District Health Barometer (DHB)


What is the District Health Barometer (DHB)?
The District Health Barometer is a publication that provides functional information for monitoring progress as a means to help improve health systems organisation and delivery, and in so doing, enhance the quality of and access to primary health care.
Funded by the National Department of Health, the DHB tracks, over time, important aspects of health system performance at district level. The content of the publication measures indicators similar to those benchmarked in district, provincial and national strategic plans, and serves a watching brief on progress against the targets set out in these plans by providing crucial quantitative input and pinpointing where serious gaps or performance issues prevail.
The DHB does not provide ‘new' information on public health management, but packages and foregrounds key data (often overlooked in other reports and tables) from a variety of sources for health managers as the main target audience. Through pooling and presenting the best available data in the most user-friendly format, the DHB also avails other sectors – such as Treasury, the international health community and donors – and the public, yearly insight into the state of South Africa’s public health sector.
As a process and an output, the Barometer supports improvement in the quality, capacity and use of health information at all levels in the public health sector.
Why a District Health Barometer?
Managers at all levels of the health system need appropriate information to assess progress on health indicators, set relevant objectives and develop plans that are well positioned for monitoring. Although an abundance of information is available, it can be too broad for targeted use and difficult to consolidate.
The goals of the DHB are, therefore, to improve the quality and transparency of health systems information in South Africa, to build and store an authoritative and accurate database of key health and health-related indicators, and to produce an annual publication of health sector performance data covering several years, thereby enabling ongoing monitoring and evaluation.
All editions of the District Health Barometer have been well received at every level of the public health sector.
Highlighting performance 
By presenting analysis of a carefully selected range of health indicators (from which comparisons between and among districts, and across provinces, can be made), the DHB facilitates identification of areas of poor quality requiring appropriate corrective measures.
Data quality
The DHB has helped in the pursuit of more reliable health information. Awareness is growing among district management that if data collected at base level are not accurate, the information presented in the DHB will also be skewed, which leads to recording and dissemination of incorrect district rankings.
Among stakeholders, the DHB has stimulated focus on the importance of the District Health Information System (DHIS) and its data quality, which needs ongoing maintenance, quality control and validation. Leadership and commitment from national level are needed to entrench acknowledgement of the immeasurable value of the DHIS to health systems strengthening.
Building capacity
The DHB has cultivated recognition of the need for capacity-building in information systems at all levels, but especially at management level.
Definitions and targets
The core concept of a reliable data-driven, inter-district comparison – the foundation on which the DHB initiative is constructed – has defined the need to standardise indicator definitions and to publish an agreed set of achievable targets.
To help in strengthening capacity at a provincial and district level, ongoing workshops, presentations and meetings are held to afford district managers the opportunity to discuss the Barometer’s findings and related implications. In tandem, this builds capacity in understanding the elements of the indicators and how these can assist management in improving equity and quality of care at primary health care level.
The DHB yields a number of benefits for South Africa’s health information system, and thereby for health systems more broadly, including:
  • integration of information from a number of sources into a single, accessible repository in the public domain
  • strengthening integration in the health information system
  • assisting managers at all levels to improve the quality and use of health indicators
  • providing trend data to monitor change
  • identifying gaps in data collection
  • identifying problems with information systems or data quality
  • strengthening existing information systems and the culture of information use and feedback
  • improving and developing skills in analysis and interpretation of health indicators.
With health sector managers having endorsed the Barometer as a valuable tool, there is significant support for the publication being refined and developed in line with their current and future needs.
Project Director: Dr René English
Programme Manager: Thesandree Padayachee
Project Manager: Naomi Massyn
Technical Advisor: Candy Day
For further information, contact the Project Manager, Naomi Massyn, at naomi.massyn@hst.org.za
The District Health Barometers are freely downloadable via the following links and include full-colour graphs, league tables and GIS maps:

Most of the compressed files are in 7zip format. This free software can be downloaded from http://www.7-zip.org/

DHB_2013_14_Launch_29_Oct.potx2.98 MB