For the first time since 1998, Statistics South Africa (Stats SA) has conducted an exhaustive study of South Africa’s demographics. The first report, covering the health of South Africans, has been released.
Sulaiman Philip
Stats SA handed its 2016 South African Demographic and Health Survey (SADHS) to Health Minister Aaron Motsoaledi on 15 May 2017.
The minister welcomed the report, saying it made the business of governing easier. “What gets measured gets done and I think that’s the direction you have given us today because we know what to do and when,” he said after he was handed the survey.
The SADHS covers maternal and child health, fertility and access to contraceptives, sexual behaviour and HIV awareness, as well as the use of alcohol and tobacco.
Fieldwork was conducted by 30 teams across the country in June 2016. The research involved face to face interviews with adults in 15,000 households randomly selected from a larger group to be nationally representative. With children, the fieldwork included taking body mass index measurements and measuring height.
Fertility rate and contraceptives
South Africa was entering what Statistician-General Pali Lehohla referred to as a demographic winter. The report showed the fertility rate dropping from 2.9 children to 2.6 between 1998 and 2016. “The fertility rate stands at 2.4% for urban women and at 3.1% for non-urban women. Furthermore, the report noted that 50% of married mothers, who already had two children, had no desire for more children.”
The number of women who reported having no access to contraception dropped to 15%. In the 15-49 age group, more women reported to researchers they were using a form of contraception that they controlled. In total, 58% of those women used modern methods including contraceptive pills, female or male sterilisation, and intrauterine contraceptive device. In contrast, just 1% of women claimed to use traditional methods of contraception.
Maternal health
More pregnant women have access to antenatal care today. In 2016, 96% of children were born in a clinic compared with 83% in 1998. An interesting fact revealed in the study was that rural women were more likely to receive more than four antenatal visits during their pregnancy. Warning that all the research still needed further study, Lehohla suggested that this may be down to population density in rural areas.
In urban Gauteng, the province with the highest population density, just 62% of women will have at least four antenatal consultations. The national average is 89%.
That access to healthcare has improved since 1998 is the result of more clinics being built, especially in previously underserved rural areas. Today 93.7% of women will receive antenatal care from a medical professional at least once in their pregnancy.
Child health
Chronic malnutrition remains an issue. The study reported that 27% of children under five were medically malnourished and stunted; a further 10% were severely stunted. Malnutrition, and stunting, was more prevalent in boys, at 30%, than girls, at 25%.
The mother’s wealth and educational level were factors in the likelihood of child malnourishment. In the lowest wealth quintile, 36% of children were found to be malnourished, the level decreased to 24% and then 13% as wealth increased.
At the other end of the spectrum, 13% of South African children are overweight, double the international average.
Minister Motsoaledi responded with concern when Lehohla revealed that 10% of children in Mpumalanga between the ages of 12 and 23 months had received no vaccinations. “We are going to rush because just a month ago I was meeting a team that deals with the immunisation programme and they were praising Mpumalanga as number one with polio [vaccination],” he said.
Teenage pregnancy
Certified research findings clear the fog and allow governments to formulate policies based on actual need. In 2008, 35% of teenagers were getting pregnant; in 2016, SADHS showed that number had fallen, with 28% of 19 year olds having borne a child.
While there were still pockets that made it difficult to change the perception, Motsoaledi said: “There is a notion that grants influence young girls to produce children. The evidence before us over a period of 2008-2016 does not show any increase in the proportion of teenagers who are giving birth. Therefore it’s a myth; we can now dispel that myth.
“I’m sure if Stats SA keeps on releasing statistics like these, that [notion that teenagers become pregnant to access child grants] will start to come down.”
Sexual behaviour
Lehohla stressed that more than 90% of South Africans — 92% of women and 93% of men — were aware of their HIV status after getting tested. However, in the 15-24 age group, 31% had never been tested.
Also, the report found a stark difference in behaviour between men and women in the 15-49 age group. The average lifetime sexual partners among all men aged 15-49 who had ever had sexual intercourse came to 15, while that of women in the same age bracket came in at four.
Smoking and alcohol
White women are far more likely to indulge in risky drinking behaviour. This is classified as having five or more drinks in a single occasion. Indian women are the least likely to have a drink over the course of their lives, just 1% telling researchers they had had a drink in the 30 days before their interview.
With men, risky drinking behaviour rises with age before reaching a plateau in the 25-34 age group — where 36% admitted to excessive drinking — and then decreasing.
South Africa was among the first countries to ban smoking in public places. Since 2000, when the Tobacco Products Control Amendment Act became law, the number of South Africans who smoke has shown a steady decline. In 1998, 11% of women smoked; today the number is 7% for women 15 and older. In the same period the percentage of men has dropped from 42% to 37%.
“People have been debating, those who like to smoke arguing especially, that government laws have not changed the pattern of smoking. I’m happy that a body like Stats SA has proven that indeed it has and significantly so,” said Motsoaledi.
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