SYDNEY, Jun 17 (IPS) – Registering the birth of a newborn, which is taken for granted in many countries, has profound lifelong repercussions for a child’s health, protection, and well-being. But after initially increasing this century, the global birth registration rate has declined in the past ten years, with some countries in the Pacific and Sub-Saharan Africa facing significant challenges. Embracing new registration technologies, increasing political will, and increasing parents’ understanding of its importance are paramount to reversing the trend.
Today about 75 percent of all children aged under 5 years are registered, up from 60 percent in 2000, reports the United Nations Children’s Fund (UNICEF).
But Bhaskar Mishra, Child Protection Specialist at UNICEF Headquarters in New York, told IPS that a recent slowdown is due to persistent challenges.
“Rapid population growth, especially in Sub-Saharan Africa, is outpacing registration systems. Weak infrastructure, limited funding, and low political prioritization have also contributed to the stagnation. Additionally, families often face barriers such as high fees, complex procedures, and limited access,” he said.
Some of these hurdles exist in East Africa, where the birth registration rate is 41 percent and the Pacific Islands where it is 26 percent. At the country level, it varies from 29 percent in Tanzania to 13 percent in Papua New Guinea and 3 percent in Somalia and Ethiopia. Of an estimated 654 million children aged under five years in the world, about 166 million are unregistered and 237 do not have a birth certificate.
“Systemic and social obstacles, exacerbated by the lingering effects of COVID-19, which reversed gains achieved in previous years, mean that progress must accelerate fivefold to meet the Sustainable Development Goal target of universal birth registration by 2030,” Mishra emphasized.
One country that is striving to meet the challenge is Papua New Guinea (PNG). The most populous Pacific Island nation of about 11 million people comprises far-flung islands and an epic mountain range on the mainland where people’s daily hardships include extreme terrain, lack of roads, and unreliable transportation.
More than 80 percent of people live in rural areas and, in Madang Province, in the northeast of the country, the Country Women’s Association has worked to increase maternal and health awareness among pregnant women.
“Some don’t have access to health facilities as they are in very remote areas and it takes hours to get to a health facility, so all births are done in the village. But health facilities in some communities are rundown, there is no maintenance on the infrastructure and no health workers on the ground, so that is the most challenging,” Tabitha Waka at the association’s Madang Branch told IPS.
For a mother, recording the birth of her baby could entail long journeys in community buses along dirt tracks and unsealed roads to the registration office, along with the cost of the fares.
“Lack of information is another challenge. These rural mothers don’t have this kind of helpful information and they don’t know the importance of birth registration. And, in some communities, due to traditions and customs, they only allow mothers to give birth in the village,” Waka continued. Just over half of all births in PNG take place in a healthcare facility, according to the government.
But the country has made significant strides and, from 2023 to 2024, more than doubled the distribution of birth certificates from 26,000 to 78,000. Last July, 44 handheld mobile registration devices were supplied by UNICEF to the government and field officers have started a massive outreach mission to record births in local communities.
Then in December, the PNG Parliament passed a new bill to develop the national Civil and Identity Registry. “The Pangu-led government is a responsible government with policies based on inclusivity across the country… accurate and reliable identity information on our people is significantly vital for enabling effective service delivery and for their social well-being,” PNG’s Prime Minister, James Marape, told media in November.
There is already tangible progress, but the government’s goal to register up to half a million births every year “will require scaling up technology. The kits need to be deployed nationwide, especially in remote areas, and decentralizing certificate issuance,” Paula Vargas, UNICEF’s Chief of Child Protection in PNG told IPS. “There are bottlenecks in the process. For example, there is just one person in PNG authorized to manually sign birth certificates.”
On the other side of the world, more than half of all unregistered children live in Sub-Saharan Africa, and Ethiopia, among other countries in the region, is grappling with similar issues.
Located on the Horn of Africa, Ethiopia is more than twice the size of PNG and has a high birth rate of 32 births per 1,000 people, compared to the global average of 16. Here the majority of Ethiopia’s more than 119 million people also live in vast and remote regions.
But while birth registration is free and the government is training healthcare extension workers in the procedures, the urban-rural divide persists. The burden on rural parents of multiple visits, with long distances and costs, required to complete registration is impeding progress. The birth registration rate in the rural Southern Nations, Nationalities, and People’s Region (SNNP) is 3 percent, which is the national average, compared to 24 percent in the capital, Addis Ababa.
Dr. Tariku Nigatu, Assistant Professor of Public Health at Ethiopia’s University of Gondar, told IPS that improvements could be driven by “integrating the registration service with the health system, availability of resources to support interventions to boost birth registration and infrastructure for real-time or near real-time reporting of births.”
UNICEF has also assisted Ethiopia in deploying mobile registration kits to healthcare workers in remote communities, including those experiencing instability, “ensuring that children born during emergencies or while displaced are not excluded from legal identity and protection,” Mishra said. Currently a humanitarian crisis and insecurity are affecting people’s lives in the northern Tigray region following a civil war from 2020-2022.
Lack of understanding and misconceptions about birth registration also need to be addressed, Nigatu emphasized.
“There are myths in some communities that counting the newborn as ‘a person’ at an early age could bring bad luck to the newborn. They do not consider the child worthy of counting before people know it even survives the neonatal period,” he said. This is partly due to the country’s high neonatal mortality of 30 in every 1,000 live births, with around half occurring within 24 hours after birth, he explained.
Messaging also needs to reinforce how birth registration is of lifelong importance to a child. There are high risks and human disadvantages for the uncounted millions of children without an official existence. They will have a greater fight to rise out of poverty, to resist sexual exploitation, abuse, child labor, and human trafficking, and to access legal protection, voting rights, even formal employment, and property ownership.
But birth registration is only the first step to their protection and well-being.
“It only works when backed by strong systems and services. This includes linking registration to services such as immunizations, hospital births, and school enrollment,” Mishra said.
In the wider context, having accurate birth and population data is essential for governments to plan public services and national development and equally critical to assessing progress on the Sustainable Development Goals.
Note: This article is brought to you by IPS Noram, in collaboration with INPS Japan and Soka Gakkai International, in consultative status with the UN’s Economic and Social Council (ECOSOC).
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