Infant mortality has risen to 60 per 1 000 live births, compared to the1998 figure of 45 per 1 000.
This sharp increase in child mortality has been attributed to a deterioration in child health, despite free health care and nutrition
HIV and AIDS is the largest cause of fatalities in children younger than five, accounting for 40 percent of deaths.
Lower respiratory infections, diarrhoea, low birth weight and protein  energy malnutrition, all associated with poor socio-economic
conditions, were responsible for 30 percent of childhood deaths.
The study indicated that HIV and AIDS resulted in the deaths of 42 749 children under the age of five in 2000, with 32 636 fatalities recorded
for the above four causes.
As children get older, the leading causes of death shift away from HIV and Aids, with road traffic accidents accounting for about 50 percent
of deaths in the five to nine-year-old age group. Girls in this age  group are still vulnerable to HIV and Aids, which accounts for 33
percent of fatalities.
HIV and Aids fails to feature in the 10-14 year-old age group, where  road traffic accidents and homicide or violence are responsible for 33
percent and 15 percent of deaths respectively.
MRC researcher Nadine Nannan points out that although the data between 1992-2002 shows an
increase in child mortality, there is no comparative data yet available for post 2002.
Projections showed that child mortality would peak at around 2002/03 due to the HIV/AIDS pandemic, but subsequent data is yet to be
released, said Nannan.
Nannan cautioned that current data was gathered prior to government's  roll-out of its mother-to-child transmission prevention programme.
A mother-to-child transmission prevention programme could reverse the trend of increasing child mortality as the number of infected infants
is reduced, she said.
The United Nations Children's Fund (Unicef), concurs with the MRC study, saying child mortality in South Africa had risen between 1990-
2002. Unicef says 42 percent of global deaths in children under the age of five occur in sub-Saharan Africa.
World governments pledged in 2000 to reduce the under-five mortality  rate by two-thirds - from 93 per every 1 000 to 31 per every 1 000 by
Unicef executive director, Carol Bellamy, says an estimated 11-million annual child deaths are preventable. Some are the direct result of
illness and others are due to indirect causes such as conflict,  marginalisation and HIV/AIDS, said Bellamy.
Bellamy pointed out that half of child deaths were caused by  malnutrition and the lack of safe water.
She said that cost-effective measures such as vaccines and micronutrient supplementation, would save the lives of million of
The world knows what it takes to improve child health and survival yet millions of the world's young citizens still die because they lack
access to basic services, said Bellamy.
Leading causes of death in SA children under five in 2000.
* HIV and Aids - 40 percent
* Low birth weight - 11 percent
* Diarrhoeal diseases - 10 percent
* Lower respiratory infections - 5,8 percent
* Protein-energy malnutrition - 4,3 percent.
42 percent of global deaths in children under five years of age occur in sub-Saharan Africa.
Below-five mortality rate for South Africa in 2000 is an estimated 95  per 1 000 children.
South African infant mortality has risen to 60 per 1 000 live births,  compared to the 1998 figure of 45 per 1 000. (Source: Pretoria News,
October 26, 2004)