Innovations in Partnerships and Technology for Birth Registration
Workshop about designing school furniture with 3D models
BANGLADESH, 2012. Children stand with their birth registration cards at Mirtinga Tea Estate in Maulavi Bazar, Sylhet on 5 December 2012. © UNICEF/BANA2012-02020/JANNATUL MAWA

Generally, the fields of child health and child protection are viewed and operate as two separate technical sectors. Like many technical areas in international development, these two sectors operate as silos and working cross-sectorally tends to be more of the exception rather than the norm. Yet, evidence shows that there is an inter-relationship and synergy between child health and child protection, and it would make sense if we did more to leverage that synergy.

We know, for example, that children who are registered at birth and receive birth certificates are more likely to access health services and receive all the health benefits that come with those services. We also know that children who are physically (and mentally) healthy are better suited to recover from the trauma associated with emergencies and armed conflict situations. This may be over-simplifying the correlation, but it is hard to deny the inter-relationships between child health and child protection.

UGANDA, 2013. Officials at Mulago hospital enter particulars of children and their parents into Mobile Vital Records System (Mobile VRS) to obtain short birth certificates. Mobile VRS is an innovative technology supported by UNICEF to improve birth registration in Uganda. © UNICEF/UGDA201300593/MICHELE SIBILONI

There are some organic areas where child protection efforts can be coordinated and work in tandem with the health sector. For example, the opportunity that antenatal and obstetric health services afford to register births and deliver birth certificates is obvious. In fact, the coordination between birth registration and health is the foundation for an increasing number of birth registration programs, particularly those which use mobile technology, such as UNICEF’s Mobile VRS (Vital Registration System)[1], reported in my last blog post.

Leveraging the synergies between child protection and health is being explored as a key strategy in UNICEF’s efforts to conceptualize how to best use technology to improve child protection outcomes. UNICEF is already using technological innovations in a number of other areas of child protection.[2] Realizing the potential that technology and other innovations offer, UNICEF recently launched an initiative to establish a conceptual framework that can guide UNICEF country offices in using technology to improve child protection outcomes in their country programs. Developing this conceptual framework uses birth registration as a foundation, but involves looking at other areas of child protection, identifying gaps in those areas and assessing if and how technology can effectively best address those gaps to achieve better results.

KENYA, 2011. UNICEF Nutrition specialist Olivia Agutu posts a ‘tweet’ (text message) via her cellular phone, outside the nutrition centre in the Ifo refugee camp in North Eastern Province, near the Kenya-Somalia border. © UNICEF/NYHQ2011-1017/RICCARDO GANGALE

The health sector may not be an operational partner with all child protection programs in the same way as it can be for birth registration programs.  Not all child protection interventions integrate with health services as easily as integrating birth registration with antenatal, delivery and vaccination services.  However, with respect to conceptualizing how technology can be used to improve results, the health sector can offer some useful models for the child protection sector.

Using innovations in technology in the health sector has been on the rise in the last few years. Evidence showing improvement in health outcomes and efficiencies has been building at a steadily rapid pace. Mobile phone technology, for example, has been used to increase the number of women attending antenatal clinics, improve adherence to HIV treatment regimens, train midwives to recognize obstetric danger signs, and follow-up mother-baby pairs in the prevention of mother-to-child transmission interventions.

Examples of Using Mobile Technology in Health

  • An emerging body of evidence shows that the use of SMS messaging through mobile phones significantly improves the follow-up rate for HIV+ women enrolled in prevention-of-mother-to-child transmission (PMTCT) programs to return with children to receive early infant diagnostic (EID) testing.
  • A randomized control trial in Kenya looking at pediatric malaria treatment showed that the use of text messaging improved treatment protocol management by nearly 25%.
  • A program along in Zanzibar reported that using mobile technology and SMS text messaging increased the odds of women attending the recommended 4 antenatal visits and the presenting for delivery in the presence of a skilled birth attendant.
  • Numerous studies report the use of mobile and web-based technology to increase efficiencies and accuracy of data collection related to health conditions such vaccinations, EID results and the progression of pregnancies.
UGANDA, 2013. Red cross and UNICEF officials use Rapid Family Tracing and Reunification System (RapidFTR) at Bubukwanga transit Centre. The RapidFTR system is used to collect and share information via mobile phone about children and families in emergencies which information aids family tracing and reunification of unaccompanied minors. © UNICEF/UGDA201300354/ISAAC KASAMANI

The evidence for using technology in health offers practical models and guidance for conceptualizing how technology can be applied to the field of child protection. The key is to look at how the technology is being used, or the application of the technology and then see how the application can be adapted in the child protection sector.[3] Application is more relevant (to developing a child protection conceptual framework) than whether the technological innovation is being used in HIV, child health or any other health condition.

To clarify this point, reference is made to a framework recently published which breaks down the use of mobile technology in health into 12 applications[4]:

  1. Client education and behavior change communications
  2. Sensors and point of care diagnostics
  3. Registries/vital events tracking
  4. Data collection and reporting
  5. Electronic records (case management)
  6. Electronic decision support (information protocols, algorithms, checklist)
  7. Provider-to-provider communication (user groups, consultations)
  8. Provider work planning and schedules
  9. Provider training and education
  10. Human resource management
  11. Supply chain management
  12. Financial transactions and incentives.
GHSP-13-00031-Mehl_Figure 1
mHealth researchers and implementers at the World Health Organization (WHO), the Johns Hopkins University Global mHealth Initiative, the United Nations Children’s Fund (UNICEF), and frog Design have jointly developed the ‘‘mHealth and ICT Framework’’ to describe mHealth innovations in the reproductive, maternal, newborn, and child health (RMNCH) field, in which mobile health technologies have been broadly implemented over the last decade across the developing world. Read more

While not every one of these applications can be adapted or conceptualized for child protection, many of them can be. So, as we develop a conceptual framework for using technology in child protection, we can reference and adapt the conceptual framework for using technology in health that has been developed after years of experience.

Future postings will explore how these applications for using mobile technology in health can be adapted for using technology in child protection.

Bill Philbrick
Innovation and Child Protection Project Lead

[1] Uganda’s Mobile VRS (Vital Records System) represents a good model exhibiting traits of a functional CRVS system and using innovate technology to improve birth registration. Developed by UNICEF, in partnership with URSB, the government partner, and Uganda Telecom, a private sector partner (which also hosts the system), Mobile VRS is a phone and web-based application that uses USSD, SMS and a web-based interface to streamline, simplify and decentralize birth and death registration in Uganda.

[2] In addition to birth registration, one of the most successful uses of technology has been using mobile phones to reunify displaced children with their families (Rapid FTR).

[3] “Functionality” can also be used in the place of “application”.

[4] Source: article “mHealth innovations as health system strengthening tools: 12 common applications and a visual framework” on Global Health: Science and Practice. The use of mobile technology in health is commonly referred to as “mHealth”.

ZAMBIA, 2011. Remind MI agent Cecilia Chaamwe speaks to Universe Sindamu at her home in Chiima village near the Nameembo Rural Health Centre in Zambia’s Southern Province on October 18, 2011. Chaamwe met with Sindamu to notify her through the SMS message that she needed to return to the clinic for her 6 week old son’s vaccinations. © UNICEF/ZAMA2011-0019/CHRISTINE NESBITT

Read also Bill’s post about Reaching the unreached: Innovations and child protection

Other stories that you might be interested in:

mHealth innovations as health system strengthening tools: 12 common applications and a visual framework

1000 days: A mHealth product overview

Prototyping birth registration services in Nicaragua

Making people count by counting people

Nigeria – Using RapidSMS for birth registration

Innovations in Partnerships and Technology for Birth Registration
Workshop about designing school furniture with 3D models