A scandal of invisibility: making everyone count by counting everyone

This paper is the first in a series of Lancet papers about the importance of collecting data for health development. The absence of reliable data on numbers of births and numbers and causes of death render most of the world’s poor people as unseen, uncountable, and hence uncounted. The paper makes a case that civil registration, vital statistics, and data for cause of death are essential public goods as they provide crucial information for policy, planning, and evaluation in all sectors of development. As a legal document, birth registration proves identity and citizenship, which provide access to state services and defence against exploitation or protracted hardship in times of emergency.

The paper argues that now is the time to make the long-term goal of comprehensive civil registration in developing countries the expectation rather than the exception. It is essential that governments recommit resources to the registration of births and deaths, and to certify the causes of deaths in the world’s poorest countries. The international health community can assist by sharing information and methods to ensure both the quality of vital statistics and cause of death data, and the appropriate use of complementary and interim registration systems and sources of such data. [adapted from author]