Country with High Mortality Rate


This paper explores mortality rate in South Africa. Most of the countries in Africa are developing countries which are characterized by high mortality rates according to majority of studies. South Africa will offer an interesting and a unique mortality study. The reasons are the following: First, South Africa has one of the highest prevalence of HIV/AIDS in the world with over 5 million individuals infected. Secondly, South Africa is more industrialized compared to other African countries. Lastly, its economy is well developed compared to most of African countries.


South Africa is located on the southern part of Africa. It is surrounded by Botswana, Namibia, Zambia and Malawi. It covers a total area of 471,359 sq mi. It has three capital cities which serve different purposes. They include Pretoria (executive), Cape Town (legislative) and Mangaung (judicial).


The population in South Africa is made up of indigenous Blacks, European and mixed South Asian descent. The country has total population of 50,587,000 (2011 est.). The population of the black people in South Africa is pre-dominant compared to other population sub-groups. Black population in South Africa represents 79.5%, white 9%, coloured 9% and Asian-Indian 2.5% (2011 est). South Africa had an annual population growth rate of 1.1 % in 2010. The black African of South Africa includes Zulu, Xhosa, Sotho and Tswana. The remaining percentage represents the other subgroups including the white population of South Africa. The official languages spoken in South Africa include English, Afrikaans, Ndebele, Pedi, Sotho, Swati, Tsonga, Tswana, Xhosa, Venda and Zulu. The main religion is Christianity. It also exercises Hinduism, Islam and traditional beliefs.

The government

South Africa has a democratic multiparty parliament. The government is characterized by the three arms of power. The first is executive, which represents the president who is elected for 5 years term by the National Assembly. The second arm is legislative which consists of two houses: the National Assembly and the National Council of Provinces. Under the 1997 constitution (the current constitution), the National Assembly has 400 members who have control over money related matters. The National Council of Provinces consists of 90 members, 10 from each province. The council of provinces represents the interest of provinces and it belongs to the second chamber. The seats in the National Assembly are allocated according to the percentage of votes each party has. The third arm of government is judiciary which is independent. The highest court which deals with constitutional issues is the constitutional court while Supreme Court is the highest court which deals with non constitutional issues.


The economy of South Africa can be defined as both industrialized and productive. It economy has many features associated with developing countries. For example, its economy is characterized by uneven distribution of resources (wealth and income). It is also characterized by division of labour between informal and formal sector of production. The formal sector of the economy is well developed and includes activities like manufacturing, mining, agriculture, and other services. South Africa is rich in minerals. It is the world’s main exporter and producer of platinum. It also mines manganese, gold, titanium, vanadium and chrome. It exports great percentage of coal. The Gross Domestic product (GDP) grew to $357.1 billion in 2010. The real GDP growth rate was 3.7% in 2008, -1.8 % in 2009, and 2.8% in 2010. South Africa had an unemployment rate of 25.7% in the second quarter of 2011.

State of Health (Diseases/Violence/Accidents)

Since 1994, the state of health in South Africa improved. But, in the recent past, the early achievements and gains have deteriorated due to the burden of HIV/AIDs, weak health systems, and lack of morale in staff. South Africa has one of the highest prevalence rates of HIV in the world. The country has a record of more than 5 million infected persons. It is estimated that 1000 new infections take place daily. TB also contributes to the mortality rate in South Africa. Other diseases which have a high prevalence are obesity, mental illnesses, diseases associated with smoking and alcoholism. The main contributors to obesity are change in lifestyle, diet and less physical activity (Coovadia & Jewkes 2009).

Violence is still evident in South Africa. World Health Organization declared violence a major concern in public health in 1996. World Health organization gave classifications of violence which include youth violence, child abuse, sexual violence, violence by an intimate partner, abuse of the elderly and collective violence. It is estimated that in every 26 minutes, a woman in South Africa is raped. This form of gender based violence is believed to high prevalence of HIV. The reason is that protective factors are defied and the victims are exposed to high risk of contracting diseases. Accidents are less reported in South Africa apart from those whose main cause is violence (Coovadia & Jewkes 2009).

Culture/Traditional Medicine

Traditional medicine and healers play a crucial role in South Africa. Although the government does not recognize their efforts, considerable percentage of the population opts for traditional medicine. Since HIV has a high prevalence in South Africa, infected people try traditional medicine in search of cure. Somehow, the constitution of South Africa relates traditional medicine with human rights. The practice of visiting traditional healers is common among Zulus (Richter 2003).

Healthcare System and Delivery

Ministry of Health is the main governmental Health-Related Agencies. Under the ministry of Health, South Africa has 388 public hospitals in total. These hospitals can be classified national hospitals, provincial and township hospitals. Medicine Control council is the only Health Regulatory Organization in South Africa. Its main aim is to protect and to safeguard the public by making sure that medicines used and sold in South Africa are effective, safe, and meet health standards (WHO 2005).

According to report released by Nursing Council of South Africa, there are over 98,000 registered nurses, 36,000 enrolled nurses, and 51,000 auxiliary nursing. Moreover, in 2006, World Health Organization produced a report showing that there were over 33,000 registered medical doctors in South Africa. Also report noted that the main problem in healthcare sector is shortage of nurses, health workers, and medical doctors.

Great emphasis is put in place to ensure that nurses get quality education from colleges. Colleges are set apart to train professional nurses. After they graduate from nursing colleges, nurses are trained for two years in order to be accredited and registered with nurses’ association. South African nursing is the only accrediting organization in South Africa. Its main duty is to oversee the training of nurses to ensure that they are competent in order to provide quality healthcare in South Africa. Nurses in South Africa have several associations. They include Democratic Nursing of South Africa, South African Nursing Council, Association of Nursing Agencies of South Africa and Neonatal Nursing Association of South Africa.

Health Priorities

The main priority for South Africa is to combat epidemics. South Africa should put enough measures to prevent and control HIV/AIDs and TB, and to establish centers to control emergence of TB. South Africa should allocate enough resources (funds and experts) in both private and public sectors to control epidemics. The government of South Africa should put measures which combat epidemics caused by alcohol and smoking. Government should ensure that campaigns are done to educate citizens on importance of quality diet and exercise. South African government has succeeded in provision of primary healthcare (The Globe 2004). However, the quality of service should be improved. Drugs should be adequate and accessible. Government of South Africa should ensure equal distribution of healthcare facilities depending on the needs. It should also ensure sufficient health professionals in the public sector (Murray & Lopez 1997).

Nursing Implications

In order to ensure that the government and other involved bodies meet the priorities mentioned, nursing profession and nurses working in South Africa play a crucial role. Nurses can act as educators. They can facilitate meetings with public on prevention of epidemics like HIV. They can also educate the public on dangers of alcohol, smoking and poor diet. Nurses can also act as managers of the centers set up by government. They can advice TB patients on how to manage their health. Nurses can also act as advisors. They can advice citizens on foods that make up balanced diet and those which boost immunity (Jansen 2004).

The working morale of nurses should be boosted to ensure that they work effectively and efficiently. By doing so, the quality of services offered will be improved, thus, improving the quality of life. Nurses can advise the concerned stakeholders on the present loopholes in healthcare sector and how to correct the situation. Nursing profession can liaise with current accrediting body to ensure professionals in public hospitals. Nurses can also prevent further infection of HIV especially during birth. Moreover, nurses can advise government on how to distribute funds because they understand the needs in health sector (WHO 2000).


Coovadia, H., and Jewkes, R. (2009).The health and health system of South Africa: historical roots of current public health challenges. The Lancet, 374 (9692): 817-834.

Jansen, J. (2004). Changes and continuities in South Africa’s higher education system,

1994 to 2004.Changing class: Education and social change in post-apartheid South Africa, 1 (2): 293-314.

Murray, C., and Lopez, A. (1997). Mortality by cause for eight regions of the world: Global Burden of Disease Study. The Lancet, 349 (9061): 1269-1276.

Richter, M. (2003). Traditional medicines and traditional healers in South Africa. Treatment Action Campaign and AIDS Law Project, 17 (4): 25-35.

The Globe. (2004). Global status report: alcohol policy. World Health Organization. Web.

WHO. Mental health atlas 2005. Web.

WHO. (2000). Obesity: preventing and managing the global epidemic. World Health Organization technical report series, 7 (894): 110-120.

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