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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
Colombia
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Civil Registration System
National Civil Registration Agency
National Level Agency
Does the law designate a national level agency responsible for civil registration?
Yes. National Civil Registry Office (Registraduría Nacional del Estado Civil, RNEC).
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.
The National Civil Registry Office (Registraduría Nacional del Estado Civil, RNEC) is the national authority responsible for civil registration, including birth and death registration. It is a constitutional body within the Electoral Organization (Organización Electoral) and is not under a ministry (it operates as an autonomous constitutional organ).
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.
Article 45 of Decree 1260 of 1970 provides a list of informants, without naming hierarchy of informants. The list for who should declare and request birth registration, is as follows: father, mother, other ascendant, closest elderly relatives, director or administrator of the public or private establishment in which birth occurred, the person who has picked up the abandoned newborn, the director or administrator of the establishment that has taken charge of the newborn child, or an interested party over eighteen years of age.
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?
Issuing evidence of birth
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.
For births that occur outside health facilities but under medical supervision, Article 49 of Decree 1260 of 1970 states that the certificate from the doctor or nurse that assisted in the mother during labor, will be used as confirmation of the birth by civil status register the official. In the absence of a certificate, the birth will be confirmed by an affidavit of two competent witnesses.
What is the role of the health sector in birth registration for births occurring in health facilities?
Informant
,
Issuing evidence of birth
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.
Article 49 of Decree 1260 of 1970 states that the certificate from the doctor or nurse that assisted in the mother during labor, will be used as confirmation of the birth by civil status register the official. In the absence of a certificate, the birth will be confirmed by an affidavit of two competent witnesses.
Death Registration
Declaration and Notification
Informants
Who is designated as the primary informant for natural deaths that occur in a health facility?
Nearest relative
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.
Decree 1260 of 1970, Article 74 designates the following informants for deaths: the surviving spouse, closest relatives, people living in the place where the death occurred, the doctor who attended the deceased in their last illness, and the funeral home. When the death takes place in an institution—listed in the Article as including barracks, convents, hospitals, clinics, asylums, jails, and other public or private establishments—the director or administrator of that institution is also required to report it. The decree does not define “health facility,” but hospitals and clinics appear explicitly within this list of institutions. Article 74 does not establish any hierarchy among the informants; all persons listed are equally entitled and obligated to report 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?
Providing Medical Certificate of Cause of Death
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.
For deaths occurring outside health facilities, Decree 1260 of 1970, Article 76 assigns the health sector the same role as in all other settings: a medical doctor must issue the medical certificate of cause of death, which is required for the civil status registrar to complete the death registration. The certificate must be issued free of charge by the doctor who attended the deceased in their last illness; if unavailable, it must be issued by a forensic doctor, then a public health doctor, and, if none are present, by any doctor working in the area or holding an official medical post. Only if no doctor is available may two competent witnesses confirm the death. Aside from issuing the medical certificate of cause of death, the law does not assign health-sector workers a role in reporting or registering deaths that occur outside health facilities.
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.
Decree 1260 of 1970, Article 76 assigns the health sector a central role in confirming deaths that occur in health facilities. A medical doctor must issue the medical certificate of cause of death that allows the civil status registrar to complete the death registration. The certificate must be provided free of charge by the doctor who attended the deceased in their last illness; if unavailable, it must be issued by a forensic doctor, then a public health doctor, and, if none are present, by any doctor working in the area or holding an official medical post. Only when no doctor is available may two competent witnesses confirm the death. Other than issuing the medical certificate of cause of death, the law does not assign health sector workers a role in reporting or completing the death registration.
Stillbirth Reporting
Reporting System
Compulsory Coverage
Does the law mandate reporting of all stillbirths through the health sector?
Mandatory
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.
Colombian law mandates reporting of all stillbirths through the health sector by requiring medical certification of every fetal death. Law 9 of 1979 (Arts. 523 and 525) requires the Fetal Death Certificate to be completed by the attending physician (or the physician performing an autopsy), except in cases of force majeure. Joint External Circular 0037 of 2015 confirms that fetal deaths must always be medically certified, for health and demographic statistics, and are not part of civil registration. This obligation applies to both in-facility and community stillbirths, using standardized national forms.
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.
