Main Agincourt office

Main Agincourt Field Offices

The Agincourt Health and Socio-Demographic Surveillance System (HDSS), located in rural northeast South Africa close to the Mozambique border, provides the research plaform for the Rural Public Health and Health Transitions Research Unit of the Medical Research Council (MRC) and University of the Witwatersrand, South Africa (the MRC/Wits-Agincourt Unit). Its origins lie in the university’s ‘Health Systems Development Unit’ that in the early 1990s focused on district health systems development, sub-district health centre networks and referral systems and training of clinically oriented primary health care nurses.

AHDSS in SAAHDSS in Mpumalanga


AHDSSThe Unit’s goal / mandate is:

To better understand the dynamics of health, population and social transitions in rural South (and southern) Africa in order to mount a more effective public health, public sector and social response.

Agincourt  Health and Socio-Demographic Surveillance System (Agincourt HDSS)
An HDSS is a longitudinal population registration system that monitors demographic dynamics in a geographically defined population.

At baseline in 1992, some 57,600 people were recorded in 8,900 households in 20 villages; by 2006 the population had increased to about 70,000 people in 11,700 households. This increase is partly due to Mozambican in-migrants overlooked in the baseline survey; and to a new settlement established as part of the post-apartheid government’s Reconstruction and Development Programme. In 2007 the study area was extended to include the catchment area of a new privately supported community health centre established to provide HIV treatment prior to public sector roll-out of HAART. By mid 2011, the population under surveillance comprised some 90,000 people residing in 16,000 households in 27 villages. In the first quarter of 2013, another 4 villages were added making the number of research villages under surveillance 31, the population some 116 000 in 21 500 households.  Households are self-defined as “people who eat from the same pot of food”. Given sustained high levels of temporary labour migration in Southern Africa, we include temporary migrants resident for less than six months per year who retain close ties with their rural households. There have been 23 update rounds, conducted strictly annually since 2000, and currently round 24 is underway. Participation is virtually complete with a 0.08% refusal rate in 2016.  Read more about the Agincourt HDSS in this article: Profile: Agincourt Health and Socio-demographic Surveillance System.

The Agincourt HDSS was a founding member of the International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) and provides leadership to INDEPTH multi-centre initiatives in adult health and ageing and migration and health.