Birth defect registries: the vagaries of management- the British Columbia and Alberta case histories.

Birth defect surveillance is of increasing interest and importance, especially since the discovery that folic acid fortification or supplementation can prevent a large proportion of neural tube defects. Funding is a constant problem, but management or policy can also lead to changes in ascertainment and quality, and even to the threat of actual closure. This is a case study of 2 Canadian registries-British Columbia and Alberta-from an historical point of view. The lessons here are applicable to many registries or surveillance systems. To succeed, 4 things must be in place-stated objectives of the program, funding (preferably government, but may start with a grant or foundation), support from public health departments, and someone to champion the cause. The importance of medical consultants cannot be overstated.