Objective  To examine the issuance and management of birth certificate in seven provinces of China for providing suggestions of improvement.

  Methods   Using a self-designed questionnaire based on expert consultation, we conducted a survey among seven provincial-level administrative departments during September – October 2018 to collect information on issuance, replacement, reissue and invalidation of birth certificate.

  Results  The requirement for direct issuance of birth certificate by midwifery agencies was implemented in all the provinces and for two of the provinces, 58.33% and 57.89% of all initial birth certificates were issued by primary public medical institutions in 2016 and 2017, respectively. The annual ratios of estimated number of birth certificates to be issued versus that of actually issued were 1.26, 0.96, and 0.99 in 2015, 2016, and 2017, respectively. The timeliness of the issuance was gradually improved, with an increased ratio from 70.29% to 88.78% for the initial birth certificate issuance; both the ratios of birth certificates reissued and replaced were increased from 0.75% to 1.09% and from 0.70% to 0.93%; but the ratio of the birth certificates being invalidated was decreased from 0.66% to 0.42% during the three year period.

  Conclusion  The regulation on issuance and management of birth certificate were well implemented during 2015 – 2017 in seven provinces across China.