Selected results: Gauteng Seretloane Mabitsela

Background The South Africa Demographic and Health Survey (SADHS) 2016 is a national sample survey designed to produce information on health and nutrition of the population of South Africa Statistics South Africa (Stats SA) implemented the survey in collaboration with the National Department of Health (NDoH) and the South African Medical Research Council (SAMRC) The SADHS 2016 is the third DHS to be conducted in South Africa The first SADHS was conducted in 1998 and the second one in 2003

Objectives of the survey To provide information on family planning, maternal and child health, child survival, HIV/AIDS, reproductive health, nutrition, and adult health in South Africa. Information collected will assist health policy makers to plan and prioritise health programmes for all people living in South Africa

Information Collected in SADHS 2016 Demographic indicators Reproductive health & contraception HIV prevalence of adults Under-5 mortality rate, infant mortality rate, neonatal mortality rate, maternal mortality ratio, fertility rates Number of sexual partners, STIs, circumcision, use of contraceptives, unmet family planning Context for all other programme information Maternal, new-born & child health programme indicators Management of NCDs & risk factors Women’s status Uncontrolled hypertension, high HBA1c, chronic respiratory disease, overweight and obesity, smoking, alcohol, eating fruit and vegetables, drinking sugar sweetened beverage and intention to change salt intake Ante-natal care, HIV testing, births in facilities, post natal care, exclusive breast feeding, infant feeding, underweight, stunting, anaemia, diarrhoea and respiratory infection Women’s role in household decision making, domestic violence

Diabetes and HIV testing Blood Pressure Measurement Types of testing Anthropometry Anaemia Testing Height and weight measurements recorded for children age 0-59 months and for women and men age 15 and older Blood specimens for anaemia testing were collected from women and men age 15 and older and from children age 6-59 months Diabetes and HIV testing Blood Pressure Measurement Biomarkers collected finger-prick blood specimens for laboratory Diabetes (HbA1c) and HIV testing from women and men age 15 and older who consented Three blood pressure measurements were taken from consenting women and men age 15 and older using Omron 1300 digital blood pressure monitors

SA fertility rate is declining

Fertility

2,4 3,1 In 2016 the Total Fertility Rate stood Fertility at for Urban Women for Non-Urban Women 2,4 3,1

by 19 years of age 16% of girls have begun childbearing Fertility by 19 years of age 16% of girls have begun childbearing Hospital School Girls with lower levels of education are more likely to fall pregnant.

Percentage distribution of teenagers who began childbearing by age As expected teenage pregnancy increases with age. Fewer 19 year olds have begun childbearing in 2016

Percentage distribution of teenagers who began childbearing: Gauteng The Northern Cape and North West have the highest percentages of teenagers who began childbearing, Gauteng is just below the country average of 15,6%

Fertility preferences 61% of Married Mothers who already have 2 children have no desire for more children or sterilised 88% of Married Mothers who already have 4 children have no desire for more children or sterilised 88% 61%

Contraception 58% of all women 15-49 not only use contraception but use modern methods of contraception

Contraception Contraceptive use among women currently married or living with someone as married

Contraception: Gauteng Contraceptive use among women currently married or living with someone as married

Selected contraceptive use amongst sexually active women Contraception Selected contraceptive use amongst sexually active women Unmarried - use of injectables declined from 44% to 26%

Contraception Selected contraceptive use amongst sexually active women Unmarried: condom use increased from 3% to 24%

Contraception preferences: Gauteng Selected contraceptive use amongst sexually active women in GP Injectables the most preferred method, unmarried= is male condom, married= injectables

Summary: contraceptive use Overall, first commonly used = Depo (3 months), followed by male condom Drop in selected methods of contraceptives except for male condom among both unmarried and married women Among currently married woman 15% of family planning need is unmet

Infant and child mortality rates are basic indicators of a country’s socioeconomic progress as well as quality of life

Comparison of childhood mortality, 1998 and 2016 Deaths per 1,000 live births in the 5 years before the survey

Child health

Immunisation coverage 24-35 months

Immunisation coverage 24-35 months Only 42% of 24-35 month old children have received all age appropriate vaccinations.

Immunisation coverage 24-35 months: Gauteng Low levels all vaccinations Only half received measles 2

Nutritional Status of Children by Age Pattern Stunting is low height for age Stunting clearly remains a national concern.

Breastfeeding Status of Babies 0-5 Months 32% of children less than 6 months are exclusively breast fed which is less than the recommended 50% of exclusively breastfeeding as per WHO recommendation

Adult health risk factors

Multiple Sexual Partners (2+) in past 12 months 5% Among the men who had two or more partners in the past 12 months, 65% of them reported using a condom during their last sexual intercourse. Multiple Sexual Partners (2+) in past 12 months Among the women who had two or more partners in the past 12 months, 58% reported using a condom during their last sexual intercourse Multiple Sexual Partners (2+) in past 12 months

Multiple Sexual Partners (2+) in past 12 months in Gauteng Condom Use 62% Multiple Sexual Partners (2+) in past 12 months in Gauteng Multiple Sexual Partners (2+) in past 12 months Female 4% 62% Condom Use Among the men who had two or more partners in the past 12 months, 68% of them reported using a condom during their last sexual intercourse. Among the women who had two or more partners in the past 12 months, 62% reported using a condom during their last sexual intercourse Male 17% 68% Condom Use Multiple Sexual Partners (2+) in past 12 months

Intercourse in the past 12 months with a person who was neither their spouse nor lived with Among the men who had intercourse with a person who was neither their spouse nor lived with them, 69% used a condom at last sexual intercourse Among the women who had intercourse with a person who was neither their spouse nor lived with them, 60% used a condom at last sexual intercourse

Intercourse in the past 12 months with a person who was neither their spouse nor lived with them in Gauteng Among the men who had intercourse with a person who was neither their spouse nor lived with them, 67% used a condom at last sexual intercourse Female 43% 66% Condom Use Among the women who had intercourse with a person who was neither their spouse nor lived with them, 66% used a condom at last sexual intercourse. Male 67% Condom Use 55%

Sexual partners Gauteng=5 Gauteng=24 The average number of lifetime sexual partners among all men age 15-49 is 15 Gauteng=24 The average number of lifetime sexual partners among all women age 15-49 is 4 Gauteng=5

Women have higher levels of knowledge regarding testing than men Knowledge and History of HIV Testing Women have higher levels of knowledge regarding testing than men Women 15-49 Men 15-49 92% 93% Know where to test 82% 69% Ever Tested 59% Tested in the past 12 Months and received the last results 45% In the age group 15-24, 31% of women and 42% of men have never tested for HIV and AIDS

Knowledge and History of HIV Testing: Gauteng LP 88% Men 91% Women Knowledge of where to test GP 96% Men 91% Women South Africa 94% Men 93% Women MP 94% Men 97% Women NW 97% Men 98% Women FS 96% Men Women KZN 93% Men 91% Women NC 86% Men 93% Women EC 96% Men 97% Women WC 93% Men Women

Ever tested and received results: Gauteng Women have higher levels of testing than men GP 70% Men 80% Women LP 55% Men 78% Women South Africa 69% Men 82% Women MP 72% Men 86% Women NW 74% Men 84% Women FS 74% Men 84% Women KZN 73% Men 81% Women NC 62% Men 81% Women EC 63% Men 86% Women WC 74% Men 82% Women

Women have higher levels of testing than men Tested in the 12 months and received results: Gauteng Women have higher levels of testing than men

Nutritional Status Based on BMI score, two-thirds (68%) of women in South Africa are overweight or obese Just under one third of men (31%) are overweight or obese.

Prevalence of hypertension (blood pressure >140/80 mm/Hg and/or medication) by Sex and Age Group Hypertension increases with Age. After age 45, women have higher percentage of those who are hypertensive than men

Prevalence of hypertension (blood pressure >140/80 mm/Hg and/or medication) by Sex: Gauteng Gauteng ranking third lowest for both men and women

Prevalence of Anaemia in Adults by Age 31% of adult women and 17% of adult men are anaemic

Prevalence of Anaemia in adult women: Gauteng 32% of adult women in Gauteng anaemic, ranked third

Prevalence of Anaemia in adult men: Gauteng 17% of adult men anaemic in Gauteng, same as the National

Break/Section Slide Achohol and Tobbaco Smoking and alcohol

Prevalence of Tobacco use by Population Group and Sex Overall males smoke daily more than women Male Female Cigarette smoking between the different population groups more similar in males as opposed to females Coloured and white women have much higher prevalence of cigarette smoking (38% and 15% respectively) than Black/African and Indian women (3% each).

Prevalence of Smoking Cigarettes by women: Gauteng One in 20 women smoke

Prevalence of Smoking Cigarettes by Men: Gauteng One in four men smoke

Report having drunk alcohol in the past 7 days by Population Group and Sex Alcohol consumption is more common among men than women

Report having drunk alcohol in the past 7 days by Sex: Gauteng Men has the highest rate

Experience of violence

Domestic violence 1 in 5 women report having experienced physical violence 21% of women over 18 years has experienced physical violence

Domestic violence in Gauteng Physical violence: Ever=18% and in the 12 months= 8% Sexual violence: Ever=8% and in the 12 months=3%

Conclusion Information collected will assist health policy makers to plan and prioritise health programmes for all people living in South Africa A comprehensive and detailed report due February 2018 The Key Indicator Report is available on the Stats SA website www.statssa.gov.za