Since 2009, the birth registration coverage rate has not exceeded 65 percent. This remains a serious concern, given that all children born in Ghana are entitled to be registered at birth. Of greater concern are the disparities between regions, within regions, between urban and rural areas, and between socio-economic groups.[v]

Some clear actions have already been taken towards this commitment. They include mobile registration services in hard-to-reach areas, improved supply of registration materials, and renewed collaborative efforts with the health and education systems. Discussions to partner with communication networks to apply technology to improve registration coverage are now taking place. Moreover, efforts are underway to reform civil registration and vital statistics systems nationally, in order to improve national planning across all sectors of the country, including those of particular relevance to children.


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Identity registration is not only a matter of human rights but it also serves as an important instrument for planning about health, education and overall development. This paper examines the chances of a child born in Ghana between 2001 and 2006 obtaining legal status of identity.

Overall, our findings give an impression of birth registration being a privilege for children whose parents are educated, wealthy and resident in urban communities. Policies meant to increase uptake have to be broad-based, targeting the less privileged particularly with practical interventions such as transport vouchers to registration centres. This may help appropriate meaning to international protocols on birth registration as a human right issue to which Ghana affirms.

The first point of call between individuals and their states is being registered and counted as part of the state, bestowing on them all rights and privileges that the state provides. Dow [1] described birth registration as the first ticket to citizenship without which an individual does not exist legally and could be denied privileges and rights a nation allows. The Plan International [2] elaborated the rights perspective position in the following:

Research evidence suggests that where individuals have limited or have not been provided with adequate citizenship right through birth registration and issuance of a birth certificate, the capacity of individuals to fully asset their civic, political, legal and social identities are significantly constrained [4]. For instance, the absence of civic citizenship right has positive association with inability of individuals to claim full fundamental human rights. In the same vein, political participation such as voting cannot be fully ascertained or granted to non-citizens whilst social rights, which validate access to health care, education, pension and poverty reduction benefits can also be compromised [6].

Despite the fact that birth registration enhances social, economic and political rights, it can be utilised for unscrupulous activities. In the apartheid South Africa, civil registers were used for political surveillance and persecution [15], used by the Nazi regime to track and persecute Jews [16], to restrict civil freedom in communist China and Soviet Russia [12] and the Rwandan genocide [17].

However, the various instances of unscrupulous application of birth/identity registration databases should not form the basis for denying individuals this right [3, 18]. The institutions and the individuals entrusted with such data are required to uphold high standards of ethics. There could also be provisions for stern international sanctions against deceitful application of identity registration records [18].

Several social, cultural, economic and political factors, at both macro and micro levels, have, diversely, affected high enrolment in identity registration in most part of the developing world, particularly in Asia, Latin America, the Caribbean and Africa. In sub-Saharan Africa, for instance, the population without birth registration certificate is about 65 % [13]. Over the years, some concerted efforts have been made to achieve acceptable up-take of birth registration in Africa, although spearheaded by Non-Governmental Organisations (NGOs) such as Plan International and UNICEF.

In Ghana, vital events registration started as far back as 1888. Initially, it was limited to the registration of deaths, which was also confined to expatriate workers in the colonial government service and mining and other merchandise companies. Later in 1912, the system was expanded to include births. Since then, the processes of birth registration have evolved in synergy with legal framework(s) establishing events registration. Beginning with the Cemeteries Ordinance of 1888, event registration legal framework was amended in 1891. The legal framework was changed to Births, Deaths and Burials Ordinance in 1912 and later amended in 1926 and it was subsequently amended to Registration of Births and Deaths, Act 301 of 1965. The various amendments that the legal frameworks have gone through were all generally intended to improve events registration. The current system of event registration in Ghana is managed under the auspices of Ministry of Local Government and Rural Development. The core mandate of the registry is to provide accurate and reliable information on all births and deaths, which occur within Ghana for socio-economic development of the country through their registration and certification.

At the international front, Ghana, in February 1990, was the first country in Sub-Saharan Africa that ratified the UN Convention on the Rights of the Child. After more than a decade, coverage of birth registration in the country as at 2008 was 51 % and coverage of all vital events (birth, death and marriage) was 25 %. To improve birth registration in the country, the financial cost has been scrapped to encourage registration within the first 12 months after birth. Registration is also limited to a registration centre in the region of delivery. We hypothesize that the low costs associated with birth registration in the country are, therefore, not expected to result in differences in registration by parental wealth index.

The results also point to widespread variations in child registration by religious affiliation of the head of the household. Approximately, 71 % of children whose heads of household were affiliated to Traditional Religion were not registered. Children who come from households with Moslems as the heads were less likely to be unregistered.

Mothers with some formal primary, secondary and other higher educational qualification were more likely to register their children than mothers with no education. The relationship between maternal education and birth registration is significant in all but Model 6, which includes place of delivery (public versus private health centre). In a similar respect, wealthier households were more likely to register their children than poorer households (Table 2) compared to children resident in poor households, regardless of the control factors. Rural dwellers were less likely to register their children than urban dwellers. With no religion as base group, children from Moslem households were at a fairly constant and significant higher likelihood of being registered in all the estimation models shown in Table 2.

This study explored identity registration in Ghana with emphasis on factors that enhance the chances of a child gaining identity at birth. Overall, close to half (47.6 %) of Ghanaian children born between 2001 and 2006 had not been registered. The cost of registration of children and lack of knowledge about the need for it dominated the reasons for not registering a child at birth. The discrete choice modelling analysis shows that children had higher chances of staying unregistered if their parents and heads of households were affiliated to Traditional Religion, resident in rural communities, in the Eastern Region, were poorer and less educated.

Our finding that maternal education improves the likelihood of children being registered is not surprising as it is consistent with normative and empirical evidence. Castro and Rud [14] found from Peru and Costa Rica similar issues relative to child registration and maternal education. Among the many returns to education is an expectation that it will eventually increase the stock of quality and quantity of available information. This finding is, therefore, consistent with our expectations. Like in all countries, evidence of birth registration is required before one could process passport application in Ghana and well-educated women are more likely to be cognisant of this practice than those who are not educated. Female formal education is a tool for poverty reduction. In this study, we have demonstrated that the financial cost associated with child registration was a barrier to registration. Formal education for women therefore provides a useful strategy for improving child registration.

The empirical model also revealed significant spatial variations in child registration in the country. Children born in the three northern regions (Northern, Upper East and Upper West) had better chances of being registered. Although it is difficult to tease out specific factors contributing to this observation, it seems that the Community Health Services Programme (CHPS) [20], which has operated in the northern regions longer than in other areas might be contributing to improvements in child registration. CHPS seeks to promote maternal and child health particularly targeting people in deprived communities. Registration of vital events, including births forms part of the activities of CHPS personnel and this could have possibly contributed the observed spatial patterns.

: This study examines registration timelines of antiretroviral medicines (ARVs) in Ghana and Kenya, to assess whether prior reviews by the US Food and Drug Administration Tentative Approval or WHO prequalification (WHO/PQP) affect in-country approval timelines. Data were collected from online and national databases. Median in-country review period in Ghana was 9 months compared with 25 months in Kenya. ARVs with Tentative Approval and WHO/PQP status did not benefit from shorter in-country review periods. e24fc04721

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