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Research Highlights

Burden of disease information (evaluation and synthesis of data)
Rapid Mortality Surveillance

The work done by the unit in estimating the mortality trends in South Africa brought into sharp focus the extent of the impact of HIV/AIDS. The public interest in the initial findings was unprecedented and it was l ultimately utilised by policy makers in guiding and evaluating the nation’s response to the epidemic The unit was part of an Interdepartmental Task team to assist with improving mortality statistics and estimating the impact of HIV/AIDS set up in 2001. This involved briefing sessions with various heads of government departments and resulted in Statistics South Africa strengthening their systems for processing cause of death data. While much progress has been made in improving the national cause of death statistics, there are still areas of concern.

In terms of timely monitoring of childhood and adult mortality rates, the unit, in collaboration with the Centre for Actuarial Research at UCT and the MRC Biostatistics Unit has developed the Rapid Mortality Surveillance (RMS) system to monitor the trend and the number of deaths recorded on the national population register. Since 2009, analysis of the RMS data has provided empirical estimates of the following key health-related indicators: the maternal mortality ratio, the neonatal, infant and under-5 mortality rates as well as life expectancy and measures of adult mortality. The system produces an annual report of these universal indicators two years sooner than the published vital registration data. View the complete Reports

Western Cape Mortality Surveillance System
The unit has been involved in a collaborative project with the Western Cape Department of Health and the City of Cape Town to develop a mortality surveillance system that reports on mortality at district and sub-district levels in the province. It makes use of cause of death information provided on death notifications for deaths registered with the Department of Home Affairs. It groups causes into meaningful categories, makes adjustments for the ill-defined causes and makes use of population estimates for calculating age-standardised mortality rates. The latest report presents the Western Cape mortality profile for 2011, by sub-district, and includes a more complete analysis of the causes of death in children under-5 years than in previous reports. Western Cape mortality profile.
Injury Mortality Survey

BoDRU, in collaboration with the Gender and Health and Biostatistics unit, conducted a survey of more than 25,000 non-natural deaths that presented to mortuaries in 2017 in order to:

  • describe the incidence of fatal injury rates in South Africa by age, sex and cause
  • compare the provincial injury mortality rates for fatal injuries

Key messages of the 2nd Injury Mortality Survey for 2017 include:

  • Road traffic deaths decreased significantly between 2009 and 2017.
  • Homicides account for more than a third of injury deaths, with rates seven times the global average and no substantial decrease since 2009.
  • The 2017 Injury Mortality Survey (IMS) findings have been validated by alternative routine data, collected by the police and road traffic authorities.
  • The findings by manner of death are more specific to informing national and provincial injury prevention efforts than official death notification data.
  • The findings highlight the role of alcohol in homicide and road traffic mortality.

Please view the key findings and the full report here:  The 2nd Injury Mortality Survey: A national study of injury mortality levels and causes in South Africa in 2017

Please click to view the previous Injury Mortality Survey 2009 report.

Eastern Cape Province Cancer Registry
This is the only population-based cancer registry in South Africa which has been in existence for more than 20 years. The overall aim of the registry is to continuously identify and register all incident cancer cases who reside in eight selected magisterial districts in the former Transkei region of the Eastern Cape Province. Both active and passive methods are used in data collection; with the former being mainly used. A reliable database is generated and maintained to provide information about incidence of cancers and trends over time in a rural setting of South Africa and contributes to pooled studies of cancer epidemiology that include staging and cancer survival studies. Furthermore, data from the register are used periodically to contribute to the Africa chapter in Cancer Incidence in Five Continents (CI5) published by the WHO International Agency for Research on Cancer (IARC). View the complete Report
South African Demographic and Health Surveys
The unit played an important role in co-ordinating South Africa's first Demographic and Health Survey (SADHS) of 1998. The findings of the SADHS highlight the health inequalities that exist in South African society. The survey is a key tool to assist policy makes in redressing the unequal distribution of health care and to ensure that health policy and legislation are consistent with the objectives of achieving greater access and better quality of care and other health benefits for all South Africans. This was repeated by the National Department of Health in 2003 and a new SADHS is planned to be in the field in 2015.
Evaluation of Health Information Systems

The Burden of Diseases Unit in collaboration with John Snow’ Enhancing Strategic information (ESI), and the South African National Department of Health conducted a Rapid Information Needs Assessment of the District Health Information System in 2012, to inform health information system priorities and give input into the National Strategic Plan for Health Information Systems (HIS) in South Africa. The assessment focused on human resources, hardware and DHIS software.

The unit is also currently undertaking a comprehensive evaluation of the performance of the routine health information systems (RHIS) in selected districts in KwaZulu Natal and the Western Cape, in terms of data accuracy and use of information at both the facility and district levels. This research focuses on strengthening the RHIS that support maternal and child health programmes, specifically focusing on data quality of the Prevention of Mother-to-Child Transmission of HIV (PMTCT), and immunization programmes. The study also assesses the behavioural (competence in RHIS tasks, data quality checking skills, problem-solving skills, and motivation) and organisational determinants (supervision, planning, training, governance) affecting RHIS performance in South Africa.