A Birthday Gift

  • Published Date: January 2017
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“In 2010, I was shocked to meet a child whose whole future was at risk—just for lack of a birth certificate,” says Dr. Fougnique Tuho, Head Doctor of Kaniasso Health Center in northern Côte d’Ivoire. “Without this piece of paper, he could not even take the entrance examination for sixth grade.”

At the time, Dr. Tuho thought this is an isolated case. Then he discovered that lack of birth registration has affected many lives in Côte d’Ivoire. Today, more than 1.3 million children under five lack birth certificates, as do 1.5 million between ages 5 and 17 years, according to Government of Côte d’Ivoire and UNICEF figures. Children born in rural areas—whether at home or in a health center--are least likely to be registered.

In late 2015, Dr. Tuho participated in a Leadership Development Plus (LDP+) program as part of the USAID-funded Leadership, Management, and Governance (LMG) Project in Côte d’Ivoire. He joined one of the four Improvement Teams in his region of Kabadougou-Bafing-Folon. They aimed to ensure that pregnant women attended all four recommended prenatal visits. Then something clicked. “During one of the LDP+ training exercises, we were asked to dream and then establish a common vision. My dream was that every child born receive a birth certificate.”

When he returned to his health center, he put into action what he had learned: mobilizing colleagues, educating community groups, and persuading government officials not only about prenatal visits but also about birth registration. He rallied official support for his vision of every child officially registered, and worked with local officials to make it happen.

The team’s results were dramatic: within three months, more than 40 percent of pregnant women were attending their fourth prenatal visit. In addition, more than 20 children had been born at the center—and each one was officially registered. As of January 2016, all of the women who come to the center for prenatal care simply present birth certificates or other identification papers for themselves and their spouse, plus about $1.75. The health center records the information along with the baby’s birth. Three days later, when the mother leaves the center, she carries both baby and birth certificate.

Through the LDP+, health workers are developing the skills and attitudes not only to improve health—but to advance civil society as well.