Public Health Governance, Legal Frameworks, and Financial Accountability: A New Paradigm for Sustainable Civil Registration and Vital Statistics Systems

Civil Registration and Vital Statistics (CRVS) systems are foundational to public health governance, providing continuous, universal, and legally grounded data on births, deaths, and causes of death. These systems are indispensable for health planning, monitoring epidemiological transitions, and tracking progress toward Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) (1–3). Despite global commitments, CRVS systems in many low- and middle-income countries (LMICs) remain incomplete and inequitable. While global initiatives have largely focused on technical enhancements—digitization, training, and data systems—these efforts often overlook deeper systemic constraints related to governance fragmentation, weak legal enforcement, and inadequate financial sustainability (2,4). This editorial argues for a paradigm shift: sustainable CRVS systems must be anchored in an integrated triad of public health governance, legal frameworks, and financial accountability, supported by a domestic resource mobilization (DRM) (5).