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South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

ABSTRACT: OBJECTIVE: To analyse trends in under-five mortality rate in South Africa (1990-2011), particularly the contribution of AIDS deaths. METHODS: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data. RESULTS: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37-39% of child deaths were due to AIDS in 2004-2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%. CONCLUSION: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall.

SUBMITTER: Kerber KJ

PROVIDER: S-EPMC3815090 | biostudies-other | 2013 Oct

REPOSITORIES: biostudies-other

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South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

Kerber Kate J KJ Lawn Joy E JE Johnson Leigh F LF Mahy Mary M Dorrington Rob E RE Phillips Heston H Bradshaw Debbie D Nannan Nadine N Msemburi William W Oestergaard Mikkel Z MZ Walker Neff P NP Sanders David D Jackson Debra D

AIDS (London, England) 20131001 16

<h4>Objective</h4>To analyse trends in under-five mortality rate in South Africa (1990-2011), particularly the contribution of AIDS deaths.<h4>Methods</h4>Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data.<h4>Results</h4>Differences between the models resulted in varyi ...[more]

PMID: 23863402

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South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

Publications

South African child deaths 1990-2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

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