Where death stalks our young children

21 October 2015 - 02:11 By Katharine Child

Mpumalanga is the worst place to be a sick or malnourished child in South Africa. In this province, children admitted to hospital have the lowest chance of leaving the facility alive.This is according to the District Health Barometer published by Health Systems Trust, which contains health statistics from each of South Africa's 52 districts.The statistics show that overall the country has made good progress in improving children's health, with the number of children born with HIV down from 8% in 2008 to 1.5%.Ninety percent of children have been immunised against a number of diseases.However, the report shows that children under five in OR Tambo in Eastern Cape and Ehlanzeni in Mpumalanga are more likely than children in other districts to die in hospital from diarrhoea, pneumonia or severe malnutrition.About 20% of children under five admitted to hospital with severe malnutrition in Mpumalanga die, way above the Department of Health's goal of 8%.About 5% of all children with pneumonia and diarrhoea in Mpumalanga die, compared with a 2.9% national average for pneumonia and 3.3% average for diarrhoea."These are kids in poorer communities who don't have access to clean water and are not well-nourished as healthy food is more expensive."They also get to hospital later because of the cost of transport and the distance they have to travel. They arrive sicker and the hospitals have poor quality of care," said Wits Public Health Professor Kathleen Kahn.Health Systems Trust technical specialist Candy Day said: "Under-five mortality rates have been reduced in many countries, [including South Africa] ... child deaths and under-nutrition are becoming increasingly concentrated in the most deprived communities."University of Cape Town's public health professor David Coetzee said children in rural areas were often sicker than children in urban areas."A child who dies of diarrhoea in Eastern Cape is most likely also malnourished even if the death certificate doesn't say so. There is a lot of poverty in Mpumalanga and Eastern Cape."Coetzee said Western Cape and Gauteng have very good mother-to-child HIV prevention programmes so HIV rates are lower. Children with HIV are more likely to get bad diarrhoea and pneumonia.Western Cape public health professor David Sanders, however, said the death rate from severe malnutrition in Western Cape looked too low to be accurate...

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