Knowledge and practice of health care workers regarding the civil registration and vital statistics system in Cameroon: The case of the Dschang Health District
Description
Background: There is a growing interest in civil registration-generated data, particularly in developing countries, where high-quality vital statistics data are crucial for computing numerous sustainable development goals indicators. However, in many of these countries, civil registration and vital statistics (CRVS) data are often unavailable or estimated too poor for citation. This study aimed to describe the CRVS organization and processes in Cameroon and assess related healthcare practitioners’ knowledge and practices in the Dschang health district (DHD). Methods: We conducted a desk review to describe the CRVS organization and processes, and an analytic cross-sectional survey involving health facility event informants (HFIs) in the DHD. Semi-structured questionnaires were used to conduct interviews and assess their knowledge of the different components of CRVS, as well as their notification and registration practices. Logistic regression was employed to determine associations between suspected factors and notification practice, with statistical significance set at p<0.05 . Results: A total of 89 HFIs were assessed. Only 6.7% (n=6) of the HFIs demonstrated adequate knowledge of CRVS. The most well-known component of CRVS among the actors was its legal framework, with 71.9% (n=64) of HFIs being aware of the legal provisions concerning birth and death registration obligations. However, knowledge of other components was generally poor. Birth and death notification practices were deemed adequate for 88% (n=78) and 35% (n=31) of HFIs, respectively. A Longer duration of the health facility activity (p=0.043) and female sex (p=0.044) were predictors of better CRVS knowledge. A Higher health facility category alone was associated with better birth and death notification practices (p=0.010). Conclusion: Cameroon CRVS system is not fully organized. This study also reveals suboptimal CRVS knowledge and practices among health care practitioners in DHD. Improvement can be achieved through intensified training of actors, particularly in older health facilities, and the provision of necessary resources.
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This was a facility-based cross-sectional survey conducted over a period of three months at the Dschang Health District, from April 2021 to June 2021. To select our population of participants, we consecutively visited all 69 of the 79 functional health facilities that provided delivery care in the DHD. A semi-structured questionnaire was used to directly interview the informants at each visited health facility. The questionnaire was developed based on a comprehensive literature review that included the WHO assessment tool “Rapid assessment of national civil registration and vital statistics systems”. It was subsequently pretested and finalized for evaluating the knowledge of the current performance of the national CRVS system and the practice of notification in health facilities. The questionnaires consisted of three main sections: identification, practice of the facility, and knowledge of the respondent. A composite CRVS knowledge score was developed based on the cumulative score of correct responses to various items related to different components of the CRVS system. This score aimed to assess the overall understanding of the respondents regarding the CRVS system in Cameroon. To calculate these scores, the cumulative scores were divided by their respective maximum scores, resulting in proportions. These proportions were then dichotomized into inadequate (≤ 0.4) and adequate (> 0.4) categories. This categorization aimed to classify the level of adequacy in the respondents' knowledge and practices related to birth and death notification within the CRVS system.