An Evaluation of Vital Registers as Sources of Data for Infant Mortality Rates in Cameroon

The aim was to evaluate the accuracy of vital registers in reporting of infant mortality in Cameroon. Vital registration in Cameroon is dependent on parents filing the papers with the district attorney and paying 600 francs. Birth certificates are required for family allowance claims by employees tax deductions school attendance applications for employment national identity cards and proof of paternity. Death certificates are required for insurance claims inheritance transportation only of the deceased and cessation of family allowances. Data were obtained from the Buea Subdivision of the southwest province of Cameroon in November and December 1992 from interviews from 30 high school and university students and a household census of 6178 households in the 23 villages. All births and deaths were recorded that occurred between November 1 1991 and October 21 1992. Registration data from the councils was also obtained for the same period. The results indicated 1569 births and 106 infant deaths. 98% of births were in health institutions. 1% of urban births occurred at home and 4% of rural births occurred at home. 53% of infant deaths occurred in health institutions and 47% occurred at home. 44% of urban deaths occurred at home and 40% of rural deaths occurred at home. 62% of all reported births were registered: 69% in urban areas and 52% in rural areas. 80% of births were registered within a month after births. Only 33% of reported births could be confirmed by a birth certificate since they were kept by the father. 84% of births were registered by fathers or male relatives. 4% of infant deaths were reported to have been registered. 32% occurred prior to discharge from the health institution. Cross checking of reported and registered births was not possible since anonymity was protected. The council had registered 1716 births who ranged in age at time of registration from 1 day to 59 years. 52% were under 1 year old at registration. Registration increased at aged 4 10-13 and 17-20 years. 59 deaths were registered by the council of which 90% were registered by the end of the 4th month following the death but only 7% were infant deaths. Family allowance was found to be significantly associated with birth registration. Coverage and timeliness would be substantially improved by registration in medical institutions; elimination of registration fees would also increase coverage.