In 1992 a decision was taken to establish a health and socio-demographic surveillance system in a remote rural area in South Africa. The idea was to try and anticipate the kinds of health system reforms the country would need as it prepared for the end of apartheid, and the building of a new democratic state.
The decision followed the realisation that there was no reliable information for planning a health system that could service all South Africans. Under apartheid health provision was skewed towards white people who represented only 13% of the country’s population.
Leading academics set up the surveillance system which now covers 31 villages and 120,000 people in rural north eastern South Africa. The project involved recording every member of every household – residents and temporary migrants – and regularly updating every birth, migration in and migration out, and death, as well as cause of death.
We also recorded education and household assets as a measure of socio-economic status, social grants, labour migration, among others.
Known as Agincourt, this project is now one of the longest running surveillance surveys on the African continent. The Agincourt Research Centre has developed a robust research infrastructure that undertakes work that is locally embedded and globally resonant, and is responsive to intractable health and development challenges confronting rural South and sub-Saharan Africa.
The centre has been producing interdisciplinary research aimed at addressing inequalities and enhancing health, well-being and economic prospects for people throughout their lives.
Research done over the past 26 years captures the dynamic transitions underway in the community. It provides insights into changes across people’s lives, helps to evaluate interventions, and provides information for local, provincial and national policy and planning.
As part of the project, a partnership was created six years ago to measure health and ageing specifically. Called Health and Aging in Africa: Longitudinal Study of an INDEPTH Community (HAALSI), it involves the Harvard Centre for Population and Development Studies and South Africa’s Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt). The study is funded by the National Institute on Aging, of the National Institutes of Health in the US.