Tracking progress on the health status and service delivery outcomes for neonates and children in the Metro West geographic service area of the Cape Metropole, 2010 - 2015
Date
2019-04
Journal Title
Journal ISSN
Volume Title
Publisher
Health & Medical Publishing Group
Abstract
Background. Monitoring the health status of populations of children is one of the building blocks of the health system. The provision of an
indicator dashboard with disaggregated data that are collected over time can be used to gauge the performance of the health system, guide
the allocation of resources and prioritise health interventions within districts.
Objectives. To determine neonatal and child mortality, morbidity and health service outcomes over a 6-year period in the Metro West
geographic service area (GSA) of the Cape Town metropole.
Methods. A dashboard with key indicators was developed using existing data.
Results. From 2010 to 2015, there was a decrease in the perinatal mortality rate from 31.7 to 24.8 per 1 000 deliveries, and the early
neonatal and neonatal mortality rates from 7.8 and 8.6 to 7.0 and 8.2 per 1 000 live births, respectively. The main obstetric causes of
early neonatal deaths were antepartum haemorrhage (22 - 24%) and unexplained intrauterine death (13 - 16%); the main neonatal
causes were immaturity (17 - 34%), congenital abnormalities (23 - 29%) and hypoxia (23 - 26%). Under-five mortality decreased in 2013
from 25 to 22 per 1 000 live births, with the main causes being neonatal conditions (32%), pneumonia (25%), congenital abnormalities
(9%), injuries (8%) and diarrhoea (8%). Fifty percent of child deaths were out of hospital, with pneumonia and diarrhoea accounting
for more than half of these. There was an improvement in health service coverage rates in 2015: immunisation <1 year old (99%);
measles second dose (85%), pneumococcal third dose (100%) and rotavirus second dose (100%); maternal antiretroviral coverage
(90%); HIV testing in mothers (93%); HIV DNA polymerase chain reaction testing in babies (97%); and a decrease in HIV transmission
(2%). Exclusive breastfeeding coverage rates at 14 weeks, and vitamin A supplementation at 12 - 59 months, were only 30% and 44%,
respectively, across the GSA.
Conclusion. There was a decrease in perinatal, early neonatal, infant and under-five mortality in Metro West over the 6 years. Further
reductions in under-five mortality will require focusing on interventions to reduce neonatal and out-of-hospital deaths across the service
delivery platform. Home visits to at-risk mothers and infants by community health workers could prevent out-of-hospital deaths and
improve exclusive breastfeeding and vitamin A coverage. This will require increasing the number of community health workers and
broadening their scope of practice.
Description
CITATION: Hendricks, M. K. et al. 2019. Tracking progress on the health status and service delivery outcomes for neonates and children in the Metro West geographic service area of the Cape Metropole, 2010 - 2015. South African Journal of Child Health, 13(1):36-43, doi:10.7196/SAJCH.2019.v13i1.1581.
The original publication is available at http://www.sajch.org.za
The original publication is available at http://www.sajch.org.za
Keywords
Newborn infants -- Medical care -- City of Cape Town (South Africa), Children -- Medical care -- City of Cape Town (South Africa), Newborn infants -- Health -- City of Cape Town (South Africa), Children -- Health -- City of Cape Town (South Africa)
Citation
Hendricks, M. K. et al. 2019. Tracking progress on the health status and service delivery outcomes for neonates and children in the Metro West geographic service area of the Cape Metropole, 2010 - 2015. South African Journal of Child Health, 13(1):36-43, doi:10.7196/SAJCH.2019.v13i1.1581.