This document features nine recent innovations and lessons learned from UNICEF programmes which are illustrative examples of some of our work on equity and reaching the most marginalized. They are presented here to share the experience of UNICEF and its country-level partners in working to reach the most marginalized in order to share lessons we have learned and the good practices we have identified. The cases highlighted in this publication are highly diverse examples – from women’s participation to deliver messages on immunization in Afghanistan to Brazil’s effort to achieve universal birth registration, lessons learned from community engagement in a rural neglected area in Uganda, and the experience from a child-friendly programme implemented in one of the poorest provinces in Vietnam.

This research, the second of two case studies, explores coordination through the lens of civil registration and vital statistics, with particular reference to birth registration in Peru. It focuses on the role that coordination can play in making birth registration function effectively. While the capacity of governments to deliver the function of birth registration is central to this paper, the role that understanding coordination can play in improving public services is examined, especially services for children. The capacity to register the births of children is a long-standing function of governments, and can be seen as a test of government effectiveness. In Peru, backward mapping showed that the trails from local and district registrars to the government registration organization (RENIEC) stopped almost immediately. This seems to point towards the centralized structure and top-down approach of RENIEC; to sustain its achievements to date and to reach the final three per cent of unregistered births it should consider incentivizing and empowering local and community administrations.

This report, commissioned by the Rights of the Child Commission (RCC) and United Nations Children‟s Fund (UNICEF), presents the findings of a two-month research project to examine the situation of birth registration among children in Guyana. The study included a detailed desk review and field research in four of ten administrative regions of Guyana (Regions 1, 2, 7 and 10). The study engaged both Duty Bearers and Rights Holders at the national, regional and community levels. In total 618 households were interviewed and data for 1,770 children were recorded. In addition, the study engaged a wide range of stakeholders at the national level including leading experts and professionals within the government and non-governmental sectors. These include the Ministry of Home Affairs, which has responsibility for birth registration, the Ministry of Amerindian Affairs, the Ministry of Health; Ministry of Labour, Human Services and Social Security; Children‟s Legal Aid and regional officials. The study examined various aspects of a child‟s identity rights including: an assessment of (i) legislation, (ii) policy and practice and (iii) attitudes and behaviors of care givers (parents and/or health workers). The major findings are grouped into three key categories; policy, prevalence and practice.

Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety. Since 2005, the World Health Organization’s World Alliance for Patient Safety has undertaken the Project to Develop an International Classification for Patient Safety (ICPS) to devise a classification which transforms patient safety information collected from disparate systems into a common format to facilitate aggregation, analysis and learning across disciplines, borders and time. A drafting group, comprised of experts from the fields of patient safety, classification theory, health informatics, consumer/patient advocacy, law and medicine, identified and defined key patient safety concepts and developed an internationally agreed conceptual framework for the ICPS based upon existing patient safety classifications. The conceptual framework was iteratively improved through technical expert meetings and a two-stage web-based modified Delphi survey of over 250 international experts. This work culminated in a conceptual framework consisting of ten high level classes: incident type, patient outcomes, patient characteristics, incident characteristics, contributing factors/hazards, organizational out-comes, detection, mitigating factors, ameliorating actions and actions taken to reduce risk. While the framework for the ICPS is in place, several challenges remain. Concepts need to be defined, guidance for using the classification needs to be provided, and further real-world testing needs to occur to progressively refine the ICPS to ensure it is fit for purpose.

The article introduced a new definition of “drowning” (1). Most of the time we intuitively know what drowning is until someone asks us explicitly to define it. In scientific research, meaningful definitions are essential for comparability and reproducibility. Drowning has been listed as the second leading cause of death from unintentional injury in WHO reports, after road traffic accidents (2). Many questions can be asked as to whether this is really the case in various countries, whether the data are comparable across cultures, and what can be done about it. Surely such a frequent event, with its serious consequences of death and disability, requires widespread public health attention, especially as drowning can be prevented by simple measures.

The 11th revision of the International Classification of Diseases and Related Health Problems (ICD) will be developed as a collaborative effort supported by Webbased software. A key to this effort is the content model designed to support detailed description of the clinical characteristics of each category, clear relationships to other terminologies and classifications, especially SNOMED-CT, multi-lingual development, and sufficient content so that the adaptations for alternative uses cases for the ICD – particularly the standard backwards compatible hierarchical form – can be generated automatically. The content model forms the basis of an information infrastructure and of a webbased authoring tool for clinical and classification experts to create and curate the content of the new revision.

Civil registration is integral to the Indonesian government’s current poverty-reduction strategy, both for its ability to confer legal identity to citizens and as the principal source of the country’s vital statistics. Unfortunately, ownership of key civil registration documents, such as birth certificates and death certificates, remains exceptionally low, and governments are often unable to access timely, reliable, and comprehensive vital statistics. This work is a product of the staff of the Center on Child Protection Universitas Indonesia (PUSKAPA). The study sought to provide the Government of Indonesia (GoI) with an evidence base of the bottlenecks, gaps, strengths, and opportunities in the existing systems, identify models from comparable countries, and assess relevant contextual variations within Indonesia to inform planning and implementation of an enduring solution. This involved a three-part systematic desk review, key informant interviews, focus group discussions, and a cross-sectional, multi-stage cluster survey at the sub-district level in the provinces of Aceh, Central Java, and South Sulawesi.

Articles Data sharing in the Pacific - New Zealand and Niue share registration data Kyrgyzstan progressing on a national strategy for CRVS International conference on CRVS in Bangladesh in January 2018 New Zealand launches online marriage registration Events Certification of Causes of Death Meeting, 28-30 November 2017, Suva, Fiji Capacity building workshop for selected National CRVS Focal Points, 12-14 December 2017, Bangkok, Thailand Harnessing the Power: CRVS Systems for 2030 Global Agendas, 27-28 February 2017, Ottawa, Canada *For other issues of the newsletter