Cameroon

Introduction

The purpose of this report is to provide a brief introduction to the civil registration and vital statistics (CRVS) systems in Cameroon.

The information was collected through a questionnaire completed by the National Civil Status Registration Office in December 2018 and supplemented by a desk review of available documents. The report presents country background, selected indicators relevant for CRVS improvement processes, stakeholders’ activities, as well as resources available and needed to strengthen CRVS systems, coordination, among others.

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Disclaimer: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations.

Country profile

Cameroon is a country in Central Africa. It is bordered by Nigeria to the west and north; Chad to the northeast; the Central African Republic to the east; and Equatorial Guinea, Gabon and the Republic of the Congo to the south. Cameroon has a coastline on the Atlantic Ocean. Cameroon has ten semi-autonomous regions.

475650UN Demographic Yearbook. https://unstats.un.org/unsd/demographic-social/products/dyb/dyb_2017/. Accessed on March 3, 2019.

TOTAL SURFACE AREA (SQUARE KILOMETERS)

POPULATION (MILLIONS)

2014

Capital City

Yaoundé

Official working language(s)

French and English

Ministry responsible for civil registration

Ministry of Decentralization and Local Development

Civil registration agency

National Civil Status Registration Office (BUNEC)

National statistical office

National Institute of Statistics

CRVS Dimensions

Birth

Completeness of birth registration	(N/A)
Children under 5 whose births were registered	61% ( 2011The DHS Program – DHS 2011 - https://dhsprogram.com/pubs/pdf/FR260/FR260.pdf )
Births attended by skilled health professionals	65% ( 2016World Health Organization (WHO) –Cameroon Factsheet of Health Statistics 2018 - http://www.aho.afro.who.int/profiles_information/images/4/4d/Cameroon-Statistical_Factsheet.pdf )
Women aged 15-49 who received antenatal care from a skilled provider	( NA )
DPT1 immunization coverage among 1-year-olds	93% ( 2017UNICEF. 2017. The State of World’s Children 2017. https://www.unicef.org/sowc2017/ )
Crude birth rate (per 1,000 population)	36 ( 2016 )
Total fertility rate (live births per woman)	4.7 ( 2016 )
Adolescent fertility rate (per 1,000 girls aged 15-19 years)	108.8 ( 2016World Bank. 2018. Adolescent Fertility Rate. https://data.worldbank.org/indicator/SP.ADO.TFRT )
Population under age 15	42.7 ( 2017United Nations. 2017. World Population Prospects: The 2017 Revision, Volume II. https://esa.un.org/unpd/wpp/Publications/Files/WPP2017_Volume-II-Demographic-Profiles.pdf )

Death

Completeness of death registration	N/A
Crude death rate (per 1,000 population)	10 ( 2016 )
Infant mortality rate (probability of dying by age 1 per 1,000 live births)	55.1 ( 2017 )
Under five mortality rate (probability of dying by age 5 per 1,000 live births)	84 ( 2017World Bank. 2018. Mortality rate, under-5. https://data.worldbank.org/indicator/SH.DYN.MORT )
Maternal mortality ratio (per 100,000 live births)	596 ( 2015World Bank. 2018. Maternal mortality ratio (modeled estimate). https://data.worldbank.org/indicator/SH.STA.MMRT )

Marriages and divorces

Marriage registration rate	N/A
Women aged 20-24 first married or in union before age 15	10 ( 2014UNICEF. 2018. Global databases. Based on Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS) and other nationally representative surveys. https://data.unicef.org/topic/child-protection/child-marriage/ )
Women aged 20-24 first married or in union before age 18	31 ( 2014 )
Divorce registration rate	NA

Vital statistics including causes of death data

Compilation and dissemination of CR-based statistics

N/A

Medically certified causes of death data

1% (2017)

(

2017

)

Civil registration system

Legislative Framework

The Government of the Republic of Cameroon enacted a civil status Law No. 2011/011 on 6 May 2011 which modified and replaced the Ordinance No. 81-02 of 29 June 1981https://data.unicef.org/wp-content/uploads/2017/12/ORDONNANCE-N%C2%B0-81-002-du-29-J-CAMEROUN.pdf. The new law improved several provisions of the 1981 Ordinance, in particular the organization of civil registration and provisions relating to the status of natural persons. The law came into force immediately after it was issued.

This new law covers births, marriages, deaths, adoptions, legitimations, and recognitions. The 2011 law makes the declaration and registration of births, deaths and marriages mandatory for all people residing in the country, irrespective of their citizenship status, and for Cameroonians residing abroad, with the competent nearest civil status registrar. Emphasis is also placed on the confidentiality of information and security of civil registration records as well as the interactions between key stakeholders of the civil registration system. However, the law is silent on the collection and sharing of information for vital statistics and the computerization of the civil registration system.

Management, organizations and operations

National CRVS systems coordination mechanisms

A high-level coordination committee called the Steering Committee of the Civil Registration Rehabilitation Program of Cameroon (PRE2C) was created by Order No. 019/CAB/PM of 24 February 2015. This is one indication of the commitment of the Government to make civil registration a priority. It is chaired by the Minister of Decentralization and Local Development. Membership and includes representatives of the following ministries, departments and agencies:

Presidency of the Republic;
Prime Minister’s Office;
Ministry of Decentralization and Local Development (MINDDEVEL);
Ministry of Justice (MINJUSTICE);
Ministry of Public Health (MINSANTE);
Ministry of External Relations (MINREX);
Ministry of Finance (MINFI);
Ministry of Economy, Planning and Spatial Planning (MNEPAT);
Ministry of Social Affairs (MINAS);
Ministry of Basic Education (MINEDUB);
Ministry of the Promotion of Women and the Family (MINPROFF);
National Institute of Statistics (INS);
National Bureau of Civil Registration (BUNEC);
General Delegation for the National Security (DGSN);
Directorate General of External Research (DGRE);
State Secretariat for Defense in charge of the National Gendarmerie (SED);
Special Fund of Equipment and Intermunicipal Intervention (FEICOM)

Technical Working Group

The Committee has a Technical Secretariat coordinated by the Director of Local Services of the Ministry of Decentralization and Local Development. BUNEC plays a central role in the institutional arrangements and the facilitation of the coordination of the civil registration system.However, it should be noted that the Technical Secretariat of the Civil Status Steering Committee is coordinated by the Director of Services of the Ministry of Decentralization and Local Development. Nevertheless, the coordination between sectors and services is currently ineffective as each actor is assuming its responsibilities for the registration of vital events in silos without any institutionalized monitoring system.

Administrative level registration centres

The civil registration is semi-decentralized with a local offices on the one hand, and a structure responsible for the management of the system at the National level. Civil registration offices are located at two levels: there are main civil status centers located at the chief towns of the communes (District level) and the secondary civil status centers located in villages or neighborhoods within the Commons. This second group is the lowest administrative level of registration of vital events. There are a total of 2,724 civil status centers, including 374 in urban areas (main centers) and 2,350 in rural areas (secondary centers).

Accessibility of civil registration services

According to the estimate provided by BUNEC, most households are located 1 to 5 kilometres away from most of the civil status centres. The estimated time to cover this distance on foot was less than 4 hours for those residing further away from the registration centres. Travel time could also be reduced significantly – less than an hour - when an informant used a vehicle or motorcycle. However, households living in remote and hard-to-reach areas of the country are facing a real problem of accessibility to the civil status centers in terms of distance and cost.

Registration of vital events

With regard to the registration of vital events, it is worth noting the following:

Registration of births and deaths is free;
The health sector is currently playing an important role in the reporting of the occurrence of births and deaths that occur in health facilities to BUNEC;
The law on civil registration does not give a definition of live births and deaths as recommended by the United Nations; and
The establishment of civil registration records is not synchronized with vital statistics data collection. Similarly, information on the cause of death is not systematically collected at the time of registration.

Vital event	Fee for registration		Cost of registration	Remarks
Vital event	Yes	No	Cost of registration	Remarks
Birth		X		Some dishonest officers request payment of fees.
Marriage		X		Payment for stamps to be affixed on marriage certificates and registers. It has been observed that in some places registrars are asking for inappropriate amounts.
Divorce		X
Death		X

Backlog of unregistered births

In Cameroon, births in communities must be notified to the competent civil registration regional officer within 90 days. In the case of births in health facility, the person in charge of the health facility should notify the local registrar about the event within 90 days. The parents of the child have an additional 60 days to register the event. As for deaths, the reporting period is 90 days whether the event occurred in a health facility or in a community.
Despite the legal deadlines, under-registration of civil status remains high, adding continuously to huge existing backlog of unregistered births. This under-registration is often attributed to the lack of knowledge of responsibilities on the part of health professionals, customary practices delaying registration beyond the stipulated period, lack of demand for certificates, as well as distance and associated travel costs to the nearest civil status service.

Interface with other sectors and operations

The system of civil registration currently in force in Cameroon does not allow real interoperability with other government sectoral ministries or agencies, such as the national statistical office. However, as part of the implementation of the Strategic Plan for the Rehabilitation of Civil Registration of Cameroon (2018-2022), a Master Plan for the computerization of the civil registration system was developed and adopted by the Government on 12 September 2018. This master plan provides in its implementation phase an interface between the civil status system and other sectors, such as the national identity agency, ministries of justice, transport and health, insurance agencies and companies, public and private banks, the driver’s license issuing department, public service and others. The introduction of the Unique Personal Identification Number (NIPU) for the registration of vital events is expected to facilitate the establishment of links between the civil registration and the ministries and sectors mentioned above.

Vital statistics system

The National Institute of Statistics is the government organ that facilitates and organizes official statistics in the national statistical system. It is responsible for collecting, compiling and disseminating data.

The production of vital statistics from civil registration is very low or non-existent in Cameroon. To date, the little data available are those from MICS and DHS. In fact, the laws and regulations relating to civil registration and those governing the national statistical system do not take into account the need for coordination between the National Institute of Statistics and BUNEC for the production of reliable vital statistics from a civil registration.

To remedy this lack of updated statistics, BUNEC, which is also responsible for the production of vital statistics from civil registration records, envisages to exploit the registers for statistical purposes through the operation denominated “Production of the Statistics Baseline of Civil Registration, 2018”. In addition, a study is being carried out through the German Development Agency (GIZ)-supported Program for the Modernization of Civil Status (PAMEC) for the development of a national strategy for the collection of vital statistics.

Causes of death

In Cameroon, health statistics are generated from different sources in the Ministry of Public Health (MINSANTE) - the National Health Management Information System (NHMIS) Program being the main source, and several other priority health related programs such as HIV/AIDS, Malaria, the Expanded Program on Immunization, Maternal and Infant Mortality, etcComplementary Evaluation Report of the Civil Registration and Vital Statistics Recording System in Cameroon : "The production of statistics on the causes of death", page 37, July 2016. The National Health Information System is supposed to federate all these sources of information but it has not been implemented so far.

Public health facilities play a key role in recording and reporting the occurrence of death and the causes of death. The responsibility of producing a medical certification of death and ascertaining the cause of death is the duty of medical doctors in urban health facilities, and of nurses in rural areas. The medical death certificate is given to the family of the deceased for declaring the event to the Civil Registrar. The Registrar completes the death registration record with the usual administrative information on the deceased but without reporting the cause of death. The Civil Registration Act does not require the Registrar to record cause of death in the register. Information on the cause of death is subsequently not coded according to the International Classification of Diseases and Related Health Problems (ICD) by the doctor or anyone else.

Digitization

Computerization

The civil registration system is not yet computerized in Cameroon, although a Master Plan for the Computerization of the National System of Civil Registration was developed before. BUNEC, as mentioned earlier, is setting the ground for the digitization of the civil registration system. In this regard, an enabling legal framework for a modern computerized environment of the Civil registration system was removed and a bill was drafted in February 2019. BUNEC believes that the computerization of civil status will eventually simplify CR procedures and processes, allow better archiving of legal documents, and improve accessibility of services. It will also enable the timely compilation, production and dissemination of reliable vital statistics.

Mobile technology application

As part of the implementation of the "Universal Birth Registration Project in Africa", BUNEC has tested the application of mobile technology in three municipalities of the country. A short electronic birth notification number has been assigned for this purpose by the relevant technical services. The technical and financial support for this initiative will be provided by UNICEF, with the help from the network of local operators. The objective is to test the impact of this technology on the promptness and completeness of the reporting of institutional and community events.

Sample registration forms

Birth certificate Marriage certificate Death certificate

Improvement initiatives and external support

Improvement plan and budget

Strategic plan

The complementary evaluation of the civil status system was carried out in 2016 with the technical support of UNICEF. It led to the development of a Strategic Plan for the Rehabilitation of civil registration for the period 2018 to 2022.

Budgetary allocations and requirements

Currently, information on the budget allocation for registration of vital events is not available despite the establishment by BUNEC of a national consultation framework of civil registration stakeholders and the setting up of the steering committee. Therefore, .information is not available on the share reserved for civil registration activities in the budget of other sectors such as the Ministry of Health, National Institute of Statistics, Ministry of Decentralization and Local Development, Ministry of Justice, Ministry of Foreign Affairs, Ministry of Social Affairs, Ministry for the Promotion of Women and the Family, and others.

Activities identified in the national plan as high priorities

The following activities have been identified as high priority areas in the Strategic Plan for the Rehabilitation of Civil Registration of Cameroon (2018-2022):

Revision of the legal framework in order to adapt it to international standards;
Improvement of the availability and the quality of the civil registration (to reinforce the reception and material capacities of the registration centers, and make them functional);
Improvement of the civil registration process (formalization of processes, capacity building, better skill mix and capacity of civil registration staff);
Improve the registration of vital events (define and institutionalize the role of the actors, put in place tools for registering deaths and causes of death);
Develop advanced strategies for the registration of vital events in community settings;
Institute a communication strategy integrating the community participatory approach;
Introduce the accessibility of service for the population;
Organize clearance of the back log of unregistered vital events, in particular births;
Provide the system with a master plan for computerization and implement the overall IT architecture with the central registry of civil registration;
Improve the quality and timelessness of production, dissemination and use of vital statistics.

Proposals to improve coordination

The coordination of stakeholders is paramount for the success of any action to strengthen the civil registration system. To this end, the General Director of BUNEC has made the following suggestions for improving the coordination of interventions by national and international actors.

Coordination among national key CRVS stakeholders:

Strengthen the composition of the Steering Committee (enhancing the role of civil society) and the periodicity of the sessions of the Committee;
Establish, under the Coordination of the BUNEC, a permanent working group, constituting a framework for consultation between the actors of the system;
Share a common understanding and vision of the system by all actors; and
Strengthen the political will of government through sufficient allocation of resources for the implementation of the current strategic plan.

Coordination between national stakeholders and development partners.

Ensure the representativeness and participation of the development partners in the steering committee;
Establish a system for monitoring the support and interventions of the various Development Partners in order to avoid duplication of projects;
Improve the exchange of information between development partners and national stakeholders; and
Establish a trust fund for sustainable financing of civil registration.

Additional Materials

Websites

National Office of Civil Registration National Office of Statistics Ministry of Public Health UNICEF-Cameroon WHO-Cameroon

Additional materials

Study on Gender and Civil Status (March 2011) Ministry of Territorial Administration and Decentralization / CIVIPOL-Conseil. Civil Registration Rehabilitation Program of Cameroon.

Study on the taking into account of minorities (marginal populations) by the system of civil status (January 2011) Foundation Paul Ango Ela of Geopolitics in Central Africa.

Study on consular posts and civil status (2012). Ministry of Territorial Administration and Decentralization / CIVIPOL-Conseil. Civil Status Rehabilitation Program of Cameroon

Diagnostic study of the civil registration system in Cameroon and feasibility of a priority intervention program, CIVI.POL Conseil, financing C2D, 2006-2007 (5 reports)

Training Manual on Civil Registration, CIVIPOL (2015)

White Paper on Civil Registration, CIVIPOL (2016)

Conclusion

The government of Cameroon has demonstrated political will to improve the registration of vital events and the production of vital statistics. In this respect, a series of measures have been taken to date, namely the revision in 2011 of the 1981 ordinance which governed civil registration and the implementation of the Civil Registration Rehabilitation Program of Cameroon (PRE2C), the creation of BUNEC, a the adoption of the strategic plan for the rehabilitation of civil registration for the period 2018-2022, as well as the adoption on 12 September 2018 of the master plan for the computerization of the national civil registry system for the period 2019-2023.

On the other hand, some major challenges requiring urgent consideration remain. On the part of the civil registration system, the challenge is inadequate financing to implement the civil status improvement strategic plan and the master plan for the computerization of the National System of Civil Status. The data compiled by the BUNEC are in principle to be transmitted to the National Institute of Statistics for compilation and dissemination of vital statistics. Although it is generally held that timely registration is improving in Cameroon, the civil registration system does not currently allow the sharing of information for the statistical compilation of data.

Endnotes

[footnotes]

Annex

Structure organisationnelle de l’administration des systèmes d’ESEC