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This study examines spatial differentials in childhood mortality in South Africa using data from the 2001 population census. Of the complex routes of geographical area hierarchy maintained by South Africa, one route links provinces to Magisterial Districts (MDs). There are in all 354 MDs and nine provinces. Our analyses are conducted mainly at the level of MDs. The results show that provincial level indicators mask huge disparities in child health experienced by certain segments of the population. Children born in MDs such as Tabankulu, Lusikisiki, Bizana, Flagstaff, Libode and in the Eastern Cape Province in general are the most threatened early in life. Under prevailing mortality conditions, more than 10% of the children born in these districts are unlikely to celebrate their fifth anniversary. Most of the high mortality MDs form clusters that sometimes cut across provincial boundary. As it is to be expected, most of these high risk districts are among the poorest in the country as measured by average monthly expenditure. However, the worse-off districts, health-wise, are not necessarily the poorest and similarly, the best child health achievers are not necessarily the most economically well-off. On the basis of these findings, implementing policies targeting such high risk districts would seem a more rational way to help close the within country disparities in child mortality and thereby speed up progress toward the MDGs target

Spatial Differentials in Childhood Mortality in South Africa: Evidence from the 2001 Census