Local level |
• Poor understanding of the rationale and importance for registering among health staff and families. |
• Poor access to registrars. |
• Difficulties in defining a neonatal death as opposed to a stillbirth. |
• Local health staff having poor access to data due to family seclusion and high mobility in society. |
• Reports by Village Health Workers being based on verbal reporting. |
Health system level |
• Reports being based on aggregates and not on individual data, making cross checking and additions impossible. |
• The responsibility of reporting not being clearly communicated within the health system. |
• Inadequate report forms. |
• Infant mortality, but not neonatal mortality, being used in national statistics and surveys. |
• Families and not the health system being ultimately responsible to register a birth or death. |