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Since 2004, there has been a progressively more active system-wide approach to tackling the AGE incidence, morbidity and mortality. This involves the media, community and hospital services and progressive provision of basic amenities to the city’s over 200 informal settlements. Though covering the whole metropolitan area, this plan focuses on areas with the highest child mortality from AGE. In 2009, a data collection system was set up to monitor the scale and impact of the annual AGE peak from February to April that involved all 11 public hospitals (5 district, 3 regional and 3 central) in the city. All incident cases were counted on admission to a ward; inter-hospital transfers were not counted to avoid double counting. Deaths were counted, and information on co-morbid diseases such as HIV and malnutrition was collected on each death using the Child Healthcare Problem Identification Programme. 2 In all, 3 568 children were admitted during the 3-month period, approximately 1% of the city’s estimated 333 700 children under 5 years of age (Department of Health, unpublished data). The largest concentration of patients (1 476 patients, 41.4% of the total) was admitted to the Red Cross War Memorial Children’s Hospital, which drains three sub-districts (under-5 population 137 000) that contain areas with high social deprivation indices.

Childhood in-hospital mortality from acute gastro-enteritis in Cape Town