Medical Research Council: Vaccine and Infectious Disease Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg, South Africa.
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg, South Africa.
Glob Health Action. 2021 Jan 1;14(1):1874138. doi: 10.1080/16549716.2021.1874138.
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. Several challenges were encountered during the initiation of the HDSS, including difficulties in community mobilisation and entry, stakeholders' engagement and participation, inaccessibility problems and concerns about safety of fieldworkers, and difficulty in getting/recruiting technical staff with requisite experience. Nevertheless, the SaT-HDSS was successfully established through application of several strategies, including continuous community engagement and stakeholders' mobilisation; in-depth training and retraining of all study staff; technical support from well-established HDSS sites across Africa, and international academic collaborations. Despite the challenges of undertaking routine surveillance of a hard-to-reach and highly mobile population, the SaT-HDSS was successfully established with a high-retention rate. The HDSS offers an important lens on morbidity and mortality and serves as a platform for pilots of interventions and programmes aimed at improving health and well-being of an urban population.
可靠的民事登记和人口动态统计系统（CRVS）对于估计死亡率和人口变化至关重要，对于公共卫生和社会经济规划至关重要。非洲的 CRVS 系统很大程度上不完整，因此健康和人口监测系统（HDSS）填补了 CRVS 的空白，尽管南非现有的 HDSS 都在农村地区。这限制了此类数据在南非这样的国家的普遍性，南非超过 60%的人口居住在城市地区，而且获得卫生和社会服务存在限制。我们描述了在约翰内斯堡的索韦托和坦贝莱（SaT-HDSS）建立 HDSS 站点的方法、成就、挑战和经验教训；这是南部非洲第一个基于城市的 HDSS。我们还强调了在 HDSS 中实施的一些研究。在 2017-2020 年期间，HDSS 已登记了 124169 人，并通过三轮数据收集跟踪了该人群的 95%。在启动 HDSS 时遇到了一些挑战，包括社区动员和进入、利益攸关方参与和参与、无法进入以及对现场工作人员安全的担忧，以及难以获得/招募具有必要经验的技术人员。然而，通过应用一些策略，SaT-HDSS 成功建立，这些策略包括持续的社区参与和利益攸关方动员；对所有研究人员进行深入培训和再培训；来自非洲成熟 HDSS 站点的技术支持，以及国际学术合作。尽管对难以接触和流动性强的人群进行常规监测存在挑战，但 SaT-HDSS 还是以高保留率成功建立。该 HDSS 为发病率和死亡率提供了重要视角，并为旨在改善城市人口健康和福祉的干预措施和方案的试点提供了平台。
