Monitoring of non-communicable diseases such as hypertension in South Africa: Challenges for the post-2015 global development agenda

Candy Day, Pam Groenewald, Ria Laubscher, Sabrina Chaudhry, Nienke van Schaik, Debbie Bradshaw


Background. Examining the non-communicable disease (NCD) profile for South Africa (SA) is crucial when developing health interventions that aim to reduce the burden of NCDs.

Objective. To review NCD indicators in national data sources in order to describe the burden of NCDs in SA, using hypertension as an example.

Methods. Age, gender, district of death and underlying cause of death data were obtained for 2008 and 2009 mortality unit records from Statistics SA and adjusted using STATA 11. Data for raised blood pressure were obtained from four national household surveys: the South African Demographic and Health Survey 1998, the Study on Global Ageing and Adult Health 2007, and the National Income Dynamics Study 2008 and 2010.

Results. The proportion of years of life lost due to NCDs was highest in the metros and least-deprived districts, with all metros (especially Mangaung) showing high age-standardised mortality rates for ischaemic heart disease, cerebrovascular disease and hypertensive disease. The prevalence of hypertension has increased since 1998. National household surveys showed a measured hypertension prevalence of over 40% in adults aged ≥25 years in 2010. Treatment coverage was 35.7%. Only 36.4% of hypertensive cases (on treatment) were controlled.

Conclusion. Further work is needed if NCD monitoring is to be enhanced. Priority targets for NCDs must be integrated into national health planning processes. Surveillance requires integration into national health information systems. Within primary healthcare, a larger focus on integrated chronic care is essential.

Authors' affiliations

Candy Day, Health Systems Trust, Durban, South Africa

Pam Groenewald, Burden of Disease Research Unit, Medical Research Council, Cape Town, South Africa

Ria Laubscher, Biostatistics Unit, Medical Research Council, Cape Town, South Africa

Sabrina Chaudhry, Health Systems Trust, Durban, South Africa

Nienke van Schaik, Health Systems Trust, Durban, South Africa

Debbie Bradshaw, Burden of Disease Research Unit, Medical Research Council, Durban, South Africa

Full Text



Non-communicable diseases; Hypertension

Cite this article

South African Medical Journal 2014;104(10):680-687. DOI:10.7196/SAMJ.7868

Article History

Date submitted: 2013-12-18
Date published: 2014-08-13

Article Views

Abstract views: 4672
Full text views: 7693

Comments on this article

*Read our policy for posting comments here