Reliable civil registration and vital statistics (CRVSs) are essential for estimating mortality rates and population changes, and are critical for public health and socio-economic planning. CRVSs are largely incomplete in Africa, thus Health and Demographic Surveillance Systems (HDSSs) fill gaps in CRVSs, albeit existing HDSSs in South Africa are in rural areas. This limits the generalisability of such data in a country such as South Africa where over 60% live in urban areas, and where there are limitations to access health and social services. We describe the approaches, achievements, challenges and lessons learned in setting up a HDSS site in Soweto and Thembelihle (SaT-HDSS), Johannesburg; which is the first urban-based HDSS in Southern Africa. We also highlight a number of studies being implemented in the HDSS. In 2017–2020, the HDSS has enrolled 124,169 individuals and followed up 95% of this population through 3 rounds of data collection.

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Approaches, achievements, challenges, and lessons learned in setting up an urban-based Health and Demographic Surveillance System in South Africa

Authors: Sunday A. Adedini, Dineo Thaele, Matshidiso Sello, Portia Mutevedzi, Cleopas Hywinya, Nonhlanhla Ngwenya, Nellie Myburgh, Shabir A. Madhi