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The District Health Barometer Year 1, January-December 2004


The District Health Barometer (DHB) is a collection of health indicators which presents a snapshot of how well the health districts in South Africa provide primary health care to the population. These indicators do not provide any form of complex analysis or in-depth research, yet they point to districts that need improvement and support and likewise to those districts that a​re doing well. They show how districts are performing relative to one another and relative to their province and the national average.

Using the District Health Barometer (DHB), comparisons can now be made between the six metropolitan districts, between the 13 rural node districts or between any districts that are of a similar socio-economic status and size. The purpose of this first District Health Barometer is to function as a tool to monitor progress and support improvement of equitable provision of primary health care, as well as to highlight data irregularities and errors that may occur in the collection and collation of data available in the national District Health Information System.

The majority of data have been extracted from the DHIS, June 2005. TB data was obtained directly from the National TB register and per capita expenditure was sourced from the South African Health Review (SAHR) 2003/4 Chapter 20. Most of the indicators cover the calendar year (Jan-Dec 2004) unless otherwise indicated

The interpretation of the indicators, graphs and maps is based on the underlying data. Therefore, it is important to note that the interpretations in this DHB are only as good as the data which is collected at facility level and collated at district level. If these data are incorrect, then the resulting indicators and the subsequent interpretation will also be incorrect.

The indicators have been grouped into categories. There is a short introduction for each indicator describing its meaning and use. Thereafter, values of the indicator in each district are illustrated on a national map and a graph. This is followed by a short narrative analysis and discussion of how the districts compare with each other, and to the national averages and targets, where these are available. Comparisons are also done among the 13 rural node health districts and the 6 metropolitan health districts. The 13 integrated, sustainable, rural development node (ISRDN) districts have been identified as the districts with the least resources, capacity and infrastructure whilst the 6 metros are thought to be the most well-resourced, with the largest capacity and the best infrastructure. The indicators are compared and discussed across these districts as separate groupings in order to compare like with like. Finally, the provinces are compared with each other.

The selection of indicators that make up the District Health Barometer, fall into one or other of the following categories:

Input indicators (e.g. Per capita health expenditure on PHC)

Process indicators (e.g. Nurse clinical work load)


Outcome indicators (e.g. TB cure rate)

Health Status (Impact) indicators (e.g. Stillbirth rate)

The publication can be downloaded from