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Release of premier resource on healthcare delivery launched in Pretoria

​​The 14th edition of the District Health Barometer (the Barometer) was released in Pretoria today.  

According to Health Systems Trust who produce the publication annually, the Barometer, provides information on health system performance, inequities in health outcomes, and health resource allocation and delivery.  While the findings present a mixed picture of provinces and districts, the document shows slow but sustained progress in many areas which augurs well for South Africa reaching some of the targets of the Sustainable Development Goals.

The emphasis in the latest edition of the Barometer is on the Sustainable Development Goals - particularly goal 3.8 which- among other things - challenges countries to achieve universal health coverage. The Barometer reports on the four categories of indicators that are used to compute a universal health service coverage index: reproductive, maternal, newborn, and child health, infectious disease control, non-communicable disease management, and service capacity and access.

"The data shows that efforts to strengthen the health system are paying dividends at district level as gains continue to be reflected in a number of areas" said CEO, Dr Themba Moeti. 


The latest Barometer indicates that:

  • The country has seen a downward trend in the national maternal mortality in facility ratio and neonatal death in facility rate over the last five years.
  • The pneumonia incidence, number of deaths, and case fatality rates have declined over the past decade signalling a positive move towards achieving an under-5 mortality rate of less than 25 per 1 000 live births.
  • The treatment success rate for patients who were started on the WHO recommended nine-month regime for multi-drug resistant tuberculosis has shown better outcomes than those on the 24 month regimen.
  • Worryingly, the country did not meet the global target for immunisation under 1 year coverage of 90% in 2018/19; the global elimination target of 95% for measles 2nd dose coverage or elimination target of less than 1 measles case per million population. The main reason may have been that data for the numerators were collected mainly by public sector facilities, but the denominator includes the total under 1 year population (including those who receive services in the private sector), leading to an under-measurement of the indicator.
  • 65% of people living with HIV are on antiretroviral therapy, and South Africa will have to accelerate efforts reach the national target of 81% by December 2020. ​
  • There has been a steady decline in acute malnutrition; the case fatality rate has declined from 19.3% in 2009/10 to 7.1% in 2018/19. The highest severe acute malnutrition case fatality rate was reported in North West (9.3%), while the lowest was reported in the Western Cape (1.6%). 
  •  On the flip side, the age-standardised prevalence of overweight and obesity increased over a 10-year period, with the latest data seeming to suggest a stabilisation; while diabetes prevalence is increasing rapidly in South Africa as a whole.
  •  The country's concerted efforts to improve cervical cancer screening has resulted in an increase in coverage over the last decade, with about 65% of eligible women (aged 30 years and older) currently receiving screening.


The publication is complemented by the District Health Profiles, an electronic accompaniment to the Barometer which reports on 48 indicators such as the social determinants of health, women and maternal health, child and school health, and communicable and non-communicable diseases.  Information on the country's progress towards the achievement of the 90-90-90 targets for HIV and TB as well as the population distribution, local municipality boundaries and health facility locations, the leading causes of death and budget and expenditure information for each district are also included.