Birth Registration: Can Better Records Improve Child

Why is birth registration a child health issue?

A birth certificate can have consequences far beyond paperwork. WHO identifies missing birth registration or certification as a potential barrier to health care, immunization, nutritional support and insurance. The effect depends on how services are organized locally, but the underlying concern is straightforward: children can encounter difficulties proving their identity or eligibility when documentation is required. [WHO birth-registration indicator guidance](https://www.who.int/data/gho/indicator-metadata-registry/imr-details/coverage-of-birth-registration-%28-%29).

This connection is part of WHO's SCORE health-data agenda. The technical package highlighted in the supplied headline was launched on August 27, 2020, during the COVID-19 pandemic. Its examples included registering births so children could access essential services. That makes birth registration an established health-system priority, rather than a newly announced medical intervention. [WHO's SCORE announcement](https://www.who.int/news/item/27-08-2020-new-who-technical-package-health-data-for-covid-19-response).

Registration also serves a population-health purpose. Knowing how many children live in an area helps authorities plan facilities, staffing and vaccination services. The practical implication is that incomplete records can leave planners with an incomplete picture of demand; improving registration can strengthen planning, although records alone cannot supply medicines or staff clinics. [WHO birth-registration indicator guidance](https://www.who.int/data/gho/indicator-metadata-registry/imr-details/coverage-of-birth-registration-%28-%29).

How many children lack birth registration or certificates?

UNICEF's report, The Right Start in Life: Global levels and trends in birth registration, 2024 update, distinguishes between an unrecorded birth and a registered birth for which the family lacks a certificate. Together, these categories accounted for more than 200 million children under five without certificates. Its estimates also identified 37 million unregistered infants younger than one. These are figures from the 2024 report, not newly measured totals for October 2026. [UNICEF's report](https://data.unicef.org/resources/the-right-start-in-life-2024-update/).

The distinction matters when designing solutions. A child whose birth has never been registered needs the event entered into the civil registration system; a family whose child is already registered may need help obtaining proof. WHO describes registration, certificate issuance and the production of population statistics as connected functions of a working system. A practical implication is that progress should include whether families actually receive usable documentation, alongside whether an official record exists. [WHO civil registration overview](https://www.who.int/data/data-collection-tools/civil-registration-and-vital-statistics-%28crvs%29).

How can routine health visits help families complete registration?

WHO identifies repeated contact with health workers as an opportunity to improve registration. A facility birth offers an early opening, while immunization appointments and growth checks provide later opportunities to reach children whose births were missed. The proposed approach uses encounters already taking place within health services to support birth notification and registration. [WHO's overview of registration opportunities](https://www.who.int/data/data-collection-tools/civil-registration-and-vital-statistics-%28crvs%29/birth-registration-coverage-overview).

Operational guidance describes a sequence of checks: whether the birth was registered, whether a declaration reached the registrar, whether registration was completed and whether the certificate reached the family. Depending on the local system, health workers can provide guidance, help transmit information or facilitate delivery of certificates. The practical implication is that handing families a form may be insufficient if no one checks whether the process was completed. [WHO guidance on health-sector contributions to civil registration](https://iris.who.int/bitstream/handle/10665/341911/9789240020566-eng.pdf).

These recommendations describe how services can work together; they do not establish a specific reduction in illness or mortality from registration alone. Their immediate purpose is to close documentation gaps and support access. Evaluating a programme should therefore examine both completed registration and whether families encounter fewer obstacles when seeking care.