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National Injury Mortality Surveillance System (NIMSS)

Injury is one of the major causes of death in South Africa. External causes of death are vital for monitoring demographic, seasonal and socio-economically related trends in these major causes of death and disability. Since 1991 and Act No. 52 of 1992 which precluded entry of the external cause of death in the death register for injury cases, such information has been missing from the national vital statistics on causes of death. Police data systems only record information for violence, and the national transport information system records information for an uncertain subgroup of motor vehicle collision deaths. Death due to suicide and other unintentional causes, where the manner of death is undetermined, are not tracked by any agency.

The National Injury Mortality Surveillance System (NIMSS) was established in 1999 to fill this gap by providing more comprehensive information about deaths due to external causes. The information is collated from existing investigative procedures at medico legal laboratories and state forensic chemistry laboratories. All deaths due to external causes are included, allowing an overview of how the different categories of external cause (e.g. gunshots, drowning) contribute to the profile of non-natural mortality in men, women, and children.

Project goals

The goals of NIMSS are to:

  • Provide ongoing and systematic information about the incidence, causes and consequences of all non-natural deaths
  • Enable the early identification of new injury trends and emerging problem areas
  • Monitor seasonal, longitudinal and geographical variations in the non-natural death profile
  • Identify priorities for injury and violence prevention
  • Help evaluate direct and indirect violence and injury prevention and control measures

Utility of NIMSS

The NIMSS provides the most detailed source of information on the who, what, when, where and how of fatal injuries in South Africa. Over the past decade the NIMSS collected fatal injury information from up to 62 medico-legal laboratories across all nine provinces of South Africa, accounting for between 39% and 52% of all injury deaths.

The NIMSS contributes widely to the injury prevention and safety promotion agenda in the country. Further to providing participating facilities with mortuary-specific reports that serve as mortuary management tools, the NIMSS enables capacity development, information dissemination and collaborative research among many stakeholders. Since its inception in 1999, the NIMSS has provided data for detailed analyses of the occurrence of violence, traffic and non-traffic unintentional mortality in cities and provinces in South Africa. For example, the NIMSS has enabled the comparison of injury magnitude and trends in both urban and rural areas of South Africa with current analyses involving these differences in overall injury and traffic-related injury deaths. The NIMSS has demonstrated to be particularly useful in providing pointers for improving the prevention and control of injuries in South Africa, and in evaluating the impact of direct (e.g. gun law enforcement) and indirect (e.g. socio-economic development) interventions that are expected to reduce some of the major causes of fatal injury.

For more information and reports based on the National Injury Mortality Surveillance System, see