Birth registration is a priority for child survival.

There are many child-headed families and adolescent carers as a result of the HIV/AIDS epidemic in Southern Africa [1]. The lack of earnings in such families exacerbates household poverty with predictable impact on the health and well-being of the remaining household members. There are opportunities for these multiply deprived households to apply to the South African state for maintenance grants which can supplement monthly household income by 25%. Unfortunately, in order to be considered eligible for a government grant applicants must produce either a bar-coded identification document , which is granted upon provision of a birth certificate or the birth certificate itself. Many child-headed families do not possess these identity documents. Globally, 50 million children are not registered at birth and therefore have no civil identity; as far as the state is concerned they are essentially invisible [2]. UNICEF states that birth registration 'represents the starting point for the recognition and protection of every child's fundamental right to identity and ex-istence'; the World Bank describes a birth certificate as a 'permanent, legal and visible recognition by the state of a child's existence as a member of society' [3, 4]. A lack of registration creates a barrier to several essential services: such children may not have access to health care or education, be unable to enrol in school and may not be adopted nor protected from exploitation such as sex-trafficking or military conscription [5]. The deaths of unregistered children go largely uncounted with profound public health implications [6]. The concept of birth registration as a basic human right was officially established at the 1989 United Nations Convention on the Rights of the Child. Article 7 of the Convention states that: The child shall be registered immediately after birth and shall have the right from birth to a name, the right to acquire a nationality and as far as possible, the right to know and be cared for by his or her parent [7]. Despite this, it is estimated that in 2000 41% of all births were not registered [5]. The inverse care law applies to vital registration—countries most in need of a functional registration system to strengthen health and educational systems have the lowest coverage. Sub-Saharan Africa and South Asia had the lowest regional registration rates in 2000 with 70 and 63%, respectively [5]. However, these are estimates—the true scale of the problem is unknown due to the very nature of …