Global Fund risks Medicines without Doctors if it doesnt finance health sector scale-up

A team of international health experts this week warned the Global Fund to Fight AIDS, TB, and Malaria: fund the salaries of health workers or else risk a situation in which medicines for these three diseases are made available in poor countries but there are no health professionals to deliver them.

The District Health Barometer - Year 2005/06

Published by: 
Health Systems Trust

The District Health Barometer (DHB) supports district managers with monitoring and evaluation of district performance and with their annual District Health Plans. It translates routinely collected service level data into information that supports effortless interpretation which leads to engagement.

The report compares key health indicators between the six metropolitan districts, between the 13 rural node districts and between all the districts throughout the country. Analysis of this carefully selected range of health indicators, facilitates identification of problem areas and the corresponding corrective measures. Inequities between rural and urban areas are addressed throughout the report.

Managers at all levels in the health sector and those in other sectors such as the national treasury, academia and policy, can use the DHB to

  • investigate reasons why and solutions to inequitable access to health within and between districts,
  • plan and facilitate equitable distribution of funds
  • identify gaps in data quality
  • identify research into equity,
  • identify operational research for clarification of reasons of poor performance and identification of corrective measures.


The DHB is a unique tool which aims to improve the quality, capacity and use of health information and the equitable allocation of health resources at all levels.

Table of Contents ('right click' on the link and chose 'file save as')

Full pdf of the DHB

Introduction, Background and Overview

Section A: Indicator comparisons by district

  1. Socioeconomic Indicators
    1. Deprivation Index
    2. Access to Water
  2. Input Indicators
    2.1 Per Capita Expenditure on Primary Health Care (excluding district hospitals)
    2.2 Proportion of District Health Services Expenditure on District Management
    2.3 Proportion of District Health Services Expenditure on District Hospitals
  3. Process Indicators
    3.1 Nurse Clinical Workload
    3.2 Average Length of Stay
    3.3 Bed Utilisation Rate
  4. Output Indicators
    4.1 Male Condom Distribution Rate
    4.2 Immunisation
    4.2.1 Immunisation Coverage
    4.2.2 Immunisation Drop Out Rate (DTP1-3)
    4.3 Caesarean Section Rate
    4.4 PMTCT Indicators
    4.4.1 Proportion of antenatal clients tested for HIV
    4.4.2 HIV Prevalence amongst antenatal clients tested
    4.4.3 Nevirapine uptake rate among pregnant HIV+ve women
    4.4.4 Nevirapine uptake rate among babies born to women with HIV
    4.5 Primary health care utilisation rate
  5. Outcome Indicators
    5.1 Incidence of STI treated-new
    5.2 Tuberculosis
    5.2.1 Smear Conversion Rates
    5.2.2 TB Cure Rate
    5.3 Diarrhoea incidence in children under 5 years
    5.4 Not gaining weight rate under 5 years
    5.5 Delivery rate in facility
  6. Impact indicators
    6.1 Stillbirth rate
    6.2 Perinatal mortality rate (PNMR)

Section B: District and Province Profiles 
- Eastern Cape Province
- Free State Province
- Gauteng Province
- KwaZulu Natal Province
- Limpopo Province
- Mpumalanga Province
- Northern Cape Province
- North West Province
- Western Cape Province

Map of 53 Health Districts in South Africa
Data Tables
Correlation Graphs
Deprivation Indices
The District Health Information System
Tuberculosis Surveillance and data collection in South Africa
Indicator Definitions
References and further reading

Seeing pill-swallowing no TB cure

Directly observed therapy (DOT) -- a controversial technique in which health care workers or community volunteers watch patients swallow tablets -- does not have a significant impact on tuberculosis patients, according to a new report from The Cochrane Library. Still, DOT remains a central tenet of international recommendations for curbing the spread of treatment-resistant bacteria, and experts say they are unconvinced that cliniciansshould abandon the technique.

Mozambique to double number receiving AIDS drugs

Mozambique will provide free anti-retroviral AIDS drugs to some 50 000 people by the end of 2006. Mozambique has been hailed by international lenders as a model reformer that has grown its economy at an average rate of 8% over the past decade.

WHO's AIDS Target - An Inevitable Failure

The World Health Organization (WHO) initiative to treat 3 million HIV-infected people in low- and middle-income countries by the end of 2005 (popularly known as the 3 by 5 initiative) has failed. Unrealistic assessments of how many people could be treated in the time frame explain the failure. But there has been additional fallout from the fiasco. Relations are frayed between WHO officials and South Africas health minister, who is trying to step up her nations AIDS treatment program responsibly. Additionally, because drugs were qualified for use before they had been properly tested and then later withdrawn, the 3 by 5 initiative added to uncertainty about how to proceed in many treatment programs around the world.

Viewpoint: HIV/AIDS and the health workforce crisis: What are the next steps?

In scaling up antiretroviral treatment (ART), financing is fast becoming less of a constraint than the human resources to ensure the implementation of the programmes. In the countries hardest affected by the acquired immunodeficiency syndrome (AIDS) pandemic, AIDS increases workloads, professional frustration and burn-out. It affects health workers also directly, contributing to rising sick leave and attrition rates. This burden is shouldered by a health workforce weakened already by chronic deficiencies in training, distribution and retention. In these countries, health workforce issues can no longer be analysed from the traditional perspective of human resource development, but should start from the position that entire societies are in a process of social involution of a scale unprecedented in human history. Strategies that proved to be effective and correct in past conditions need be reviewed, particularly in the domains of human resource management and policy-making, education and international aid. True paradigm shifts are thus required, without which the fundamental changes required to effectively strengthen the health workforce are unlikely to be initiated.