SA’s injury statistics are not accurate, experts warn

South Africa’s death statistics are not accurate, says the South African Medical Research Council, calling for changes to the official death notification form.

• South Africa does not gain accurate statistics on deaths from injuries, the South African Medical Research Council (SAMRC) has warned.
• This is because the official death notification form does not allow for the reporting of the manner of death.
• Official mortality statistics overestimate accidental injuries and underestimate homicides, transport and suicide deaths, says the SAMRC.

Reporting of gun crime in South Africa is wildly inaccurate, work by the South African Medical Research Council (SAMRC) suggests. This is because the official death notification form does not distinguish between gun deaths from accidents and gun deaths from homicide.

The SAMRC has called on the government to update the country’s official death notification form. In a September 2023 South African Medical Journal (SAMJ) editorial, researchers and scientists Pam Groenewald, Richard Matzopoulos, Estevão Afonso and Debbie Bradshaw, say the form does not comply with international standards. While the World Health Organisation recommends reporting manner of death on the medical certificate for cause of death, South Africa’s form does not allow this, they say.

As a result, South Africa does not acquire accurate information on injury statistics, says Groenewald, a specialist scientist at SAMRC.

“Given that South Africa has got a really high injury burden, this is really not acceptable,” she said.

The SAMRC has press release, the SAMRC said natural deaths had spiked during Covid waves, while injuries had fallen during government-imposed lockdowns and alcohol sales bans. “Of particular concern is the significant impact of alcohol bans on injury-related deaths,” the council said.

The release also said the statistics are necessary to develop and monitor programs to reduce injuries and violence, and track Sustainable Development Goals of road traffic injury reduction, gender equality and reducing violence-related death rates.

South Africa’s official mortality statistics overestimate accidental injuries and underestimate homicides, transport and suicide deaths, according to a research report also published in the September 2023 SAMJ.

In official death notification form data from Stats SA for 2017, nearly 99% of firearm deaths were classified as accidental and only 1% as homicide. But the SAMRC’s National Cause-of-Death Validation Project (NCoDV) found more than 88% of firearm deaths were homicide, and its Injury Mortality Survey (IMS) found more than 93%.

Similar differences occurred for suicides. Only 0.3% of firearm deaths were recorded as suicide in the 2017 Stats SA data, but they were recorded as 7% in NCoDV and IMS data.

The research report says NCoDV and IMS provide more detailed and consistent data on causes of injury than the death notification form, but they are costly and time-consuming, and not feasible for routine surveillance.

“It costs a lot of money, when we could be getting this data in with every death certificate that gets completed,” Groenewald says.

She says the SAMRC has been asking for an updated death certificate form since 2012.

No annual mortality report since 2018

Also, Stats SA has not published an updated mortality report since the pandemic. The last official report was released in 2021 for the year 2018.

“We’ve got no cause-of-death data at all, not honest injuries, nothing. We haven’t seen a death certificate from during the Covid period; we don’t know what doctors gain reported,” she said. “It’s mind boggling.”

Felicia Sithole, deputy director of media relations for Stats SA, said in a statement that the Mortality and Causes of Death report had been delayed by a backlog of processing death notification forms as a result of the Covid lockdown, and because of Census 2022 work.

Sithole said Stats SA is committed to publishing the 2019 and 2020 Mortality and Causes of Death reports by the finish of March 2024.

“Stats SA fully comprehends the importance of the Mortality and Causes of Death release, especially during the Covid-19 pandemic, and acknowledges that our data must conform to international standards,” she said.

The SAMRC report also calls for the dormant National Forensic Pathology Services Committee to be reactivated. This would encourage improve data quality, the report says. The committee, established in 2014, has been inactive since 2018/9.

Foster Mohale, a media officer for the Department of Health, said the Minister of Health is in the process of appointing a modern National Forensic Pathology Services Committee.

The Department of Home Affairs had not responded to requests for comment at the time of publication.

© 2023 GroundUp. This article is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

You may republish this article, so long as you credit the authors and GroundUp, and enact not change the text. Please include a link back to the original article.

We assign an invisible pixel in the article so that we can count traffic to republishers. All analytics tools are solely on our servers. We finish not give our logs to any third party. Logs are deleted after two weeks. We enact not use any IP address identifying information except to count regional traffic. We are solely interested in counting hits, not tracking users. If you republish, please carry out not delete the invisible pixel.