One of the insidious forms of social inequality suffered by a third of children born around the world is the lack of registration of their birth. A situation that is more worrying in developing countries, including Benin. To address this situation, Dogbo municipal administration has initiated a collaborative approach involving all stakeholders in order to take control of its development. The present study carried out a documentary review and the experience of Dogbo Municipality in birth registration. Actors were interviewed on the basis of an expert choice taking into account the main factors involved in the process of birth registration and other civil status facts ranging from the municipal administration to the village level with the concept of saturation. From the first year of intervention, all births of the municipality are declared and registered. Withdrawal of birth certificates was carried out at a rate of 58.10% over the period considered. Death registration, on the other hand, increased gradually from 85 in the first year to 159 in the four–year interval. The process thus set in motion makes it possible to move to a phase of systematic registration of births and deaths with the prospect of extending it to other vital events. An experience highly appreciated by the actors at the national and international level. This received the first award of the European Parliament "PLATEFORMAWARDS" for the promotion of good governance.

Keywords: birth declaration, registration, social inequalities, community empowerment, Benin, West Africa

AS, administrative secretary; C/CSO, chief civil status officer; CO, collection officers; CV, chief of village; DC, district chief; ENABEL, Belgian agency of international development; FM, frequency modulation; GIZ, German agency for international development; ID, identity (card); ISCSM, integrated system of civil status management; MC, maternity chief; PASS, health system support project; PNC, prenatal consultations; RGPH, general census of population and housing; TFP, technical and financial partners; UNICEF, united nations children fund; V, volunteers; VNG, international cooperation agency of the association of Netherlands municipalities

More than a third of the world's children born every day do not have any type of identification to access the social, civic and economic systems needed to live normally in our increasingly globalized world.^1,2 This is a form of insidious social inequality marginalizing a large part of the population in terms of personal development and their contribution to that of the nation.^1,3,4 A situation that persists because the governments of these children have not built or supported the mechanisms for reporting births and accounting for everyone. What are the root causes of such a situation when we know that some of these countries have the capacity to build and manage nuclear weapons without being able to give their children the official proof of their existence and consequently of their participation to the society? Moreover, the vast majority of countries involved have acceded to the 1989 Convention on the Rights of the Child, including Article 7, which expressly states that all children have the right to be registered. More than a quarter of a century later, many show little progress.

In Benin, as in other countries of the West African region, where the State does not register more than 50% of its population,^5,6 a birth certificate remains necessary both for school registration and taking various exams. In recent years, some of these countries, such as Cape Verde, have seen an improvement in the situation. In Dogbo Municipality, for lack of ID, at the beginning of 2010, more than five hundred children were prevented every year from taking their school exams while adults could not access some public or private services. The municipal authorities then decided, with the support of their partners, to contribute to improving the municipality's performance in the management of acts and facts of civil status, in particular with a view to obtaining factual data intended to favor local development planning.

In the context described above where many deliveries are still too often done at home, it is essential to be able to rely on a community empowerment process by facilitating birth registration for easy access to health, social and administrative services. The initial hypothesis is that the management of civil status acts and facts at the municipal level is effective only in a context of community organization involving several actors (technical and political) working together/collaborating regularly to properly play their role.

Dogbo municipality

Dogbo Municipality is located in Couffo Region. It is bounded to the north by the Municipalities of Lalo, Toviklin, and Djakotomey; to the south by the Municipalities of Lokossa and Bopa; to the East by the Atlantic Region and to the West by Togo. It covers an area of ​​approximately 475km². It includes 07 Districts and 65 villages. The population of Dogbo Municipality is estimated at 114,094 inhabitants in 2017 (RGPH-4) (Figure 1).

Figure 1 Dogbo administrative map.

The current demographic pressure on the natural resources of Dogbo Municipality reveals negative impacts on biodiversity and population (health, income, equity and security). If nothing is done, future generations may have to cope with the decline in food and palm oil production; declining soil fertility; dwindling pastoral space and ruminant and pig farming in crisis; the crucial scarcity of timber and firewood; the degradation of the living environment in the city of Dogbo. In order to avoid this catastrophic case, it is necessary to control the evolution of the population with a view to organizing development actions. This is one of the reasons for setting up the birth registration project in the Municipality.

Methods

The study conducted a literature review and the experience of the Dogbo Municipality in birth registration. Actors were interviewed on the basis of an expert choice taking into account the main factors involved in the process of birth registration and other civil status facts ranging from the municipal administration to the village level with the concept saturation. The interviews focused on knowledge of the new communal approach to civil status, the role played by the actor, personal impressions, difficulties, perspectives and lessons learned including the conditions of transferability to other Municipality of Benin. A summary of the data was made. Data analysis was carried out by thematic grouping on the basis of the different sections of the intervention.

Documentary review

The documentation was made on the basis of an established checklist, at the town hall level, in the personal archives and on the appropriate websites for a literature review. It made it possible to estimate the costs accumulated in the experience with the persons in charge and, in a general way, to appreciate the interest and the importance of the registration of the facts of civil status in general and that of the births in particular.

Data collection from stakeholders

In-depth individual interviews were held with key stakeholders comprising: Mayor, 1st Deputy mayor, Chief registrar, Former district chief, District or village chiefs, Public and private maternity officers, Civil society, School directors, District secretaries, and trainees (Figure 2).

Figure 2 Multi-stakeholder birth declaration and registration system in Dogbo Municipality.
(CO, collection officers; V, volunteers; C/CSO, chief civil status officer; AS, administrative secretary; MC, maternity chief; DC, district chief; CV, chief of village).

Intervention

The intervention that lasted 4years (2013-2016), consisted of strengthening the process of management of acts and facts of civil status in general, and the registration of births and deaths in particular through:

1. Realization of community participatory diagnosis: This situation analysis has made it possible to note that in Dogbo Municipality, until 2012, the birth registration process has the following weaknesses:

1. Systematic non-reporting of births by parents.
2. Incompleteness of the information provided on the vouchers.
3. Lack of signature and/or stamp of the registrar on the certificates.
4. Poor record keeping: loss of stumps in some registers and loss of other record.
5. Frequent stock out of birth registration record and vital registration registries.
6. Lack of competence of certain civil servants in matters of civil status.
7. Lack of qualified personnel to effectively cover the population’s needs for the provision of services.
8. Poor organization of services and non-interest in the civil status service.
9. Lack of statistical data.
10. Non-withdrawal of the vouchers by the parents.
11. Lack of collaboration and responsiveness between maternity and vital statistics departments.
12. Ransom of users, etc.

2. Faced with this situation, Dogbo City Council, decided on January 2, 2013, to develop civil registration system improving project with the slogan "Stop the bleeding: a child, an act of birth''. With the support of Enabel and the city of Roeselare (Belgium), the focus has been on:

1. Strengthening the effectiveness of the personnel assigned to the management of the civil status (recruitment of nine data collection officers on the town hall own resources).
2. Strengthening collaboration between maternal health services and vital statistics officers.
3. Involvement of other actors in the civil status management process, including village chiefs, community volunteers and data collection officers.
4. Organizing large awareness sessions for the population through various communication channels in the Municipality.
5. Establishing an Integrated System of Civil Status Management (ISCSM) through computer software.
6. Digitizing birth certificates to facilitate, secure and make durable archiving, etc.

3. Reinforcement and transfer of skills to local actors: training of 150 people, members of the community organization (53 community volunteers, 53 village chiefs, 13 maternity ward managers of health centers, 21 state agents civil society and 10 local elected officials) on the laws relating to civil status in Benin. The involvement of community actors (community volunteers and village leaders) in training anticipated the creation of secondary civil status centers by the central level which took place at the end of 2015, i.e. two years after the training.
4. Close monitoring/support for actors in the field (formative supervision): monitoring organized by the chief civil service to assess the level of progress of the commitments relating to the implementation of the roadmap drawn up after the Training. This monitoring periodically reinforced by Enabel makes it possible to assess the ability of the actors to play their role and identify technical (filling and taking good care of the tools) or organizational (work organization) difficulties. It is carried out through the collection of data sheets and data at the level of the services involved and the collaboration between actors of health centers and districts, for example, in order to put forward recommendations. This system also makes it possible to unveil the organizational potential of the actors and takes into account the good performance of the working tools and data collection.
5. Establishment of a system for the collection and management of vital events data: a community organization put in place to provide complete information on the reporting components, a complete and regular data sheets collection; declaration of birth at the level of the maternity ward of the health centers (to be transmitted to the civil registration centers for registration) and an exhaustive/regular report in relation to the acts and facts of civil status registered at the level of the services of civil status. For more efficiency, the town hall installed computer software, the ISCSM, generating statistical data weekly. The use of this software promotes reliable data management and good archiving.
6. Establishment of a system for archiving vital events data: setting up a system for digital archiving of civil registration stubs, in this case those of the birth certificates. This mechanism limits the loss, damage or destruction of documents due to multiple searches and photocopies to be performed on the same records in a manual filing system.
7. Cumulative awareness of the distribution of birth certificates to users of vital events services: from 2013 to 2016, several communication activities were developed around acts of civil status through: radio (35 programs implemented), places of worship (100 discussion sessions), health centers (91 sessions during prenatal consultations (PNC) and routine immunization), and visits to villages (53 sessions completed). These sessions were conducted by community organization actors followed by free distributions of the certificates. During sensitization sessions in the villages, community volunteers put a particular emphasis on their role of watch and orientation of pregnant women for the PNC and the prevention of at-risk deliveries at home.
8. Mobile court hearings were also organized in 2016 to establish certificates (birth affidavit) for the benefit of 500 children candidates for academic exams (with the support of UNICEF).
9. Supporting the process with human, material and financial means: resources mobilized under this initiative are as follows:

1. Recruitment of nine collection agents paid from the city council budget to facilitate the collection of birth records at health centers and boroughs, and to liaise with community volunteers and village chiefs for declaration of home births and distribution of birth certificates.
2. Purchase of 13 motorcycles to ensure the travel of the agents during sensitization sessions in the villages and regular collection of birth records in maternity wards.
3. Provision of nine laptops to vital registration and data centers and two printers for printing digitized records to users.
4. Acquisition and installation of ISCSM for the daily monitoring of civil status operations;
5. Use of two partner radios (the voice of Lokossa and Radio Couffo FM) for awareness-raising programs for the population.
6. Use of mobile digital cinema facilitating awareness-raising sessions on the importance of the birth certificate and
7. At the financial level, the overall cost of the system put in place for the modernization of the civil records and records management process is estimated at US$ 104,595 whose contribution from the Municipality is estimated at US$60,560, or 58% of the total amount. These costs take into account acquisition and installation of the software, data collection officers’ salaries, and the counterpart of partners support for the implementation of the different activities.

10. Experience-sharing between actors: throughout the duration of the experiment, experience-sharing between actors is translated not only into the periodic exchange between officers from different districts of the Municipality but also between key actors from other municipalities of Benin like that of Bassila. These discussions focused on best practices, lessons learned and perspectives to stimulate positive competition. Experience-sharing is also reflected in the numerous exchange visits received by Dogbo Municipality as well as its participation in conferences (national, regional and international) to present the initiative (Table 1).

In total, 19 actors were interviewed in a detailed individual interview.

Declaration and registration of births (Figure 3)

1. Average of 3,162 births per year (reported at 100%).
2. Ratio: 48.75% girls vs. 51.21% boys.
3. No data in 2012, the initiative started at the end of 2012 and before that date no data was available.

Figure 3 Status of birth declaration and registration from 2012 to 2016.

Withdrawal of birth certificates (Figure 4)

4. Average withdrawals per year: 2,335, representing a withdrawal rate of 58.10%.
5. 2013 stock includes certificates not withdrawn from previous years.

Figure 4 Birth certificates withdrawn over the 2013–2016 period.

Death registration (Figure 5)

6. Deaths of men>Deaths of women.
7. Progressive increase in the registration of deaths each year.
8. Declaration of deaths has gradually returned to habits, which justifies the gradual increase in the number registered. Before, people did not declare deaths, so the number seems to be increasing, which is not necessarily the case.

Figure 5 Deaths registration in the municipality over the period 2012 to 2016.

In short, to ensure the systematic registration of all births and other vital events, Dogbo Municipality has carried out an important reform concerning the reorganization of all civil registration services from the district level to the city ​​council also taking into account the community level. This mechanism has yielded qualitative results, including:

9. Availability of birth certificates.
10. Permanent availability and good management of work tools that used to be out of stock (birth declaration, birth registration records).
11. Improved collaboration between actors and reduced complaints about missing information on birth records.
12. Emergence of good practices such as improving completion of birth records by health workers and the transmission of vouchers n°2 at the civil registry level. Increasingly, some midwives are taking advantage of antenatal consultation sessions to sensitize women on the declaration and registration of births and for the distribution of vouchers n°1 in collaboration with the registrars.
13. Improved information flow between actors: a mechanism for collecting records and regular transcription, helping to facilitate data management.
14. The diligence of the agents and district chiefs processing declarations: reduction of the time of establishment of the birth certificates and thus compliance with the statutory deadline of 21days defined by Benin children’s code. The certificates thus established are assigned free of charge.
15. Improving the archiving of documents and data: digitization has been adopted in the Municipality as an alternative to securing birth certificate strains.
16. The functional and efficient system of data collecting and managing through ISCSM.
17. The positive assessment of the General Directorate of Civil Status who wishes to make the Dogbo experience a textbook case for the implementation of the achievements in the other municipalities of Benin.

In addition, from 2013 to 2016, 34 visits from other municipalities of Benin and technical and financial partners (TFP) were registered at the level of Dogbo Municipality to take inspiration from this initiative. Following its visit, GIZ (German Agency for International Development) supported 25 municipalities (32.5%) of Benin throughout the country under the model of Dogbo with technical support from that Municipality.

Finally, Dogbo Municipality, for its birth registration management model, received in 2018 in Belgium, the first award of the first edition of the European Parliament Competition, the "PLATEFORMAWARDS" for the promotion of the good governance through decentralized cooperation involving 33 countries from four continents.

The decision of the Dogbo City Council to go to a systematic recording of vital events shows the feasibility of the action provided that it works in a collaborative way with voluntary and enlightened local actors. The experience arouses the enthusiasm of other municipalities of Benin and other regions, a sign of the proven awareness of a need to be addressed.¹ following the intervention and in matters of civil status, we now note in Dogbo Municipality:

1. Availability of accurate demographic data.
2. Good control of the number of children with or without a birth certificate.
3. Permanent availability and good management of civil registration tools.
4. A functional ISCSM.
5. Collaboration between actors with a functional collaboration mechanism.
6. Compliance with the statutory deadline for declaration and registration of births.
7. Improved archiving (securing strains).
8. Transferability of the experience of Dogbo Municipality: 34 visits from other municipalities, both national and regional.
9. Implementation of projects to support other municipalities by TFP from the Dogbo model.

These different results elicit some comments.

Birth registration

In a communal administration that is poorly trained on civil status in general, birth registration suffers from numerous shortcomings, as was the case in Dogbo until 2012. With the initiative from 2013 involving all actors and until at the community level, all births are registered. Only hidden ones could possibly escape the systematic declaration. And this must be very rare in this case because all births are reported including those occurring at home. The mechanism in place allows an instant update of the number of inhabitants of the municipality. This should inspire national authorities for implementation of a policy aiming at the establishment of a database of the population at the national level integrating the 77 municipalities of the country. 

Withdrawal of birth certificates

Non-withdrawal of certificates by parents is a significant problem. As a result, many of the certificates actually withdrawn remain an important indicator of the effectiveness of outreach activities. Apart from the start of the experience year (2013) where few data from previous years should be taken into account, the rate of withdrawal of certificates is about 70% per year. It is estimated that 20% of the undelivered certificates come from children whose parents reside in the neighboring municipalities of Dogbo. This change of behavior is induced by outreach activities leading to the distribution of certificates, organized towards the populations and the school principals. They push parents to withdraw the certificates of children, especially for schooling needs especially as the withdrawal is free. If compulsory schooling enters into practice, many parents will be forced to withdraw the birth certificates of their children. 

Registration of deaths

Following the reorganization of the civil status services and the establishment of ISCSM in the municipality, it was quite normal to know the number of inhabitants, and the registration of other facts of civil status, in particular deaths are undertaken in parallel. According to recorded certificates, there are more deaths of men than women between 2013 and 2016 in the Dogbo Municipality. This could explain why, despite a high rate of male birth, the female sex outweighs the total number of inhabitants of the municipality. The analysis of these data could also lead the municipality to look for some causes of death in the population to undertake specific actions in regard to the population health.

Challenges

In view of the system in place and the results obtained, efforts must be sustained to ensure the sustainability of the birth registration process and to establish a sustainable basis for communal management of civil status. Some challenges should be addressed to ensure the process is solidly grounded.

1. Improving the quality of the civil status file through an integrated approach is an important issue for local governance in order to make statistics as vital as the more reliable civil status data.
2. Given the level of impoverishment of the population as well as the low rate of literacy, there is a problem of conservation of components and birth certificates given to parents. An empowering participative reflection with the populations could lead to an acceptable solution taking into account the living conditions. This would strengthen the initiative.
3. Capacity building for different actors is a necessity.
4. Sensitization should be continued at the community level followed by the distribution of certificates not withdrawn by the parents until the integration of this practice in the habits of the populations.
5. The implementation of reinforcement measures such as the systematic schooling of children coupled with the requirement to produce the birth certificate at enrollment to entrench the practice of withdrawing vouchers n°1 and the establishment in time of birth certificates by parents.
6. The registration of deaths and marriages will allow a better follow-up of the evolution and the population trends.
7. Systematic and compulsory registration of marriages could be a way to fight against forced marriages and early marriages.
8. The maintenance of equipment and computer hardware becomes a challenge for the security of the system.

The present experience of improving access to the birth certificate in the Dogbo Municipality produces encouraging results for the benefit of the population. It has positively influenced the relationships between the different actors. The strategies used make it possible to strive towards the respect of the declaration within 21days and the immediate establishment of the birth certificate as provided by applicable laws. Dogbo Municipality shows that an activity as vital for local development as birth registration requires the political will of the actors for its implementation. Facilitating birth registration improves the rate of birth registration and withdrawal of certificates by parents. But it remains a challenge that requires more supervision of field agents, sustained motivation of actors, acquisition of equipment and quality equipment, maintenance and rational management. Given its fundamental role in the emergence of a nation, every effort must be made to pursue such action.

None.

None.

Author declares that there are no conflicts of interest.

1. Andrews M. Invisible children: birth registration is a prerequisite for equality. UK: The Guardian; 2014.
2. Mondiale B. New York: Count each life so that each life counts. 2014.
3. A right of every child at birth: inequalities and trends in birth registration. New York: UNICEF; 2013. 48.
4. Closing the gap in a generation: Health equity through action on the social determinants of health. Commission on Social Determinants of Health. Geneva: WHO; 2008. 256 p.
5. Ministry of the Interior/Benin. State of play on vital events in Benin. Office of Studies SAGE-C. Cotonou; 2010. p. 70.
6. Djiman DEA. Complexity of the birth registration process in Benin and recommendations for simplification. In: International Symposium "Children without registration, women without rights". Bourg‐en‐Bresse: Women's Eyes Association; 2013. p. 1–11.