Determinants and patterns of timeliness of birth registrations in Uganda: insights for improving coverage (2020–2024)

This study evaluated the efficiency of birth registration in Uganda from 2020 to 2024, identifying regional and health facility-based effects and determined the demand side factors influencing the time-to-notification. Using a quantitative approach, birth registration data from this period were analyzed through descriptive statistics and statistical tests, including the Kruskal‒Wallis and Chi-Square tests, to assess nuances between notification timeliness and demand side factors; regional and facility-level differences in notification-registration conversions. Predictive models for timeliness of notifications and registration based on demand and supply side of factors were explored using multinomial logistic regression models.Findings indicated a balanced sex distribution but significant inefficiencies, with only 7% of births registered on time and a median notification delay of approximately 3 years and 2 months. Regional disparities were evident, as the Central Region accounted for 36% of registered births, while the North Eastern and North Western Regions had the lowest rates (9% each), underscoring infrastructural challenges. Facility-based disparities were also notable, with Medical Centers exhibiting the longest delays and Referral Hospitals the shortest, highlighting the role of healthcare infrastructure in registration efficiency.Addressing these inefficiencies requires targeted public awareness campaigns, improved infrastructure, and digital registration platforms. Integrating birth registration into maternal and newborn care, training healthcare providers, and implementing policy reforms—such as mandatory immediate birth notification and fee waivers—can enhance efficiency. Additional resources should be allocated to underperforming regions, including mobile registration units to improve access. Establishing a nationwide monitoring system will enable data-driven improvements, ensuring timely birth registration and access to legal identity for all children in Uganda.