All in PDF formatFull Report
All in PDF format
Preface
Acknowledgments
Summary of Findings
Map of South Africa
1.1 History, Society and the Economy
1.2 Geography
1.3 Demographic Data and Population Policies
1.4 Health Policy Goals, Priorities and Programmes
1.5 Objectives and Organisation of the 1998 South Africa Demographic and Health
Survey
Chapter 2 Characteristics of Households and Respondent
2.1 Distribution of Household Population by Age and Sex
2.2 Household Composition
2.3 Educational Level of Household Members
2.4 School Attendance
2.5 Grants and Pensions Received by Households
2.6 Housing Characteristics
2.7 Water and Sanitation
2.8 Household Durable Goods
2.9 Characteristics of Women Aged 15-49
2.10 Child care for Working Mothers
Chapter 3 Fertility Part 1 | Part 2
3.1 Introduction
3.2 Fertility Levels
3.3 Fertility Differentials
3.4 Fertility Trends
3.5 Children Ever Born and Living
3.6 Birth Intervals
3.7 Age at First Birth
Chapter 4 Contraception and Fertility Preferences
4.1 Knowledge of Contraceptive Methods
4.2 Ever use of Contraception
4.3 Source of Contraceptive information
4.4 Age at First Use
4.5 Current Contraceptive Use
4.6 Number of Children at First Use
4.7 Knowledge of Fertile Period
4.8 Postpartum Amenorrhoea, Abstinence and Insusceptibility
4.9 Timing of Sterilisation
4.10 Source of Contraceptive Method
4.11 Quality of Contraceptive Services
4.12 Breaks in Contraceptive Use
4.13 Intention to Use among Non-Users
4.14 Reason for Non-use
4.15 Preferred Method of Contraception for Future Use
4.16 Exposure to Family Planning Messages in the Electronic Media
4.17 Acceptability of Media Messages on Family Planning
4.18 Exposure to Family Planning Messages in the Print Media
4.19 Discussion of Family Planning with Husband
4.20 Attitudes of Couples Toward Family Planning
4.21 Perceptions About the Legality of Abortion
4.22 Fertility Preferences
4.23 Need for Family Planning Services
4.24 Ideal Number of Children
4.25 Wanted and Unwanted Fertility
Chapter 5 Sexual Behaviour and HIV/AIDS
5.1 Introduction
5.2 AIDS Knowledge and Awareness
5.3 Sources of knowledge abut HIV/AIDS
5.4 Perception of the Risk of Getting HIV/AIDS
5.5 Opinions About Reporting HIV/AIDS Status
5.6 Age at First Sexual Intercourse
5.7 Recent Sexual Activity
5.8 Number of Sexual Partners
5.9 Relationship with Last Sexual Partner
5.10 Condom Use
5.11 Treatment of Women
Chapter 6 Infant and Child Mortality
6.1 Introduction
6.2 Levels and T rends in Infant and Child M ortality
6.3 Socioeconomic Differentials in Childhood M ortality
6.4 Demographic Differentials in Childhood M ortality
6.5 Environmental Factors and Childhood Mortality
6.6 High-Risk Fertility Behaviour
Chapter 7 Maternal and Child Health
7.1 Antenatal Care
7.2 Tetanus Toxoid Vaccination
7.3 Assistance and Medical Care at Delivery
7.4 Characteristics of Delivery
7.5 Maternal Mortality
7.6 Stress Incontinence
7.7 Immunisation Coverage
7.8 Differentials in Vaccination Coverage
7.9 Prevalence of Diarrhoeal Diseases
7.10 Treatment of Diarrhoeal Diseases
7.11 Prevalence of Acute Respiratory Infection (ARI)
7.12 Serious Accidents and Injuries
Chapter 8 Infant and Child Feeding Practices
8.1 Initiation of Breastfeeding
8.2 Duration of Breastfeeding
8.3 Frequency of Breastfeeding
8.4 Weaning Foods
8.5 Termination of Breastfeeding
9.1 Introduction
9.2 Sexual Behaviour
9.3 Contraception and Use of Condoms
9.4 Incidence of Intentional and Unintentional Injury
9.5 Patterns of Exposure to Tobacco
9.6 Alcohol Use/Misuse by Adolescents
9.7 Anthropometry of Adolescents
9.8 Abnormalities in Blood Pressure
9.9 Chronic Obstructive Pulmonary Disease and Asthma in Adolescents
Chapter 10 Mortality and Morbidity in Adults
10.1 Introduction
10.2 Adult Mortality
10.3 Chronic Diseases
10.4 Reported Cancer Pattern10.5 Self-reported Prevalence and Incidence of Tuberculosis
10.6 Injuries
10.7 Occupational Health: Disease and Injury in Working Adults
10.8 Prevalence of Symptoms of Sexually Transmitted Diseases among Men
Chapter 11 Utilisation of Health Services and Chronic Medication
11.1 Introduction
11.2 Health Services Attended
11.3 Satisfaction with Health Services
11.4 Access to M edical Aid
11.5 Self-Reported Chronic Disease Drugs Used
11.6 Payment for Prescribed Medication for Chronic Diseases11.7 Patterns of
Prescribed Medication for Common Chronic Diseases
11.8 Chronic Disease Drug Utilisation in Private and Public Sectors
11.9 Patient Knowledge of Their Chronic Disease Drugs
Chapter 12 Hypertension, Chronic Obstructive Pulmonary Disease and Asthma in Adults
12.1 Introduction
12.2 Hypertension
12.3 The Mean Blood Pressure, Pulse Rates and Pulse Pressure of Adults
12.4 the Prevalence of Hypertension and Treatment Status of Hypertensive Participants
12.5 Hypertension Risk Factors
12.6 Patient’s Reported Frequency of BP M easurements and Knowledge of
their Measured BPs
12.7 Comparison of BP Control between the Public and Private Health Services
12.8 Chronic Obstructive Pulmonary Disease and Asthma
12.9 Self-Reporting of Respiratory Diagnoses
12.10 Reporting of Symptoms
12.11 Association of Respiratory Symptoms and Abnormal PEFR with Risk Factors
Measured in the Survey
12.12 Discussion
Chapter 13 Adult Health Risk Profiles
13.1 Introduction
13.2 Prevalence of Tobacco Use Among Adults
13.3 Perceptions about Tobacco Use and Cessation Patterns in Adults
13.4 Exposure to Environmental Tobacco Smoke and Dust/fumes in the Work Place
13.5 Patterns of Alcohol Consumption
13.6 Risky Drinking and Alcohol Dependence
13.7 Perceptions of Own Body Weight
13.8 Weight, Height, and Mid-upper Arm Circumference
13.9 Body Mass Index (BMI) and Prevalence of Obesity
13.10 Waist and Hip Circumference and W aist/hip Ratio
Chapter 14 Oral Health and Oral Care in Adults
14.1 Introduction
14.2 Perceptions of Oral Health Problems
14.3 Utilisation of Health Services
14.4 Loss of Natural Teeth and Use of Dentures
14.5 Oral Health Practices
14.6 Knowledge about Fluoride in Water
14.7 Research P roposals
Chapter 15 Policy Implications
15.1 Major Findings
15.2 Population Issues
15.3 Child Health
15.4 Youth and Adolescent H ealth
15.5 Maternal and Reproductive Health
15.6 HIV/AIDS and STDs
15.7 Adult Health
15.8 Oral Health
15.9 Use of Chronic Medication
15.10 Conclusions
Appendix A Sample Design
Appendix B Estimates of sampling errors
Appendix C Data Quality Tables
Appendix D Establishing reference and predictive values
for Peak Expiratory Flow Rate (PEFR) for the SADHS Sample
Appendix E Persons involved in the 1998 South Africa
Demographic and Health Survey
Appendix F Questionnaires
The 1998 South Africa Demographic and Health Survey (SADHS) is the first study of its kind to be conducted in South Africa and heralds a new era of reliable and relevant information in South Africa. The SADHS, a nation-wide survey has collected information on key maternal and child health indicators, and in a first for international demographic and health surveys, the South African survey contains data on the health and disease patterns in adults.
Plans to conduct the South Africa Demographic and Health Survey go as far back as 1995, when the Department of Health National Health Information Systems of South Africa (NHIS/SA) committee, recognized serious gaps in information required for health service planning and monitoring. Fieldwork was conducted between late January and September 1998, during which time 12,247 households were visited, 17,500 people throughout nine provinces were interviewed and 175 interviewers were trained to interview in 11 languages.
The information from this benchmark survey will be used to evaluate health programmes of the department, describe health status and will be instrumental in identifying new directions for the national and provincial health programmes in South Africa. The survey findings serve as an important tool for programmes to assess progress and highlight some of the challenges facing the health sector in continuing to improve the health status of all South Africa, now and into the new millennium.
I would like to extend my sincere gratitude to all who have made the completion of the 1998 South Africa Demographic and Health Survey possible. I am deeply indebted to the staff of the National and Provincial Departments of Health for their hard work. Thanks also go to the Medical Research Council, Macro-International and USAID for their technical advice and support, and the Centre for Health Systems Research and Development, University of the Orange Free State for conducting the field work. Very special thanks go to the families and individuals who participated for sharing information about themselves and giving their invaluable time without which this study would not have been possible.
Finally, I would like to invite all to make use of the data in search of strategies and plans for the improvement of the health of all South Africans
Dr M E Tshabalala-Msimang
Minister of Health
The 1998 SADHS is a project which was initiated and primarily funded by the Department of Health. In its implementation several organisations and numerous individuals put a great deal of effort into ensuring that the project was conducted to the best of our abilities. In the first instance, I wish to express my gratitude to the National Health Information Systems Committee colleagues in the Provincial Departments of Health and the National Department of Health for the various roles they played in the course of this project.
I would like to use this opportunity to thank the staff of the Medical Research Council (MRC) for their role in coordinating the design of the survey and the sample, the questionnaire development and pilot testing, writing supervisors’ and interviewers’ manuals, and data processing. The MRC also played an important role in organising the field staff training, monitoring fieldwork and drafting reports. My special thanks in this regard goes to Dr Debbie Bradshaw for ensuring the smooth co-ordination of the fieldwork by the MRC.
My thanks also go to the Centre for Health Systems Research and Development at the University of Free State in partnership with King Finance for implementing the fieldwork. Let me also use this opportunity to express my gratitude to the Human Sciences Research Council for their assistance in the survey planning and design, as well as in the training, fieldwork monitoring, analysis and report writing and to Statistics South Africa, for their assistance with drawing up the sample. Many thanks to Macro International Inc. of Calverton, Maryland for providing technical assistance to the project as part of its international Demographic and Health Surveys program, and the United States Agency for International Development (USAID)/South Africa for paying for the technical assistance to the project. I would like to express my sincere appreciation to the members of the project management committee, the project technical team and all the technical consultants to the project for their contributions to the project.
I would like to thank Mrs Golda Chimere-Dan (Coordinator of the SADHS in the Department of Health) Ms Nolwazi Mbananga (SADHS Coordinator), and Ms Annie Cross (Macro International) for their effort in producing this preliminary report on time. Finally, thanks go to Dr L E Makubalo for directing the SADHS project.
Dr Ayanda Ntsaluba
Director General
Department of Health