Reinstated South Africa Demographic and Health Survey (SADHS) reveals limited improvement in the state of country's health

Cape Town | Preliminary results of the 2016 SADHS have been released.  The national household survey collected a wide range of health data, by way of face-to-face interviews, from over 11 000 households around the country over a period of one year.  The survey outlines vital introductory information to inform health policy and the management of strategic programmes.  It reveals essential demographic indicators on maternal, new-born and child health; HIV and sexual behaviour; management of non-communicable diseases as well as the status of violence against women in the country.

Sexual behaviour & teenage pregnancy

45% of women and 55% of men aged between 15 and 49 reported to have had sex with neither their spouse nor someone they were living with in the past 12 months. “This is particularly dangerous within the context of HIV in South Africa,” says SAMRC’s Burden of Disease Research Unit Director Professor Debbie Bradshaw. “Our survey showed that 32% of men and 40% of women did not use condoms in these incidences and this does not help to control the epidemic.”

The survey shows that the proportion of teenagers aged 15-18 years who have started childbearing has shown little change since 1998, contrary to wide-spread perceptions that the teenage pregnancy rate has increased. The fertility rate for teenagers is 71 per 1,000 women aged 15-19, showing little change since 1998, while the proportion of 19 year olds is lower than it was in 1998.

Nutrition

According to the survey, stunting (being short for one’s age) remains a national concern, with 27% of children displaying signs of chronic malnourishment.  While the prevalence of stunting raises concern, some encouraging statistics from the survey showed an overall decline in the under-5 mortality and the infant mortality rates with 42 deaths and 35 deaths per 1,000 live births, respectively, for the 5 years preceding the survey.  The survey also showed that the neonatal mortality rate has also dropped to 21 deaths per 1,000 live births, accounting for about half of under-5 deaths.

“Although we have observed a significant increase in exclusive breastfeeding from 8% in 2003 to 32% in 2016, stunting prevalence remains extremely disturbing given the long-term consequences on health and development of children,” says SAMRC Medical Director and Chief Specialist Scientist Professor Ali Dhansay.

Violence

As expected, the results of the study revealed that intimate partner violence is widespread in the country, with 8% of women who were interviewed conceding to have experienced physical violence in the past year and one in five reporting that they had experienced physical intimate partner violence in their lives.

“It is challenging to collect such information and the methodology could possibly understate the true extent of the problem,” says SAMRC’s Gender and Health Research Unit Deputy Director Professor Naeemah Abrahams. “Given the daily media reports of violence against women and children, it is important that we develop national strategic plans that will curb gender based violence.”

Non-communicable diseases

Non-communicable diseases (NCD) remain a major concern with high levels of overweight and obesity amongst South African women who present an above 35.0kg/m2 body mass index (BMI) as well as five out of every ten adults being hypertensive.

“These results were expected as our NCD specific studies have shown that South Africa has the highest rate of overweight and obesity in sub-Saharan Africa with more than 70% of women being overweight,” says the SAMRC’s NCD Research Unit Director and research co-investigator Professor Andre Kengne.  “The SAMRC’s 2nd National Burden of Disease Study has shown and it is time that we wake up to this cold fact and that we need to address the risk factors that contribute to overweight and obesity. Non-communicable diseases are fast becoming the leading cause of death now accounting for more than HIV and TB”, concluded Kengne. 

The SADHS was undertaken as a partnership between the National Department of Health (NDoH), Stats SA and the South African Medical Research Council (SAMRC).