DISTRICT HEALTH BAROMETER 2023/24 RELEASE
Health Systems Trust Launches the 17th Edition of the District Health Barometer and Enhanced Interactive Dashboard
11 April 2025 – Johannesburg, South Africa
The Health Systems Trust (HST), a leading health systems strengthening non-governmental health organisation proudly announces the release of the 17th edition of the District Health Barometer (DHB) for 2023/24, accompanied by a newly enhanced online interactive dashboard.
The DHB continues to serve as an indispensable resource for health professionals, policymakers, and researchers, offering comprehensive analyses of the performance of South Africa's 52 health districts using key public health indicators. This edition continues HST's unwavering commitment to supporting evidence-based decision-making aimed at strengthening health systems and promoting equity in health service delivery and access.
This year's edition provides 16 chapters covering key areas such as maternal, child and neonatal health, priority communicable and non-communicable diseases, service capacity, access, and the integration of environmental drivers of health outcomes. Notably, the inclusion of a comprehensive chapter on climate change and health demonstrates HST's commitment to providing relevant and timely data encompassing established and emerging health priorities to inform policy and practice.
The upgraded DHB dashboard now offers users an even more powerful tool for analysis and decision-making. With the inclusion of subdistrict data in an interactive format, stakeholders can easily compare indicators across different geographic areas and defined periods of interest. The user-friendly interface enables seamless data downloads, empowering users to further explore and apply the findings according to their needs.
Key Highlights from the 2023/24 DHB
Communicable diseases: HIV
Substantial progress has been made towards achieving the UNAIDS 95-95-95 targets. The national rate of clients remaining on ART increased from 65.1% in 2019 to 70.7% in 2024, with the City of Johannesburg achieving an impressive 93.0% among the districts. National viral load suppression rates among adults rose from 88.1% in 2020 to 92.4% in 2024, nearing the UNAIDS target of 95%.
These improvements reflect the strength of South Africa's national HIV response, with notable achievements such as Joe Gqabi (Eastern Cape) and Xhariep (Free State) districts recording 100% viral suppression among children aged 1-4 years in the first quarter of 2024.
Non-communicable diseases: Cervical Cancer Screening Coverage
All provinces and districts recorded increases in cervical cancer screening coverage in 2023/24. Notably, KwaZulu-Natal achieved 72.3% coverage, the highest of the nine provinces, and surpassing the World Health Organization's target of 70%. This achievement highlights the potential and benefits of sharing best practices between provinces and districts to accelerate progress toward WHO's elimination targets for cervical cancer by 2030.
Child nutrition: Severe Acute Malnutrition (SAM) Case Fatality Rate (CFR)
Nationally, the severe acute malnutrition case fatality rate declined from 7.7% to 7.0% over the past five years, with the North West being the best performing province on this indicator with a low SAM CFR of 2.1%. While Limpopo recorded the highest rate at 12.9%, encouragingly, 29 districts experienced a decline in SAM CFR between 2022/23 and 2023/24. Strengthening community-based approaches for early detection and intervention remains a national priority.
Child health: Immunisation
KwaZulu-Natal achieved impressive coverage rates with 94.5% for immunisation under one year and 95.6% for measles second-dose coverage, meeting national targets. Mpumalanga was the second-best performing province for both indicators achieving coverage rates of 88.2% and 90.4% respectively. This achievement underscores the effectiveness of enhanced communication strategies and digital platforms in promoting vaccine uptake and acceptance.
Climate change and health
This chapter underscores the urgent need to prepare South Africa's health sector for the impacts of climate change. It calls for the development of indicators to track, mitigate, and prevent climate-related health risks. By offering actionable insights, the chapter aims to inform and strengthen climate and health policies, supporting the transition toward climate-resilient health systems. While broadly relevant, it will be particularly valuable to health policymakers and managers seeking to better understand and respond to the growing intersection between climate change and public health in South Africa.
What is the District Health Barometer?
The District Health Barometer is a comprehensive statistical and analytical resource providing an overall view of district health performance. Covering 52 health districts in nine provinces, the Barometer is used as a resource by the National Department of Health to develop strategy, monitor district performance, and inform planning at district, provincial and national and levels. The DHB plays an important role in providing information for district managers to benchmark their districts against others in the country and in strengthening the use of data for priority-setting and decision-making. The interactive DHB dashboard contains the data visualisations for the different sections found in the District Health Barometer publications.
About the Health Systems Trust
The Health Systems Trust (HST) is a pivotal player in the South African public health landscape, dedicated to health systems strengthening, research, and strategic support in implementing priority health programmes. Established in April 1992, HST has continuously contributed to the evolution and development of South Africa's health system through its innovative research and technical support and capacity development efforts. Today, HST remains committed to ensuring equitable access to quality health care for all through rigorous research, data analysis, policy and programme implementation support and knowledge dissemination.
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