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Civil Registration and Vital Statistics

Plan International

About Plan International

Plan International is an independent development and humanitarian organisation, active in over 70 countries. Its mission is to advance children's rights and equality for girls, with a 5-year ambition to transform the lives of 100 million girls. They work with vulnerable children, especially girls, to help them learn, lead, decide and thrive.

Challenge description

290 million of the world’s children under 5 do not have a birth certificate. That’s about 45 per cent. Without it, these children are denied access to basic services and put at greater risk from trafficking and abuse. Our work with Plan International has meant helping to to solve complex, entrenched problems rooted in this lack of early registration.

According to the World Health Organisation, tens of millions of children go unregistered every year, and they also estimate that two-thirds of deaths are never registered - if a country doesn’t know how many/why its citizens are dying there is no way of reducing premature mortality or preventing avoidable deaths. Without access to accurate birth and death statistics, governments face huge obstacles to developing effective public policies around health, education and even basic human rights.

Plan wanted to finding a way to deliver universal birth and death registration in countries that have struggled with it due to patchy infrastructure. Paper records, easily damaged or lost, prevent more sophisticated use of data and even when things have been digitised, efforts to improve are hampered by outdated legacy software.

Plan International

What we did

Plan is helping to create a system that aims for 100% coverage in birth and death registration – a system where nobody is left out. To do this meant combining the best of Futurice’s capabilities in design, development and strategy, to create an open source architecture for a platform that can be used anywhere in the world, alongside a robust devops framework to roll it out. So how did we go about it?

A key focus of the project was to educate people about why it’s important to register births and deaths. Our first step was to develop a prototype and demonstrate what the project could look like. We then workshopped user-centred design in a country context in order to develop a playbook for digital birth registration. The country we chose for our first pilot was Bangladesh – a country with a sophisticated digital first strategy but where cultural factors, combined with patchy infrastructure in remote areas and bureaucracy stop people from registering births.

Plan International

Rimu shows off her birth certificate. Photo courtesy of Plan International.

Plan International

With complete immersion in the working environment of community health workers and registration clerks, we got right up close to the problem. Focus groups and prototype testing sessions took place to ensure the system worked for its end users, taking into account – for example – variation in reading ability and the relevance of features for different types of user. We worked in particular with a local research team in Bangladesh to embed user feedback throughout the project. This was real human centred design, with travel to remote rural areas of Bangladesh to engage with people struggling to provide services through power cuts, transport issues, server downtime, and slow or no internet connectivity.

In terms of technology, the platform Futurice opted for uses Progressive Web App technology which allows the developers to build an app-like experience using non proprietary (check) web technology. Health workers save an app to their home screen that looks and feels exactly like an app even though its actually a web page. Unlike conventional apps, progressive web apps use less data (check), are constantly updated and responsive, and are connectivity independent which means they can be used offline and on low quality networks. This is important in remote rural areas where there is poor connectivity. What’s more it doesn’t require health workers using the system to have state of the art mobile devices. Thanks to its offline functionality, updating the system is really easy which means health care workers can collect data locally and then upload.

Our first-hand experience of data collection in the field, combined with our thorough understanding of the needs of government and other users allowed us to deliver clear and effective digital design. We also advised on the creation of user-centric services that could scale to work in any country.

Why it matters

The ability to register the births and deaths in a country allows civil institutions to reduce corruption and combat human trafficking, slavery, under-age marriage and many other forms of abuse. It’s vital for the equitable provision of healthcare, and a foundational element of property law and many other legal rights.

It’s fantastic to be able to tackle so many problems at the root. We’ve come to understand just how huge the positive impact that registering births and deaths can have, and we’re proud to have helped deliver a system which will do just that.

“Futurice helped us to embrace a human-centred approach to product development. This will be essential if we are to realise the vision for OpenCRVS; to ensure that all individuals on the planet are recognised, protected and provided for from birth”

- Edward Duffus, Head of Innovation, Plan International

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