Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct 23;27(16):2637-48.
doi: 10.1097/01.aids.0000432987.53271.40.

South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

Kate J Kerber  1 , Joy E Lawn, Leigh F Johnson, Mary Mahy, Rob E Dorrington, Heston Phillips, Debbie Bradshaw, Nadine Nannan, William Msemburi, Mikkel Z Oestergaard, Neff P Walker, David Sanders, Debra Jackson
Affiliations
Free PMC article

South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

Kate J Kerber et al. AIDS. .
Free PMC article

Abstract

Objective: To analyse trends in under-five mortality rate in South Africa (1990-2011), particularly the contribution of AIDS deaths.

Methods: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data.

Results: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37-39% of child deaths were due to AIDS in 2004-2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%.

Conclusion: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Trend in percentage of under-five deaths in South Africa due to AIDS in South Africa.
Fig. 2
Fig. 2
Under-five mortality rate trends in South Africa, 1990–2011.
Fig. 3
Fig. 3
Neonatal mortality rate trends in South Africa, 1990–2011.
Fig. 4
Fig. 4
Antenatal HIV prevalence and prevention of mother-to-child transmission (PMTCT) scale up in South Africa, 1990–2010.
Fig. 1
Fig. 1
Panel 1: Challenges in assessing neonatal mortality in settings with high HIV-prevalence
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. UNICEF Levels and trends in child mortality report 2012: estimates developed by the UN Inter-agency group for child mortality estimation. 2012; New York:UNICEF, the World Health Organization, the World Bank, and the United Nations Population Division, http://www.childinfo.org/files/Child_Mortality_Report_2012.pdf (Accessed 6 June 2013)
    1. Bradshaw D, Pillay-Van Wyk V, Laubscher R, Nojilana B, Groenwald P, Nannan N, et al. Cause of death statistics for South Africa: challenges and possibilities for improvement. 2010; Cape Town:Medical Research Council, www.mrc.ac.za/bod/cause_death_statsSA.pdf (Accessed 22 May 2013)
    1. Nannan N, Dorrington R, Laubscher R, Zinyakatira N, Prinsloo M, Darikwa TB, et al. Under-5 mortality statistics in South Africa: shedding some light on the trends and causes 1997–2007. 2012; Cape Town:South African Medical Research Council, http://www.mrc.ac.za/bod/MortalityStatisticsSA.pdf (Accessed 22 May 2013)
    1. Birnbaum JK, Murray CJ, Lozano R. Exposing misclassified HIV/AIDS deaths in South Africa. Bull World Health Organ 2011; 89:278–285 - PMC - PubMed
    1. Mayosi BM, Lawn JE, van Niekerk A, Bradshaw D, Abdool Karim SS, Coovadia HM, et al. Health in South Africa: changes and challenges since 2009. Lancet 2012; 380:2029–2043 - PubMed

Publication types