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Alarming rise in maternal deaths

THE number of women who die in South Africa during or shortly after pregnancy has shown an "alarming" upward trend, says the 2010 medium-term budget policy statement (MTBPS).

According to the document, tabled by Finance Minister Pravin Gordhan in Parliament on Wednesday, South Africa's maternal mortality rate rose from 369 deaths per 100 000 births in 2001, to 625 in 2007.

It notes that the country is "unlikely" to achieve its 2015 Millennium Development Goal (MDG) target of no more than 38 deaths per 100 000 births.

The MTBPS also notes a disturbing rise in under-five infant mortality between 1999 and 2007, from 59 per 1 000 births to 104 over this period. This means more than one in 10 South African infants is dying before their fifth birthday. The MDG target is no more than 20 deaths per 1 000 births. The MTBPS says this target, too, is unlikely to be achieved.

The document says that while South Africa has seen improvements in ante-natal care coverage and use of modern contraceptive methods, "the country's maternal mortality is rising - an alarming trend". It attributes this to "the prevalence of HIV, together with complications associated with hypertension and deficiencies in obstetric services".

On child mortality, it says South Africa's rates "are unacceptably high and far above comparable international norms".

The MTBPS figures come a week after the United Nations (UN) Population Fund's "State of World Population 2010" report found that the number of babies who die in the first year of life is lower in Botswana and Namibia than in South Africa. The report showed the infant mortality rate in South Africa (for children under a year) was 43 in every 1 000 live births, compared to 32 in Botswana and 30 in Namibia.

SAPA, 27 October 2010

Infant deaths report grim reading

Infant mortality rates are lower in Botswana and Namibia than they are in South Africa. According to a table of indicators contained in the United Nations Population Fund (UNFPA), "State of World Population 2010" report, released yesterday, infant mortality in South Africa is 43 per   1 000 live births. The rates in Botswana and Namibia are 32 and 30 respectively. Other Southern African neighbours have higher rates of infant deaths: 65 per 1 000 live births in Lesotho; 83 in Mozambique; 59 in Swaziland; and 51 in Zimbabwe.

The report says the data estimates are for this year, and the source is the United Nation's Population Division (UNPD). On life expectancy, the report shows this is considerably higher, for both males and females, in Botswana and Namibia than in South Africa. According to the table, life expectancy in Namibia is 61.2 and 62.7 years, for males and females respectively. In Botswana the figures are 55.7 and 55.0 years, and in South Africa 50.6 and 53.2 years.

The 2010 report also contains a comparison, by country, of reproductive health indicators, including births per 1 000 woman aged 15 to 19, and contraceptive and HIV prevalence rates. It says that in sub-Saharan Africa, the southern Africa region has by far the lowest adolescent birth rate - 61 per 1 000 girls - and the highest contraceptive prevalence, at 59% for all methods and 58% for so-called modern methods. In contrast, the rest of the sub-regions in sub-Saharan Africa (including Eastern, Middle and Western Africa) have adolescent birth rates well over 100 per 1 000 girls, and contraceptive prevalence rates at 26% or less. The report said "modern methods" of contraception include "male and female sterilisation, IUD (intra-uterine device), the pill, injectables, hormonal implants, condoms and female barrier methods".

On HIV prevalence rates, South Africa and its neighbours stand out way above other countries in the world. Swaziland has the highest prevalence rate - 26.1% of those aged 15 to 49 - followed by Botswana, 23.9%; Lesotho, 23.2%; South Africa, 18.1%; Namibia and Zimbabwe, both 15.3%; and Zambia, 15.2%. By comparison, India has an HIV prevalence rate of 0.3%, and Brazil 0.6%. In a separate table of demographic, social and economic indicators, the report says South Africa's population of 50.5 million will rise to 56.8 million by 2050. The total population of Africa, currently (2010) just over one billion, will almost double - to 1.998 billion - over the next 40 years.

SAPA, 21 October 2010

Southern Africa life expectancy rising slightly
 
A dramatic fall in life expectancy in southern Africa caused by AIDS in the 1990s appears to have bottomed out, with new treatments bringing a slight rise in recent years, according to a United Nations (UN) report. However, the region remains the only one in the world where life expectancy is currently less than it was in the early 1990s - and in the case of women, significantly less.

Women form the majority of HIV-positive adults in sub-Saharan Africa, as well as in North Africa and the Middle East, said the report, "The World's Women 2010." In the period 1990-95, life expectancy at birth in southern Africa - South Africa, Namibia, Botswana, Swaziland and Lesotho - was 64 for women and 59 for men. That fell to 51 for women and 49 for men in 2000-05, but rose slightly in 2005-10 to 52 for women and 51 for men. In estern, central and western Africa, where some countries were also hard-hit by AIDS, life expectancy increased slowly but steadily over the same period and now stands at 57 for women and 54 for men.

The report by the UN department of economic and social affairs attributed the modest uptick in southern Africa to the development and improved availability of medical treatments for HIV. Sub-Saharan Africa remains the region worst affected by HIV, accounting for some two thirds of all people living with the virus worldwide. However, a UN report last month said new infections fell by more than a quarter in 22 countries between 2001 and 2009. In South Africa, at least 5.7 million people out of a population of 50 million are infected with HIV and an estimated 1 000 people die each day due to AIDS-related complications. However, the country now has the world's largest programme to treat the disease with antiretroviral drugs (ARVs), which can prolong the life of those suffering from the incurable illness.

The report found that women live longer than men in all regions of the world, typically by about five years, but are more likely than men to die from cardiovascular diseases, especially in Europe. The longest-lived women are to be found in Japan, with an average life expectancy of 86, and the longest-lived men in Iceland, where the figure is 80. At the other end of the scale, life expectancy in Afghanistan and Zimbabwe is below 45 for both men and women. The report said there had been a "noticeable recovery" in longevity in eastern Europe and the former Soviet Union, where life expectancy plummeted following the collapse of communist rule in the late 1980s and early 1990s. Men in particular are living longer due to reductions in heart disease deaths.

Reuters via The Citizen, 21 October 2010

Find new ways to finance AIDS fight

The South African Business Coalition on HIV/AIDS (Sabcoha) has called on the Government to lead discussions with the private sector to find new ways to finance the fight against the disease. South Africa has one of the world's worst HIV/AIDS epidemics, with an estimated 5.7 million people infected. While South Africa is one of the few African countries able to afford significant funds, the Government is also dependent on the assistance of external donors such as the US Presidential Emergency Plan for AIDS Relief. Brad Mears, Sabcoha's CEO, said the global recession has led to international donors reducing their contributions to agencies such as the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, raising fear about the long-term sustainability of external funding for South Africa.

The South African private sector could help bridge that gap, Mears said. He asked whether donor funding could not be paired with that of private equity to provide the capital injection needed to address human capacity constraints and develop much-needed infrastructure and called on the Government, perhaps under the leadership of departments like Trade and Industry, Finance and Health, to lead discussions with the private sector in this regard. Mears made his remarks ahead of the launch of the coalition's Community Fund, which aims to raise R500 million by the end of next year to support the Government's HIV-testing campaign. The campaign aims to test 15 million people for HIV, high blood pressure and diabetes by the end of June next year.

It is part of the Government's plan to accelerate its HIV/AIDS prevention and treatment programmes in line with its commitment to halve the number of new HIV infections between 2006 and next year, and to ensure that 80% of HIV/AIDS patients needing treatment have access to the required drugs. The private sector's target is to reach 2 million people, one million people who belong to medical aid schemes and another one million who are uninsured.

Mears said this campaign would continue until December next year. He said that while the initiative was driven by his organisation, it was open to everyone in business. He added that a lot of work had been done in securing preferential rates for testing kits, which could be accessed by Sabcoha members. The test will cost R300 per person. Companies will use internal resources in cases where they are available and there are six disease management centres that have been contracted to assist Sabcoha with testing.

The coalition also launched a web-based reporting tool for companies, which will be used to monitor and evaluate the private sector campaign. The information will be given to Government and will be available to the public in a form that does not identify specific companies or individuals. Mears said Sabcoha would like to see companies being able to benchmark their outcomes against their competitors, but emphasised that companies would be measuring themselves against an industry average and not against specific companies.

Tamar Kahn: Business Day, 19 October 2010
Lauren Petersen: The Citizen, 19 October 2010
Slindile Khanyile: Business Report, 19 October 2010

Who calls in sick the most?

Most South African companies have an absenteeism rate which is way over the acceptable limit, according to a report released by software company CAM Solutions. The statistics for the report were generated from information on the sick certificates of more than 180 000 employees in 60 local businesses, over a period of one year.

CAM Solutions CEO, Johnny Johnson, said the absenteeism rate of employees in the mining industry was 3.1%, in the medical industry 2.8% and local government employees had an absenteeism rate of 2.7%. In the financial services sector, the absenteeism rate was 1.7%, one of the lowest in the report. Johnson said absenteeism in the mining industry was most likely high due to the severe conditions in mines, as well as strict health and safety regulations which applied to mining employees. He said miners had to take sick leave if they were too sick to work underground, as conditions below ground could be gruelling.

Sectors such as financial services usually had lower levels of absenteeism because they employed more skilled workers, who in turn earned more than their blue collar counterparts. Johnson said the usual trend was the lower the salary, the higher the absenteeism rate. Sick absenteeism should be about 1.5% - which meant that for every 250 working days per year, the average employee should take 3.75 days off sick. Johnson said most South African companies had an overall absenteeism rate of between 2.0% and 6.0% - way over the acceptable limit.

Gillian Lumb, a Director in the Employment Law Practice area at the business law firm, Cliffe Dekker Hofmeyr, said that better management of absenteeism by South African employers was critical. She said employers needed to use the provisions of the Basic Conditions of  Employment Act, which allow for unpaid sick leave if employees are absent on more than two occasions in an eight-week period (or for more than two consecutive days) and if they failed to produce a medical certificate. She said the employer should also interrogate the medical certificates received from employees and if necessary take disciplinary action where medical certificates were fraudulent. According to Lumb, a lesser used provision of the Basic Conditions of Employment Act was section 22(6), which enabled an employer to agree with an employee to reduce the pay which the employee received for sick leave by up to 25%. She said that if an employer made use of this provision, it could encourage employees not to take as much sick leave as they would not be paid in full for the sick days taken.

Lumb said every employer should put in place clear, written procedures relating to absenteeism and that disciplinary action should be taken against employees who failed to comply with the provisions. There were also those employers who offered attendance bonuses to incentivise employees to attend work and in this way reduce absenteeism. The report said that about 43.5% of employees never took sick leave. Lumb said this percentage could easily be increased if the right systems were put in place.

Sowetan, 19 October 2010

Diet fads 'can be fatal'

Protein shakes, cabbage soup and diet pills are just some of the things parents are forcing their overweight children to swallow. With the number of children on fad diets on the rise, dieticians warn that quick-fix eating plans can lead to serious health complications and even death.

Johannesburg dietician Jacqui Smith is treating an increasing number of such children. She said the damage to their health, metabolism, and to their relationships with food, are always evident and difficult to repair, often leading to eating disorders. She said that putting children on fad diets should be illegal, adding that children should be given the best start in life by encouraging a healthy, balanced diet. In an attempt to lose weight fast and before they hit the beach, adults are also succumbing to weight-loss products offering miracles in "just 30 days". A 36-year-old London mother who consumed nothing but meal-replacement drinks for a month, died last week. Smith warned that fad diets are very popular at this time of year, with South Africans aiming for the perfect beach bodies. She said that there was always a new fad diet being discovered, but they all had one thing in common - they might give fast results in terms of weight loss on the scale, but they were not sustainable and the weight usually came back just as fast as it was lost. Smith said one then had to deal with the consequences, such as a negative effect on metabolism and often general health as well.

Nivashni Nair: The Times, 18 October 2010

HIV threat to unborn

Almost one in three pregnant women in South Africa is HIV-positive - and if they do not receive treatment their babies will be born carrying the AIDS virus. The 29.4% national average of HIV-positive pregnant mothers was revealed by Health Minister Aaron Motsoaledi in Johannesburg at the launch of the 20th National Antenatal Sentinel HIV and Syphilis Prevalence Survey 2009. The deputy chairman of the SA National Aids Council, Mark Heywood, said the figure was "extremely and unacceptably high". Motsoaledi could not say how many HIV-positive pregnant women were receiving drugs to prevent transmission of the HI virus to their children. His department wanted to establish that. He said all that was known was that 70 000 babies were born HIV-positive every year, but the Department had decided to cut this figure to below 5%. Motsoaledi wants all pregnant HIV-positive women to start prevention-of-transmission treatment as early as 14 weeks into their pregnancy. The previous guideline was to introduce treatment at 28 weeks. The survey - of 33 841 pregnant women at 1 457 antenatal clinics in October 2009 - found that the percentages of pregnant women who tested positive for HIV were: KwaZulu-Natal 39.5%; Mpumalanga 34.7%; Free State 30.1%; North West 30.0%; Gauteng 29.8%; Eastern Cape 28.1%; Limpopo 21.4%; Northern Cape 17.2%; and, Western Cape 16.9%. National figures show that the percentage of pregnant mothers attending public clinics who tested HIV-positive rose dramatically from 4.3% in 1993 to 30.2% in 2005. Since then, the annual surveys have shown a "flattening out" at about 29% for 2007, 2008 and 2009. But Motsoaledi said he was "concerned" by the "high" statistics in the worst-hit districts, all in KwaZulu-Natal.

Harriet McLea: The Times 12 November 2010