Birth registration is compulsory14 for all children born in Tanzania regardless of whether they are citizens, non-citizens or refugees. Despite this, only 19 per cent of births are registered according to the TDHS 2004/2005, with great disparity between urban and rural areas.15 Currently it is estimated that only 7 per cent of children have a birth certificate. Key constraints on the mainland include lack of public awareness of the importance of birth registration and process by which births are registered, and the significant cost implications for a service that is ostensibly ‘free’. Costs include: fees for late registration (after 90 days and 30 days in mainland and Zanzibar respectively); purchase of the certificate itself (at USD 3.5); and travel-related costs. The Registrar General’s office lacks the capacity, equipment, and materials necessary to make the system work, and there is a lack of policy and legislative mandate to ensure accountability and coordination (between, for example, health facilities, schools, and village executive officer). In addition, there is a lack of law enforcement to make birth registration compulsory. Tanzania introduced the Civil Registration Programme at Local Government Authority level (and Shehia level in Zanzibar). Compulsory registration is also undertaken in dispensaries and health centres situated in villages. Taking into account that some villages are very far from registration offices, the Government has instituted a mechanism to supervise the compulsory registration at village level under the supervision of the Village/Shehia Executive Officers. In every district there is a Registrar responsible for registering birth, keeping safe custody of copies of birth certificates, and forwarding originals to the Administrator General or Birth and Death Registrar. Since 1998 the Department of the Administrator General, with the assistance of UNICEF, has been involved in continuous capacity building in terms of awareness and training to its personnel, including district, ward, and village staff including health practitioners. Similar capacity building has been undertaken in Zanzibar in all 10 districts. 14 To As regulated by Cap 108 the Births and Deaths Registrations Act in the Mainland and the Zanzibar Cap 90 Birth and Deaths Registration Decree. 15 50 per cent for urban mainland and 11 per cent for rural mainland. 18