1. Improving Fiji’s Vital Statistics
“TOGETHER”
The Fijian Experience on Civil Registration and Vital
Statistics
Shivnay Naidu
Director Health Information, Research and Analysis
Friday 19th April 2013
Global Summit on CRVS (Bangkok, Thailand)
“Make Every Life Count”

2. Improving Fiji’s Vital Statistics
“TOGETHER”
Layout
1. Fiji CRVS System
2. Personal Experience
3. Process Involved
4. Key Challenges Encountered
5. Benefits to Fiji
6. SWOT
7. Outcome
8. Progress
9. Way Forward
10. Lessons Learnt – can be applied?
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3. Improving Fiji’s Vital Statistics
“TOGETHER”
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4. Improving Fiji’s Vital Statistics
“TOGETHER”
Structure of Civil Registration & Vital Statistics
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Health
Register General Bureau of Statistics
National Vital Statistics
Medical Officers, Nurse
Practitioners
1. Divisional Hospitals
2. Sub-Divisional Hospitals
3. Health Centres
4. Nursing Stations
Provincial Office
District Officers
Towns, Village
Birth and Death Occurrence
1. Ministers
2. NGOs
3. Donors
4. Public
5. Researchers
6. Others
Data Sources
Registration
Users of Statistics
General Public
ITC Services
(Govnet – PATIS,
BDM)

5. Improving Fiji’s Vital Statistics
“TOGETHER”
Experience
• Commitment and dedication was required on my behalf and Mr
Serevi
• Prioritization among other activities for these meetings
• Getting all stakeholders to meeting was a major challenge
(discussed later)
• Understanding the importance of CRVS and its benefits to Fiji
• Trying to interpret and analyse assessments and tools
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6. Improving Fiji’s Vital Statistics
“TOGETHER”
Process Involved
Awareness and
Advocacy of
CRVS
•HIS Short Course
Aug 2011
•Bag Meeting (PHIN
VP) Feb 2012
Establishment
of CRVS
Committee
•Membership
identification
•Support from Senior
Executives for
release of members
•Define what to do
and why
Assessments
Review
•Previous
Assessments (HMN
etc)
•Rapid Assessments
Holiday Inn
Workshop
•Support from WHO,
HIS Hub, SPC
Recommendati
ons and Way
Forward
•19 recommendations
for improvements
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7. Improving Fiji’s Vital Statistics
“TOGETHER”
Key Challenges for the Process
• Leadership and Governance
• Communications
• Meeting Logistics
• Incentives for meeting
• Accountability and Responsibility
• Attendance
• Technical Expertise
• Drivers for change
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8. Improving Fiji’s Vital Statistics
“TOGETHER”
Benefits to Fiji
• Understanding the importance of CRVS and use of it
• Strengthened relationship between stakeholders
(MoH, RG, BOS, ITC, PD)
• Country led and owned process of identifying areas of
improvement
• Developed prioritized recommendations and action plan with
estimated cost implications
• Some progress already made 
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9. Improving Fiji’s Vital Statistics
“TOGETHER”
Attrition
Change in Leadership
Change in Country Priorities
Natural Disasters
Threats
Lack of Coordination between key agencies
Poor Attendance
Competing Priorities
Staff Transfers
Data Extraction
Weaknesses
Unfavourable
Leadership & Management Support
Team Work & Communication
Ownership & Accountability
Finance and Resources
Previous Country Assessments
Strong ICT Infrastructure
Strengths
Favourable
Internal
Assistance from BAG, UQ HIS Hub and
WHO
External ICT Audit – Yalamanchilli
Minister’s High Level Meeting
Pacific Vital Statistics Plan
Training and Capacity Building
Opportunities
External
SWOT
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10. Improving Fiji’s Vital Statistics
“TOGETHER”
Holiday Inn – Milestone (after 10 committee meetings:
25th September 2012)
• Coordination, cooperation, collaboration and commitment from all
stakeholders for this meeting
• Joint effort in preparing slides and presenting
• Consensus on 19 recommendations
• Using HIS Hub tool WP23 – prioritization of recommendations
were made
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11. Improving Fiji’s Vital Statistics
“TOGETHER”
Some memories from the meeting.
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12. Improving Fiji’s Vital Statistics
“TOGETHER”
Outcome
Made under 5 different categories
• Legal
• Registration Practice
• ICD Compliant Practices
• Data Quality, Dissemination, Access
• Coordination
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13. Improving Fiji’s Vital Statistics
“TOGETHER”
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Category No Recommendations
1 Review of Legislation
2 Strengthen data sharing and define roles of each agency
3 Review of Policy - compliance and litigation
4 Increase registration in remote and difficult areas
5 Address late registration
6 Mass catch-up of registration
7 Engage with broader group of stakeholders (incl. local community)
8 Improve monitoring of collection process
9 Investments - capacity building and infrastructure
10 Improve death certification quality
11 Improve coding quality
12 Improve quality and reliability of data
13 Improve human resources for data collection and analysis
14 Improve access to vital statistics data and reports
15 Build Local capability to use their own data/statistics.
16 TOR of committee - more committed
17 Improve Cordination - national and local
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Examine and Define roles and responsibilities in administrative
processes
19 Agree on administrative boundaries
Legal
Registration Practice
ICD Compliant Practices
Data Quality, Dissemination, Access
Coordination

14. Improving Fiji’s Vital Statistics
“TOGETHER”
Progress
• Budget Approved for 2013
o $20,000 by RG on improving registration
o MOH
 $100,000 for ICD 10 Coder Training
 $50,000 for CoD Training Nationally
 $10,000 for CRVS Training
o BOS
• Some budget for data analysis and production
• Legal
o Sub-committee for review of legislation established
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15. Improving Fiji’s Vital Statistics
“TOGETHER”
Progress ….cont
• Registration Practices
o Production of awareness flyers in iTaukei language
o Mass Registration
o Workshop planned for May for developing strategies to conduct mass
registration
o Infrastructure: Interoperability of systems assessment being undertaken
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16. Improving Fiji’s Vital Statistics
“TOGETHER”
Progress ….cont
• ICD Compliance
o ICD 10 Train of Trainers 30th – 31st October 2012 (2 Medical Officers)
o ICD 10 AM License Deed renewal obtained from Australia
o Contract term extended to 30th June
o CCOD training conducted in March for Central Division 30 MOs (by ToT
MO)
o ICD 10 Training for all medical recorders and coders in May 2013
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17. Improving Fiji’s Vital Statistics
“TOGETHER”
Progress…cont
• Data Quality, Dissemination and Use
o Data sharing between BOS and MoH (2008 – 2010)
o Update of DC records with address and occupation completed for 2008 -
2010 completed on Feb 28th
o Use of ANACOD tool for quarter 1 data quality audit
o Provision of computers at HIU for BOS staff
o Provision of workstation at CWM for RGs staff for registration (BDM)
o In-house training by CRVS Short Course participants at MoH (others to
follow MoH)
o Health Information Bulletin includes vital statistics
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18. Improving Fiji’s Vital Statistics
“TOGETHER”
Progress…cont
• Coordination
o 4 meetings already conducted in 2013
o TOR of committee in draft form
o Involvement of ITC Services for e-gov services (citizen portals)
o Technical/Donor coordination planning meeting to be undertaken in May
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19. Improving Fiji’s Vital Statistics
“TOGETHER”
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Category Way Forward
Legal Technical Assistance required for review of policy
Workshop Planning and Preparations
Develop Flyers in three languages
Develop media advertisement (content)
Meeting with Provincial District Officers
Targeting Remote Areas(Technology)
Training Materials
QUT time and commitment
Awareness with Senior Management
Data Analysis and Use
More training for staff
Finalise TOR
Develop and define roles and responsibilities
Finalise MoH and EA boundaries
GIS Mapping and Use
Registration Practice
ICD Compliant Practices
Data Quality, Dissemination, Access
Coordination

20. Improving Fiji’s Vital Statistics
“TOGETHER”
Lessons learnt – that can be applied
• Communicate, Communicate and Communicate
• Identify a champion (s) – driver of change
• Establish a CRVS Committee – dynamic and strong chairperson
• Identify strengths and build on it
• Conduct rapid assessment and prioritisation of recommendations (of
challenges) – work towards a CRVS Strategic Plan
• Work on things that can be done quickly and get management support – quick
wins
• Data and knowledge sharing – MoU, Memos etc
• Get technical support and assistance from experts (BAG) but own the process
– its yours
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21. Improving Fiji’s Vital Statistics
“TOGETHER”
• Thank You for your Attention.
• Vinaka Vakalevu.
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