Official South African mortality statistics over-estimate accidental injuries and under-estimate homicides, transport and suicide deaths, warns the South African Medical Research Council (SAMRC), with gun crime reports, in particular, being “wildly inaccurate”.
This is because the official death notification form does not allow for the reporting of the manner of death, it says, and does not differentiate between gun deaths from accidents and gun deaths from homicide.
It has again called on the government to update the official death notification form, writes Sonia Rao in GroundUp.
In a September 2023 South African Medical Journal (SAMJ) editorial, researchers and scientists Pam Groenewald, Richard Matzopoulos, Estevão Afonso and Debbie Bradshaw, said the form does not comply with international standards.
While the WHO recommends reporting manner of death on the medical certificate for cause of death, South Africa’s form does not allow this, they said.
As a result, the country does not have accurate information on injury statistics, said Groenewald, a specialist scientist at SAMRC.
“Given that South Africa has got a really high injury burden, this is not acceptable,” she added.
The SAMRC said accurate, timely mortality data for natural and non-natural deaths were especially important after the Covid pandemic.
The SAMRC said natural deaths had spiked during Covid waves, while injuries had fallen during government-imposed lockdowns and alcohol sales bans.
Particularly concerning was “the significant impact of alcohol bans on injury-related deaths”, the council said.
Gun deaths
In official death notification form data from Stats SA for 2017, nearly 99% of gun deaths were classified as accidental and only 1% as homicide. But the SAMRC’s National Cause-of-Death Validation Project (NCoDV) found more than 88% of firearm deaths were homicide, and its Injury Mortality Survey (IMS) found more than 93%.
Similar differences occurred for suicides. Only 0.3% of firearm deaths were recorded as suicide in the 2017 Stats SA data, but they were recorded as 7% in NCoDV and IMS data.
The research report says NCoDV and IMS provide more detailed and consistent data on causes of injury than the death notification form, but they are costly and time-consuming, and not feasible for routine surveillance.
“It costs a lot of money, when we could be getting these data in with every death certificate that gets completed,” Groenewald said, adding that the SAMRC has been asking for an updated death certificate form since 2012.
Last annual mortality report: 2018
Stats SA has not published an updated mortality report since the pandemic. The last official report was released in 2021 for the year 2018.
“We’ve got no cause-of-death data at all, not just injuries, nothing. We haven’t seen a death certificate from during the Covid period; we don’t know what doctors have reported,” she said. “It’s mind-boggling.”
Felicia Sithole, deputy director of media relations for Stats SA, said the Mortality and Causes of Death report had been delayed by a backlog of processing death notification forms because of the Covid lockdown, and because of Census 2022 work.
Stats SA was “committed to publishing the 2019 and 2020 Mortality and Causes of Death reports by the end of March 2024”, she said.
The SAMRC report also calls for the dormant National Forensic Pathology Services Committee to be reactivated, to help improve data quality. Established in 2014, it has been inactive since 2018/9.
Department of Health media officer Foster Mohale said a new committee was currently being appointed.
GroundUp article – SA’s injury statistics are not accurate, experts warn (Creative Commons Licence)
See more from MedicalBrief archives:
Impact of gun violence on SA’s healthcare system
SA homicides 7x global average, with sharp force the major cause of death
SA has higher suicide mortality that most of Africa – IRR
Law enforcement and drunk driving — how to curb SA’s road crash epidemic