GOMA, Democratic Republic of Congo – During a recent visit to the Muungano La Resurrection Hospital, in Goma, the capital of North Kivu province in the east of the Democratic Republic of Congo (DRC), around a dozen pregnant women sit on narrow benches in a small wooden building, sheltering from the sun while they wait for a prenatal consultation.

As the health agent talks to the women about how to look after themselves while they are pregnant, she also stresses something important they should do for their babies once they are born: Register their births and get a birth certificate.

In North Kivu, one of the Congolese provinces worst afflicted by the ongoing armed conflict between government forces and militia groups, the vast majority of newborn children are invisible to the authorities. Simply getting a birth certificate is almost impossible in a country wracked by political and economic instability.

Without documentation to serve as proof of age, parentage and identity, children cannot access basic services like healthcare, education and social security. And the lack of legal registration puts children – especially girls – at greater risk of early or forced marriage, or sexual abuse.

The lack of a birth certificate has a “significant impact on the lives of girls,” says Marie Diop, the UNICEF child protection specialist in North Kivu. In particular, it affects “their rights to inheritance and the prevention of and protection from early marriage [which] is a form of sexual and gender-based violence that has a considerable impact on the lives and well-being of girls, curbing their access to education, presenting risks to sexual and reproductive health and more.”

UNICEF says nearly 40 percent of girls in DRC marry before age 18. After they get married, girls often quit school and get pregnant, which can present a significant health risk. Young brides are also more likely to suffer abuse.

Without birth certificates to prove their legal age, girls in DRC cannot attend school, making them more vulnerable to arranged early marriage, which families may see as the only way to provide for their daughters.

“Early marriage can have grave physical, psychosocial and socioeconomic consequences in the lives of girls, including in terms of risks during pregnancy and birth,” says Diop.

Legally Invisible

After 20 years of conflict, the DRC has no way of collecting meaningful data on its people – the last complete national census in the country was held in 1984. But according to the country’s second Demographic and Health survey, which took place from November 2013 to February 2014 and was financed by USAID and other international organizations, only 25 percent of Congolese children have been properly registered after birth. The rest are not officially recognized by law.

That rate is well below the average for sub-Saharan Africa’s children under five. UNICEF says 44 percent of children across the region are registered, and the rate in West and Central Africa is slightly higher at 47 percent.

The situation in DRC’s North Kivu is even worse: Only 7 percent of the children in the province are registered and even fewer – 5 percent – have received birth certificates.

Part of the problem, say health experts, is cost. By law, each newborn in DRC should get a birth certificate for free within the first 90 days of their birth, but 20 years of conflict have left the government badly short of funds.

Even with financial support from international organizations, attempts to grant free birth registration to every child are stymied by administrative costs and a system that is “open to abuse from underpaid civil servants,” said the NGO World Vision in a report to the Universal Periodic Review at the United Nations Human Rights Council.

Poor families living in remote areas find it hard to get to urban centers to register their children, according to local authorities and hospital staff. Those who finally make it after the three-month deadline are charged up to $200, an impossible amount for many.

For the past few years, UNICEF and the Congolese authorities have been working on joint efforts to register births by proxy in maternity clinics, health centers and during vaccination campaigns. Before the program started in Eastern DRC in 2013, there were only three bureaus in the whole of Goma to get a birth certificate. “Women had to go more than 6 miles (10km) just to attempt to register their babies,” says Donatieu Bwiko, a North Kivu provincial authority. There are now 11 registration centers in Goma, including the Muungano center, and another 42 bureaus in maternity hospitals across the province. The government has also shortened and simplified the registration process, mainly by making hospitals and health clinics responsible for registering a birth, rather than expecting parents to travel long distances and wait hours in line to register their babies in the days after the birth are born.

At the Muungano center, every child born there is automatically registered, says Kahindo Furaka, the local nurse in charge of registration. “The registration here is free,” she says. “At the end of each week I take the papers to the authorities to sign.”

Charline Bisimwa, 21, was one of the mothers waiting to take advantage of the hospital’s quicker, easier registration service so she could get birth certificates for her newborn twin sons. The mother of three had been abandoned by her husband and left with no home and no way to earn a living. If she hadn’t been able to register her twins at the hospital, they may have grown up never being officially recognized by the state. “I came here to do the registration because it is easy, rather than going to the commune office quite far, as I am alone,” Bisimwa she says. “I don’t have any money.”

Fabiola Ortiz’s reporting trip to DRC was funded by the Erasmus Mundus Journalism Consortium and the Reporting Right Livelihood 2017 journalism program.