Need for services for the care and prevention of congenital disorders in South Africa as the country's epidemiological transition evolves.

Abstract

The lack of prioritisation of services for the care and prevention of congenital disorders is a global concern. Reducing child mortality (MDG4) can be achieved by middle- and some low-income nations, including South Africa (SA), by focusing on congenital disorders. We performed a situational analysis of epidemiological transition and services for congenital disorders in SA to highlight their renewed need, in the form of a review of epidemiological transition in SA from 1990 related to the HIV/AIDS epidemic and services for congenital disorders. In the early 1990s in SA decreasing infant and child mortality revealed the previously hidden burden of disease of congenital disorders. Approaches to confront this burden were developed and incorporated in national policy guidelines published in 2001. The emergent HIV epidemic buried the issue, and as services for HIV/AIDS developed, services for the care and prevention of congenital disorders were simultaneously neglected. They are now at a base lower than in 2001. Infant and child mortality rates are at a more advanced level than their previous best levels in the early 1990s, but they are stagnating. There is therefore a renewed need for services for the care and prevention of congenital disorders. The present limited state of these services must be rectified urgently. Services for the care and prevention of congenital disorders require prioritisation again in accordance with Resolution WHA63.17 of the World Health Organization, and to achieve the human dignity and constitutionally and legally enshrined rights of people affected by congenital disorders.