Role of community health workers (CHWs) in vital events tracking

Functioning civil registration and vital statistics (CRVS) systems provide essential input for health planning and evaluation. However, an estimated 1/3 of global annual births and 2/3 of annual deaths are not legally recognized in CRVS systems. Where coverage is poor community health workers (CHWs) can serve as agents to track vital events. This panel describes global CRVS system improvement efforts focusing on the role of CHWs and using vital statistics to improve health. We explore challenges in linking vital events data into national CRVS systems by reviewing activities of multiple CHW programs, including: the CORE Group Polio Eradication Initiative, various NGO child survival projects, and emerging national community-based surveillance systems. We also review work from the Institute for International Programs at Johns Hopkins University (IIP-JHU) to assess accuracy, reliability, and completeness of reporting events for real-time mortality monitoring in Ethiopia, Ghana, Malawi, and Mali. With video footage of CHWs in action, we then learn about Millennium Villages Project's (MVP) groundbreaking mHealth software used by CHWs to track health information and conduct verbal autopsies (VAs) to determine cause of death. Multiple programs have demonstrated that CHWs are an ideal asset for improving CRVS system coverage while providing local areas with real-time health information for planning and improvement. With vital events tracking support by CHWs, CRVS systems can provide the opportunity for civic engagement in health issues, enabling involvement of local leaders, small populations, and program managers in the cause of reducing maternal and child mortality with accurate means of measuring progress.