In the past two years alone, more than 1 000 children under five have died from hunger, with deaths in this age group generally showing a big increase since 2020, notes MedicalBrief.
Health Minister Dr Aaron Motsoaledi, responding to a question by DA health spokesperson Michele Clarke about the number of youngsters who have died in public health facilities since 1 January 2023, painted a sombre picture.
The Department of Health monitors deaths in children under five in all government facilities, he said, adding that aggregated data on common causes for these death (diarrhoea and pneumonia) as well as data on underlying causes, such as severe and moderate acute malnutrition, are collected routinely through the District Health Information System (DHIS).
The most affected provinces were KwaZulu-Natal, Limpopo, the Eastern Cape and Gauteng, reports TimesLIVE.
In 2023, a response to a DA question revealed 12 582 children had died from severe acute malnutrition and moderate acute malnutrition in the decade since 2013.
Preventable diseases
But it’s not just starvation and malnutrition that are contributing to the concerningly high child mortality rates.
Other preventable and treatable diseases, apart from pneumonia and diarrhoea, and which include respiratory infections, are the leading causes of death among children under five, according to the latest figures from StatsSA, which show a significant rise in children’s deaths.
Professor Shanaaz Mathews, research director at the Department of Paediatrics and Child Health at the University of Cape Town, told Health-e News that under-five deaths had risen to 40 per 1 000 live births in 2022. In 2020 it was 28 per 1 000.
“The reasons for the increase after the Covid-19 lockdowns are unclear, as there have been long delays in the release of causes of death data,” she said.
In 2020, during the most stringent lockdown restrictions, there had been a downward trend in child mortality.
“The numbers of registered deaths suggest that the winter increases in respiratory syncytial virus (RSV) and other pneumonias, as well as seasonal outbreaks of diarrhoea, were absent,” added Mathews.
She said the lockdown restrictions on socialising and travelling might have protected children from infectious diseases.
Primary causes
The Department of Health attributes the primary causes of death to neonatal factors (birth defects, lack of oxygen during and after birth, infections), pneumonia, diarrhoea, and moderate and severe acute malnutrition.
Mathews said malnutrition was often an underlying cause of death in young children, but that there were also concerns that Covid-19 disrupted childhood immunisation programmes. This was reflected in a fall in vaccination rates among infants.
“The immunisation coverage dropped from 83.5% to 79.5% in 2020,” she said.
Lower respiratory tract infections, predominantly pneumonia, remain a major cause of disability and death in children under five, all of which were largely vaccine-preventable, she added.
Immunisation rates have remained below their pre-Covid-19 levels in Limpopo, Mpumalanga, Gauteng, the Northern and Western Cape.
Poisoning and other risks
Professor Ziyaad Dangor, clinical research director at Wits Vaccines and Infectious Diseases Analytic Research Unit (VIDA), said inaccurate diagnoses and subsequent inappropriate patient treatment also contributed to high rates of children’s death.
“They die of infections and at times underlying health problems.”
And, of course, another common cause of death in children is poison, an issue which has been widely reported in recent months.
He said children can get poisoned from touching affected surfaces, with the toxin being absorbed through the skin.
“This is not something new … There are also different types of poison, the first being paraffin, which can affect the lungs. However, children don’t die from this. Then there are pesticides like mothballs, that can result in severe disease if eaten.”
Government interventions
National Health spokesperson Foster Mohale said the department was initiating evidence-based interventions focused on the prevention, early detection, treatment, and referral of children with common childhood illnesses, including acute malnutrition, diarrhoea, pneumonia, HIV and TB.
“There is ongoing capacity building for clinicians to prevent and manage these illnesses… The department has taken key actions to improve monitoring and evaluation through routine programmes,” he added.
“It also follows the implementation standard inpatient paediatric register to improve data quality and the use of data for identifying and responding to deficiencies.”
See more from MedicalBrief archives:
SAHRC gives government deadline to address Eastern Cape malnutrition crisis
SA’s malnutrition crisis: 15 000 hospitalised in 2022/23
Free State infant malnutrition and deaths from starvation on the rise