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Birth certificates are the cornerstone for establishing legal identity around the world. Despite their importance, birth certificates are frequently simple, handwritten paper documents or computerized printouts, submitted with little attention to security. The birth certificate issuance process is often decentralized, potentially leading to different formats within the same country. These features make birth certificates relatively easy to forge and difficult to authenticate. In many countries, applying for a passport requires the submission of a birth certificate, a process that can be inefficient, and at the same time may not enable the full authentication of individuals. A similar situation may exist in other circumstances, for instance, when applying for school or university admission, driver's licenses, marriage and separation certificates, and welfare benefits; enrolling for health care or health insurance; or registering to vote. One way to solve this problem is to make the birth certificate a highly secure document (like a banknote or passport), with personalization and issuance completed under highly secure conditions. Some countries are using a digital birth certificate (DBC). The birth certificate as a digital credential has become relevant in the context of sustainable development goal. Given the increasing digitization of state records and processes, as well as greater connectivity among departments, a DBC, if issued in a secure manner, can enable more timely processing and a greater level of authentication. In addition to having the capacity and administrative processes in place to manage DBCs, countries require a corresponding legal framework to recognize DBCs. This guidance note provides select country examples of manual and electronic birth registration and certification processes and discusses the principal requirements for moving toward DBCs, with suggestions on how to meet the requirements.

Health Service Management and Delivery --- Health, Nutrition and Population --- ICT Applications --- Information and Communication Technologies

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This report summarizes key findings from the endline assessment of the pilot project, Improving Birth Registration Using Existing Community Structures and Immunization Processes. The project was undertaken in Yilmana Densa and Goji Qolela woredas (districts); Hintalo Wajirat and Enderta woredas; and Amibara and Awash Fentale woredas, which are the intervention and control woredas in Amhara, Tigray, and Afar regions, respectively. The overall objective was to enhance a well-functioning civil registration and vital statistics (CRVS) system by integrating community health structures with civil status offices. This assessment was quasi-experimental by design and used longitudinal data, supplemented by a methodology like the one used in the baseline survey to compare improvements in key variables. The assessment compared intervention and control groups, with measuring use of civil registration services, and compared the outcome of the CRVS service provision in terms of improvement. The assessment used qualitative and quantitative methods of data collection and analysis. Some of the key findings of the assessment include: After introduction of the project, the rate of births registered within 90 days increased from the previous year and was greater than in the control woredas; CSOs in the intervention areas regularly visited communities for awareness creation and motivation and for registration when the WDA invited them; qualitative data from KIIs and FGDs generally indicate that the large increase in birth registration in Afar was the result of the presence of CSOs at the kebele level, community mobilization, and no civil status office staff turnover during the project; the community consistently reviewed the registration progress monthly, identifying challenges faced and ways forward at the kebele level, and noted this in the minutes.

Health Service Management and Delivery --- Health, Nutrition and Population --- Immunizations --- Information and Communication Technologies

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The Thai civil registration (CR) system was established two centuries ago. Over the past four decades, the system has changed from a manual, paper-based registration system to a centralized, electronic, online system. A unique identification number (UIN) system was implemented in 1982, along with a computerized CR database system. The Thai citizen identification card has evolved along with the two systems from a paper card to an integrated circuit-chip smart card. All provincial-, district-, and municipality-level registration offices are linked online to the central CR system database. Thailand's vital statistics (VS) system has improved since 1996, when the CR system began feeding electronic birth and death data directly into the VS management system. VS reports are now up to date, of good quality, and available for use by any agency that needs them. Thailand declared its universal health coverage (UHC) policy in 2001. Health insurance coverage was expanded to all Thais through the Universal Coverage Scheme. The use of UINs and CR databases has enabled and facilitated rapid enrollment of beneficiaries and improved the beneficiary registries of all three of the country's major insurance plans. All Thais are entitled to coverage from one of these plans. The use of UINs and personal demographic information from the CR system significantly improved the quality of health care information and provider payment systems. Misuse of UINs and personal information in CR is threatening the integrity of the UIN and central CR databases. New initiatives by the Thai government, such as the National Digital Identification Platform project, are ongoing to expand e-government and private services and to prevent the misuse of personal information and personal identity challenges.

Health Insurance --- Health Service Management and Delivery --- Health, Nutrition and Population --- Information and Communication Technologies

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This case study on Malaysia is part of phase two of the multicountry Universal Health Coverage study series (UNICO), which explores propoor universal health coverage (UHC) programs, which expanded one or more of the three dimensions of the UHC cube, breadth of population coverage, depth of service coverage, and height of financial coverage, in a manner that is propoor. Malaysia is one of only a handful of global examples of low-income or middle-income healthcare systems which had been able to deliver equitable and effective health outcomes at low cost and with strong financial protection, through public sector supply-side investments. The experiences and lessons learnt from Malaysia's Public Healthcare System (PHS) are hence relevant for low, and low-middle-income countries considering such a pathway to UHC. Sections two to four of this case study describes the political, economic, and population context in which PHS exists, and covers two important aspects of PHS, service delivery and health financing, which are instrumental to its success. PHS coexists with a large parallel private sector, which is described together in these sections. Additional topics on PHS, its institutional architecture, management of its benefits package, and information environment, are covered in sections five to seven. Two major focus areas are then discussed: the first focus area (section eight) discusses how PHS achieved propoor coverage through implicit targeting, while the second focus area explores the interrelationship between PHS and the private sector. Section 10 concludes with a proposed reform agenda for Malaysia.

Accountability --- Demographics --- Health Economics and Finance --- Health Insurance --- Health Service Management and Delivery --- Health, Nutrition and Population --- Private Health Insurance

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The objective of this report is to provide guidance on the design and implementation of service delivery models that promote integration of care. Specifically, the report seeks to (i) systematically review the main reform levers of integrated care; (ii) identify processes needed to create an enabling environment for the implementation of integrated care; and (iii) provide guidance on sequencing the different levers and support strategies. This report builds on the findings of recent work that systematically analyzes well-functioning integrated programs in the European Union, North America, and elsewhere, as well as five case studies in Croatia and Poland that were carried out as part of this report.

Health Care Reform --- Health Service Management and Delivery --- Health Systems Development and Reform --- Health, Nutrition and Population