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Disclaimer / Limitations
This country’s legal measures were reviewed by our legal staff in consultation with in-country lawyers and/or CRVS legal experts. All efforts were made to ensure the accuracy of the legal analysis, however, if you consider there to be any discrepancies or if there have been changes in the law of the country since our staff last updated the legal analysis, we welcome any additional information or insights. Please contact us via this form.
Role of the Health Sector
Bolivia
Responsive Image
Civil Registration System
National Civil Registration Agency
National Level Agency
Does the law designate a national level agency responsible for civil registration?
Yes. Servicio de Registro Cívico—SERECI (Civic Register System)
Recommended Practice based on International Guidelines
The law should clearly establish an agency with responsibility for managing the civil registration system. The structure of the civil registration system varies across countries. Some countreis have a centralized system (controlled at the central government level). Others have a decentralised system (controlled at the sub-national government level). Often, control of the system is shared between the national government and subnational governments. However, even in a fully decentralized system, there should be an agency at the national level to enforce minimum standards or to work cooperatively with decentralized jurisdictions and offices to ensure generally uniform practices and procedures.
Birth Registration
Declaration and Notification
Informants
Who is designated as the primary informant for births occurring in health facilities?
Either parent
Recommended Practice based on International Guidelines
The informant is the person who reports to the local registrar the occurrence of a vital event within the prescribed time limit. The law should establish, clearly and unequivocally, one person primarily responsible for providing the information needed for birth registration to the civil registrar. The head of the health facility should be the primary informant for live births occurring in a health facility. Alternative informants, in order of priority, are: mother, father, nearest relative of the mother, any adult having knowledge of the facts. Additionally, the legislation should explicitly state what type of facility is considered a “health facility” for purposes of being an informant.
Under Resolution No. 616 of December 29, 2004, the parents or legal guardian are designated as the primary informants for birth registration. In their absence, relatives up to the third degree of kinship may submit the registration application, and if no relatives are available, municipal, ecclesiastical, administrative, or judicial authorities may do so. The Resolution does not distinguish between births occurring inside or outside health facilities, nor does it assign a specific role to health personnel in the registration process.
Birth Registration
Declaration and Notification
Role of the Health Sector
What is the role of the health sector in birth registration for births occurring outside health facilities?
Unclear
Recommended Practice based on International Guidelines
For births that occur outside a health facility, the most effective approach is to designate the birth attendant - e.g., doctor, nurse, or midwife - as the informant. For births occurring outside a health facility without a birth attendant, an effective approach is to designate community health workers (including vaccination workers, nurses, doctors and other health professionals who see newborns for paediatric visits) as informants to register the birth of children that are unregistered and visited by them. Alternatively, some countries follow a two-step process, wherein the healthcare workers notify the birth to the civil registrar; however, the parent or other informant must still declare the birth to the civil registrar in order to register the birth.
Bolivian legal documents do not state what the role of the health facility, or its head (or their designees) is, in cases of births occurring outside of health facilities.
Law Source
What is the role of the health sector in birth registration for births occurring in health facilities?
None
Recommended Practice based on International Guidelines
For births occurring in health facilities, the most effective approach is to designate the head of the institution (or designee) as informant. Some countries follow a two-step process, in which the health sector notifies the registrar of the birth (providing some, but no all, needed information), but he parents must still declare the birth to the registrar in order for the birth to be registered. This two-step approach is considered less effective in ensuring high registration rates. In some countries, the health sector is neither informant nor notifier, but instead simply issues a document to the parent(s) that serves as proof of the birth. The health sectors limited role in this third option is not recommended practice. Finally in some countries, specified health staff may be designated as registrars or assigned some registrar functions, which helps bring registration closer to the people.
Bolivian legal documents do not designate the head of the health facility (or their designees) as informant.
Law Source
Death Registration
Declaration and Notification
Informants
Who is designated as the primary informant for natural deaths that occur in a health facility?
Unclear
Recommended Practice based on International Guidelines
The informant is the person who reports to the local registrar the occurrence of a vital event within the prescribed time limit. The law should establish, clearly and unequivocally, one person primarily responsible for providing the information needed for death registration to the civil registrar. The law may designate alternative informants and establish the order in which each of them must assume his or her responsibilities. For natural deaths occurring in health facilities, the head of the health facility or other health staff should be primary informant. Alternative informants, in order of priority, are: the nearest relative/next of kin or any adult with knowledge of the facts. Additionally, the legislation should explicitly state what type of facility is considered a “health facility” for purposes of being an informant.
The law does not clearly designate a single primary informant for deaths occurring in health facilities, as recommended by international guidelines. However, Article 48 of Supreme Decree No. 24247 of March 7, 1999, establishes that the Civil Registry Officer records the death upon presentation of the medical certificate attesting to the death, which implies that the physician is the person providing the information when the death occurs within a health facility. In places where no physician is available, the article states that the Civil Registry Officer must verify the death.
Death Registration
Declaration and Notification
Role of the Health Sector
What is the role of the health sector in death registration for natural deaths occurring outside health facilities?
Issuing evidence of death or other equivalent document
Recommended Practice based on International Guidelines
The health sector can play an important role in notifying vital events, such as deaths, that occur outside health facilities where health workers attend patients and their families in the community. Countries may designate medical officers or community health workers as informants for deaths that occur in the community. Or Alternatively, the health care worker may notify the civil registrar of the facts of death, but the nearest relative still needs to register declare the death to the civil registrar in for the death to be registered. Finally, in some countries health workers may only provide a document, such as a notice of death, to the nearest relative as official evidence of the death, which the informant submits when declaring the death.
Medical attendant is designated as the person to issue the medical certificate of the cause of death. If death occurs outside of health facilities, a doctor of the closest facility is designated to issue the certification
What is the role of the health sector in death registration for natural deaths occurring in health facilities?
Issuing of evidence of death, death record or equivalent document
Recommended Practice based on International Guidelines
When a death occurs in a healthcare facility,designating the head of the health facility as the informant, is the most effective way of ensuring that all deaths in health facilities are registered in a timely and accurate manner. In some countries the health facility performs a notification function, collecting relevant information about the death and passing it to the civil registrar. In that situation, the informant (usually the nearest relative) still needs to declare the death to the civil registrar in order for the death to be registered. When the health facility is the notifer, the health facility will usually be required to provide the family with some form of evidence or record of the death to be used by the informant for registration. In some countries, the health sector is neither informant nor notifier, but instead simply issues a document to the family that serves as proof of the death. Finally in some countries, specified health staff may be designated as registrars or assigned some registrar functions, which helps bring registration closer to the people.
For information on the role of health facilities in determining cause of death and completing medical certificates of cause of death, see the "Cause of Death" topic.
The doctor is required to issue a medical certificate of the cause of death when the patient dies from the illness for which he or she was being treated.
Stillbirth Reporting
Reporting System
Compulsory Coverage
Does the law mandate reporting of all stillbirths through the health sector?
Recommended Practice based on International Guidelines
Tracking stillbirths and other fetal deaths is important for statistical and public health planning. If stillbirths are tracked through the health sector, the law (or guidelines and SOPs) should require the health sector to report fetal deaths to the central health ministry. For in-facility stillbirths, reporting responsibility should fall on the head of the health facility or attending medical professional. For community stillbirths, reporting responsibility is place on the birth attendant, who may be required to report the ministry of health directly, or may report through a local health facility.
Our staff is undertaking analysis for this metric. Please check back later.
Law Source
Stillbirth Reporting
Reporting System
Role of the Health Sector
What is the role of the health sector in stillbirth registration?
Recommended Practice based on International Guidelines
UN guidelines provide that the head of the health facility is the preferred informant for stillbirths. Where the stillbirths are registered via the civil registration system this should be specified in the law. As with live births, some countries require the health sector to notify information about stillbirths even where the designated informant is the mother and/or father. Where the mother and/or father is the primary informant, the health sector would usually be required under the law to provide a notice of some sort as evidence of the stillbirth for the purposes of registration.
