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Good news: Child mortality is on the decrease in SA

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The under five mortallity rate has decreased dramatically and it looks as though we are well on our way to meeting the Sustainable Development Goals (SDGs) set out for us.
The under five mortallity rate has decreased dramatically and it looks as though we are well on our way to meeting the Sustainable Development Goals (SDGs) set out for us.

There’s never a good time to bring up child mortality. It’s a distressing and depressing subject that always leaves you feeling heartbroken, and even more so when the numbers are specific to the community in which you live. But Statistics SA explains in a recently released report presenting the Under Five Mortality Rate, that reporting on child mortality is crucial for planning and developing health strategies, policies and interventions to ensure the safety and protection of all children.


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To see how South Africa is fairing for the period 2006-2016, and in the hope of getting ever closer to these targets, we present the key findings from the report: 

  • A higher proportion of deaths for children under 5 were that of males (53%), compared to females (46%).
  • 48% of deaths were from urban areas and 45% were from rural areas.
  • By population group in South Africa, the under 5 mortality rate (U5MR) was lowest among White (14,8) and Indian/Asian groups (21,8), followed by Coloureds (30,2) and Blacks Africans (52,4).
  • Provincially, Western Cape (24,5) and Gauteng (34,3) had the lowest U5MR per 1 000 live births, while Free State (68,4) and KwaZulu-Natal (62,6) had the highest.
  • In total 54 580 deaths for children under 5 were reported by households.
  • KwaZulu-Natal reported the highest (15 843), followed by Gauteng (8 591), however, the absolute number of deaths cannot be compared due to differing population sizes.
  • 80% of deaths for children under 5 were as a result of natural causes, the most of which include intestinal infectious diseases, as well as respiratory and cardiovascular disorders specific to the perinatal period. Significantly, influenza and pneumonia – both preventable – was also mentioned and ranked third responsible for the countless deaths.
  • The most significant finding, however, is the downward trend in U5MR nationally from 75 deaths per 1000 live births in 2006 to 34 deaths in 2016. 

The under 5 mortallity rate has decreased dramatically and it looks as though we are well on our way to meeting the Sustainable Development Goals (SDGs) set out for us, which currently lies at 25 deaths per 1000 live births (see above graph).


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The report highlights that the mortality rate for younger children is high globally as a result of causes such as pneumonia, diarrhea and malaria, as well as malnutrition, unsafe water, sanitation and hygiene, all of which can either be prevented or controlled.


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So in even better news, the reason for the decrease has much to do with the government's efforts to prevent disease, with particular mention in the report of the proper administration of ARV treatment that prevented mother-to-child transmission of HIV.

It's important to note that there had been an increase in the child mortality rate in the 1990s. This was around the same time the epidemic started gaining much traction in SA. But significantly, ARVs were made available in hospitals in 2004 and the report states that in 2005 the rate dropped dramatically once more (as indicated in the above graph).

It is evident that reports such as this, placing importance on child mortality rates as well as the causes of death, is crucial in the prevention of these deaths. The stats not only provide us with the reason for why we absolutely must monitor and report on child mortality rates, as heartbreaking a subject as it is, but also shows us that we can improve it.

Chat back:

What do you think is the key to improving the U5MR in South Africa? Where should the government direct their efforts? Tell us and we may publish your comments. Do let us know if you'd like to remain anonymous.

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