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Child(1) deaths in South Africa remain excessively high despite the switch to democratic rule ten years ago. The latest Medical Research Council policy brief(2) estimated that the Infant Mortality Rate (IMF) for the year 2000 was 60 deaths per 1 000, while the Under-5 Mortality Rate (U5MR) stood at 95 per 1 000 live births.
However, the UN Development Programme(3) estimated an IMR of 56 per 1 000 and an U5MR of 71 per 1 000 for the year 2001. On the other hand, the United States Census Bureau(4) estimated that the IMR for 2002 was 62 per 1 000 and 124 per 1 000 for the U5MR.
The question that arises is why the estimates for such significant indicators are so markedly different within a given period? These discrepancies, which were also encountered by the Institute during the production of a
child death fact sheet
in 2002, as well as a concern over seemingly increasing child deaths, thus prompted the Child Health Services Programme to launch the
Child Death Review Project.
The project is aimed at developing a comprehensive understanding of the causes, extent and information systems related to child deaths in South Africa by conducting a 10-year review (1994-2003) based on available information on child deaths. The objectives of the study are to:
- Conduct a rigorous review of the literature on child deaths in South Africa.
- Identify and describe key sources and systems of information on child deaths at a national and provincial level.
- Analyse and interpret the available information on child deaths.
- Identify situations that would provide more in-depth understanding on the causal and underlying factors of child deaths in order to augment into national and provincial data.
- Produce various reports outlining recommendations for further research and changes at legislative, policy, programme and service delivery levels and disseminate innovative outputs on child deaths for a range of stakeholders.
- Advocate for concerted actions through the dissemination of findings.
To unpack issues related to the project, the Programme hosted a meeting with child death researchers, where the following challenges and opportunities were identified:
- The urgency of a better understanding of the information system that houses child death data across different agencies.
- The lack of uniform definitions for key concepts, such as peri-natal deaths and primary and underlying causes of death, without which research results are methodologically incompatible.
- Experts in the field seem to produce their own results independent of each other, with no uniform platform to strengthen findings.
- While much information exists on death data related to children under-5, less exists on ages 6-10 and much less on children 11-18 years.
- Existing data is often located on a much smaller scale within research projects, untapped institutional databases and collated (but not analysed) routine administrative data.
- A significant proportion of child deaths are unrecorded on the government’s registration system because many children do not have official birth registration documents.
- Individual research studies with a smaller sample size can hold invaluable information on the underlying causes of death that are not apparent at or incorporated into the national level.
The child death review study will provide the best available information located within a child rights framework, and aims to articulate the results to be easily understood by government decision-makers, service providers and civil society. The intended research outcomes are to set up a process to advocate for and host an inquiry into child deaths at parliamentary level, and to give input into the review and reform of child health policy, procedures and systems.
For more details, please contact
Kashifa or
Maylene.
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1 |
Child is a person under the age of 18 years as defined by the SA Constitution and the UN Convention on the Rights of the Child |
| 2 |
Bradshaw D, Groenewald P, Laubscher R, Nannan, Nojlana B, Norman R, Pieterse D and Schneider M (2003) Initial estimates from the South African National Burden of Disease Study, 2000, MRC Policy Brief No I. Cape Town: Medical Research Council |
| 3 |
www.undp.org |
| 4 |
www.dec.org |
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