Pregnancy registration systems can enhance health systems, increase accountability and reduce mortality.

As many low- to middle-income countries strive to achieve targets of reduced maternal, neonatal and infant mortality set by the Millennium Development Goals, health system innovations which can accelerate progress are being carefully examined. Among these are technologies and systems which aim to strengthen frontline health workers and the health systems within which they work, by enabling the registration of pregnancies, births and outcomes. Accurate, population-based numerators and denominators can help to improve accountability of the health system to provide expected routine antenatal and post-natal care, as well as emergency support and referral, as needed. The enumeration of women of reproductive age, followed by prospective, voluntary registration of pregnancies has the potential to support governments, health agencies, and the populations they serve, to ensure public health service delivery and to guide informed policies.