Research Overview

About the MRC/Wits-Agincourt Unit
The Agincourt Health and Socio-Demographic Surveillance System (HDSS), located in in rural northeast South Africa close to the Mozambique border, provides the foundation 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. The Agincourt HDSS was a founding member of the International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) (

Framework highlighting focal research areas of the MRC/Wits-Agincourt Unit

COVID-19 Response
2020 brought challenges, demands and opportunities, and the senior management team of the MRC/Wits-Agincourt Unit has responded in a highly effective way scientifically, operationally, administratively, providing support to local and district health services. The MRC/Wits-Agincourt Unit rose to the challenge posed by the COVID-19 outbreak whilst maintaining continuity of more than 25 years of data collection, working with Ehlanzeni District on an urgent COVID-19 response, and repurposing the health and sociodemographic surveillance system (HDSS).

Health and Social Systems

The dynamics of health transition are reflected in the burdens affecting rural adults. Studies are occurring in epidemiology and treatment of epilepsy as well as the health and wellbeing of ageing populations.

Adolescent Health & Development
In rural South Africa morbidity, mortality and growth failure associated with malnutrition exist alongside female obesity and emerging cardiovascular disease. By tackling proximal issues of infant growth and nutrition, and social and emotional development in children, we aim to impact more distal outcomes including cognitive development, educational attainment, and adult metabolic disease.

Research & Evaluation Platform – Trends and Transitions
This theme seeks to understand dynamics of demographic and epidemiological change in rural populations undergoing rapid and multiple transitions, and to identify the forces driving that change.

Adult Health & Wellbeing
The Agincourt Unit is examining the immediate and longer term impacts of HIV/AIDS and antiretroviral therapy roll-out. This work will support provincial and national efforts and provide evidence on delivery models, coverage and individual and population impacts of ARTs, as well as efforts to improve chronic disease treatment.

Social & Environmental Determinants
Rural households remain under pressure. Sudden shocks, whether job loss or death of a breadwinner, can destabilise households; similarly, protracted stresses such as drought or chronic illness can undermine coping capacity and livelihoods. Key to understanding how to improve health and social development is to examine the strategies employed by households to gain livelihoods and cope with shocks and stresses.