Healthcare

The Birchwood National Consultative Health Forum Declaration on Primary Health Care

We, the members of the National Consultative Health Forum, representing government, public and private health sectors, statutory bodies, academic and research institutions, community organisations, civil society, non-governmental organisations and organised labour, in our meeting at Birchwood conference centre, Gauteng Province, held on 10-11 April 2008, on Primary Health Care to commemorate the 30th anniversary of the Alma Ata Declaration, hereby:

Government to curb private healthcare costs

The government is to intervene to curb rocketing private healthcare costs and prevent the sector's demise, Health Minister Manto Tshabalala-Msimang said on Tuesday. The health charter task team, among others, has been discussing the challenge of making healthcare more affordable, she told the National Assembly's health committee. However, these discussions are taking much longer than anticipated, with no indication of the outcome. I have therefore decided that the current challenges in the private sector are best resolved through legislative interventions, she said. The resolutions at the private healthcare sector indaba (meeting), convened by the Health Ministry in September last year, have mandated the Health Department to introduce legislative interventions to address the high costs of private healthcare, she said.

Medical aids want competition leeway

The Board of Healthcare Funders (BHF) has asked the Competition Commission to exempt medical schemes from provisions in the Competition Act that stop them from working as a collective on matters such as setting tariffs and defining patient benefits. The BHF, which represents 85% of SAs medical schemes, said its application was intended to deal with a host of unintended consequences arising from a ruling by the Competition Commission in 2004 that banned collective bargaining in the sector. The ruling was aimed at fostering competition, but was undermining schemes ability to safeguard their economic future, it said .

The District Health Barometer - Year 2006/07

Published by: 
Health Systems Trust

The District Health Barometer (DHB), now in its third year, is a tool to monitor and support improvement of equitable and efficient provision of primary health care in South Africa by the monitoring of a selected set of socio-economic and health care indicators. The report, which is available on an annual basis and which draws upon data from the District Health Information System (DHIS), StatsSA, the National Treasury (BAS data) and the national TB register, seeks to highlight inequities in health resource allocation, inputs, outputs and outcomes as well as the efficiency of health processes between provinces and between all districts in the country, with particular emphasis on rural and urban (metropolitan) districts.

The DHB is guided by an advisory committee made up of managers from the Departments of Health at national, provincial and district level, and also includes experts and stakeholders from the academic and research arenas. The committee meets twice a year, once to review the final draft and once to plan the next report.

The principle on which the DHB is based is that there should not be any primary data collection in order to construct the indicators. The indicators chosen are all based on secondary data that are either readily available, or on available data that needed manipulation. Averages have been calculated, i.e. for the metro and ISRDP districts and primary health care expenditure values are calculated from the data received from Treasury. Where the data are not publicly available, such as with the DHIS and Treasury data, HST have asked for and received written permission to use the data.

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

DHB 2006/07

Foreword
Introduction and Overview

Section A - Indicators

1. Socio-economic Indicators
1.1 Deprivation index
1.2 Access to Water
1.3 Inequity: The gap between the most and least deprived districts

2. Input Indicators
2.1 Per Capita Expenditure on Primary Health Care
2.2 Proportion of District Health Services Expenditure on District Management
2.3 Proportion of District Health Services Expenditure on District Hospitals
2.4 Cost Per Patient Day Equivalent in District Hospitals

3. Process indicators
3.1 Nurse Clinical Workload
3.2 Bed Utilisation Rate
3.3 Average Length of Stay
3.4 Clinic Supervision Rate

4. Output Indicators
4.1 Immunisation
4.1.1 Immunisation coverage
4.1.2 Immunisation drop out rate
4.2 Caesarean Section Rate
4.3 Male Condom Distribution Rate
4.4 PMTCT Indicators
4.4.1 Proportion of antenatal clients tested for HIV
4.4.2 HIV prevalence rate amongst antenatal clients tested
4.4.3 Nevirapine uptake rate among pregnant HIV+ve pregnant women
4.4.4 Nevirapine uptake rate among babies born to HIV+ve pregnant women
4.5 Primary health care utilisation rate

5. Outcome indicators
5.1 Incidence of New Sexually Transmitted Infections
5.2 Tuberculosis
5.2.1 Smear conversion rate
5.2.2 TB cure rate
5.3 Diarrhoeal Incidence in Children Under 5 Years
5.4 Rate of Children Under 5 years not Gaining Weight
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
- South Africa
- Eastern Cape Province
- Free State Province
- Gauteng Province
- KwaZulu Natal Province
- Limpopo Province
- Mpumalanga Province
- Northern Cape Province
- North West Province
- Western Cape Province

Appendices:
Appendix 1: Correlation of the national antenatal sero-prevalence survey with the national District Health Information System
Appendix 2: Deprivation Indices
Appendix 3: Further notes on methodology
Appendix 4: Indicator Definitions and Sources

Raw Data, Sources and Working Documents:

Project Manager Gauteng District Health Systems

Closing date: 29 February 2008

HST is seeking to appoint a Project Manager to provide strategic and technical support to District Health Planning, District Expenditure Reviews, Service Transformation Plans, District Health Information Systems and Clinic Supervision in the Gauteng Province.

Struggle for the health of the nation will resume

HEALTH care in SA is a famously contested sphere, and this year is likely to see intense lobbying by diverse interest groups as the government continues to try to regulate their activities. Several important bills are due to go before Parliament, and key sections of other acts need to be brought into effect. The governments desire to make health care more affordable and narrow the gap between the services available to rich and poor drives much of the legislation that has been passed, or is in the pipeline.

District Health Systems Development Facilitator

Closing date: 25 January 2008

We are seeking to appoint a facilitator on a one year fixed-term contract to support District Health Systems Development in Gauteng, with a specific focus on strengthening District Health Planning, District Health Information System (DHIS), District Health Expenditure Reviews (DHER) and Quality Assurance (QA) programs.

South African Health Review 2007

Series Name: 
South African Health Review
Published by: 
Health Systems Trust

The Role of the Private Sector within the South African Health System
The South African Health Review (SAHR) is an annual publication of the Health Systems Trust (HST), which has been published since 1995. The SAHR seeks to provide a South African perspective on prevailing international public health issues, to stimulate debate and critical dialogue and to provide a platform for assessing progress in the health sector.

Full SAHR 2007

Foreword
Contents and Acknowledgements
Editorial

Oversight: Principles and Policy
1 Stewardship: Protecting the Public's Health
2 Health Policy and Legislation

Pooling of Resources and Purchasing of Health Care
3 Health Care Financing and Expenditure
4 Medical Schemes
5 Social or National Health Insurance
6 Health Information Systems in the Private Health Sector
7 Health and Health Care in the Workplace
8 Rationing of Medicines and Health Care Technology

Health Care Delivery
9 Human Resources for Health
10 Public-Private Partnerships:A Case Study of the Pelonomi and Universitas Hospital Co-Location Project
11 Private Hospitals
12 Traditional and Complementary Medicine
13 Economics of the Traditional Medicine Trade in South Africa
14 HIV and AIDS, STI and TB in the Private Sector

Indicators
15 Health and Related Indicators

Glossary
Index

If you would like to order a hard copy of the SAHR 2007, please click >>here>>.

Press Release

These are the drivers of our healthcare inflation

It seems you cannot open a newspaper or financial journal anywhere in the world without finding articles about the unacceptable cost of private healthcare, or the high rate of medical inflation. In South Africa, these articles are embedded with doom and gloom the very survival of the private healthcare system is called into question on a regular occasion.