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Health Systems Trust publishes the District Health Barometer 2016/17

Leading public health non-profit organisation Health Systems Trust (HST) today published its 12th edition of the District Health Barometer (DHB) 2016/17.The publication seeks to highlight, health system performance, inequities in health outcomes, and health resource allocation and delivery, as well as to track the efficiency of healthcare delivery processes across all provinces and districts in South Africa. Over the years, the DHB has become an important planning and management resource for health service providers, managers, researchers and policy-makers.

This year, the DHB contains 47 indicators, with trend illustrations and health profiles across South Africa's nine provinces and 52 health districts. The district chapters are aligned with the National Department of Health's district health plans format to enable district managers to have all the relevant information available in one document for planning and monitoring purposes.

Commenting on its release, CEO of Health Systems Trust, Dr Themba Moeti said that the value of the publication lies in both the depth and breadth of information that the Barometer brings together. "The health indicators are augmented by data on socio-economic determinants of health as well as other demographic information such as medical scheme coverage, causes of death and levels of education.  The collation of data using various sources of information enables us to develop a more contextual understanding of the challenges facing each district which is absolutely critical for effective planning for service delivery", said Moeti.      

The 2016/17 DHB paints a mixed picture in the national profile; however, significant gains were noted in more areas compared to previous years:

South Africa still faces a quadruple disease burden, namely: communicable diseases with maternal, perinatal and nutritional conditions; HIV and TB; non-communicable diseases (NCDs); and injuries. The percentage of the burden due to NCDs and injuries increased since 2010. The percentage of the burden due to NCDs remains the highest at 38%, followed by HIV and TB at 27%.

  • There has been a marked reduction in delivery in facility under 18 years rate in South Africa over the past six years. The rate dropped from 8.1% in 2010/11 to 6.8% in 2016/17. The rate is the highest in the most rural districts.

  • South Africa has shown a decreasing trend in the maternal mortality in facility ratio (iMMR) over the past five years, from 132.9 deaths per 100 000 in 2012/13 to 116.9 maternal deaths per 100 000 live births and almost reached the national iMMR target of 115 per 100 000 live births.

  • More than 70% of women that delivered at public hospitals and clinics received postnatal care within six days after the delivery.

  • South Africa exceeded the national target for antenatal 1st visit before 20 weeks rate for the second year in a row.  More than 65% of pregnant women had a booking visit (first visit) before they were 20 weeks (about half way) into their pregnancy in 2016/17.

  • The antenatal client initiated on ART rate was 95.1% nationally, the highest percentage since 2010/11. Only 1.3% of babies born from HIV-positive mothers tested HIV-positive at 10 weeks.

  • The percentage of children that died in hospitals due to diarrhoea, pneumonia and severe acute malnutrition has reached its lowest levels since 2010/11.

  • The national cervical cancer screening coverage increased by 11.2 percentage points between 2012/13 and 2016/17 and the rate of 61.5% almost reached the national target of 62% in 2016/17.

  • The national couple year protection rate (CYPR) increased by 6.8 percentage points between 2015/16 and 2016/17 and the CYPR of 70.2% in 2016/17 was significantly higher than the national target of 50%.

  • The national TB treatment success rate has reached its highest level since 2007 and was 81% in 2015. The success rate for drug resistant TB increased by 3.3 percentage points between 2013 and 2014 and was 50.5% in 2014.  

  • The number of male condoms distributed continued to increased; a total of 917 253 117 male condoms were distributed in South Africa in 2016/17.

Areas for improvement are:

  • The exclusive breastfeeding rate at 14 weeks remains low at 41.6% and has not met the national target of 55%.

  • The immunisation coverage under 1 year is the lowest in the past five years and was only 82.3% in 2016/17.

  • Only 51.6% of clients 5 years and older were screened for TB at PHC facilities and many more clients should be screened as an attempt to reach the national target of 94%.

An electronic copy of the District Health Barometer is accessible via the HST website -