Description: The data set consists of 39 transcripts of interviews with professional health workers. Gauteng province was excluded from the study as approval from Department of Health could not be obtained. Abstract: This project was conceived to investigate the functionality of the South African civil registration and vital statistics system, and to identify those shortcomings that undermine its effectiveness and accuracy in the surveillance of birth and death statistics relative to expectant mother, infants and children. Through a Gap analysis the challenges, bottlenecks and short circuits (the 'gaps') within the surveillance system that serve to compromise the efficiency and effectiveness of the system were identified.

The project's aim was to strengthen the existing surveillance strategies for monitoring maternal and child morbidity and mortality in South Africa. The objectives of the project were the following: assess the current surveillance system and strategies for monitoring maternal and child morbidity and mortality in order to identify gaps and challenges within the system; and to describe the availability and performance of maternal, obstetric and infant health care services.

The gap analysis included gathering information related to the functioning, challenges and efficiency of the surveillance system at all levels including communities and assessment of the availability and performance of the Civil Registration and Vital Statistics system (CRVS) and maternal and child health (MCH) services.

All nine provinces of South Africa were included in the gap analysis. A total of eighteen (18) districts, one urban and one rural per province participated in the gap analysis. The target population included Department of Home Affairs and Department of Health officials working in different components of the CRVS system and MCH respectively at community, facility, district, provincial and national level. It also included all community leaders (these included traditional leaders, community leaders and farm owner/representative), Traditional Birth Attendants (TBAs), community health workers and pregnant women. For the health facility assessment, the target population included selected public health facilities across the nine provinces and health professionals in charge of MCH and notification of diseases and stillbirths. Data collection included both qualitative and quantitative approaches.

Digital audio recording

Face-to-face interview

Focus group

Self-completion

Professional health care workers responsible for MHC, who support birth and death registration and work or live in the participating communities and were present at the time of the study and have agreed to participate and signed the consent form.

Sampling

Different sampling methods were used to select districts and participants for the different components of the project. The sampling methods used are discussed below.

Sampling of the districts

A total of 18 districts (9 rural and 9 urban) were selected. From each province one urban and one rural district were selected to be included in the surveillance. Convenient sampling approach was used to ensure that the selected urban district is the district that hosts the provincial offices and rural district to be the one furthest from the provincial capital. Within each district the following were included in the sample: villages, Department of Home Affairs (DHA) offices (district and local office), urban and informal areas. In total, 18 rural communities (9 rural villages and 9 farms); 18 rural district (local) DHA offices; 18 urban settlements (9 formal & 9 informal); 18 urban district (local) DHA offices were selected. These selected areas formed part of the gap analysis conducted at community level. Convenient sampling approach was used to ensure that the selected DHA offices within the sampled districts were servicing the selected village, farm, informal settlement and formal settlement in that particular district. The sampled villages formed part of the catchment area of the selected health facilities. That is, the health facilities of focus were treated together with their catchment areas as communities. Detailed sampling approaches used to select participants are discussed below.

Sampling of professional health care workers

Professional health care workers including community based professional healthcare workers were sampled within the facility that was sampled to participate. Depending on the size of the facility, that is, the number of professional health care workers responsible for women's health and how busy the clinic was at the time of the information gathering a take all approach or convenient sampling approach was used for the professional health care workers sampling. This was dependent on the number of professional health workers, work allocation and how busy the clinic was. One-on-one or group discussions were held with available professionals as a group or individuals responsible for maternal and child health services in their health facility.