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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.
Achoki, Tom; Sartorius, Benn; Watkins, David; Glenn, Scott D; Kengne, Andre Pascal; Oni, Tolu; Wiysonge, Charles Shey; Walker, Alexandra; Adetokunboh, Olatunji O; Babalola, Tesleem Kayode; Bolarinwa, Obasanjo Afolabi; Claassens, Mareli M; Cowden, Richard G; Day, Candy T; Ezekannagha, Oluchi; Ginindza, Themba G; Iwu, Chidozie C D; Iwu, Chinwe Juliana; Karangwa, Innocent; Katoto, Patrick Dmc; Kugbey, Nuworza; Kuupiel, Desmond; Mahasha, Phetole Walter; Mashamba-Thompson, Tivani Phosa; Mensah, George A; Ndwandwe, Duduzile Edith; Nnaji, Chukwudi A; Ntsekhe, Mpiko; Nyirenda, Thomas Elliot; Odhiambo, Julius Nyerere; Oppong Asante, Kwaku; Parry, Charles D H; Pillay, Julian David; Schutte, Aletta Elisabeth; Seedat, Soraya; Sliwa, Karen; Stein, Dan J; Tanser, Frank C; Useh, Ushotanefe; Zar, Heather J; Zühlke, Liesl J; Mayosi, Bongani M; Hay, Simon I; Murray, Christopher J L; Naghavi, Mohsen.
  • Achoki T; Research, Africa Institute for Health Policy, Nairobi, Kenya.
  • Sartorius B; Center for Pharmaceutical Policy and Regulation, Utrecht University, Utrecht, Netherlands.
  • Watkins D; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
  • Glenn SD; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Kengne AP; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA.
  • Oni T; Department of Medicine, University of Washington, Seattle, WA, USA.
  • Wiysonge CS; Department of Medicine, University of Cape Town, Cape Town, South Africa.
  • Walker A; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  • Adetokunboh OO; Department of Medicine, University of Cape Town, Cape Town, South Africa.
  • Babalola TK; Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa.
  • Bolarinwa OA; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Claassens MM; School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
  • Cowden RG; School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
  • Day CT; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
  • Ezekannagha O; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  • Ginindza TG; Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa.
  • Iwu CCD; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
  • Iwu CJ; Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
  • Karangwa I; Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.
  • Katoto PD; Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
  • Kugbey N; Department of Biochemistry and Microbiology, University of Namibia, Windhoek, Namibia.
  • Kuupiel D; Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa.
  • Mahasha PW; Department of Psychology, University of the Free State, Park WEst, Free State, South Africa.
  • Mashamba-Thompson TP; Health Systems Research Unit, Health System Trust, Westville, South Africa.
  • Mensah GA; Independent Consultant, Awka, Nigeria.
  • Ndwandwe DE; International Institute of Tropical Agriculture, Ibadan, Nigeria.
  • Nnaji CA; Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
  • Ntsekhe M; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
  • Nyirenda TE; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
  • Odhiambo JN; South African Medical Research Council, Cape Town, South Africa.
  • Oppong Asante K; Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa.
  • Parry CDH; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
  • Pillay JD; Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo.
  • Schutte AE; University of Environment and Sustainable Development, Somanya, Ghana.
  • Seedat S; School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
  • Sliwa K; Department of Nursing, Research for Sustainable Development Consult, Sunyani, Ghana.
  • Stein DJ; Grants, Innovation and Product Development Unit, South African Medical Research Council, Cape Town, South Africa.
  • Tanser FC; Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
  • Useh U; Department of Medicine, University of Cape Town, Cape Town, South Africa.
  • Zar HJ; Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, Maryland, USA.
  • Zühlke LJ; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
  • Mayosi BM; School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
  • Hay SI; South African Medical Research Council, Cape Town, South Africa.
  • Murray CJL; Division of Cardiology, University of Cape Town, Rondebosch, Western Cape, South Africa.
  • Naghavi M; The Cardiac Clinic, Groote Schuur Hospital, Cape Town, South Africa.
J Epidemiol Community Health ; 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1629386
ABSTRACT

BACKGROUND:

Over 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.

METHODS:

We 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.

RESULTS:

Across 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.

CONCLUSIONS:

Reductions 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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Jech-2021-217480

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Jech-2021-217480