Strengthening the link between civil registration and health services
is key to UNICEF strategy to improve birth registration rates in Senegal
After checking baby Yatma’s heartbeat and going over family planning methods with Yatma’s young mother, midwife Oumy Thiam peeled off her medical gown and headed out the door, a pile of papers under her arm.
It was noon, but Oumy wasn’t heading on a break. Instead, she jumped on the back of a motorcycle taxi at the entrance of the health center and traversed the short distance to the town hall to deposit birth records.
As the head of the maternity ward at the Moricounda Health Center in Sédhiou, Oumy’s medical purpose went hand-in-hand with a whole other undertaking – that of ensuring babies like four-month old Yatma would exist in government registrars.
According to UNICEF, West and Central Africa has the lowest birth registration rates in the world, and throughout Sub-Saharan Africa possession of a birth certificate is even less common. Registration is ideally done as soon as possible after the birth has occurred, and preferably within the first year. Whereas Senegal has mechanisms in place for registering births, systematic and timely birth declarations remain a challenge.
Dr. Amadou Yedi Camara, the District Chief Doctor of Sédhiou, alleges that ‘’Registration is a cultural frame of mind. If you’re baptized, then you exist in African culture. In this rural zone, lack of knowledge on how to register a child’s birth is another barrier.’’
UNICEF recognizes birth registration as a first step in securing children’s recognition before the law, safeguarding their rights and ensuring that any violation of those rights does not go unnoticed. Without proof of age, children can be exposed to precarious marriage, barred from taking school exams, and miss out on exercising lifelong civic rights.
 A Snapshot of Civil Registration in Sub-Saharan Africa. UNICEF [https://data.unicef.org/resources/snapshot-civil-registration-sub-saharan-africa/]
In the southern Casamance region of Senegal where births are not systematically registered, health services are rapidly accelerating change. ‘’Parents don’t always recognize the use of registering their babies, but when the mother gives birth in a health center, we get her contact and can invite her to a postnatal checkup’’, details Oumy.
‘’The contribution of the health sector to civil registration in Senegal has been phenomenal,’’ explains Mamadou Ibrahim Ndiaye, the District Head of Social Action in Sédhiou who oversees an initiative called ‘’Le Premier Cadeau.’’ Co-launched by the regional medical and social action authorities in Sédhiou, it’s a collaboration that informs mothers that the ‘’first gift’’ they can give their children is identity and recognition before the law and ensures that all children coming into contact with the health system are declared. With donations of hygiene products, healthcare providers incentivize mothers to attend three postnatal consultations in the weeks following birth. Strategically, the second postnatal appointment is set on the 9th day postpartum as in Senegal a baby’s name is traditionally given seven day after birth. On the day of their second appointment, midwives can therefore record the baby’s name and accompany parents in the civil registration process.
Strengthening and systematizing linkages between civil registration and the delivery platforms of other social services is a key UNICEF strategy in improving birth registration rates in Senegal. Coupling birth registration with maternal health services has been particularly successful. ‘’I’ve been working in this facility since 2014, and this is the first time that birth registration has been functional, since March 2020. Ever since ‘’Le Premier Cadeau’’ began, I’ve been seeing women come for all three appointments and getting their babies’ birth certificates done. It used to be just under 50% and then it went to 81%’’, says midwife Oumy Thiam from the Moricounda Health Center in Sédhiou.
‘’We work directly with the midwife because she is aware of every birth. When a midwife is involved, registration levels increase significantly’’, adds Mamadou Ibrahim Ndiaye. In the meantime, midwives like Oumy will continue to embody the remarkable partnership between civil registration and health services, ensuring the 60 to 80 babies she delivers each month have their first gift.