placestats

Birth registration vs. Skilled birth attendance

Holds up after adjusting for income

Across 156 countries, Birth registration and Skilled birth attendance rise and fall together at r = +0.78 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to +0.58 (q = 0.012, allowing for the many pairs tested). Much of the first figure is that both measures rise with national income, but a moderate positive link remains.

Comparing countries across the middle half of skilled birth attendance, 84% to 99.6% of births, birth registration is better by 17.2% of children under 5 at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 13.1% of children under 5.

Link before adjusting (r)+0.775p = 1.5e-32 · 156 countries
After adjusting for national income+0.585p = 1.4e-15 · likely range [+0.47, +0.68]
p, allowing for regions5.2e-5standard error 0.057 · 7 regions
Check for luck (q)0.012across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Birth registration · % of children under 5link with income +0.87 · proxy
Skilled birth attendance · % of birthslink with income +0.69 · high

Both of these rise and fall closely with national income, so a strong link between them before adjusting was close to certain. Read the adjusted figure, not the first one.

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Birth registration · % of children under 5 →Skilled birth attendance · % of births →2.7%100%31.9%100%Afghanistan: 42.3% of children under 5, 61.8% of birthsAngola: 25% of children under 5, 49.6% of birthsAlbania: 98.4% of children under 5, 99.8% of birthsAndorra: 100% of children under 5, 100% of birthsUnited Arab Emirates: 100% of children under 5, 99.2% of birthsArgentina: 99.7% of children under 5, 98.8% of birthsArmenia: 99.3% of children under 5, 99.8% of birthsAustralia: 100% of children under 5, 96% of birthsAustria: 100% of children under 5, 98.1% of birthsBurundi: 83.5% of children under 5, 76.5% of birthsBenin: 85.6% of children under 5, 78.1% of birthsBurkina Faso: 76.9% of children under 5, 79.8% of birthsBangladesh: 56% of children under 5, 59% of birthsBulgaria: 100% of children under 5, 94.5% of birthsBahrain: 100% of children under 5, 99.6% of birthsBelarus: 100% of children under 5, 99.9% of birthsBelize: 95.7% of children under 5, 94.6% of birthsBolivia: 91.9% of children under 5, 81.1% of birthsBrazil: 96.4% of children under 5, 98.4% of birthsBarbados: 98.7% of children under 5, 98.4% of birthsBrunei Darussalam: 99.9% of children under 5, 99.6% of birthsBhutan: 99.9% of children under 5, 98.9% of birthsBotswana: 87.5% of children under 5, 99.8% of birthsCentral African Republic: 44.8% of children under 5, 40.3% of birthsCanada: 100% of children under 5, 98% of birthsChile: 99.4% of children under 5, 99.8% of birthsCote d'Ivoire: 71.7% of children under 5, 84% of birthsCameroon: 61.9% of children under 5, 69% of birthsCongo, Dem. Rep.: 40.1% of children under 5, 85.2% of birthsCongo, Rep.: 95.9% of children under 5, 91.2% of birthsColombia: 96.8% of children under 5, 98.8% of birthsComoros: 87.3% of children under 5, 82.2% of birthsCabo Verde: 91.4% of children under 5, 97.3% of birthsCosta Rica: 99.6% of children under 5, 99% of birthsCyprus: 100% of children under 5, 99.3% of birthsCzechia: 100% of children under 5, 99.8% of birthsGermany: 100% of children under 5, 96.2% of birthsDenmark: 100% of children under 5, 95.3% of birthsDominican Republic: 92.2% of children under 5, 99.2% of birthsAlgeria: 99.6% of children under 5, 98.8% of birthsEcuador: 87.2% of children under 5, 99.4% of birthsEgypt, Arab Rep.: 99.4% of children under 5, 97.1% of birthsSpain: 100% of children under 5, 99.9% of birthsEstonia: 100% of children under 5, 99.6% of birthsEthiopia: 2.7% of children under 5, 49.8% of birthsFinland: 100% of children under 5, 99.5% of birthsFiji: 86.6% of children under 5, 99.8% of birthsFrance: 100% of children under 5, 98.2% of birthsGabon: 89.6% of children under 5, 89.3% of birthsGeorgia: 98.5% of children under 5, 99.8% of birthsGhana: 70.6% of children under 5, 78.9% of birthsGuinea: 62% of children under 5, 55.3% of birthsGambia, The: 59% of children under 5, 83.8% of birthsGuinea-Bissau: 46% of children under 5, 53.8% of birthsEquatorial Guinea: 53.5% of children under 5, 68.3% of birthsGreece: 100% of children under 5, 99.9% of birthsGuatemala: 96.4% of children under 5, 69.6% of birthsGuyana: 98.1% of children under 5, 97.6% of birthsHonduras: 97% of children under 5, 94.1% of birthsCroatia: 100% of children under 5, 99.9% of birthsHaiti: 84.8% of children under 5, 41.6% of birthsHungary: 100% of children under 5, 99.7% of birthsIndonesia: 77% of children under 5, 94.7% of birthsIndia: 89.1% of children under 5, 89.4% of birthsIreland: 100% of children under 5, 99.7% of birthsIran, Islamic Rep.: 98.6% of children under 5, 99% of birthsIraq: 98.8% of children under 5, 95.6% of birthsIceland: 100% of children under 5, 97.4% of birthsItaly: 100% of children under 5, 99.8% of birthsJamaica: 98% of children under 5, 99.7% of birthsJordan: 98% of children under 5, 99.7% of birthsJapan: 100% of children under 5, 99.8% of birthsKazakhstan: 99.7% of children under 5, 99.9% of birthsKenya: 66.9% of children under 5, 70.2% of birthsKyrgyz Republic: 98.9% of children under 5, 100% of birthsCambodia: 73.3% of children under 5, 98.7% of birthsKiribati: 91.6% of children under 5, 91.9% of birthsLao PDR: 73% of children under 5, 64.4% of birthsLiberia: 66.3% of children under 5, 84.4% of birthsSt. Lucia: 92% of children under 5, 100% of birthsLesotho: 44.5% of children under 5, 86.6% of birthsLithuania: 100% of children under 5, 100% of birthsLatvia: 100% of children under 5, 99.9% of birthsMorocco: 96.9% of children under 5, 86.6% of birthsMoldova: 99.6% of children under 5, 99.6% of birthsMadagascar: 73.8% of children under 5, 45.8% of birthsMaldives: 98.8% of children under 5, 99.5% of birthsMexico: 97% of children under 5, 96.6% of birthsMarshall Islands: 83.8% of children under 5, 92.4% of birthsNorth Macedonia: 99.8% of children under 5, 100% of birthsMali: 86.7% of children under 5, 67.3% of birthsMalta: 100% of children under 5, 99.8% of birthsMyanmar: 81.3% of children under 5, 60.2% of birthsMontenegro: 99.4% of children under 5, 98.8% of birthsMongolia: 99.6% of children under 5, 99.3% of birthsMozambique: 55% of children under 5, 73% of birthsMauritania: 44.8% of children under 5, 70.4% of birthsMalawi: 67.2% of children under 5, 96.4% of birthsNamibia: 78.1% of children under 5, 88.2% of birthsNiger: 63.9% of children under 5, 43.7% of birthsNigeria: 42.6% of children under 5, 50.7% of birthsNicaragua: 84.7% of children under 5, 94.1% of birthsNorway: 100% of children under 5, 99.2% of birthsNepal: 77.2% of children under 5, 77.2% of birthsNew Zealand: 100% of children under 5, 96.5% of birthsOman: 100% of children under 5, 99.9% of birthsPakistan: 42.2% of children under 5, 68% of birthsPanama: 96.7% of children under 5, 95% of birthsPeru: 96.4% of children under 5, 94.9% of birthsPhilippines: 91.8% of children under 5, 84.4% of birthsPapua New Guinea: 13.4% of children under 5, 56.4% of birthsPoland: 100% of children under 5, 99.6% of birthsPortugal: 100% of children under 5, 98.6% of birthsParaguay: 71% of children under 5, 92.2% of birthsWest Bank and Gaza: 99.2% of children under 5, 99.7% of birthsQatar: 100% of children under 5, 100% of birthsRomania: 100% of children under 5, 93% of birthsRussian Federation: 100% of children under 5, 99.6% of birthsRwanda: 85.6% of children under 5, 94.2% of birthsSaudi Arabia: 99.2% of children under 5, 94.8% of birthsSudan: 67.3% of children under 5, 77.7% of birthsSenegal: 78.7% of children under 5, 74.5% of birthsSingapore: 99.9% of children under 5, 99.6% of birthsSolomon Islands: 88% of children under 5, 86.2% of birthsSierra Leone: 90.4% of children under 5, 86.9% of birthsEl Salvador: 91.2% of children under 5, 99.9% of birthsSomalia, Fed. Rep.: 5.9% of children under 5, 31.9% of birthsSerbia: 99.9% of children under 5, 99.9% of birthsSao Tome and Principe: 98.6% of children under 5, 96.8% of birthsSuriname: 98.3% of children under 5, 98.4% of birthsSlovak Republic: 100% of children under 5, 98% of birthsSlovenia: 100% of children under 5, 99.8% of birthsEswatini: 53.5% of children under 5, 88.3% of birthsTurks and Caicos Islands: 99.2% of children under 5, 100% of birthsChad: 25.7% of children under 5, 47.2% of birthsTogo: 82.9% of children under 5, 69.4% of birthsThailand: 99.8% of children under 5, 99.1% of birthsTajikistan: 95.8% of children under 5, 94.8% of birthsTurkmenistan: 99.9% of children under 5, 100% of birthsTimor-Leste: 60.4% of children under 5, 56.7% of birthsTonga: 97.7% of children under 5, 98.3% of birthsTrinidad and Tobago: 96.5% of children under 5, 100% of birthsTunisia: 99.9% of children under 5, 99.5% of birthsTurkiye: 98.4% of children under 5, 97% of birthsTuvalu: 87.2% of children under 5, 99.5% of birthsTanzania: 26.4% of children under 5, 63.5% of birthsUganda: 32.2% of children under 5, 74.2% of birthsUkraine: 99.8% of children under 5, 99.9% of birthsUruguay: 99.8% of children under 5, 100% of birthsUnited States: 100% of children under 5, 99.1% of birthsViet Nam: 96.1% of children under 5, 96.1% of birthsVanuatu: 43.4% of children under 5, 89.4% of birthsSamoa: 66.9% of children under 5, 88.9% of birthsSouth Africa: 88.6% of children under 5, 96.7% of birthsZambia: 14% of children under 5, 80.4% of birthsZimbabwe: 48.7% of children under 5, 86% of birthsANDCODETHHTILTUMDGNERQATSOMTCDVUTZMB

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted+0.7751.5e-32156
By rank (Spearman), not adjusted+0.7652.8e-31156
Standard (Pearson), adjusted for national income+0.5851.4e-15156
By rank (Spearman), adjusted for national income+0.4253.7e-8156

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 156 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.191 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from +0.558 (without AGO) to +0.626 (without HTI). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: HTI (+0.041).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific23+0.53
Europe & Central Asia40+0.34
Latin America & Caribbean26+0.07
Middle East, North Africa, Afghanistan & Pakistan16+0.94
Sub-Saharan Africa44+0.56

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third52+0.49
Middle third52+0.73
Richest third52+0.21

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians98+0.48
Muslims40+0.83

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France22+0.44
Never a European colony17+0.95
Spain19+0.46
United Kingdom49+0.70

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = +0.455 after dropping 21 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 0years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

Not enough history inside each country to look at this over time. That needs countries measured for several years in a row, and at least one of these measures is measured too rarely.

The data


% of children under 5
% of births		Years
United States USA100%99.1%2022, 2020
Slovenia SVN100%99.8%2022, 2012
Slovak Republic SVK100%98%2020, 2021
Russian Federation RUS100%99.6%2022, 2020
Romania ROU100%93%2020
Qatar QAT100%100%2020, 2019
Portugal PRT100%98.6%2020
Poland POL100%99.6%2017, 2021
Oman OMN100%99.9%2018, 2020
New Zealand NZL100%96.5%2022, 2019
Norway NOR100%99.2%2022, 2021
Malta MLT100%99.8%2022, 2021
Latvia LVA100%99.9%2022, 2017
Lithuania LTU100%100%2020, 2021
Japan JPN100%99.8%2022, 2021

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Birth registration

Completeness of birth registration (%)

UNICEF · CC BY 4.0 · updated quarterly

A measure of how far the state reaches: whether it knows a child exists. Based on surveys and sparse. It is near 100 across the rich world, so all the variation is at the other end.

Skilled birth attendance

Births attended by skilled health staff (% of total)

UNICEF and WHO · CC BY 4.0 · updated quarterly

Based on surveys, so a country reports it every few years rather than yearly.

How this was computed

Data used: most recent value in 2010-2025; values come from 2010–2022. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Birth registration and Skilled birth attendance

This page shows that two measures go together. It does not show that Birth registration changes Skilled birth attendance, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Birth registration or Skilled birth attendance