South African Health Review 1998

Author: 
Ntuli, Antoinette (ed)
Publication Year: 
1998
Series Name: 
South African Health Review
Issue: 
1998
Published by: 
Health Systems Trust
ISSN: 
1025-1715

The 1998 Review concentrates on equity and attempts to highlight progress that has been made as well as identify blocks to providing equitable public sector services throughout South Africa. Research commissioned specifically for the Review sheds light on the health status of South Africas population and key areas of the health system including finance and expenditure, human resources, information systems, pharmacy, and service delivery in clinics and district hospitals. This is provides a comprehensive, authoritative and independent review of South Africas health system.

In 1998 the greatest inequity remains the difference between those who predominantly use private sector health care and those who do not. Just under one fifth of South Africas population belong to a medical aid scheme, yet this group has access to 85% of pharmacists and 60% of medical specialists working in South Africa.

In the field of public sector spending comparisons of provincial health budgets indicate that great steps forward were made in the years 1995/6 and 1996/7 with most budgets coming closer to the national average. However since that time progress has stagnated, with the gap between expenditure per person in the North West, Mpumalanga and Northern provinces and the national average remaining a cause for concern. Comparisons of spending within provinces indicate that disparities are greater even than those between provinces. In Potchefstroom and Grahamstown Districts for example, for every R4 spent on health services in the public sector, R1 was spent in the Odi and Mount Frere Districts.

With regard to the distribution of health sector personnel, disparities tend to occur between the more urbanised and historically better funded provinces and those which are predominantly rural. For example there are forty nurses per 10,000 population in the Western Cape whereas in the Northern Cape and Mpumalanga there are only 20 and Gauteng has 2000 people to every pharmacist while the comparable figure in the Northern Province is 16000.

A survey of 294 clinics and 84 regional and district hospitals provides information about service delivery and indicates the variations that exist between provinces and between rural and urban facilities. While 100% of clinics in the Northern Cape have all TB drugs available this is true for only 20% of clinics in the Northern Province and HIV testing is available in less than half of clinics in the Eastern Cape, North West, KwaZulu-Natal, and Northern Provinces. The investigation of maternal deaths was used as one of the indicators to measure the quality of care in hospitals and it was found that less than half of hospitals have meetings where infant and maternal deaths are investigated and discussed.

Results of this survey are compared with a survey of clinics undertaken in 1997 and the findings indicate improvements in some areas. Seventy one percent of all clinics have a functioning telephone in 1998 as compared with 63% in 1997 and 83% of clinics provide family planning services on a daily basis in 1998 as compared with 72% in 1997.

The South African Health Review is accompanied by Technical Reports that provide more detail in the areas of financing, the private sector, pharmacy and service delivery in hospitals and clinics.

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SAHR 1998 Chapter 1335.97 KB
SAHR 1998 Chapter 2321.58 KB
SAHR 1998 Chapter 3287.61 KB
SAHR 1998 Chapter 4483.8 KB
SAHR 1998 Chapter 5251.1 KB
SAHR 1998 Chapter 6248.67 KB
SAHR 1998 Chapter 7402.41 KB
SAHR 1998 Chapter 8342.96 KB
SAHR 1998 Chapter 9338.21 KB
SAHR 1998 Chapter 10301.73 KB
SAHR 1998 Chapter 11365.53 KB
SAHR 1998 Chapter 12314.68 KB
SAHR 1998 Chapter 13372.05 KB
SAHR 1998 Chapter 14489.58 KB
SAHR 1998 Indicators201.83 KB
SAHR 1998 Index128.88 KB
SAHR 1998 References149.68 KB
Measuring Quality of Care in SA761.04 KB
Production and Distribution of Human Resources in Pharmacy748.55 KB
Private Health Care in South Africa896.21 KB
Equity in Public Sector Health Care Financing805.4 KB
A review of Health Management Training5.59 MB