CHAPTER ONE INTRODUCTION TO THE STUDY
Introduction
Life is associated with events, beginning with birth and ending with death as the final exit of man. In one’s lifetime, events like adoption, migration, marriage and dissolution of marriage may occur. All these incidents are recorded using the civil registration systems to generate vital information needed by governments for planning policies in national development (Mills, Abouzahr, Kim, Rassekh & Sarpong, 2017; Brolan, & Gouda, 2017).
Birth registration is a vital component of Civil Registration and Vital Statistics (CRVS). It is the continuous, permanent and universal recording of the occurrence and characteristics of births in a civil registry according to the legal requirements of a country (UNICEF, 2013; Jackson, Duff, Kusumanigrum & Stark, 2014). It is the right of every child to have an identity and a nationality. Birth registration offers every child the first legal document. The lack of birth registration excludes children from exercising their fundamental human rights such as accessing healthcare and education. It also exposes them to forms of abuse such as sexual exploitation (UNICEF, 2005, Ball, Butt & Beazley, 2017).
Birth registration produces information necessary to monitor population growth through measures such as total fertility rates and life expectancy and other important measures to determine development in a nation (Shibuya &Gilmour, 2015; Uzobo & Egharevba, 2016). As a result, data on the number of newborns is key to population planning in Ghana. It contributes to reliable administrative, statistical systems and realization of human rights. It assists in the estimation and
calculation of infant mortality rates and fertility rates to measure the progress and problems facing the population (WHO,2013; Pais, 2009).
Efficient birth registration system is an essential factor for achieving and evaluating Sustainable Developments Goals (SDGs) (Mills et al, 2017). By 2030, the aim of SDG Target 16.9 is that countries should provide a legal identity for all. Legal identification facilitates access to social protection systems and services for all, leaving no one behind. About a third of the SDG indicators entered into Global SDG Indicator Database require data from a birth registration system (Setel, AbouZahr, Karpati & Bratschi, 2018).
United Nations emphasizes that information sourced from birth registration systems aid governments to effectively plan for the current and future needs of a country (Setel et al, 2018; Garenne, Collison & Kabudula, 2016). Therefore, if a state deems it necessary to develop, it should consider improving her birth registration systems, but unfortunately birth registration has received less attention in Ghana leading to improper planning (Fagernas & Odame, 2013).
Nearly half of the children under five in Ghana are still unregistered (UNICEF, 2013). Mothers are primary caregivers and responsible for the wellbeing of their children. Studies have shown that educated mothers take important decisions on behalf of their children (Cadwell & Cadwell, 1993). As such, higher level of education of mothers affect the roles mothers play in the lives of their children, likewise the birth registration status of a child (Frost, Forste & Haas, 2005). Therefore, this study seeks to examine the influence of maternal education on birth registration among children less than five years in Ghana.
Background
Birth of a child is a vital event among humans. The world’s population is increasing and as such, governing bodies need to make provisions to meet demands of the growing population, hence the necessity of birth registration (Jewkes &Wood, 1998). A child’s birth is documented in the civil register with authority from the government, providing the legal identity, hence enabling individuals exercise their human rights (Setel et al, 2007; Todres, 2003). The process of birth registration is a necessity for a nation and its indigenes because it offers statistical administrative purposes for a country and legal benefit to an individual. The statistics aids the country keep track of its own population figures, differentials and trends whereas the legal aspects acknowledge the existence of a child, establish family ties and track major life events from birth to death (UNICEF, 2005; Isara & Atimati, 2015; Musah, Abdulai, Dawuni & Abdul-Hanan, 2015; Kirby, 2015).
Birth registration differs across the globe (Bhatia, Ferreira, Barros & Victora, 2017). The child protection unit of the United Nations Children’s Fund reports 25 percent of all children under 5 years never get registered. In Sub-Saharan Africa, only 44 percent of children under 5 are registered whereas 98 percent of children under 5 are registered in Europe (UNICEF, 2013). In East Africa, in countries such as Ethiopia, and Tanzania, it is rare to possess a birth certificate. In West and Central Africa, about 63 percent of children under 5 are registered whilst Eastern and Southern Africa record the least in Africa with only about 47 percent of children under 5 registered (Bhatia et al, 2017).
In developing countries, there are obstacles that impede smooth operation of birth registration (Pais, 2009). Barriers to birth registration include distance from place of residence to nearest
registration facilities, lack of awareness of citizens on the benefits of birth registration, inadequate funding for publicity and outreaches, lack of logistics, and limited number of skilled personnel to register births (UNICEF, 2005; Jewkes & Wood, 1998; Owusu-Agyei et al, 2012). Fees for registering a birth or obtaining a birth certificate can be excessively expensive for some people (UNICEF, 2005). These barriers can be categorized into direct costs and indirect costs. Accessibility is an example of indirect costs which affect the poor tremendously. This affects most rural folks because they are poor (Fagernas & Odame, 2013). Thus, a higher proportion of urban dwellers register their births compared to rural folks (Amo-Adjei & Annim, 2015).
Also, social and cultural factors influence birth registration, likewise the cost involved in registration (AbouZhar et al, 2015; Chereni, 2017). Traditional customs and practices might not encourage or emphasize formal birth registration processes. Customs such as naming ceremonies in African settings are sources of delayed birth registration and sometimes eventually non- registration (UNICEF, 2005). This occurs because in African settings, depending on the ethnic group, there are specific rites as part of the naming ceremony which takes some time. For example, in North Central Namibia, the grandfather of the child is supposed to name a child. If the child’s grandfather is not available, the family deliberates how to handle the issue (MHAI, 2014). Another challenge in registering births in some communities in Africa is due to the superstition that when people are counted, they experience untold frequent death rates. In the traditional Akan enclaves of Ghana such as Denkyira, Fantes and Wassa, cobs of corns are used to represent people when there is an inevitable need to say the number of children in a family (Baidoo, 2012).
Furthermore, certain institutional procedures and processes do not allow children without the father’s involvement or identification cards to register (Amo-Adjei & Annim, 2015). Mothers have
to wait for their husbands before children are registered, which contributes to delays in birth registration. In cases of doubtful paternity of children, it becomes difficult to register children in countries such as Namibia because of the laid down procedures. As a result, some mothers shy away and do not register their children at all (Todres, 2003; MHAI, 2010). Also, birth registration is cost-free within the first year of birth of a child in Ghana. After a year, birth registration is referred to as late and penalties are charged, preventing the less privileged people from registering (UNICEF, 2013).
Birth registration systems have progressed in developed countries whilst in developing countries they are lagging behind. UNICEF financially and technically supported the registration of almost 30million children through programming in 75 developing countries (UNICEF, 2005). Through UNICEF’s efforts to integrate birth registration into the reproductive and health service in the Gambia, birth registration increased from 64 percent to 71 percent within a year in 2008 (Muzzi, 2010; UNICEF, 2008). In Latin America, having a birth certificate improves a child’s life by providing access to healthcare. Although a birth certificate does not guarantee protection, it can help protect children from exploitation and in cases involving family ties (UNICEF, 2005; Brito, Corbacho & Osorio, 2013; Kirby, 2015).
The educational process transmits knowledge. It enables mothers understand causes and remedies of socioeconomic issues including birth registration. Education helps mothers change attitudes concerning traditional beliefs and practices. As such, educated women do not take these beliefs into consideration when making decisions which affect the outcome of their children (Frost, Forte & Hass, 2005). Education offers exposure to people, giving them the opportunity to be in social
groups, bringing about awareness to seek social services for their children like birth registration (Amo-Adjei & Annim, 2015).
Also, mothers with higher levels of formal education tend to have increased decision-making power within the family, compared to mothers with no education or low-level education (Frost et al,2005 Andrabi, Das & Khwaja, 2012). Education influences the socio-economic status of women, since most educated mothers are likely to be gainfully employed (Dake & Fuseini, 2018). It increases mother’s ability to move around since they have greater control over economic resources (Mohanty & Gebremedhin, 2018). These qualities of educated mothers can help increase birth registration in Ghana.
Statement of the problem
In Ghana, about 50% of children under five are still unregistered, rendering them stateless and invisible (UNICEF, 2013; Kidane, 2014; Setel, 2007). The low levels of birth registration are due to factors such as lack of awareness and funds (Pais, 2009; UNICEF, 2005). Apart from these factors, social and structural conditions in households often hinder smooth registration of births (AbouZhar et al, 2015). Birth registration if not obtained for a child does not only deny the child legal identity and existence, but stops the child from accessing basic fundamental human rights (Todres, 2003). For instance, children lacking birth certificates are in danger of lifetime marginalization from access to education, health services and conditional cash transfer bonuses in some countries (Ball, Butt & Beazley, 2017).
In addition, they may be refused civil rights such as adoption, inheritance and may be exposed to abuse and human trafficking. Lack of birth registration renders efforts to prevent child labour
useless. As a result, this contributes to conscription and ineligible young girls coerced into marriage without proof of age (UNICEF, 2013). Nevertheless, these dreadful possible consequences, the associations between the dearth of birth registration, benefits and defenselessness have not been meticulously studied and practiced in Africa.
