South Africa - Africa Health Research Institute INDEPTH Core Dataset 2000-2017 (Residents only) - Release 2019

1.0

2019-06-26

v1 : Version extracted from analytical database ACDIS_A20180404

The health and demography of the South African population has been undergoing substantial changes as a result of the rapidly progressing HIV epidemic. Researchers at the University of KwaZulu-Natal and the South African Medical Research Council established The Africa Health Research Studies in 1997 funded by a core grant from The Wellcome Trust, UK. Given the urgent need for high quality longitudinal data with which to monitor these changes, and with which to evaluate interventions to mitigate impact, a demographic surveillance system (DSS) was established in a rural South African population facing a rapid and severe HIV epidemic. The DSS, referred to as the Africa Health Research Institute Demographic Information System (ACDIS), started in 2000.

ACDIS was established to ‘describe the demographic, social and health impact of the HIV epidemic in a population going through the health transition’ and to monitor the impact of intervention strategies on the epidemic. South Africa’s political and economic history has resulted in highly mobile urban and rural populations, coupled with complex, fluid households. In order to successfully monitor the epidemic, it was necessary to collect longitudinal demographic data (e.g. mortality, fertility, migration) on the population and to mirror this complex social reality within the design of the demographic information system. To this end, three primary subjects are observed longitudinally in ACDIS: physical structures (e.g. homesteads, clinics and schools), households and individuals. The information about these subjects, and all related information, is stored in a single MSSQL Server database, in a truly longitudinal way—i.e. not as a series of cross-sections.

The surveillance area is located near the market town of Mtubatuba in the Umkanyakude district of KwaZulu-Natal. The area is 438 square kilometers in size and includes a population of approximately 85 000 people who are members of approximately 11 000 households. The population is almost exclusively Zulu-speaking. The area is typical of many rural areas of South Africa in that while predominantly rural, it contains an urban township and informal peri-urban settlements. The area is characterized by large variations in population densities (20–3000 people/km2). In the rural areas, homesteads are scattered rather than grouped. Most households are multi-generational and range with an average size of 7.9 (SD:4.7) members. Despite being a predominantly rural area, the principle source of income for most households is waged employment and state pensions rather than agriculture. In 2006, approximately 77% of households in the surveillance area had access to piped water and toilet facilities.

To fulfil the eligibility criteria for the ACDIS cohort, individuals must be a member of a household within the surveillance area but not necessarily resident within it. Crucially, this means that ACDIS collects information on resident and non-resident members of households and makes a distinction between membership (self-defined on the basis of links to other household members) and residency (residing at a physical structure within the surveillance area at a particular point in time). Individuals can be members of more than one household at any point in time (e.g. polygamously married men whose wives maintain separate households). Obtaining information on non-resident members is vital for a number of reasons. Most importantly, understanding patterns of HIV transmission within rural areas requires knowledge about patterns of circulation and about sexual contacts between residents and their non-resident partners. To be consistent with similar datasets from other INDEPTH Member centres, this data set contains data from resident members only.

During data collection, households are visited by fieldworkers and information supplied by a single key informant. All births, deaths and migrations of household members are recorded. If household members have moved internally within the surveillance area, such moves are reconciled and the internal migrant retains the original identfier associated with him/her.

Event history data

Individual