by Miriam Mannak

Healthier cities in the RSA

New research shows a 35% decline in new HIV infections

TB is the main cause of death for HIV-infected people
virus
South Africans who live in the cities are perceived as better off than those in rural areas because they can acquire better healthcare much easier. However, the increased incidence, where women die in childbirth, children perish from preventable diseases and our country's overall disease burden makes it into the headlines on a weekly basis. 

A report by the Human Sciences Research Council states there was a 35% decline in new HIV infections between 2002 and 2008, but the prevalence of the virus remains great throughout the country – and our cities are no exception.

The Centre for Health Policy at Wits University estimates that the HIV infection rate in Buffalo City, Nelson Mandela Bay, Mangaung, Ekurhuleni, Johannesburg, Tshwane, Msunduzi and eThekwini is more than 25%. Cape Town is the exception with 20%. 

Msunduzi tops the list with 42.3%, followed by eThekwini with 41.1%, Ekurhuleni with 33.8%, and Mangaung with 22%. 

Pietermaritzburg, which is part of the Msunduzi Municipality, had the highest number of HIV-related deaths in 2008.

About 27% of all deaths in the Msunduzi Municipality were linked to HIV and tuberculosis. eThekwini was a close second with 26.2%, followed by 25.9% in Nelson Mandela Bay; 25.8% in Buffalo City; 18.7% in Cape Town; and 16.5% Tshwane. 

TB is the leading cause of death for people living with HIV.

The government is one of the signatories of the international declaration that set up the Millennium Development Goals (MDGs), which are meant to be attained by 2015. One of the goals is for every signatory country to reduce the number of women who die during pregnancy or childbirth to 38 fatalities per 100 000 births – a reduction of 75%. 

Now, three years before the deadline, high maternal mortality rates continue to be a problem in South Africa. 

A report released in 2010 by Human Rights Watch, an international non-governmental organisation dedicated to protecting the human rights of people around the world, states that South Africa’s national maternal mortality rate had increased from 369 to 625 per 100 000 births between 2001 and 2007. 

While Caesarean sections are no magic potion for keeping women in labour alive, the rate at which this procedure is administered in the country is regarded as a key indicator of how much access there is to overall maternal health. 

The District Health Barometer (DHB) is published by the Health Systems Trust, a non-profit organisation that aims to assist the transformation of South Africa’s health system. The 2010–2011 DHB states that Nelson Mandela Bay is the best place to get a caesarian birth. Last year, about 40% of all babies born in this city’s district hospitals were delivered by caesarian section.  Next on the list are eThekweni, Ugu in KwaZulu-Natal, Cape Town, and Uthungulu (also in KZN). 

For a more in depth view on this topic, make sure that you get your copy of issue 45 of Service magazine.

Miriam Mannak
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