Newborns Get Birth Certificates Thanks to Inspired Leadership in Cote d’Ivoire

 {Cloteni Coulibaly/MSH}Dr. Fougnique Tuho, Head Doctor, Kaniasso Health CenterCloteni Coulibaly/MSH

"In 2010, I was shocked to meet a child whose whole future was at risk, just for lack of a birth certificate," said Dr. Fougnique Tuho, head doctor of Kaniasso Health Center in northern Côte d'Ivoire. "Without this piece of paper, a child could not even take the entrance examination for sixth grade."

At the time, Tuho thought this was 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, according to the 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, Tuho participated in a Leadership Development Plus (LDP+) program as part of the USAID-funded and MSH-led Leadership, Management and Governance Project in Côte d'Ivoire. Tuho 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 would receive a birth certificate," he said.

When he returned to his health center, Tuho 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 being 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, mothers who come to the center for prenatal care simply present a birth certificate or other identification papers for herself and her spouse—plus a fee of around $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 her baby and her child's birth certificate.

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

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