Migrants form an integral part of South Africa. In line with South Africa’s status as a signatory of the Refugees Act, migrants have been included in the population that will receive basic health care services under the National Health Insurance (NHI). Understanding the burden of disease of migrants will play a significant role in the sustainability of NHI. Against this backdrop, this presentation analyses the causes of death registered by Statistics South Africa (Stats SA) for the years 2009 to 2015 and compares African migrants from four countries with the largest population in the country (Lesotho, Malawi, Mozambique and Zimbabwe,) and local South Africans. Initial findings show a much higher percentage of unnatural deaths among foreign nationals from these countries when compared with the local population. Using the CDC10 coding and in line with the Global Burden of Disease, the researchers used the data provided by Stats SA Nestar and grouped in three categories namely, deaths due to i) communicable diseases, neonatal and nutritional diseases ii) non-communicable diseases, and iii) external causes, namely violence and trauma.
Summary measures, frequencies and proportions were used to describe and compare causes of death among South Africans and African immigrants aged between 5 and 65 years old. Years of Potential Life Lost (YPLL) were calculated to compare premature mortality among immigrants and South African citizens. Standardized annual average YPLL rate per 1000 inhabitants was estimated at 23.07 for South Africans and of 27.59 for African immigrants. A higher YPLL rate for African immigrants was found in the categories of death due to non-communicable disease and death due to violence and trauma. These findings need to be seen in the light of social determinants of health, the rights and the entitlements approach. Overall migrants heightened death rates are related to the impact of contextual factors such as living and working conditions and barriers to access health care that migrants face. More specifically, migrants heightened death rates due to violence and trauma should be interpreted in light of the xenophobic sentiments observed in the country over the last decade. A perspective on these deaths argues for the need to attend to their everyday occurrence, often not accounted for in reports of xenophobic violence in South Africa. These finding will have larger implications for health policy and planning in the country and NHI in particular.