Selected health indicators for Free State and a reflection on how they relate to the MDGs

1. Selected health indicators for Free State and a reflection on how they relate to the MDGs ’Maletela Tuoane-Nkhasi Statistics South Africa Symposium on evidenced based decision-making Bloemfontein, 10-11 October 2013

2. Contents of presentation • Government priorities on health • Data sources of health statistics • Selected health indicators for Free State • Infant mortality • Under-five mortality • Maternal mortality • Communicable diseases • Non-communicable diseases • Concluding remarks

3. Government priorities on health • Three Millennium Development Goals related to health • “A long and healthy life for all South Africans” • Increasing life expectancy • Decreasing maternal and child mortality • Combating HIV and AIDS and decreasing the burden of disease from tuberculosis • The National Development Plan – 2030 • Increase life expectancy at birth to 70 years • Progressively improve tuberculosis prevention and cure • Reduce maternal, infant and child mortality • Significantly reduce prevalence of non-communicable diseases • Reduce injury, accidents and violence by 50% from 2010 levels

4. Data sources on health statistics • Censuses • Population-based surveys • Health facility records • Mortuary records • Demographic surveillance sites • Civil registration system

5. Data sources on health statistics – Stats SA • There is no dedicated health survey that is conducted by Stats SA • Limited/selected health statistics derived from the following sources: • Censuses / Surveys: • General Household Survey • Living Conditions Survey • Income and Expenditure Survey • Community Survey • Population censuses • Administrative source: • Death notification system

6. Selected health indicators for Free State • MDG indicators • Infant mortality • Under-five mortality • Maternal mortality • Selected communicable diseases • Flu or acute respiratory tract infections • Diarrhoea • TB • HIV/AIDS • Selected non-communicable diseases • Asthma • Diabetes • Hypertension • Arthritis • Injuries

7. Analyses on MDG indicators • Data source • Mortality and causes of death data from South Africa’s civil registration system • This source was used for monitoring Goals 4 and 5 in the 2013 MDG report • Limitations with the data • Incomplete registration of death • Ill-defined causes of death • Misclassified causes of death • What is presented • Absolute number and percentage distribution to show trends • Methodology of adjusting for incomplete registration of death at provincial level under review

8. Infant mortality

9. Infant deaths by age: Free State, 1997-2010

10. Infant deaths by district: Free State, 1997-2010

11. 10 leading causes of death for infants: Free State, 2006 & 2010

12. 5 leading causes of death for infant by district: Free State, 2010

13. Under-five mortality

14. Under-five deaths by age: Free State, 1997-2010

15. Under-five deaths by district: Free State, 1997-2010

16. 10 leading causes of death for children under-five years: Free State, 2006 & 2010

17. 5 leading causes of death for children under-five years by district: Free State, 2010

18. Maternal mortality

19. Maternal deaths: Free State, 1997-2010

20. Maternal deaths by district: Free State, 1997-2010

21. Causes of maternal deaths: Free State, 2010

22. Other health indicators • Data source • General household survey, 2012 • Flu, diarrhoea and TB – based on questions on whether individuals suffered from these illnesses in the month prior to the survey • Chronic conditions – if individuals were informed by a medical practitioner or nurse if they suffered from the conditions • Limitations with the data • Self-reported • Survey undertaken between July and September – affects seasonal conditions • What is presented • Percentage distributions by age and sex

23. Communicable diseases

24. Free State 46,9% Flu or ARTI 48,3% 46,0% Age group

25. Free State 3,4% Diarrhoea 3,6% 3,3% Age group

26. Free State 2,4% Tuberculosis 4,7% 1,0% Age group

27. Free State 3,0% HIV or AIDS 3,6% 2,3% Age group

28. Non-communicable diseases

29. Free State 1,5% Asthma 1,6% 1,3% Age group

30. Free State 5,4% Diabetes (age 25+) 6,5% 4,2% Age group

31. Free State 19,7% Hypertension (age 25+) 26,3% 12,2% Age group

32. Free State 5,1% Arthritis (age 25+) 7,5% 2,3% Age group

33. Free State 0,3% Cancer 0,4% 0,1% Age group

34. Injuries

35. Percentage of people who suffered from specific injuries 0,34% of injuries 0,33% of injuries Severe trauma MVAs

36. Concluding remarks • Stats SA has some information available to monitor health indicators at provincial and sub-provisional level • Levels and trends • Data have limitation • Need to undertake a national health survey (Demographic and Health Survey) • Required to provide the much-needed health information in the country, especially at sub-national level • Monitoring health-related MDG indicators at province level requires concerted efforts by relevant stakeholders • Use of current information • Necessary adjustments on the data • Identification of other data sources to complement available information