Maternal mortality in South Africa in 2001: from demographic census to epidemiological investigation

Michel Garenne, Institut Pasteur
Kourtoum Nacro, United Nations Population Fund (UNFPA)

The 2001 South-Africa census included questions on maternal deaths in the previous 12 months. MMR was estimated at 542 per 100000 live births. This high level occurred despite a low proportion of maternal deaths (6.4%) among deaths of women aged 15-49 years. It was due to the astonishingly high level of adult mortality, some 4.7 times higher than expected. The main reasons for these excessive levels were HIV/AIDS and external causes of death. Estimates of MMR were found to be consistent with other findings in the country. Differentials in MMR were considerable: 1 to 9.2 for race, 1 to 3.2 for provinces, and 1 to 2.4 for levels of education. Relationships with income and wealth were complex, with highest values for middle income and middle wealth index. The effect of urbanization was small, and reversed in a multivariate analysis. Provincial levels of MMR correlated primarily with HIV/AIDS prevalence.