Provincial differentials in under-five mortality in South Africa.

Abstract

Producing child mortality estimates at a provincial level is equally as important as producing estimates at a national level. This allows for a more equity focused and results-driven approach to tackling every area’s apparent need, which will allow previously disadvantaged groups are given greater priority when addressing reductions in child mortality. It is the overall aim of this research to derive estimates of child mortality for the provinces of South Africa using the 2016 Community Survey and to assess the results in relation to socioeconomic and socio-demographic determinants. The estimation of child mortality is achieved through the use of indirect methods in alignment with a life table of best fit. The infant mortality rate (IMR) and the under-five mortality rate (U5MR) were estimated nationally at 55.1 and 76.1 per 1000 live births respectively. There are clear and significant provincial differentials amongst the observed levels of child mortality estimates suggesting largely that there are still pre-existing inequities, inequalities and internal challenges. The estimates obtained are reasonable, and those at national and provincial level are in agreement with results from other research. In evaluating the differentials in child mortality with associated independent variables of interest, it is evident that child mortality is higher amongst females with a lower socioeconomic status (SES) and educational attainment. In addition, there are disparities between socio-demographic variables such as race and province of residence. These results are confirmed by multilevel regression models of child mortality. The findings of this study may aid the government in implementing policies more effectively at provincial levels and enforce more focused decisions in the battle for the reduction of child mortality in South Africa.