nly Egypt, South Africa, Tunisia, Algeria, Cape Verde, São Tomé and Príncipe, Seychelles and Mauritius that have what are called functioning, compulsory and universal civil registration systems - known as CRVS systems - which record deaths. In 14 countries a maximum of only one in 10 deaths are recorded, including in Nigeria, the Democratic Republic of Congo and Cameroon. The Central African Republic (CAR) has one of the lowest performing CRVS systems on the continent following years of conflict, which is still ongoing. In 2017 only 2% of estimated deaths were registered in the country. Over half of the countries in sub-Saharan Africa only keep handwritten death records. Certain states, such as Eritrea and Burundi, have no legal requirement to register or collate deaths at all.
"CRVS systems remain dysfunctional, forcing governments to rely on surveys... which by the time they are published are already outdated," says Irina Dincu, from the Centre of Excellence for CRVS systems.
In the wake of the Ebola epidemic, and now Covid-19, having an accurate picture of who is dying, from what and where, is crucial when it comes to allocating resources. This also has implications for tracking maternal and child mortality as there are children whose birth and untimely death go unrecorded. It also means that lessons are not learnt.
"In order to help the living, we need to count the dead," UN Population Fund demographer Romesh Silva explained. Those who are missed out on the registers are often the poorest and socially excluded, he adds, and the absence of information about their deaths means that measures to deal with the causes are sometimes not taken.
Calculating a key indicator of the pandemic's fallout - known as "excess deaths" - is impossible in most countries because of the lack of CRVS systems.