Registration of births and deaths in the Marshall Islands is undertaken through the national Civil Registry Office which sits under the Ministry of Internal Affairs. The system is centralized and requires families to come to the office either in Majuro or on Kwajalein, the two most populated atolls, to complete the registration. Although registration is compulsory by law, it is still incomplete. Duplicate records are also an issue, as searching for previously issued certificates is difficult and it is not uncommon for people to simply ask for a new registration when a formal certificate is needed. Additionally, multiple programs within the Ministry of Health record births and deaths. These include data collected through the two major hospitals on Majuro and Kwajalein, and outer island health programs. Monthly reporting from the outer islands is frequently done by citizens band radio calls.
The main challenges to overcome the sparse repartition of inhabitants include a better collaboration between health information services and the civil registration office, and more generally legislative review, personnel capacity building and public awareness raising. The country also still lacks a vital statistics system capable of analysing the civil registration data.
CRVS Focal Point:
Mr. Scott Keju, Chief Statistical Collection and Data Analysis, Economic Policy, Planning, and Statistics Office
Ms. Edlen Anzures, Health Informatics Director, Ministry of Health and Human Services
Marshall Islands
Goal 1. Universal civil registration of births, deaths and other vital events
Goal 1 Targets:
1.A
By 2024, at least … per cent of births in the territory and jurisdiction in the given year are registered.
1.B
By 2024, at least … per cent of children under 5 years old in the territory and jurisdiction have had their birth registered.
1.C
By 2024, at least … per cent of all individuals in the territory and jurisdiction have had their birth registered.
1.D
By 2024, at least … per cent of all deaths that take place in the territory and jurisdiction in the given year are registered.
1.E
By 2024, at least … per cent of all deaths recorded by the health sector in the territory and jurisdiction in the given year have a medically certified cause of death recorded using the international form of the death certificate.
Goal 2. All individuals are provided with legal documentation of civil registration of births, deaths and other vital events, as necessary, to claim identity, civil status and ensuing rights
Goal 2 Targets:
2.A
By 2024, at least … per cent of all births registered in the territory and jurisdiction are accompanied with the issuance of an official birth certificate that includes, as a minimum, the individual’s name, sex, date and place of birth, and name of parent(s) where known.
2.B
By 2024, at least … per cent of all deaths registered in the territory and jurisdiction in the given year are accompanied with the issuance of an official death certificate which includes, as a minimum, the deceased’s name, date of death, sex, and age.
Goal 3. Accurate, complete and timely vital statistics (including on causes of death) are produced based on registration records and are disseminated
Goal 3 Targets:
3.A
By … (year), annual nationally representative statistics on births – disaggregated by age of mother, sex of child, geographic area and administrative subdivision – are produced from registration records or other valid administrative data sources.
3.B
By … (year), annual nationally representative statistics on deaths – disaggregated by age, sex, cause of death defined by ICD (latest version as appropriate), geographic area and administrative subdivision – are produced from registration records or other valid administrative data sources.
3.C
By 2024, at least … per cent of deaths occurring in health facilities or with the attention of a medical practitioner have an underlying cause of death code derived from the medical certificate according to the standards defined by ICD (latest version as appropriate).
3.D
By 2024, the proportion of deaths coded to ill-defined codes will have been reduced to … per cent.
3.E
By 2024, at least … per cent of deaths taking place outside of a health facility and without the attention of a medical practitioner have their underlying cause of death code determined through verbal autopsy in line with international standards.
3.F
By … (year), key summary tabulations of vital statistics on births and deaths using registration records as the primary source, are made available in the public domain in electronic format annually, and within one calendar year.
3.G
By … (year), key summary tabulations of vital statistics on causes of death using registration records as the primary source, are made available in the public domain in electronic format annually, and within two calendar years.
3.H
By … (year), an accurate, complete and timely vital statistics report for the previous two years, using registration records as the primary source, is made available in the public domain.
Goal 1. Universal civil registration of births, deaths and other vital events
Goal 1 is an expression of the internationally accepted principle of the universal coverage of civil registration. The CRVS system should register all vital events occurring in the territory and jurisdiction of the country or area, including among hard-to-reach and marginalized populations.
National Targets:
1.A
By 2024, at least … per cent of births in the territory and jurisdiction in the given year are registered.
1.B
By 2024, at least … per cent of children under 5 years old in the territory and jurisdiction have had their birth registered.
MIDTERM
2017
83.8%
1.C
By 2024, at least … per cent of all individuals in the territory and jurisdiction have had their birth registered.
1.D
By 2024, at least … per cent of all deaths that take place in the territory and jurisdiction in the given year are registered.
1.E
By 2024, at least … per cent of all deaths recorded by the health sector in the territory and jurisdiction in the given year have a medically certified cause of death recorded using the international form of the death certificate.
Goal 2. All individuals are provided with legal documentation of civil registration of births, deaths and other vital events, as necessary, to claim identity, civil status and ensuing rights
Goal 2 reflects that CRVS systems provide legal documentation of civil registration to individuals and families for legal and administrative purposes. Legal documentation is strongly linked with a broad range of rights and activities, in particular legal identity. This goal addresses the distinction between the civil registration of a vital event and the possession of formal proof that it took place, in the form of legal documentation.
National Targets:
2.A
By 2024, at least … per cent of all births registered in the territory and jurisdiction are accompanied with the issuance of an official birth certificate that includes, as a minimum, the individual’s name, sex, date and place of birth, and name of parent(s) where known.
2.B
By 2024, at least … per cent of all deaths registered in the territory and jurisdiction in the given year are accompanied with the issuance of an official death certificate which includes, as a minimum, the deceased’s name, date of death, sex, and age.
Goal 3. Accurate, complete and timely vital statistics (including on causes of death) are produced based on registration records and are disseminated
Goal 3 highlights the critical importance of civil registration being linked to the production and quality assurance of vital statistics on the occurrence and characteristics of vital events.
National Targets:
3.A
By … (year), annual nationally representative statistics on births – disaggregated by age of mother, sex of child, geographic area and administrative subdivision – are produced from registration records or other valid administrative data sources.
TARGET
Target achieved
3.B
By … (year), annual nationally representative statistics on deaths – disaggregated by age, sex, cause of death defined by ICD (latest version as appropriate), geographic area and administrative subdivision – are produced from registration records or other valid administrative data sources.
TARGET
Target achieved
3.C
By 2024, at least … per cent of deaths occurring in health facilities or with the attention of a medical practitioner have an underlying cause of death code derived from the medical certificate according to the standards defined by ICD (latest version as appropriate).
Note: This target was not monitored as part of the Midterm Questionnaire on the Implementation of the Regional Action Framework for CRVS in Asia and the Pacific.
3.D
By 2024, the proportion of deaths coded to ill-defined codes will have been reduced to … per cent.
baseline
2013
7.6%
MIDTERM
2018
4.7%
3.E
By 2024, at least … per cent of deaths taking place outside of a health facility and without the attention of a medical practitioner have their underlying cause of death code determined through verbal autopsy in line with international standards.
Note: In light of recent countries’ experiences, Verbal autopsy is not encouraged to be applied to a large population scale, but rather on a representative sample. To reflect this, Target 3E is not anymore monitored by the coverage percentage of Verbal autopsy, but by the use or not of Verbal autopsy and its different applications.
MIDTERM
Yes
3.F
By … (year), key summary tabulations of vital statistics on births and deaths using registration records as the primary source, are made available in the public domain in electronic format annually, and within one calendar year.
TARGET
Target achieved
3.G
By … (year), key summary tabulations of vital statistics on causes of death using registration records as the primary source, are made available in the public domain in electronic format annually, and within two calendar years.
TARGET
Target achieved
3.H
By … (year), an accurate, complete and timely vital statistics report for the previous two years, using registration records as the primary source, is made available in the public domain.