Birth Reporting Background and Development
1. Birth Registration System under the Household Registration Act
The household registration system can be traced back to the era of Japanese occupation (1895-1945). Marriages, divorces, births, deaths, adoptions and address changes had to be registered with the household registration office. The purposes of this system were to allow the government to obtain complete demographic data and to protect the rights of citizens.
The Household Registration Act of the Republic of China (ROC) was formulated in 1931, but did not take effect until 1946 in Taiwan. It prescribed that a birth certificate is to be issued by the physician or midwife after delivery. The newborn’s parent is to bring the birth certificate to the local household registration office for birth registration within 15 days of the birth (extended to 60 days when the Household Registration Act was amended in 2008). Failure to do so could result in a fine.
2. Origin of Birth Reporting
Health care of women and children in the ROC was promoted through local health departments that provided health care services based on information regarding newborns obtained from the household registration office. However, as birth registration was often delayed, services such as vaccination, postnatal health care and birth control were not delivered in a timely manner. If an infant died before his/her birth was registered, the parents were often reluctant to register the birth and death, making it difficult to obtain accurate statistics on infant births and deaths.
To obtain accurate and comprehensive information regarding population dynamics in a timely manner, to raise the effectiveness of women’s and children’s health care, and to enhance accuracy of birth-related data, such as mortality rate at various times during pregnancy and mortality rates of newborns and infants, the Ministry of Health and Welfare (MOHW) and its predecessor agency, Department of Health (DOH), Executive Yuan, launched a birth reporting system in 1992. This system called for birthing facilities to spontaneously report new births and stillbirths. This system was first tested in Yilan County, Taichung County and Nantou County.
3. Implementation of the Birth Reporting System
The Child Welfare Act was amended and promulgated on February 5, 1993. It stipulates that “The person who delivers the baby shall communicate the birth information with household and health authorities within ten days of the childbirth.”
To fully carry out the birth reporting policy, the former DOH prescribed the “birth reporting processing plan”. After a number of discussions with the Ministry of Interior (MOI), the Child Welfare Act authority, the MOI finalized and promulgated the “birth reporting procedures” on September 13, 1994. On December 28 of the same year, the former DOH promulgated the newly amended “birth certificate” and “stillbirth certificate”. In March 1995, the paper-form reporting procedures were implemented and remain in effect to now.
On May 28, 2003, The Child Welfare Act and The Youth Welfare Act were consolidated into The Child and Youth Welfare Act. Article 13 of the act stipulates that “The person who delivers the baby shall communicate the birth information with household and health authorities within seven days of the childbirth.” Then the law amended to The Protection of Children and Youths Welfare and Rights Act on November 30, 2011. Article 14 of the act stipulates that “The identified person will report to the health authority the relevant birth information seven days after the delivery of the baby. If it was stillborn, the same applies.” For those who were not delivered in hospitals, clinics or midwifery clinics, and cannot obtain a birth certificate, a DNA report identifying the parent-child relationship issued by a medical facility or a “birth report form” issued by a certified medical professional shall be presented to register a birth.
4. Current Differences between Birth Reporting and Birth Registration
According to The Protection of Children and Youths Welfare and Rights Act, the identified person will report to the health authority the relevant birth information seven days after the delivery of the baby. If it was stillborn, the same applies. If the person who delivers the baby cannot report the birth without complete information, he/she will repost as mentioned above. The relevant health authority will forward the birth report as mentioned in Paragraph 1 of this Article to the household and registration authority to handle it in accordance with the relevant regulations. The mother of the newborn or her spouse can use the birth certificate to register the birth with the household registration office. Differences between birth reporting and birth registration are detailed in Table 1.
Table 1. Current Comparison of Birth Registration and Birth Reporting
1. Legal Source
Article 4 of the Household Registration Act
Article 14 of the Protection of Children and Youths Welfare and Rights Act
Ministry of the Interior
Ministry of Health and Welfare
Departments of Civil Affairs, County/City Governments
Departments of Health, County/City Governments
Live births delivered in the ROC, either of the parents being a citizen of the ROC
Delivered in the ROC (any nationality):
1. Live birth
2. Stillbirth with pregnancy ≧ 20 weeks, or birth weight ≧ 500 grams
4. Person Responsible
Parent of the newborn
The person who delivers the baby
Parent personally presents the birth certificate to the household registration office.
The person who delivers the baby will report to the health authority the relevant birth information.
The relevant health authority will forward the birth report to the household and registration authority.
6. Time Frame
60 days from the date of birth
7 days from the date of birth
7. Overdue Penalty
Statistics of Population in the ROC
Annual Report of the Birth Reporting Statistics
5. Web-based Birth Reporting System
In 1995 when the preliminary stage of birth reporting was implemented, the annual number of reports ranged from 90,000 to 120,000, much lower than the birth registration figures. It drastically increased to more than 200,000 after 1999 when the plan for the improvement of birth reporting was carried out. However, the number of birth registrations was 60,000 more than the number of birth reports. Medical facilities, city/county health departments, and the Health Promotion Administration (HPA), Ministry of Health and Welfare and its predecessor Bureau of Health Promotion (BHP), Department of Health, Executive Yuan, often created repetitive records and compiled similar types of data. As medical facilities often postponed mailing or accidentally lost birth information, new birth data were not received until months later, making it impossible for medical administrators to provide timely health care to newborns. Thus, accuracy of birth reporting and women’s and children’s health care were negatively affected.
Birth reports contain much public health information. The practice of birth reporting is worth encouraging because the information acquired is valuable for women’s and children’s health policy formulation and academic research. In July 2001 when the former BHP took over the task of handling birth reports, it looked into the practices of Kaohsiung City and Taichung City in online reporting and started planning an online reporting system. The former BHP also built a central database for the collection of nationwide birth information that could be rapidly transmitted through the Internet. Access to the information can only be made with authorization by the appropriate level of administration. The information is also provided for the use of academic research on public health to strengthen health care for newborns and to fully carry out population policy. In May 2002, the former BHP developed and completed a 24-hour Web-based Birth Reporting System and provided training to the personnel concerned. Testing and promotion of the system were completed by the end of 2003. In January 2004, the system was officially in use across the nation. In response to the exponential growth of the number of foreign spouses living in the ROC, the accessibility of the Internet and the database have enabled administrators to share information and fully understand conditions of mothers and newborns at the local level.
6. “Paperless” Birth Reporting
For better resource-sharing and in accordance with the “Birth Data Network Reporting Operational Terms” of the MOI implemented in April 2004 interface links were established between related agencies and the household registration information system for information transmission. In the initial stage, hard copies of documents were printed along with the use of the online network. The former BHP divided birth reporting data by nationality and transmitted related files to the MOI, Immigration Bureau, Foreign Affairs Police and household registration offices. The ultimate goal was to reach paperless birth reporting before January 1, 2005.
In accordance with the organizational restructuring of the Executive Yuan, the Bureau of Health Promotion, Department of Health, was organizationally restructured to the Health Promotion Administration, Ministry of Health and Welfare on July 23, 2013. The Health Promotion Administration takes over and continues to conduct birth reporting system.
7. Web-based birth reporting system receives ISO27001 certification
To comply with the Personal Information Protection Act, the web-based birth reporting system can only be accessed with a medical certification identification card. The health care certification authority (HCA) mechanism has been applied to protect information since the beginning of 2004. In addition, an encryption mechanism has been installed to ensure the information security. This has decreased the possibility of hacking and information leaks.
In 2008, 2011, 2014 and 2017, the web-based birth reporting system received ISO27001 certification respectively, and continuing assessment in 2012、2013、2015 and 2016. The certification pointed to the confidentiality, completeness and usability of birth data. This certification also symbolizes the excellence in service quality and sustainable management of this system.