Innovations in Monitoring Vital Events. Mobile Phone SMS Support to Improve Coverage of Birth and Death Registration.A Scalable Solution (From Tanzania) - A Review

Abstract

Civil registration in developing countries is only slowly improving, and least so in Sub-Saharan Africa. An important reason why this is the case has been identified across countries: the problematic and costly access for the public to civil registration services. When early in the 2010s mobile phone use became ubiquitous and connectivity surpassed Internet coverage it did not take long for an understanding to set in that mobile phones may offer a way out of the cul-de-sac in which civil registration was and still is stuck in many low-income countries. Close to, we estimate, a hundred mobile phone projects were conducted (over 70% of which in the WHO MOVE-IT- and Millennium Villages projects) during the 2010s. An evaluation of the early use of the mobile phone for vital event reporting is a 2013 study of a project of birth- and death notification (and birth and death registration) by mobile phone conducted in Tanzania. Project design was of disappointing quality. The pilot led to the increase of birth and death registration only to underwhelming extent. The authors claim that it was not clear why: “[n]o overwhelming reason [was] provided by families for the low reporting rate.” But the reasons why are so obvious that it is astounding that the authors did not even speculate what they could be. This short paper review makes good for that glaring omission. The here reviewed pilot was infused with the “Enterprise Architecture” fad, in the world of for-profit business long discarded. It excels in the study in minute detail of the “as-is”. It fails spectacularly in the “to-be”, and has commonly (in over 90% of its application according to one study) resulted in “not-to-be”. Worse still, indications are that the aid industry has set Africa up for another decade of “worse than useless advice” and quack science to solve the continent’s intricate identity management problems. In addition a short lead-in is given to our forthcoming paper on the mobile phone-based Tanzania’s Under-Five Birth Registration Initiative (U5BRI). The project, while widely communicated as a success, is in trouble, as shown in this paper. An in-depth study of its performance will be reviewed in a forthcoming paper.