Background At 109 per 100 000 population, South Africa’s injury mortality rate is approximately 1.6 times higher than the global rate of 66.2 per 100 000. Although homicide rates declined since the 1990’s, they remain high along with road traffic injury deaths. Two injury mortality surveys for 2009 and 2017 will be utilised to determine if there was a decline in non-natural deaths over this period, and set a benchmark for future progress towards achieving the 2030 Sustainable Development Goals.

Methods We conducted a retrospective review of post-mortem reports for deaths in 2009 at a nationally representative sample of mortuaries. Logistic regression analysis tested hypotheses regarding metro/non-metro areas and manner of death. We are currently completing an enhanced repeat survey for 2017 deaths. We will estimate the weighted injury mortality profile from an unweighted sample of 31 021 records for 8 provinces and 11 350 deaths, previously captured, for the Western Cape. We will calculate age-standardized rates and Incidence Rate Ratios and model estimates comparing the 2009 and 2017 injury mortality surveys.

Results We estimated that there were a total of 52 493 (95% CI: 46 930–58 057) non-natural deaths in South Africa in 2009. We found a significantly higher likelihood for homicide in metro areas compared to non-metro areas, while transport-related deaths were significantly lower in metro areas. Firearm use significantly explained metro/non-metro differences in homicide risk.

Conclusion Targeted recommendations will be made to policy makers on interventions to reduce and prevent the very high rate of injury mortality.