Download the District Health Barometer 2007/08 here
The publication is tool through which managers in the health sector can monitor and evaluate not only trends in health status and service delivery but also the underlying quality of health information in South Africa.
This edition of the District Health Barometer presents key socio-economic and health indicators for the 2007/08 period including trends over the last 4 to 8 years. It enables readers to get a clear picture of the district health system and the provision of primary health care in South Africa.
Pertinent highlights include:
The level of deprivation of two thirds of the 52 districts in South Africa has decreased since 2005.
In 2007, the ten most deprived districts in South Africa fell within three provinces - KwaZulu-Natal (Uthukela, Ugu, Sisonke, Zululand, Umkhanyakude and Umzinyathi districts), Eastern Cape (Chris Hani, Alfred Nzo and O.R. Tambo districts) and Limpopo (Greater Sekhukhune district) with Umzinyathi district ranked as the most deprived district in the country.
Whilst an average of 88.7% of all households in South Africa had access to clean piped water, (up from 85% as measured by the 2001 Census), access to water ranged from 99.4% in the City of Cape Town to 35.6% in O. R. Tambo district in the Eastern Cape.
Nationally 14,3% of people belonged to a medical aid scheme, whilst the balance of over 40 million people were uninsured, of which the majority are dependant on the public health sector. More people residing in the metropolitan districts belonged to a medical scheme (21. 3%) than those in rural districts (5.4%).
The amount spent on non-hospital primary health care per person without a medical aid (after taking inflation into account) has on average increased from R238 per person in 2001 to R302 in 2007. The Western Cape had the highest expenditures of R428 per person, whilst in the Free State had the lowest expenditure of R233 per person.
Figures show that in 2007, the number of patients daily attended to by a nurse in a primary health care facility averaged at close on 24 patients per day.
The primary health care utilisation rate (the average number of visits per person per year) dropped marginally from an average of 2.3 visits per person per year in 2006 to 2.2 in 2007 and was clearly affected by the June 2007 public sector strike. There were far less patients seen in June than in any other month of that year.
In 2007, 84.2% of children under one year of age were immunised, up from 76.4% in 2003. The Western Cape and Gauteng provinces reached levels of over 90% of children immunised, indicating that this aspect of the primary health care system is working well.
The proportion of women tested for HIV in antenatal clinics has increased significantly from 22.1% in 2003 to 69.2% in 2006 and ranged from a high of 93.2% in the Western Cape to 58.7% in KwaZulu-Natal. The improved rates are encouraging and suggest more effective screening of pregnant women in antenatal care. There were however wide differences noted among districts and provinces and there is still much room for improvement to ensure that the targets of the Millennium Development Goals dealing with maternal mortality and HIV are addressed.
There has been a steady improvement in the TB cure rate from 50.8% in 2004 to 62.7% in 2006. In 2005 nine districts had cure rates of over 70% whilst almost double this number (16) achieved cure rates of over 70% in 2006. However the TB cure rate in KwaZulu-Natal province which has the highest number of TB cases was 52.9%. There is still a long way to go to reach the WHO target of 85% cure rate.
The seven year period 2000-2007, has seen an increasing trend in the proportion of births that take place in health facilities. Currently more than 4 out of 5 births (80.6%) take place in facilities. There has also been an increase in the caesarean section rate in district hospitals. This is an indication of improving access to public sector facilities by pregnant women.
For more information please contact:
Fiorenza Monticelli: 083 299 3899
Ashnie Padarath: 083 299 7129
HISA Announcement of Launch