Birth registration, health and human rights in Tanzania: Parents' perspectives on barriers and benefits

Birth registration is a basic human right, established by the International Covenant on Civil and Political Rights in 1966, and the Convention on the Rights of the Child in 1990. However, nearly half of children born in the developing world are not registered. In Tanzania today only sixteen percent of children have birth certificates. Why is birth registration beneficial? A birth certificate provides legal proof of age and identity, and may assist in accessing health and education services, claiming inheritance rights, or seeking protection from human rights abuses such as child labor and child marriage. Birth registration is also an important source of data which can be used to plan and improve health, education, and social services. Why are rates of birth registration in Tanzania so low, and what can be done to improve the situation? This study investigates the medical, social, cultural, political, and economic dimensions of birth registration using data from surveys of parents in more than 150 households in the city of Dar es Salaam. Analysis of ethnographic and quantitative data finds that the majority of parents are aware of the benefits of birth registration and consider it an important right for children. However, parents face many barriers to obtaining birth certificates, including high fees, confusing government bureaucracy, long travel and waiting times, and immediate competing needs for scarce household resources. A proposed policy to make nurses responsible for birth registration could improve rates substantially, but also poses significant problems for an already overburdened public health system.