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What we know about the Impact of HIV/AIDS on Teachers: a gerneral overview

What we know about the Impact of HIV/AIDS on Teachers: a gerneral overview. From Peter Badcock-Walters, Christopher Desmond, Daniel Wilson & Wendy Heard  4 June 2003. Study Objective.

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What we know about the Impact of HIV/AIDS on Teachers: a gerneral overview

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  1. What we know about the Impact of HIV/AIDS on Teachers: a gerneral overview From Peter Badcock-Walters, Christopher Desmond, Daniel Wilson & Wendy Heard  4 June 2003

  2. Study Objective • Benchmark the mortality rate amongst in-service educators in KZN by age and gender to inform future educator demand and supply planning and modelling. Method • Analysis of Annual School Survey data • 100-school random sample survey to investigate non-reporting by 90% schools • Analysis of PERSAL records • Reconciliation/analysis of trends & outcomes

  3. Education & HIV Context • Largest provincial system with 2,6 million learners & 76000 educators, in 6000 schools; • Demand: Enrolment in Grade 1 shows only 1,9% growth over 5 years, 1998 - 2002; • Supply: Educator attrition (all causes) greater than decline in demand – 6,8% in 1999 of which 0,64% estimated to be AIDS mortality; • Educators vulnerable to high rates of HIV prevalence (35%+) over several years; • Growing mortality in Private Sector increasing recruitment of educators from the system.

  4. Prevalence rates Ante Natal Clinics Schools HIV Prev. as %

  5. -12% +20% +3% -24% +27% Data: Annual School Survey

  6. Study Method • Identification of available KZNDEC data; • Analysis of Annual School Survey, capturing educator & learner mortality since 1999; • Commissioning/analysis of 100-school random sample survey to check undercount/ non-reporting by 90% of schools; • Analysis of Personnel Salary (PERSAL) system data from 1996; • Reconciliation and analysis of observed contradictions, trends and likely impact.

  7. Age Distribution of Educators

  8. Analysis: Annual School Survey • Only 8% schools in 1999 reported educator mortality – 92% balance unknown; • Reported 509 deaths (424/83% due to illness) in cohort of 68 615 publicly-paid educators = gross mortality rate of 0,74%; • 11% of schools in 2000 reported 650 deaths (580/ 89% due to illness) in cohort of 67 958 educators = gross mortality rate of 0,96%; • Mortality rate for male educators higher in 1999 (1,12% vs 0,56%) and in 2000 (1,4% vs 0,76%) than for females; • 68% of educators female, average age 37,4.

  9. AS Data: Mortality due to Illness

  10. AS Data: Mortality by Gender* Female mortality in age band 30-34 rose by 70% 1999 to 2000, and by 30% for those 35-40;* Gross number of female deaths rose from 327 to 354 (+8%) versus 253 to 300 (+19%) for males;* Percentage females dying from illness grew from 89% to 92% versus 78% to 84% for males.

  11. Analysis: Personnel Salary Records • PERSAL apparently most reliable data but suffers average reporting lag of 4,3 months; • 1998-2001 shows 84% to 87% deaths due to illness/natural causes; • 1998: mortality rate for males peaked at 1,2% 35-39, averaging 0,9%, while female rate peaked at 0,8% 30-34, averaging 0,5%. Total mortality rate for 1998 = 0,6% • 1998 PERSAL total deaths 493, 70% in age group 25-39; • Average age of educators at death 36,6.

  12. Analysis: PERSAL 1999 • 1999: PERSAL shows 530 deaths in cohort of 71084 vs 509 in 1999 Annual Survey data; • 1999 mortality rate for males peaked at 1,3% 35-39, averaging 1,1%, while females peaked at 0,7% 30-34 averaging 0,6%. Total rate = 0,7%; • 68% deaths 25-39; average age at death 36,5.

  13. Analysis: PERSAL 2000 • 2000: PERSAL shows 681 deaths in cohort of 68615 vs 654 in 2000 Annual Survey data; • 2000 mortality rate for males peaked at 1,6% 30-34, averaging 1,5%, while females peaked at 1,1% 30-34 averaging 0,8%. Total rate = 1,0%; • 67% deaths 25-39; average age at death 36,9.

  14. Analysis: PERSAL 2001 • 2001: PERSAL shows 609 deaths in cohort of 67958; there is no Annual Survey data as yet; • 2001 mortality rate for males peaked at 1,8% 50-54, averaging 1,3%, while females peaked at 0,8% 30-39 averaging 0,7%. Total rate = 0,9%; • 64% deaths 25-39; average age at death 37,8.

  15. Analysis: Sample Survey 1999 • Initiated 100-school random sample survey to explain/resolve 90% non-reporting issue; • Shows only 24% schools kept viable records; • Raises doubts about school data quality; • 1999: Showed 4 extra deaths and 1 duplication vs 12 captured via AS and PERSAL; of actual total 16, sample school principals ‘neglected’ to report 12 deaths but analysis also shows AS undercount of 8; • Sample educator cohort of 1843 suggests gross mortality rate of 0,87% for 1999.

  16. Analysis: Sample Survey 2000 • 2000: Showed 3 extra deaths and 9 duplications vs 15 captured via AS and PERSAL; of actual total 18, sample school principals only ‘neglected’ to report 6 deaths but again also shows AS undercount of 7; • Sample educator cohort of 1903 in 2000 suggests mortality rate of 0,94%; • Direct consequence of survey evidence of record keeping failure may be introduction of monthly data capture via the DEMMIS system piloted in 200 schools over 24 months.

  17. Outcomes: Mortality Trends • 90%-93% all educator deaths 1998-2001 <49; • 2124 educators of 2313 dying 1998-2001 <49; • 80%+ of this <49 group (1700) died of illness; • Mortality 3-times higher than without AIDS.

  18. Outcomes: Convergent Trends • The three data sets show fairly convergent trends and patterns in 1999, with real convergence in 2000; • In 1999, the Annual Survey suggests a gross mortality rate of 0,66%, PERSAL 0,88% and the sample survey 0,89%; • In 2000, the Annual Survey suggests a gross mortality rate of 0,96%, PERSAL 1,0% and the sample survey 0,94%; • Additional data for 2001 from PERSAL suggests a slight drop back to 0,9%.

  19. Outcomes: Post-Service Mortality? • Mortality rates used are for in-service educators only; • Studies of SA corporate sector suggest up to 50% of employees die after leaving service; • Further PERSAL analysis suggests that large numbers of educators (average age 47) are indeed leaving on medical grounds; • Must assume that in-service mortality is only a portion of the real rate, and undercounts real number of educators dying; • Research will continue to attempt to establish this position.

  20. Lessons and Conclusions • Establishing rates of mortality should not require this volume of research and analysis, and suggests the lack/failure of MIS; • The complexity of PERSAL attrition data requires extensive further analysis • There can no longer be any doubt that AIDS is impacting educators, who are dying at 3-4,5 times the expected rate without AIDS; • HIV/AIDS are adding to existing levels of attrition and dysfunction and impacting on teaching, learning, quality and outcomes – impacts that must be adequately measured.

  21. Educator Mortality in KwaZulu NatalA Consolidated Study of In-Service Impact and TrendsThank You for your Attentionenquiries: peterbw@eastcoast.co.za

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