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Health Systems Trust launches 2nd District Health Barometer

The highest per capita primary health care expenditure in the public sector by a district in South Africa during 2005/06 was R416 per person in Bophirima district in the North West province. This is in stark contrast to the lowest rate of R115 per person spent in Greater Sekhukhune, a relatively deprived district in Limpopo province.

Ekurhuleni, a bustling metropolitan district in Gauteng with some 2,5 million people is ranked second lowest in the country when looking at its average number of visits (1.2) per person per year to a public health facility. This primary health care utilisation rate reflects if the injection of resources into the district health system and primary health care over the last few years has had an effect on improving accessibility and quality and thus encourages an increase in usage. Central Karoo, with a population of just over 62 000, increased its utilisation rate to 4.5 visits per persons annually, ranking it as the highest in South Africa.

The average TB cure rate in South Africa deteriorated from 56,7% in 2003 to 50.8% in 2004, showing a wide variation across the districts, ranging from a high of 84.5% in Overberg to a low of 12% in Nkangala, although the TB smear conversion rate showed improvement from 46.6% in 2004 to 50.5 % in 2005.

These and other key health indicators and district health profiles for the 12-month period ending March 2006, are detailed in the Health Systems Trust's 2005/06 District Health Barometer (DHB) report which was released on 8 February.

The DHB was developed in collaboration with the National Department of Health and other stakeholders. It is an innovation aimed at improving the understanding and measurement of health services and health equity throughout the country, by providing a snapshot of the overall performance of the health sector across the all the health districts and provinces in South Africa.

The main purpose of the report is to monitor progress and support the improvement of equitable provision of primary health care by:

  • Collecting and analysing key health system indicators at district level
  • Ranking , classifying and analysing health districts (in various groupings e.g. metropolitan districts, rural development districts, provinces), on the basis of these indicators, and
  • Comparing these indicators over time.

The data used in the report is obtained from the District Health Information System, the financial management information system and other sources such as the National TB Register and the Census 2001.

Straightforward analyses and colourful representation of a carefully selected range of health indicators in league tables and maps, facilitates identification of problem areas and the corresponding corrective measures. Inequities between rural and urban areas are addressed throughout the report

For our prime target audience, the managers at national, provincial and district level, we hope that the DHB will assist with strategic planning purposes, with monitoring and evaluation of district performance and health service delivery and with more equitable resource allocation.

We trust that the DHB will also address the needs of users such as politicians and policy makers, with the graphic and pictorial representation allowing a clear presentation and thus an understanding of issues of quality and equity in the health sector. Other sectors, such as Treasury, the academic sector and the international health community will also be able to gain greater insight into the performance of health sector at district level.

The DHB is freely available and can be downloaded from the HST website: