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Ghana

Impact of the universal birth registration campaign

Before the universal birth registration campaign was launched in 2005 

In 2005, the number of births registered (including both adults and children) was 656,935. 67% of children under one were registered. 

Following the campaign

In 2008, the number of births registered (including both adults and children) had grown to 683,286. 51% of children under one were registered. The fall in percentage registered reflects the switch from manual to automated systems, which necessitated the retraining of staff and volunteers and affected the rate of coverage.

Government policy and practice on birth registration 

The Registration of Births and Deaths Act, 1965, provides for the registration of births, deaths and foetal deaths in Ghana. Birth registration is compulsory in all areas in Ghana. The Births and Deaths Registry, which comes under the Ministry of Local Government and Rural Development, manages the registration system, and there is an infrastructure, logistics and annual budget to support registration. Registration is coordinated from the Central Registry Office in Accra, where all national data are kept and managed. There are 10 registration regions, coinciding with the political and administrative regions, which are divided into 170 registration districts, coinciding with local authority areas. There is at least one registry office per registration district staffed by a registration assistant. A district registration officer supervises the registration system through the registries and reporting centres in the various communities in the district.

Universal birth rights campaign strategy

Ghana’s UBR campaign was based on the premise that public awareness about the importance of birth registration was virtually non-existent, whilst registration coverage was very low, especially in rural communities, due to the absence of registration facilities. At a Plan stakeholders meeting in February 2005, a goodwill ambassador was appointed to lead a public awareness campaign about birth registration across the country.  The main strategy was to promote and sustain the idea of early birth registration using music and drama in a nationwide education campaign to raise the public's awareness of the importance and benefits of early birth registration. Ghana launched its country programme on 1 September 2005 with a durbar (reception) that coincided with the second Births and Deaths Registration Day celebration at Adeiso, in the West Akyem district of the Eastern region.

  • Aim of campaign
    The overall goal was to establish a reliable registration system in Ghana. The main objective was to increase the coverage of birth registration from an all-time low level of 17% in 2002 to near 100% at the end of the programme period (2007). The key focus areas were:
  • to increase people's awareness of the importance of birth registration through effective and sustained public education in selected districts and nationwide;
  • to extend registration facilities to people's doorstep through having population  registers at community level;  
  • to improve data management (processing, storage and retrieval) at regional and national levels through computerisation of the records.
  • Expenditure per year
 2005 US$ 26,222
2006 US$ 103,889
2007 US$ 55,193
2007 US$ 9,784

Outcomes

      • Policy and legislation changes
      1. Free period for registration of infants extended from 21 days to 12 months.
      2. Institution of an annual national Births and Deaths Registration Day (celebrated on 1 September).
      3. Community population registers introduced in 21 communities across four regions.
      4. Community volunteers deployed to collect information in hard-to-reach areas.
      5. Computerisation of aspects of the registration process under way.
        • Government capacity and practice
        1. Increasing government involvement in birth registration. 
        2. Regular, though inadequate, funding of registration activity. 
        3. The government is supporting the Registry computerisation programme.
          • Monitoring and ensuring the implementation of policy and legislation related to UBR.

      Monitoring and supervision of the process is done at three levels to ensure effectiveness:

          1. a) 1st level: district registration officer of the Births and Deaths Registry  - links up with community volunteers and other field operatives, issues birth certificates, carries out awareness-raising activities, submits monthly reports on all registered births to 2nd level;
          2. b) 2nd level: regional registration officer  - supervises activities in the districts, collates monthly reports for the region and submits these to head office;
          3. c) 3rd level: inter agency coordinating team (Births and Deaths Registry, Plan Ghana and district assembly) - monitors and makes support visits to programme areas; reviews progress of the programme after implementation and impact of awareness-raising activities.
          • Creating incentives to increase the demand for birth registration
            Birth certificates are now required for: enrolment into school; securing employment (particularly within governmental agencies) obtaining travel documents (passport, visas); judicial processes involving children, among others. 
          • Waiver/reduction of costs

      All fees and penalties connected with the registration of infants under 12 months have been waived.

          • Partnerships, coordination, cooperation, alliances and coalitions

      Very useful partnerships have developed between the Births and Deaths Registry and agencies such as the Ghana Health Service, Ministry of Health, Ghana Statistical Service, Ghana Immigration Service, Ministry of Women and Children’s Affairs, Centre For Health Information Management of the Ministry of Health, with support from Plan Ghana, Unicef, the UNFPA, the Health Metrics Network and the European Union, to improve birth registration coverage to an appreciable level. 

          • Community awareness

      Recent returns for registered births suggest an appreciable public response to the awareness-raising efforts.

          • Ownership and sustainability (Have the duty-bearers, the state, taken responsibility? How have rights-holders, communities, and civil society been involved to ensure sustainability?)

      The state has been in charge of birth registration since 1912. Although funding has not attained the desired level, the basic structures and logistics have remained the responsibility of the state. Currently there are efforts to integrate t he Births and Deaths Registry into the district assemblies to ensure ownership and sustainability of the registration system.

          • The integration of the issue of birth registration with other programmes, such as maternal health

      Since 2004, the Births and Deaths Registry has participated in an annual Child Health Promotion Week organised by the Ghana Health Service in the second week of May to reach out with a comprehensive package of health and child protection services to all children. There is also a follow-up activity, the integrated maternal and child health programme, held every November. There have also been efforts to train community health nurses to assist with birth registration.

          • Registering the most marginalised and hard to reach communities  (ethnic minorities, nomadic groups, orphans, street children, migrants and refugees etc)

      The laws on birth registration cover every person born within the geographical boundaries of the country. The challenge is the non-availability of registration facilities in most rural areas. It is this situation that the community population register programme and other itinerant registration activities are seeking to address.

          • Tackling the related issues of migration, nationality and statelessness

      These issues can easily be resolved when the country achieves universal birth registration. The computerisation of records generated from the process will facilitate the sharing of information between the Ghana Immigration Service, the National Identification Authority and other stakeholders to resolve issues of citizenship and migration.

          • Linking birth registration to other children’s rights, such as increased access to health, education, inheritance rights and protection from trafficking, child labour etc

      The Births and Deaths Registry continues to work closely with several child protection and support groups, governmental and non-governmental, on the issues concerning the holistic development of the child. Several public forums and media have been used to explain the links between birth registration and the rights and protection offered to children who are registered at birth.

          • Involving children in the UBR campaign

      The Births and Deaths Registry has used Children and Youth in Broadcasting (CYIB), also known as “Curious Minds”, to propagate messages about birth registration through radio, television and community level engagements.

      Good practice

          • The use of community-based volunteers, community durbars, mobile registration sessions and the various music and drama road shows spearheaded by the country’s goodwill ambassador for birth registration have contributed to the turn around in registration coverage. These activities ensured that the public was well informed about registration and also sent registration facilities to their doorstep.
          • Removal of registration fees has provided an incentive to parents to report births for registration.
          • Distribution of gifts and souvenirs, including T-shirts, exercise books, iodated salt, customised certificate holders, have provided additional incentives for people to register births. 
          • The community population register programme identified and registered children who were above the threshold for free registration. Plan Ghana sponsored the registration of 3,000 of such children in the pilot areas. 

      Challenges, gaps and barriers

          • Low motivation to report births for registration, due to ignorance.
          • Inadequate staff for the registration machinery.
          • Absence of registration facilities and logistics in most rural communities.
          • Lack of incentives for registration volunteers.
          • Weak monitoring and supervision of registration system due to immobility of officers.
          • Inadequate funding from central government to open more registration centres closer to the people.
          • The obligatory presentation of birth certificates for enrolment into schools and for gaining employment is not well enforced, reducing the incentive. 

      National level recommendations 

      Continued public education and increased advocacy for more national support of the vital registration system. Plan Ghana has demonstrated the feasibility and effectiveness of community population registers in its pilots in 15 communities. A stakeholder meeting is due to be organised to share evaluation reports and create a platform for planning the way forward with other partners.

      Future activities 

      We intend to expand the community population register programme to cover all 17,000 localities in the country. This will ensure the prompt reporting, registration and certification of all births and deaths.

      Do you have any high-profile supporters of Plan’s UBR campaign? 

          • Minister for Local Government and Rural Development
          • Eric Okrah, Child Protection Officer, UNICEF 
          • Dr Grace Bediako, government statistician

      Campaign fact

      51,000,000 children a year around the world are not registered (UNICEF 2007)