Health care system

Hospitals without doctors

At least seven hospitals in KwaZulu-Natal have been operating without a doctor for at least two years, deepening the health crisis plaguing the province. Added to this, only 15 of the province's 64 state hospitals can boast doctor vacancy rates of under 50%, and not a single hospital in the province has every one of its doctors' posts filled.

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.

VCT Technical Advisor - Mpumalanga Province

Closing date: 26 March 2007
We are seeking to appoint a VCT Technical Advisor for a one year fixed-term contract to support District and Local Service Area (LSA) Management, and primary health care facilities to strengthen VCT services.

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

South African Health Review 2006

Published by: 
Health Systems Trust

An important purpose of the South African Health Review (SAHR) is to serve as a knowledge resource on the development of the national health system, and to contribute to the assessment of the implementation of health policies. The Review seeks to reflect on achievements made and challenges and gaps that impact on the transformation and strengthening of the South African health system. In 1996, the SAHR posed the question: What has changed for the poor, rural woman or child who presents to the clinic? Ten years on, this 2006 Review attempts to answer that question in some depth with a specific focus on Maternal, Child and Women's Health.

Table of Contents

Forword, Contents, Acknowledgements, Preface

Core Health Issues
1 Health Legislation and Policy
2 The GATS and South Africa's National Health Act
3 Health Care Financing
4 Health Management Information Systems
5 HIV and Tuberculosis Treatment Update
6 Community Participation in HIV and ARV Services

Maternal, Child and Women's Health: General
7 The context of Maternal and Child Health
8 Mortality and Morbidity Among Women and Children
9 The Impact of Male Sexuality on Women's and Children's Health

Child Health
10 Consent Laws Influencing Children's Access to Health Care Services
11 Key Childhood Health Promotion and Disease Prevention Programmes
12 Child Nutrition
13 HIV and Infant Feeding
14 Management of HIV-Infected Children
15 Chronic Conditions in Children
16 Vulnerability of Children with Disability - The impact of Current Policy and Legislation
17 The Health of Older Children in a School Setting

Women's Health
18 Maternal Care: Antenatal, peri and postnatal
19 Options for Hiv-Positive Women
20 Prevention of Cervical Cancer
21 Women's Mental Health in South Africa

22 Health and Related Indicators


Transport Policy for Health Services in the Public Health Sector - Lessons Learned from a Study of the Impact on Health Services of Public-Private Partnership for Transport in the Eastern Cape

Published by: 
Health Systems Trust

Adequate and appropriate vehicles are essential for health service delivery. These are required for transport and transfer of patients from community to health facilities and between levels of health care delivery of essential equipment, medicines and other supplies to point of service delivery transport of health workers for supervisory visits, to attend meetings and training sessions and for administrative purposes.

Hospitals overwhelmed by dying AIDS patients

Despite governments introduction of antiretroviral drugs in 2004 to contain HIV in those already infected, thousands of people are still dying of AIDS-related illnesses, and hospitals from Cape Town to Mussina are struggling to deal with the increased load.

State of the Nation: South Africa 2007

Published by: 
Human Sciences Research Council
Assembling academics, journalists, researchers and analysts, the State of the Nation: South Africa 2007 volume will provide much fuel for debate. It offers 23 diverse angles on contemporary South Africa in one compelling, comprehensive and relevant publication.

The politics section focuses on the outcome of the 2006 local government elections and issues of service delivery. The section on the economy examines the rapidly growing social welfare net, the state of our public hospitals and health delivery systems, issues of water and the environment, and heritage and tourism.

Africa is developing solutions for fighting disease and improving health, new WHO report finds

Addis Ababa, 20 November 2006 -- The first report to focus on the health of the people living in the 46 countries of WHO African Region was launched Monday in Addis Ababa, Ethiopia. Simultaneous launches of the report, titled The Health of the People: The African Regional Health Report, were held at press conferences in London and WHO Headquarters in Geneva.

Solidarity With Developing Nations - At a Cost

As concerns continue to be expressed about the departure of African medical professionals for wealthy countries, South Africa says it is not recruiting health workers from developing nations -- something that also reflects the country's own experience of the medical brain drain.