SAHR 2007 - Health Systems Trust

in the country. On the other hand low birth weight data are
considered to be unrealistically low and some suggestions
are provided to address this.
Table 28 shows the number of deaths (regardless of
underlying cause) reported in children under 5 by the vital
registration system, unadjusted for under-reporting. In raw
terms, there has been a 49.7% increase over this period
in the number of under 5 deaths reported. This increase
reflects the absolute increase in the number of deaths, but
also increased reporting and an increasing population.
In common with other cause of death data, values for the
EC and LP are lower than expected and should be treated
with caution. Unfortunately the Child Healthcare Problem
Identification Programme reported in the Saving Children
reports does not include data from either of these provinces
to verify the situation.
Bradshaw and Dorrington [SAMJ 97(582-3)] thus comment
that vital registration data cannot tell us much about the
U5MR because of the ill-quantified level of under-reporting.
They also explain why the SADHS 2003 child mortality rates
are implausibly low (although included in Tables 29 and 30
for completeness) and cannot be relied upon.
Murray et al [Lancet 370(1040-54)] published a new analysis
of country trends and forecasts of under 5 mortality in which
they estimate the number of under 5 deaths in SA for 2005
to be 77 000 (73 000-81 000) and the U5MR to be 69 (66-
73). These estimates are more in line with those of the ASSA
2003 model.
Table 28: Number of child deaths (any underlying cause of death) for each age under 5 by province, 2001-2005
Year Age EC FS GP KZN LP MP NC NW WC SA
2001 0 2 553 3 102 7 038 7 088 1 436 2 192 843 3 428 2 139 29 821
1 662 589 1 044 1 428 557 540 200 728 330 6 080
2 288 198 461 723 260 232 49 250 117 2 579
3 177 93 262 355 135 139 26 145 82 1 414
4 157 92 216 338 114 76 33 84 51 1 161
Total under 5 3 837 4 074 9 021 9 932 2 502 3 179 1 151 4 635 2 719 41 055
2002 0 3 031 3 621 8 175 7 834 1 856 2 733 786 3 901 2 412 34 351
1 623 597 1 201 1 416 581 549 171 802 289 6 231
2 296 265 536 748 314 266 49 303 163 2 941
3 198 135 321 421 148 160 30 170 111 1 694
4 181 78 205 314 113 84 33 108 65 1 181
Total under 5 4 329 4 696 10 438 10 733 3 012 3 792 1 069 5 284 3 040 46 398
2003 0 3 736 4001 9 105 8 458 2 142 3 289 811 4 352 2 389 38 287
1 747 680 1 287 1 529 639 653 179 998 322 7 036
2 361 282 557 809 287 274 56 326 142 3 098
3 213 153 315 535 189 149 33 186 97 1 871
4 175 121 237 377 146 117 20 135 76 1 404
Total under 5 5 232 5 237 11 501 11 708 3 403 4 482 1 099 5 997 3 026 51 696
2004 0 4 362 4 653 9 261 8 470 2 649 3 381 912 4828 2 596 41 119
1 915 862 1 446 1 795 930 676 216 1087 343 8 274
2 422 288 572 962 389 291 63 381 145 3 515
3 301 156 389 665 204 170 41 184 101 2 215
4 250 136 297 560 155 138 19 155 80 1 790
Total under 5 6 250 6 095 11 965 12 452 4 327 4 656 1 251 6 635 3 265 56 913
2005 0 4 591 5 006 10 191 10 170 3 159 4 058 783 5 546 2 518 46 026
1 909 824 1 334 1 809 995 832 173 1115 286 8 280
2 420 286 535 959 379 332 66 320 133 3 432
3 273 128 349 661 204 151 24 179 83 2 052
4 224 115 255 520 163 175 24 129 66 1 671
Total under 5 6 417 6 359 12 664 14 119 4 900 5 548 1 070 7 289 3 086 61 461
Source:
Calculated from StatsSA Causes of death 2005. Data not
adjusted for under-reporting of death notification.
SA total includes a few deaths where province of death is
unspecified or other.
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