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Strengthening of local vital events registration: lessons learnt from a voluntary sector initiative in a district in Southern India. Bull World Health Organ. It is a form that contains three copies: one of the copies is given to the child parents, another one is filed with the medical record and the third one is sent to health secretariats, to feed SINASC. In Brazil, the National Human Rights Program PNDH-3 has established some actions to the universalization of birth registration and expansion of basic documentation, which emphasizes DNV strengthening as an access mechanism to the civil registry and extending the issue right to midwives.
Although DNV is considered the first vital data document, it is essential for the life of Brazilian citizens, the public registration in the Civil Registry Office.
Estat Reg Civ. The expression 'live birth' means the complete expulsion or extraction of an individual out of the mother's body, regardless of the pregnancy length, and that, after separation from the mother's body, it can breathe or show any other sign of life. All live-born children in Brazil are entitled to registration and issuance of birth certificate at a registry office.
In addition to individual issues, such as identity card and citizenship, birth data supplied by Brazilian registry offices are useful for the development of indicators used in the design of public policies for Health. A pesquisa do registro civil: condicionantes do sub-registro de nascimentos e perspectivas de melhorias da cobertura.
In Brazil, some initiatives have been promoted aiming to motivate parents to register their children's birth in civil registry offices and obtain, as soon as possible, the birth certificate, such as: i grant, by the Ministry of Health, of bonuses for health care units that encourage families to register their children before the mother's hospital discharge; and ii setting up of registry offices in maternity hospitals.
Despite the implemented measures, in , , Brazilian children were believed not to have birth certificate, almost 29, of them are from Rio de Janeiro State, which corresponds to 4. One of the strategies to reduce birth under registration has been the opening of civil registry offices in public maternity hospitals.
This measure intends that no child gets discharged from the hospital without the mother carrying with her the official birth certificate. In addition to setting up registry offices, other measures to be taken, related to the conditions of pregnant women, of childbirth or of the newborn, can contribute to the greater adherence of mothers to the initiative of emitting the birth certificate still in the maternity hospital. This municipality belongs to the Metropolitan Region I of the state, it is about 28 km far from the capital of Rio de Janeiro State city of Rio de Janeiro and, in , had an estimated population of , inhabitants, presented an average human development index of 0.
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Atlas do desenvolvimento humano no Brasil [Internet]. The unit had prenatal clinic and support services such as blood bank, neonatal and adult intensive care unit ICU , in addition to offering a multidisciplinary care team, including physicians, nurses, psychologists and social workers.
From June 15 to July 31, , all mothers who gave birth to live-born children in this hospital or were assisted immediately after the baby birth were considered for inclusion in the study. The cases involving maternal death were excluded. All the live births that took place in that unit between June 15 and July 31, were considered eligible for the study.
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The sample was estimated in live births. The data were gathered by consulting the register of births that happened during the studied period, followed by identification of records, verification of the DNV copy and of the copy or note of the birth certificate. The date of each live birth and the mother's name, which were in the birth registration books, were the variables used for identification and selection of medical records for consultation.
The information on the birth certificate was obtained 15 days after the delivery day, because this is the deadline for drafting the document in registry offices of maternity hospitals. The absence of the baby's birth certificate copy with the medical record or in the electronic files of the registry office defined the dependent variable certificate yes, no.
The independent variables were obtained from the DNV pink copy and from notes recorded in the medical record, containing the following characteristics:. Initially, a descriptive statistical analysis was held to estimate the average and standard deviation SD of the numeric variables and absolute and relative frequencies of categorical variables. In multivariate modeling, the variables were included in the model one by one, using the strategy known as stepwise forward regression to obtain PR adjusted by other variables and a more parsimonious model.
Data analysis was conducted by the statistical package R version 2. Exceptional care was taken to ensure anonymity and confidentiality of the collected information. In the 45 days of study, mothers gave birth to live-born babies. There were no exclusions motivated by maternal death. However, 15 occurrences were excluded because their respective medical records were not available in the medical file.
The average maternal age was Upon DNV completion, 7. Nine babies were born before hospitalization, three of them at home and six on the street, on the way to the hospital; The distribution by sex of live births was similar, with an average birth weight of 3, Immediately after birth, most babies A total of live-born babies In the bivariate analysis, the factors associated with lack of birth registration in the maternity hospital's registry office were:. After the adjustment, we decided to keep the variable 'lack of prenatal care' PR 1. Mothers with low education level, living in different municipalities to the maternity hospital, and who gave birth before hospitalization, showed a higher frequency of non-seeking the maternity hospital's registry office to record their babies' birth.
Owing to the fact that Brazil achieved a great reduction in birth under registration, actions in small places, such as setting up registry offices in maternity hospitals, may be directed to the outlined women's profile and, thus, constitute a specific strategy to further decrease the number of children not officially recognized in Brazil.
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