THE HEALTH OF CHILDREN IN SOUTH AFRICA: SOME FOOD FOR THOUGHT

Abstract

South Africa is unique in many ways, including the state of health of its children. Discussion focuses on vital statistics -- perinatal and infant mortality rates, disease profiles, nutritional status; and demographic and socioeconomic data -- African communities, Indian communities, coloured communities, and social expenditure. The perinatal mortality rate for africans in Natal and Kwa Zulu varies from 19.7-51.9/1000 in the smaller hospitals. At the main teaching hospital in Durban, the King Edward viii, it was 75.8/1000 in 1980. The most common causes of death in the rural babies weighing more than 1500 gm were septicemia, asphyxia, meconium aspiration, and tetanus neonatorum. In those under 1500 mg the most common causes were respiratory distress, intracranial hemorrhage, and hypothermia. The main causes of the high perinatal mortality among Africans at King Edward viii Hospital were amniotic fluid infection syndrome, abruptio placenta, hypoxia, hypertension, and congenital syphilis. Accurate data for infant mortality rates for Africans are unavailable. Available data show considerable variation. The official infant mortality rates given by the State Health Department for 1975 for the country as a whole were 20.1/1000 for whites, 100.2/1000 for Africans, 104.0/1000 for coloureds, and 34.7/1000 for Asians. Black children under age 5 make up 16% of the total population but account for 55% of total deaths, whereas white children of this age make up 11% of the population and account for only 7% of total deaths. Of the 7688 admissions of African children to King Edward viii Hospital in 1980, more than 80% were due to infections, and the overall mortality in these patients was 20%. The percentage of children below the 3rd centile for weight was 6-12% for infants under 1 year old, 20-55% in children aged 1-6 years, and 30-70% in school age children. The percentage stunted (below 3rd centile for height) varied from 22-66% in preschool children. At King Edward viii Hospital, approximately 40% of children admitted are malnourished. In the main the majority of blacks are poor, illiterate, and living in overcrowded conditions. Many are unemployed or employed away from home, which causes serious disruption of family life with such consequences as teenage pregnancies and malnutrition. The mortality rates, disease profiles, and socioeconomic status of the whites in Sourh Africa are similar, and often superior, to those in Western countries. The reason for this discrepancy in the state of health and socioeconomic development of population groups is the government's policy of separate but unequal development; the policy of apartheid that reserves 87% of the land for 16% of the people, the white minority.