A nurse at Redemption Hospital in Monrovia, Liberia explains the facility's options for family planning. Credit: Travis Lupick/IPS

By Kitty Stapp
UNITED NATIONS, Jul 30 2015 (IPS)

Liberia’s Ebola epidemic may have subsided but its after-effects are still being felt, with tens of thousands of infants going unregistered at birth, the U.N. children’s agency UNICEF says.

Liberia had ranked second after Somalia among countries with the lowest levels of birth registration. But just before the Ebola outbreak, progress had been made in reversing this problem, which leaves children at risk of exploitation and raises hurdles to entering the school system.

In July 2010, a decentralised birth registration system was launched by the government, with support from UNICEF, PLAN Liberia, Crisis Management Initiative and other development partners.

In 2013, the births of 79,000 children were registered, representing about a quarter of all new births and a dramatic increase from the four percent in previous years.

But by 2014, when many health facilities had closed or had reduced services due to the Ebola response, the number of registrations fell to 48,000 – a 39 per cent decrease.

And just 700 children are reported to have had their births registered between January and May 2015.

“Children who have not been registered at birth officially don’t exist,” said Sheldon Yett, UNICEF’s Representative in Liberia. “Without citizenship, children in Liberia, who have already experienced terrible suffering because of Ebola, risk marginalization because they may be unable to access basic health and social services, obtain identity documents, and will be in danger of being trafficked or illegally adopted.”

The neighbouring countries of Guinea and Sierra Leone were also hit by the deadly virus, which weakened already fragile health systems. But in Sierra Leone, approximately 250,000 children were registered during a recent five-day birth registration and polio vaccination campaign.

UNICEF is now working to register nearly 70,000 Liberian children who weren’t registered during the outbreak.

The agency is supporting the revamp of the registration systems, and will assist with training, logistics, and outreach efforts prior to a planned nationwide campaign later this year, with the aim of reaching all children not registered in 2014 and 2015.

“No child should suffer the indignity, or not have protection from a state or other entities, and be unable to access basic services that are every child’s right just because of a lack of a registered identity,” says Yett. “We cannot, and should never let that happen.”

Altogether, more than 4,800 people died during Liberia’s Ebola outbreak, nearly half of all diagnosed cases. The country was still recovering from a devastating civil war that ended in 2003, and the virus proved especially deadly for health care workers.

According to the World Health Organization, they were 20-30 times more likely to contract the disease than the general public, given the number of patients they saw and treated.  More than 800 contracted Ebola, and more than 400 died, with the outcome of almost one quarter of the cases unknown – this in a country with just 50 doctors.

“Guinea, Liberia, and Sierra Leone entered the Ebola epidemic with severely underfunded health systems,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa. “After a year of handling far too many severely ill patients, the surviving staff need support, better protection, compensation, and reinforcements. The existing facilities need a complete overhaul, and many new structures need to be built. If another outbreak strikes, the toll would be far worse.”

Edited by Thalif Deen

The right to a legal identity is fundamental to meeting all other rights and protect a child from other forms of abuse and exploitation. Pictured here children in Kafue, Zambia. Credit: Brian Moonga/IPS

By Martin Mogwanja and Carlos Lopes
ADDIS ABABA , May 24 2013 (IPS)

There is much to celebrate this week as the African Union marks 50 years as an independent pan-African entity. 

In the last half century, Africa has witnessed an era of self-determination and independence. As the continent looks to the next 50 years, the focus must be on how to build an inclusive future based on the aspirations and rights of the continent’s more than one billion citizens.

This will rely on every country in the AU being equipped to lay the best foundation for their youngest citizens, their children.

Yet, as the talk of Africa’s new economic potential increases and more countries move into the middle income ranks, the reality is that this young continent, with half of its population under the age of 18, still has much to do if this youth dividend is to lead to a stable, democratic and fairer place where its young people can reach adulthood.

Under the AU, many progressive plans for human rights and development have been agreed.  Many of them are built on the best of international law, policy and practice. Many of them are built on the basis that the continent’s people, and especially its children, are its greatest asset.

Despite these noble commitments, there is a silent scandal that needs to be urgently addressed: the scandal of invisibility. Across the continent, millions are born and millions die with their lives unrecorded.  For example, only 44 percent of children under five years of age have their births registered.  The majority of these live in rural or remote areas and many are poor and on the periphery of Africa’s new wealth and prosperity.

One only needs to look at other successful developed regions to realise that effective, efficient and modern systems of civil registration and vital statistics form the basis of good governance, economic integration and offer the security of identity that all people require.

How can a country plan when it does not know how many people are born and where? How can a government build a health system if it does not know how many die, where and of what cause?

Conducting a census every few years is a key. But strong vital statistics based on real-time information provide leaders and decision-makers with the knowledge required to plan and deliver basic services.

The right to a legal identity, enshrined in the African Charter of the Rights and Welfare of the Child and the United Nations Convention on the Rights of the Child, is fundamental to meeting all other rights and protect a child from other forms of abuse and exploitation.

In some countries, proof of birth through a birth certificate can determine whether a child has access to primary school – or not. In others, its absence can mean a girl may be forced into early marriage because even with a law in place, she has no document to prove that she is still too young.  In yet other countries, it means that boys and girls can be forced into armed factions or exploited as cheap labour – because people with the interests of children at heart cannot make a case for exempting those too young to serve.

So if arguments for building strong civil registration and vital statistics are well accepted, why are we still not yet seeing them translated into results on the ground?

Momentum is building. African leaders agreed in 2012 to make this a priority and regular ministerial meetings are held every two years to share expertise and help strengthen civil registration systems.

Under the auspices of the Africa Programme on Accelerated Improvement on Civil Registration and Vital Statistics, African governments are now working alongside the U.N. Economic Commission for Africa, the African Development Bank and other U.N. agencies to provide the technical support needed to help build effective systems.

We have seen the introduction in some countries of technology and innovations to help leap frog progress. The U.N. Children’s Fund, with support from the European Union, is identifying ways to use new technology to increase birth registration and expand services to remote areas.

Coordination between ministries and between local, state and national governments is improving and initiatives such as setting up registration sites in hospitals and health clinics are also helping to increase the numbers of newborns being reached.

But even with this success, progress is still too slow, with too many people not registered and technological and digital advances not being introduced in areas where they could make a dramatic difference.

In remote and rural regions, civil registers often struggle, due to inadequate transport or a lack of incentives, to reach their constituents and instead wait for people to come to them. Often parents do not understand the importance of their child being registered or the contribution it could make to a country’s national development. Often budgets are inadequate to roll out services to everyone.

As African Heads of State meet to celebrate the achievements of independence and forge plans for the next 50 years, it is now time for them to be practical. Investing in civil and vital registration systems to make sure that all of the continent’s citizens, especially the very youngest, are counted right from the start is a critical first step.

*Martin Mogwanja became U.N. Children’s Fund (UNICEF) deputy executive director in 2011. He has worked all over the world for UNICEF including serving as Representative in Pakistan, Uganda, Democratic Republic of the Congo and also as deputy regional director for West and Central Africa in Abidjan, Côte d’Ivoire.

**Carlos Lopes of Guinea-Bissau is the executive secretary of the U.N. Economic Commission for Africa. He has more than 24 years experience at the U.N. as U.N. Development Programme resident coordinator and resident representative in Brazil and Zimbabwe. A member of several African academic networks, as well as a strategist and socio-economist, Lopes has vast experience in capacity-building and technical cooperation on the continent.