Fertility Trends and Unmet Needs
- Total Fertility Rate (TFR) declined from ~3.2 in the 1990s to 2.41 in 2024.
- Fertility is higher in rural provinces like Limpopo and Eastern Cape, and lower in Gauteng and Western Cape.
- Unmet need for contraception was 13.3% in 2016, with rural women more affected (17.4%) than urban (11.4%).
- Unwanted fertility: 16% of births were reported as unwanted in 2016, especially among:
- Teenagers (24%)
- Women with 3+ children (30.6%)
- Women with less education and lower wealth quintiles
Maternal and Neonatal Health
- Maternal Mortality Ratio (MMR) was 105 deaths per 100,000 live births in 2019 (per Rapid Mortality Surveillance).
- Causes of maternal death included HIV/AIDS, obstetric hemorrhage, and hypertension.
- Adolescent birth rate (15–19 years): showed a declining trend but remains high, with socio-economic and educational implications.
HIV and Antenatal Services
- Major public health success: high ART uptake among HIV-positive pregnant women.
- In 2022/23, 98.6% of antenatal clients were tested for HIV; 94.1% of HIV-positive clients were initiated on ART.
- HIV prevalence among antenatal clients declined, with regional variations still present.
Infant and Child Mortality
- Infant Mortality Rate (IMR):
- Dropped from 47.2 per 1,000 live births in 1994 to 22.9 in 2024
- Under-5 Mortality Rate (U5MR):
- Dropped from 69 (1994) to 31 per 1,000 live births (2024).
- These improvements are linked to immunisation, access to healthcare, and decline in HIV transmission
Civil Registration and Vital Statistics (CRVS)
- Birth registration:
- Improved but still incomplete in the early years of life—most children are registered after 1 year, especially in rural areas.
- Death registration:
- Now estimated to be more than 90% complete, helping to track causes of death more accurately.
- However, cause-of-death coding still has quality issues, especially for infants and maternal deaths.