oa South African Health Review - Mortality and morbidity among women and children : maternal, child and women's health : general
Mortality and morbidity trends in South Africa have been dominated by the HIV epidemic. Despite imperfect health statistics, it has been possible to observe a substantial increase in mortality of young adults during the last decade that has severely affected women aged 20 to 44 years and men in a wider age band. HIV-related diseases are by far the leading cause of death among young women as well as non-HIV-related TB and pneumonia together with homicide and road traffic accidents. Women in the slightly older age group of 45-54 years are more affected by chronic diseases such as stroke, diabetes mellitus, hypertensive heart disease, ischemic heart disease and cervical cancer. In 1998 there were indications that the maternal mortality ratio for South Africa was relatively high. Indications are that this has been exacerbated by the HIV epidemic. Mortality rates do not reflect some important aspects of health such as mental health problems. A review of available data suggest that a sizable burden of mental health problems also affect women in this age range.
While it is estimated that HIV has increased child mortality rates in South Africa, reliable data for this essential indicator are completely lacking. Government is urged to improve the situation and collect good quality data that will provide accurate statistics on this critical indicator, a key indicator to monitor the Millennium Development Goals.
Provincial variations in the mortality of children and women allude to much larger inequalities in health status that are masked by the average mortality rates presented in this chapter. Health managers at all levels of health care are urged to consider the health status of the population in their planning of programmes and services. This will require extensive improvements to the current health information system.
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