Provincial mortality in South Africa, 2000 - Priority-setting for now and a benchmark for the future

Bradshaw, Debbie, Nannan, Nadine, Groenewald, Pam, Joubert, Jane, Laubscher, Ria, Nojilana, Beatrice, Norman, Rosana, Pieterse, Desiree and Schneider, Michelle (2005) Provincial mortality in South Africa, 2000 - Priority-setting for now and a benchmark for the future. SAMJ South African Medical Journal, 95 7: 496-503.

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Author Bradshaw, Debbie
Nannan, Nadine
Groenewald, Pam
Joubert, Jane
Laubscher, Ria
Nojilana, Beatrice
Norman, Rosana
Pieterse, Desiree
Schneider, Michelle
Title Provincial mortality in South Africa, 2000 - Priority-setting for now and a benchmark for the future
Journal name SAMJ South African Medical Journal   Check publisher's open access policy
ISSN 0256-9574
Publication date 2005-07
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 95
Issue 7
Start page 496
End page 503
Total pages 8
Place of publication Claremont, South Africa
Publisher Health and Medical Publishing Group
Language eng
Formatted abstract
Background. Cause-of-death statistics are an essential component of health information. Despite improvements, underregistration and misclassification of causes make it difficult to interpret the official death statistics.
Objective. To estimate consistent cause-specific death rates for the year 2000 and to identify the leading causes of death and premature mortality in the provinces.
Methods. Total number of deaths and population size were estimated using the Actuarial Society of South Africa ASSA2000 AIDS and demographic model. Cause-of-death profiles based on Statistics South Africa's 15% sample, adjusted for misclassification of deaths due to ill-defined causes and AIDS deaths due to indicator conditions, were applied to the total deaths by age and sex. Age-standardised rates and years of life lost were calculated using age weighting and discounting.
Results. Life expectancy in KwaZulu-Natal and Mpumalanga is about 10 years lower than that in the Western Cape, the province with the lowest mortality rate. HIV/AIDS is the leading cause of premature mortality for all provinces. Mortality due to pre-transitional causes, such as diarrhoea, is more pronounced in the poorer and more rural provinces. In contrast, non-communicable disease mortality is similar across all provinces, although the cause profiles differ. Injury mortality rates are particularly high in provinces with large metropolitan areas and in Mpumalanga.
Conclusion. The quadruple burden experienced in all provinces requires a broad range of interventions, including improved access to health care; ensuring that basic needs such as those related to water and sanitation are met; disease and injury prevention; and promotion of a healthy lifestyle. High death rates as a result of HIV/AIDS highlight the urgent need to accelerate the implementation of the treatment and prevention plan. In addition, there is an urgent need to improve the cause-of-death data system to provide reliable cause-of-death statistics at health district level.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Tue, 25 Jan 2011, 10:30:09 EST