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Health trends, inequalities and opportunities in South Africa's provinces, 1990-2019: findings from the Global Burden of Disease 2019 Study

Authors :
Tom Achoki
Benn Sartorius
David Watkins
Scott D Glenn
Andre Pascal Kengne
Tolu Oni
Charles Shey Wiysonge
Alexandra Walker
Olatunji O Adetokunboh
Tesleem Kayode Babalola
Obasanjo Afolabi Bolarinwa
Mareli M Claassens
Richard G Cowden
Candy T Day
Oluchi Ezekannagha
Themba G Ginindza
Chidozie C D Iwu
Chinwe Juliana Iwu
Innocent Karangwa
Patrick DMC Katoto
Nuworza Kugbey
Desmond Kuupiel
Phetole Walter Mahasha
Tivani Phosa Mashamba-Thompson
George A Mensah
Duduzile Edith Ndwandwe
Chukwudi A Nnaji
Mpiko Ntsekhe
Thomas Elliot Nyirenda
Julius Nyerere Odhiambo
Kwaku Oppong Asante
Charles D H Parry
Julian David Pillay
Aletta Elisabeth Schutte
Soraya Seedat
Karen Sliwa
Dan J Stein
Frank C Tanser
Ushotanefe Useh
Heather J Zar
Liesl J Zühlke
Bongani M Mayosi
Simon I Hay
Christopher J L Murray
Mohsen Naghavi
Achoki, Tom [0000-0001-6309-8904]
Sartorius, Benn [0000-0001-6761-2325]
Oni, Tolu [0000-0003-4499-1910]
Adetokunboh, Olatunji O [0000-0002-4608-3951]
Bolarinwa, Obasanjo Afolabi [0000-0002-9208-6408]
Claassens, Mareli M [0000-0002-5927-284X]
Iwu, Chinwe Juliana [0000-0003-0765-7497]
Katoto, Patrick Dmc [0000-0002-0553-201X]
Nyirenda, Thomas Elliot [0000-0003-4727-7130]
Odhiambo, Julius Nyerere [0000-0002-9817-1849]
Schutte, Aletta Elisabeth [0000-0001-9217-4937]
Seedat, Soraya [0000-0002-5118-786X]
Naghavi, Mohsen [0000-0002-6209-1513]
Apollo - University of Cambridge Repository
Publication Year :
2022
Publisher :
BMJ, 2022.

Abstract

BackgroundOver the last 30 years, South Africa has experienced four ‘colliding epidemics’ of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards important Sustainable Development Goal targets from 1990 to 2019.MethodsWe analysed GBD 2019 estimates of mortality, non-fatal health loss, summary health measures and risk factor burden, comparing trends over 1990–2007 and 2007–2019. Additionally, we decomposed changes in life expectancy by cause of death and assessed healthcare system performance.ResultsAcross the nine provinces, inequalities in mortality and life expectancy increased over 1990–2007, largely due to differences in HIV/AIDS, then decreased over 2007–2019. Demographic change and increases in non-communicable diseases nearly doubled the number of years lived with disability between 1990 and 2019. From 1990 to 2019, risk factor burdens generally shifted from communicable and nutritional disease risks to non-communicable disease and injury risks; unsafe sex remained the top risk factor. Despite widespread improvements in healthcare system performance, the greatest gains were generally in economically advantaged provinces.ConclusionsReductions in HIV/AIDS and related conditions have led to improved health since 2007, though most provinces still lag in key areas. To achieve health targets, provincial governments should enhance health investments and exchange of knowledge, resources and best practices alongside populations that have been left behind, especially following the COVID-19 pandemic.

Details

Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....2c6e2d5efa14ff636909cbaba5b6ce85