required to perform the job of recording births is inadequate particularly in rural and remote areas.

“The new authority which is managing birth registration is still evolving,” says Asiimwe, “They are putting in place human resources, which hasn’t been easy.”

The Ugandan government established the National Identification and Registration Authority (NIRA) under law in March 2015 and the authority began operations in 2016. NIRA is responsible for registering and issuing certificates for births, deaths and adoptions, as well as issuing national identification cards.

Across Uganda, children who are born in hospitals have their births registered immediately. But most children are born at home and many births go unrecorded, making it difficult for the government to estimate population growth.

Government officials working in district offices distribute birth registration books to village elders, who record births. The books are periodically collected and the data is entered into an online computer system (Mobile Vital Records System). Notifications are then printed and taken back to the villages. But it can be months, or even longer between the time a child is born and the time their family receives their birth registration document due to logistical challenges.

UNICEF provides ongoing support to the government when it comes to developing the capacity needed to effectively run the birth registration system. Assistance ranges from support policy and strategic planning and development, to providing technical advice, procuring and installing computers, training staff and supplying printing materials.

Asiimwe says he is in contact with birth registration officials in more than 100 district offices and 135 hospitals across the country on an almost daily basis.

“We are in contact with every focal person we work with. Providing support, giving feedback, sharing information. Sometimes when we are in the office it’s like a call centre.”

UNICEF and the European Union are working with the government to break down barriers that prevent Ugandans from getting birth certificates for their children from getting one.

Obtaining a certificate is a two-step process: Families must first get hold of a birth notification document and then apply for a birth certificate. The certificates are currently only available in six regional NIRA offices located in urban centres across the country.

Birth certificates aren’t free and many Ugandans can’t afford the 5,000 Uganda Shillings (US$1.30) to obtain one. The cost of travelling to one of the six offices also presents a significant challenge. 

UNICEF and other international organisations are talking to the government about how some of these barriers can be overcome.