In Tanzania, a health facility serves as the first point of contact for vaccination and birth notification while the Registration, Insolvency and Trusteeship Agency (RITA) is mandated for birth registration and provision of birth certificates. At health facilities, newborns are provided with a child health card and notification card that instructs parents to process the birth certificate at RITA offices, which are decentralized at the district level.

In 2015, birth certificates’ coverage for children under 5 years was under 50 percent, according to RITA, compared to birth notification provided at health facilities. This low coverage of birth certificates was due to several factors, including delays of parents in visiting RITA offices, loss of birth notification cards in the first 90 days, limited awareness of birth certificates, and inadequate tracking of records.

These factors motivated the Ministry of Health (MOH), through the Immunization and Vaccine Development (IVD) Program and RITA, to initiate the registration of births and provision of birth certificates be conducted concurrently at health facilities. This intended to improve immunization service delivery as well as birth registration and coverage of birth certificates in the country.

Since the launch of this initiative in June 2015, the number of registrations of children under 5 years old increased from 13 percent in 2012 to 65 percent in 2021.

In this document we describe the process of integrating the electronic Tanzania Immunization Registry (TImR) and the Under 5 Birth Registration System to improve birth registration coverage. We also share lessons learned on the integration process of the two systems.