title: Understanding whose births get registered: a cross sectional study in Bauchi and Cross River states, Nigeria.
abstract: BACKGROUND
  It is a recognized child right to acquire a name and a nationality, and birth registration may be necessary to allow access to services, but the level of birth registration is low in Nigeria. A household survey about management of childhood illnesses provided an opportunity to examine actionable determinants of birth registration of children in Bauchi and Cross River states of Nigeria.
  
  
  METHODS
  Trained field teams visited households in a stratified random cluster sample of 90 enumeration areas in each state. They administered a questionnaire to women 14-49 years old which included questions about birth registration of their children 0-47 months old and about socio-economic and other factors potentially related to birth registration, including education of the parents, poverty (food sufficiency), marital status of the mother, maternal antenatal care and place of delivery of the last pregnancy. Bivariate then multivariate analysis examined associations with birth registration. Facilitators later conducted separate male and female focus group discussions in the same 90 communities in each state, discussing the reasons for the findings about levels of birth registration.
  
  
  RESULTS
  Nearly half (45%) of 8602 children in Cross River State and only a fifth (19%) of 9837 in Bauchi State had birth certificates (seen or unseen). In both states, children whose mothers attended antenatal care and who delivered in a government health facility in their last pregnancy were more likely to have a birth certificate, as were children of more educated parents, from less poor households, and from urban communities. Focus group discussions revealed that many people did not know about birth certificates or where to get them, and parents were discouraged from getting birth certificates because of the unofficial payments involved.
  
  
  CONCLUSIONS
  There are low levels of birth registration in Bauchi and Cross River states, particularly among disadvantaged households. As a result of this study, both states have planned interventions to increase birth registration, including closer collaboration between the National Population Commissions and state health services.
authors: CIET Trust, 71 Oxford Road, 2196, Johannesburg, Saxonwold, South Africa. atamadi26@gmail.com.
authors: Atam E
authors: AE
authors: Adi
authors: CIET Trust, 71 Oxford Road, 2196, Johannesburg, Saxonwold, South Africa. tukurabdu@gmail.com.
authors: Tukur
authors: T
authors: Abdu
authors: CIET Trust, 71 Oxford Road, 2196, Johannesburg, Saxonwold, South Africa. akhan@ciet.org.|Institute of Geography and urban regional planning, University of Peshawar, Peshawar, Pakistan. akhan@ciet.org.
authors: Amir
authors: A
authors: Khan
authors: Director of Vital Statistics, National Population Commission, Bauchi, Bauchi State, Nigeria. musaharuna14@yahoo.com.
authors: Musa Haruna
authors: MH
authors: Rashid
authors: Head of Department Vital Statistics, National population Commission, Calabar, Cross River State, Nigeria. ubieniebri@yahoo.com.
authors: Ubi E
authors: UE
authors: Ebri
authors: CIET Trust Botswana, PO Box 1240, Gaborone, Botswana. acockcroft@ciet.org.|CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Canada. acockcroft@ciet.org.
authors: Anne
authors: A
authors: Cockcroft
authors: CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Canada. andersson@ciet.org.
authors: Neil
authors: N
authors: Andersson
mesh_terms: D000293:Adolescent; D000328:Adult; D001719:Birth Certificates; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D009549:Nigeria; D036801:Parturition; D011181:Postnatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D012042:Registries / Q000941:ethics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires