"Birth registration is a human right, yet less than three quarters of children under 5 years of age worldwide are registered. Birth registration is fundamental to helping people access their individual rights, such as basic social services and legal justice."
United Nations, 2019, p.55
This research contributes to the literature by not only focusing on the household-level factors influencing birth registration, but also focusing on context-level factors. These context-level factors, which are factors at higher levels such as the legal system, are often disregarded in earlier studies while they are arguably important. Therefore, determinants at the household, sub-national regional, and – for the first time – national level will be investigated simultaneously.
Data from the Demographic Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), the World Bank, and the Global Data Lab were used. The combined dataset contains information on 358,842 children aged 0 to 4 years old, living in 809 sub-national regions within 40 sub-Saharan African countries. A three-level multilevel logistic analysis was used to investigate the household- and context-level determinants of birth registration.
Figure 1 on the left shows that most of the variation in birth registration, 61%, can be explained by household-level determinants (such as the age of the child, education of the parents, etcetera.). 39% of the variation can be explained by the national- and sub-national regional level. Variables at this level include living in a rural/urban, the number of conflicts, and whether the birth registration system is decentralized for instance.
Figure 2 on the right presents the odds ratios of the multilevel logistic regression. This figure also shows that not only household-level factors are important for the chances of having a birth registration, but that context-level factors also influence this decision. Among the significant determinants are living in a urban/rural area, GDP per capita, the centralization of the birth registration system, and the number of conflicts.
For birth registration: birth registration and child health outcomes, birth registration and vaccination, birth registration and education outcomes.
Beyond birth registration, but related to children: regional variations in child health due to adverse weather events, political upheaval, epi- and pandemics.