South Africa has made significant strides in HIV prevention and treatment in the past decade. Mother-to-child transmission of HIV being has dropped to 1.5% – as many of 30% of HIV-infected mothers transmitted the virus to their babies in the early 2000s. The latest rate is lower than the national target of 2%, according to the 10th edition of the District Health Barometer, an annual publication that provides a detailed breakdown of public health services in the country.
The publication, which was released by the research organisation, Health Systems Trust, in Pretoria on Tuesday, also notes that 91% of HIV-positive pregnant women in government clinics are on antiretroviral therapy – “the highest level since 2011/12”.
Maternal mortality down
There has also been a slight decrease in the national institutional maternal mortality ratio – the number of women in health facilities who died during pregnancy, child birth or 42 days thereafter. The institutional maternal mortality ratio in 2014/15 was 132.5 per 100 000 births, down from 133.3 per 100 000 live births. This is, however, still higher than the national target of 100 per 100 000.
Authors of the publication believe that this marginal decrease “is mainly related to a decrease in the number of deaths from non-pregnancy-related infections, including HIV-related deaths. The number of maternal deaths with HIV as the underlying cause is expected to decrease further with more HIV-positive pregnant women on antiretroviral treatment,” the Health Barometer states
HIV spread
An estimated 6.8 million people in South Africa are HIV positive. Although there has been a momentous increase in access to treatment, the publication notes with concern the continuing spread of HIV. “There were 469 000 new infections recorded at the end of 2012, with particularly high incidence levels among young women aged 15–24 years. Fuelling the spread of the disease is the reported decline in knowledge levels about HIV, and an increase in risky sexual behaviour.”
According to the District Health Barometer, South Africa has a high incidence of both HIV and tuberculosis (TB). It is the leading cause of death in people with HIV. The World Health Organisation estimates that people with HIV are between 20 and 32 times more likely to develop TB than those without HIV.
Other findings of the District Health Barometer include:
- The cure rate for new pulmonary smear-positive TB patients has increased over the last eight years to 76.8%.
- The stillbirth rate continued to show a downward trend and was 20.7 per 1 000 births, the lowest rate since 2001/02.
- The case of fatality rates for diarrhoea with dehydration and pneumonia and severe acute malnutrition in children under five years of age continued to show a downward trend.
- The couple year protection rate increased by almost 10 percentage points from the previous year and was 46.8% in 2014/15.
- At 90%, the immunisation coverage under one year reached its highest level since 2005/06.
- The percentage of women under 18 years of age who delivered their babies in hospitals continued to show a downward trend, reaching its lowest level since 2006/07 at 7.4%.
- The rate for antenatal clients initiated on antiretroviral therapy increased by 15 percentage points from the previous year and at 91.2% reached its highest level since 2011/12.
