1. Presented at AIDS 2010 in Vienna - Austria Place of death20062007200820092010 Hospital16.516.819.515.816.7 Emergenc y room/ out patient2.21.51.91.00.4 Dead on arrival26.027.124.026.222.7 Nursing home0.50.20.00.80.0 Home16.815.814.312.911.2 Other29.829.331.933.235.7 Total100.0 Trends and Characteristics of fatal assaults in Free State, 2006 – 2010: Findings from mortality and causes of death data Manana Kgabanyane Statistics South Africa, Free State Data and Method Data This analyses is based on mortality and causes of death data from the interactive data (SuperWeb) from Stats SA website – StatsOnline (www.statssa.gov.za). Stats SA receives death notification forms for processing from the national Department of Home Affairs. The denominator population data for the calculation of death rates per population at a particular year was extracted from the mid-year population estimates release. The death notification form captures multiple causes of death among which the underlying cause of death is derived using ACME(Automated Classification of Medical Entities). The causes of death categories in the database are based on the International Classification of Diseases, tenth revision (ICD-10). This is a classification maintained by the WHO for coding diseases, signs, symptoms and other factors causing morbidity and mortality; used worldwide for morbidity and mortality statistics, and designed to promote international comparability in the collection, processing, classification and presentation of statistics. The analysis in this report focuses on deaths for which the underlying cause of death is assault (ICD-10 codes, X85-Y09). Method Superweb was used to extract information on assault deaths from the Stats SA database. Furthermore Excel was used to calculate death rates and other percentages. The report examines trends and differentials in assault mortality using death rates (deaths per 100 000 population per given time period). The number of deaths per 100 000 population is widely used with reasonable confidence to monitor changes over time in “personal risk” levels. The death rates, which show the ratio of fatalities to population, reflect the impact of assaults on human population as a public health problem. Broad age groups are utilised in the analysis which are; 0– 14, 15–24, 25–34, 35–49, 50–64 and 65 and above. The age groups were purposely selected to reflect deaths among children (0–14), youth (15–24), young adults (25–34), the middle aged (35– 49; 50–64) and the elderly (65 years and above). Results Introduction The level of mortality is one of the indicators of the well-being and health status of a population, hence its inclusion, among others, in the construction of human development indices, the Millennium Development Goals (MDGs), and in the multi-dimensional approach to the measurement of poverty. Accurate and timely mortality statistics are needed for policy formulation, implementation and monitoring of health interventions aimed at increasing life expectancy and improving the health status of the population. Assault is classified as major form of violent crime alongside robbery and sexual assault. The 2010 findings from mortality and causes of death show that transport accidents and assault were the most common underlying causes of non-natural deaths in South Africa. The registration of deaths in South Africa is governed by the Births and Deaths Registration Act, 1992 (Act No. 51 of 1992), as amended. Net Enrolment Ratio, has hovered around 95 percent from 2001 to 2011 in Mangaung Metropolitan Municipality (Figure 2). This study reveals that Mangaung Metropolitan Municipality recorded a net enrolment rate of 95.2 percent in 2001 and 94.8 percent in 2011 (Fig 2). Figure 3 shows that out of 95.2 percent of pupils who were enrolled in 2001, 50.2 percent were boys and 49.8 percent were girls. This indicates that more boys were enrolled in schools than girls in 2001. In 2011 out of 94.8 percent of pupils enrolled, 50.7 percent were boys and 49.3 percent were girls. The study shows that the proportion of girls who were enrolled in 2001 has declined in 2011. Discussions The results from this study indicate that out of every 100 children of primary school age group 94-95 are enrolled in school. This is comparable to international accepted standards. (see Langsten, 2013). However NER does not report on the quality of education and does not indicate grade repetition. NOW DISCUSS THE GENDER DIFFERENTIALS AND ALSO CONCLUDE ON THEM BELOW Conclusions and Policy Recommendations The study indicates that there has been a 0.4% enrolment decline between 2001 and 2011. This is an indication that if the status quo is maintained, mangaung metropolitan municipality will not be able to ensure that all boys and girls complete a full course of primary education by 2015. Progress will be needed if Mangaung Metropolitan Municipality is to achieve the target of 100% by 2015. Literature cited Education for all (2008). Country report: South Africa http://www.education.gov.za/LinkClick.aspx?fileticket=rJwNOU9f82I%3d&tabid=452&mid=1034 Kiringai,J. and Levin, J (2008) Achieving the MDGs in Kenya with some aid and reallocation of public expenditures.Obrero : Obrero University. Langsten R (2013) Measuring progress toward universal primary education: An examination of indicators. Social Research Center: American University in Cairo. MDG Report (2013) Assessing Progress in Africa Toward the Millennium Development Goals. http://www.uneca.org/sites/default/files/publications/mdgreport2013_eng.pdf UNDP (2013), Millennium Development Goals: Country report http://hdr.undp.org/en/ Acknowledgments Mr Tshepang Chueu for data analysis Mrs Manana Kgabanyane for data analysis Mr Karl Heinz Joubert for mapping Mr Thabo Letsoalo for guidance Mrs Ntebogeng Madlopha for data analysis Figure 1: Map of Free State Province by district Figure 3: Enrollment by gender (%) Source: Statistics South Africa: Census 2001 and 2011 Figure 2: Number of assault deaths: Free State, 2006-2010 Though the number of non-natural deaths was declining in Free State, the number of assault deaths was increasing from 369 in 2006 to 490 in 2010. Conclusions and Recommendations The findings prove that assault poses a challenge in the province. Children as young as 0 – 14 years and the elderly (65+) died of assault. It is clear that young males of ages 15-24 and young adult males age 25-34 are at higher risk of assault than females. High proportion of assault death occurred in other places, which include those who were found murdered in the bushes. Based on these findings it is thus recommended that focused research on contributing factors to assault deaths and cases in which assault is a direct cause of death is needed to provide information for use in planning policies, intervention programmes and projects to assist the province to reduce violent deaths. Literature cited 1. Statistics South Africa. StatsOnline- Interactive Superweb data (website: http://interactive.statssa.gov.za/superweblogin.do: Stats SA http://interactive.statssa.gov.za/superweblogin.do 2. Leyland AH. Homicides involving knives and other sharp objects in Scotland, 1981–2003. J Public Health 2006. 3. Leyland AH,Dundas R. The social patterning of deaths due to assault in Scotland, 1980- 2005. Journal Epidemiology and community health 2010. 4. Statistics South Africa. 2006-2010 Mid year population estimates, South Africa, Limitations of the Study One major limitation of the data is that information on age and sex of the deceased which are key characteristics in the analysis of death rates is missing. This could have affected the reliability of the information presented here. However, the study shows indicative levels and pattern of assault deaths. Figure 3: Trend of assault death rates: Free State, 2006-2010 The number of non- natural causes of deaths were declining from 2007 (3 484) to (3 270) in 2010. From 2006 to 2007 there was an increase in non- natural causes of deaths in the province (3 302) to (3 484). The analysis also indicate that proportions of assault deaths were high among the youth (15–24) and young adults (25–34) which accounted for more than 30% assault deaths in 2006-2010. In the Free State, between 2% and 3% of children (0-14 years) had assault as an underlying cause of death during the period under consideration. Assault deaths are likely to occur in males (above 80%) than in females (less than 20%). Figure 4: Percentage of deaths associated with assault by marital status: Free State, 2010 Place of death20062007200820092010 Hospital16.516.819.515.816.7 ER/ out patient2.21.51.91.00.4 DoA26.027.124.026.222.7 Nursing home0.50.20.00.80.0 Home16.815.814.312.911.2 Other29.829.331.933.235.7 Total100.0 Marital status of people who died due to assault: About 79% were single and this can be explained by high rate of assault deaths between the youth and young adults (age groups 15-24 and 25-34). 18% were married, 2% divorced and just a percent of widows. Over 23% of assault deaths occurred on the way to hospital (Dead on Arrival), 16% at the hospital, and over 10% at home while more than 30% occurred at other places. Nursing homes accounted for less than a percent of assault deaths for the period. The results show that in 2006, the assault death rate was 12 assault deaths per 100 000 population and it increased to 15 assault deaths per 100 000 population in 2007 and then increased steadily to reach 17 assault deaths per 100 000 population in 2010. Table 1: Percentage of deaths associated with assault by place of death: Free State, 2006 - 2010