This research focuses on estimating infant and under-five mortality in South Africa for
the period 1998-2012, both to update previous estimates taking into account new data
and to assess the reasonableness of all estimates. Data from the 2011 Census and the 2012
HSRC survey were used for this purpose. The 2011 Census provided data from deaths
reported by households as well as the survival of the most recent births. The 2012 HSRC
provided full birth history data for women aged 15-49 which were used for direct
estimation of childhood mortality.
Deaths reported by households together with census estimates of the number of
children under the age of five are used to produce estimates of infant and under-five
mortality using the synthetic cohort life table approach. Blacker and Brass’s previous birth
technique is used to provide an estimate of infant mortality based on the survival of the
most recent birth in the 24 months preceding the census after correcting for the bias in
the proportion dead among most recent births relative to the proportion dead among all
births. The under-five mortality rate corresponding to this infant mortality rate is
estimated using the ratio of under-five mortality to infant mortality as observed in the
Princeton West level 19 model life tables. The direct method for estimating childhood
mortality is applied to the 2012 HSRC full birth history data. After imputing the exact
dates of birth and death, locating deaths in time and calculating the exposure to risk of
dying, the method of deriving period life tables is then followed to estimate
q )1(
and
q )5( .
Results show that the correction for the bias in the proportion dead among the
most recent births relative to the proportion dead among all births in the Previous Birth
Technique estimates did not work as estimates were still too low relative to those
produced by other researchers. Also, the direct estimates from the 2012 HSRC survey
were lower than those produced by other researchers owing to too few deaths recorded
in this survey and a large proportion of these missing ages at death. Only the estimates
from deaths reported by households were found to be useful. Thus, it was concluded that
the data from the 2012 HSRC survey and the survival of most recent births from the 2011
Census do not produce reliable estimates of childhood mortality.
It is recommended that a DHS-type survey should be conducted with one of its
purposes being to investigate the issues around childhood mortality estimation in South
Africa, particularly to improve on the quality of data available for estimation of childhood
mortality and to investigate further why the current methods are failing to produce 4
reasonable estimates of childhood mortality. Further research to investigate the extent of
the bias in the proportion of children dead among most recent births relative to the
proportion dead among all births is also needed.