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Death stats come to life
18/02/2005 16:01 - (SA)
Johannesburg - Tuberculosis, influenza and pneumonia, and cerebrovascular diseases have emerged as the leading causes of death amongst South Africans from a study of death notification forms. This is one of the key findings contained in the report on Friday by Statistics South Africa - Mortality and causes of death in South Africa 1997-2003.
The release is based on Stats SA's recently completed capturing and coding of approximately three million death notification forms (DNFs) received by the Department of Home Affairs for deaths from 1997 to 2003.
According to Statistician-General Pali Lehohla, the data gathered "provide indirect evidence that the HIV epidemic in South Africa is raising the mortality levels of prime-aged adults, in that associated diseases are on the increase".
However, stressed Lehohla, the data provided in the death notification forms do not allow determination of HIV infections or Aids-related mortality.
"To do this, analysis of the data needs to be combined with other sources of information, population projections and demographic modelling," he added.
Key findings of the mortality and causes of death study show that the number of reported deaths has been increasing steadily, which is partly associated with population growth and with improved notification. The number of deaths increased by 57% from 318 287 in 1997 to 499 268 in 2002.
The data also shows that the proportion of deaths in the age group 20-49 is increasing.
The number of adult deaths (persons aged 15 years and above) increased by 62% from 272 221 in 1997 to 441 029 in 2002.
Over the period 1997 to 2002, 53% of all deaths were male. However, this proportion declined from about 56% in 1997 to about 51% in 2002.
According to Dr Liz Gavin, acting Deputy Director-General for population statistics at Stats SA, accurate mortality statistics are needed for policy formulation, planning, monitoring and implementation of health programmes aimed at improving the health status of the population, particularly increasing the life expectancy.
"The level of mortality is one of the indicators of the level of human development, hence its inclusion in the construction of human development indices and in the multi-dimensional approach to poverty," she said.
While an increasing number of deaths are associated with lifestyle diseases - such as heart disease and diabetes - as the underlying cause, the dominant contributors to the growth in mortality are deaths associated with tuberculosis, and influenza and pneumonia.
Malnutrition was among the ten leading causes of death among children under the age of four. Although there was fluctuation during the three years in the percentages of deaths linked to malnutrition, the numbers of deaths increased steadily, Stats SA said.
The proportion of reported deaths of females is increasing relative to the total. Of the leading underlying causes of death, the main differences between the proportions of male and female deaths occur in relation to tuberculosis and chronic lower respiratory diseases, where male deaths predominate, and cerebrovascular diseases and other forms of heart disease, where female deaths predominate.
During the period for which death notification forms have been captured, the majority of deaths were linked to natural causes of death. Overall, there has been a decline in the number and percentage of deaths due to non-natural underlying causes of death.
Despite improved death registration in South Africa, particularly the introduction of a new death notification form in 1998, the quality of the information collected and the overall coverage remains imperfect, Stats SA added.
DNFs are administrative in nature and are not designed for data capturing. Many of the forms are not fully completed: often the population group was left out or the geographical area where the death occurred was not stipulated. Many forms did not detail the causes of death.
Other factors limiting the accuracy and completeness of data obtained from the death notification forms include that the data from death notification forms is subject to content errors and omissions because the information provided is necessarily obtained from an informant.
In addition, not all deaths are reported, which leads to lower estimates of the total number of deaths that have occurred in the country and may lead to an under-estimation of some causes of death.
Causes of death may be misreported on the form. This happens when an incorrect cause of death is given or when the cause of death is misreported as an unnamed cause.
The quality of the reported information is determined largely by the diligence of the certifying official.
Despite these limitations, says Lehohla, the data captured from death notification "represent a huge step forward in the recording of a time series, understanding of mortality trends and development of the accurate mortality statistics needed for implementation of health programmes". -
- I-Net Bridge (News24)
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