SA's child-deaths shame

2003-05-26 09:07

Cape Town - South Africa's infant mortality rate is considerably higher than many other countries in the same income category and even higher than many in a lower income group, says the University of Cape Town.

It said that while the country had the financial resources to decrease child deaths, it needed to examine why these were not reaching children in need, particularly those in rural areas.

"The organisation and delivery of the health system and other sectors that have an impact on health, such as social development, water, housing, transport and finance still have a long way to go towards improving child well-being," said the university's children's institute.

Child Protection Week, which aims to highlight the plight of abused children, among other things, was to be officially launched by Housing Minister Brigitte Mabandla in Pretoria on Monday. She is also acting social development minister.

The institute said child deaths were one of several important markers of a country's progress in meeting its fundamental obligations to children.

It said 45 South African children out of every 1 000 live births were likely to die before their first birthday.

Sixteen children out of every 1 000 live births were likely to die before the age of five.

HIV one of the top killers

It said children under a year needed greater attention because they were at a greater risk of dying compared to children between one and four.

Child deaths in the Eastern Cape, Free State, KwaZulu-Natal and Mpumalanga were consistently higher than the national average.

Infant and under-five mortality rates were twice as high for the Eastern Cape compared to the Western Cape.

The institute said deaths in younger children were mainly due to causes relating to a lack of good-quality health services and poor socio-economic living conditions.

HIV was now one of the top 10 causes of deaths in all age categories.

It said that although accurate data on HIV-related deaths was not available, estimates indicated that many more deaths were due to HIV in all age groups, especially the under-five age group.

"However, the method used to record the cause of deaths in South Africa makes it impossible to tell what children have died of.

"Deaths are classified into large, relatively meaningless categories, again making it difficult to identify the exact causes of death.

"Also, important underlying causes of death are often not reflected, especially in the context of HIV," it said.

The institute made a number suggestions to decrease child deaths.

On a parliamentary level, a special inquiry should be held annually in which child deaths and the underlying causes were examined and priorities made accordingly.

It said all health facilities should have a special audit to review all child deaths and ensure that procedures and protocols were put in place to minimise them.

Basic amenities needed

Annual reviews through community health committees or equivalent structures could provide communities with the tools to lobby for changes that could have a positive impact on the well-being of children.

The institute said that at relevant departmental levels, pregnant women and children's health-care needs had to be prioritised, adequate funding was needed for child health, and all children in need should have access to social security.

Basic amenities such as clean, piped water, proper sanitation and safe places where children could play were also needed.

The institute said: "The government, as a whole, must address the crisis of hunger and malnutrition, especially for children in rural areas and those affected by HIV/Aids.

"Parents, caregivers and communities must ensure that homes are safe spaces for children by keeping harmful objects and substances out of the way."

- SAPA