By Dr Tari Turner
Even before my son had a name, he had been measured. In his first hour of life, straight after he had been briefly cuddled and stared at in awe, his wrinkled body was stretched out to determine his length and then as he resumed the familiar foetal position, he was weighed in all his naked glory.
Over the next few (thankfully blurry) months, Oscar was at first daily, then weekly and monthly, weighed and measured. His growth was tracked against population norms, his development coded and his every achievement recorded in a little blue book.
Long before Oscar could count, he had been counted.
The process was so straightforward that even in my new-mama sleep-deprived state, I could manage it. It just happened. The simplicity of the process however, shouldn’t mislead us into underestimating its impact.
Those basic steps of recording Oscar’s birth and measuring his development have been fundamental to his health and wellbeing. Because Oscar’s birth was recorded, a maternal child health nurse visited us when we got home from hospital, checked that he was fine and that we were coping (just!). Oscar’s birth registration also meant that when we attended the council immunisation sessions, the vaccines he needed were there; when Oscar was ready for pre-school, a space was available; when he was unwell, we could visit a doctor; when my work took me overseas, we could get Oscar a passport and travel as a family.
Sadly, this basic system which we take for granted in most of Australia, simply does not exist in many areas of the world. In 2011, the year Oscar was born, only one third of the world’s children had their births registered as more than 100 countries did not have a system to register births and deaths, let alone one that might provide reliable information about causes of death.
A new report, Uncounted and Unreached by World Vision sheds light on the implications for these uncounted children. It is no surprise that the countries where children are most at risk of death and disease are also the countries in which children are least likely to have their births registered. Just as predictably, the likelihood of birth registration is even lower for children in areas of conflict, for remote indigenous populations, for refugee children, for children whose mothers die in childbirth and for children with disabilities – in short the children in greatest need.
As a consequence, we are in the dark about the lives and, sadly, the deaths, of millions of the world’s most vulnerable children. We do not know that they were born, whether or when they died, and we don’t know what led to their deaths.
Without this basic information, governments and other organisations cannot plan and provide the health and education systems that might have allowed these children to lead healthy, full lives.
While establishing a birth registration system sounds simple, getting such a system to work effectively on the ground can be incredibly complex, needing a serious investment of time, resources and thought.
In my work as World Vision’s Senior Health Advisor, working with communities has proven to be the key. Recording births among the more than one billion people now living in urban slums, or in transient refugee camps, or in nomadic tribes is a challenge – but it can be done.
World Vision works with communities to advocate for and invest in systems that empower communities to ensure every child is counted, so governments might be held accountable for providing the health services that communities require. Our vision is for a world where every child is counted, seen and heard.
To make sure every child counts, let’s keep talking about the millions of preventable child deaths that occur every year. Let’s challenge our politicians and leaders to stand up and be champions who help to put an end to child and maternal deaths and encourage governments and organisations to invest in information systems that count all children, even those who are hard to reach.
This Mother’s Day you can help make sure that all children are counted, because every child counts.
Dr Tari Turner is the Senior Health Advisor at World Vision Australia and mum to three year old Oscar.