The Agincourt HDSS site, measuring some 420 sq km,scovers some 120,000 people living in 21,000 households and 31 villages, lies in South Africa’s semi-arid rural north-east. Part of the Bushbuckridge ‘poverty node’ it has long been a labour sending area with limited employment opportunities despite a population density above 200 people per sq km. Located only 40km west of the Mozambican border, the area can be regarded as a cross-border region of rural southern Africa – indeed former Mozambicans make up about a third of the Agincourt population.

The Agincourt Health and Socio-Demographic Surveillance System (HDSS) is the research foundation of the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt). Work of the Unit serves to strengthen and extend a high-functioning health and socio-demographic surveillance system – including annual census, vital events and socio-economic updates. This serves as the scientific foundation for a programme of advanced research and intervention studies.


To make an exceptional scientific contribution to vulnerable communities that

  • addresses critical health and development challenges
  • enhances the quality of life and productivity of individuals and families
  • informs public policy, programmes and practice

Specific Aims

  1. To enhance capacity of the Agincourt research platform, including the Health and Socio-demographic Surveillance System (HDSS) and data management system, through:
    1. Applying strengthened measurement techniques to: cause-of-death estimation by validated verbal autopsy, full ‘reconciliation’ of in- and out-migration events, and recording of extra- household person-to-person social connections
    1. Instituting a standardized approach to each project, thus facilitating data management and linking of project datasets to the HDSS
    1.   Establishing effective, individual-level links between population records and health facility registries in the sub-district (‘clinic-HDSS link’)
    1. Implementing effective policies and methods for requesting/releasing data to students, collaborators and other scientists, including accessible web-based mechanisms.
  • To support an interdisciplinary research and intervention programme which will:
    • Analyse trends describing health, population and social transitions; support simulation of populations affected by sexually transmitted infections to predict the effects of interventions; and interpret divergences from contemporary transition theories
    • Develop and test interventions targeting critical problems affecting the health and wellbeing of children and adults, under the research themes Adolescent health and development; Adult health and wellbeing.
    • Evaluate personal effects and population impacts of decentralised delivery of highly active anti- retroviral therapy (HAART)
    • Investigate household responses to shocks and stresses
    • Inform effective responses by the health sector and related development sectors such as education.

Research Themes:

Research at the site encompasses five themes

  • Research and evaluation
  • Adolescent health and development
  • Adult health and wellbeing
  • Health and social systems
  • Social and environmental determinants of health

Agincourt HDSS site Demographic Characteristics, 2008 – 2010 

  Indicator2007/08/01 to 2008/08/012008/08/01 to 2009/08/012009/08/01 to 2010/08/02
Male Population PY389894129641641
Female Population Py423774486445399
Total Population PY813678616087040
Crude Birth Rate26.6026.0922.02
Crude Death Rate12.4611.219.69
Crude Rate of Natural Increase14.1314.8812.34
In-Migration Rate19.3221.2417.52
Out-Migration Rate19.6818.2816.79
Total Fertility Rate2.872.792.36
Infant Mortality Rate 1q054.0539.6635.019
Child Mortality Rate 4q126.7425.2215.332
Under Five Mortality Rate 5q079.3463.949.81
Life Expectancy at Birth years53.9656.5760.17

This map shows where the Agincourt study site is located within South Africa.

Map of South Africa

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