The District Health Barometer

Fiorenza Monticelli, Gauteng Health Summit, Turfontein conference centre, 17/9/ 2007

• The data contained in the DHB comes directly from the DHIS, StatsSA, Treasury (BAS)* data and the national TB register or directly from the district / province .

• None of the data values received have been changed and have merely been illustrated in graphs, maps and tables to make it easier to read for comparative purposes. Averages have been calculated, ie for the metro and ISRDP districts and PCE values calculated from the data received from Treasury.

• The DHIS data is extracted at the end of June each year, once the official data set has been signed off by the provinces and sent to Treasury and the National Department of Health.

• The data does not belong to HST, but to the DOH, StatsSA and Treasury, as applicable. Where the data is not publicly available, such as with the DHIS and Treasury data, HST have asked for and received written permission to use the data for each DHB published.

• The purpose of the DHB is to portray the data as is, in order to highlight performance and / or data quality issues. Thus, if the data looks implausible - it merely highlights data quality issues at source.

• * North West (Walker System)

Awareness

Increased awareness of : • data quality importance and issues • indicator use and interpretation of data • district performance • inadequate human resources in HIS• lack of capacity in HIS and the skillful use of

information • Areas that need urgent attention

Deprivation index 2001 and

Socio-economic quintiles

Per capita expenditure, 2005/06

0 50 100 150 200 250 300 350 400 450

Gr Sekhukhune DMMetsw eding DM

Siyanda DMG Sibande DMBohlabela DM

West Rand DMAmajuba DMNkangala DM

Waterberg DMCapricorn DM

Lejw eleputsw a DMA Nzo DM

Uthukela DMCacadu DM

Tshw ane MMN Mandela MMOverberg DM

Frances Baard DMUkhahlamba DMCape Winelands

Fezile Dabi DMO Tambo DM

iLembe DMEhlanzeni DM

Umzinyathi DMuMgungundlovu

Zululand DMBojanala Platinum

Sedibeng DMUgu DM

Mopani DMT Mofutsanyane

Motheo DMVhembe DM

Pixley ka Seme DMUthungulu DMAmathole DM

Eden DMJohannesburg MM

C Hani DMKgalagadi DMSouthern DM

eThekw ini MMEkurhuleni MM

Sisonke DMCentral DM

West Coast DMUmkhanyakude DM

Central Karoo DMCape Tow n MM

Xhariep DMNamakw a DMBophirima DMSouth Africa

Rand

EC

FS

GP

KZN

LP

MP

NC

NW

WC

SA

Per Capita Expenditure 2005/06

R270

R249

R225

R199

R232

R154

R199

• Metsweding pop=207 774 is the most socio-economically deprived in Gauteng, 6% of households without access to piped water.

• The only district without a district hospital in SA, 6 clinics and 2 mobile services (2005/6).

• The primary health care expenditure decreased from R169 per capita in 2001/02 to R119 in 2005/6 and is the second lowest in SA. Inequitable when compared to Ekurhuleni at R270.

• West Rand, pop=792 123, PCE dropped from R163 in 2001/02 to R154 per person.

• 38 Clinics, 10 Mobile clinics, 2 district hospitals, hospital on R35 more per person than Metsweding.

Per Capita Expenditure 2006/07

Per capita expenditure, 2006/07

0 50 100 150 200 250 300 350 400 450 500

SiyandaGreater Sekhukhune

Metsw edingAmajuba

EhlanzeniGert Sibande

CapricornLejw eleputsw a

UthukelaNkangalaSedibeng

O.R. TamboVhembe

Alfred NzoWaterberg

UkhahlambaThabo Mofutsanyane

iLembeZululand

UguWest RandFezile DabiUthungulu

CacaduUmzinyathi

UMgungundlovuMopani

OverbergNelson Mandela Bay Metro

Frances BaardChris HaniAmathole

SisonkeKgalagadi

Cape WinelandsPixley ka Seme

EkurhuleniBojanalaMotheo

eThekw iniCity of Johannesburg

UmkhanyakudeCentral Karoo

SouthernBophirima

City of Tshw aneCentral

EdenXhariep

City of Cape Tow nWest Coast

Namakw aSouth Africa

Rand

ECFSGPKZNLPMPNCNWWCSA

R167

R195

R221

R290

R307

R319

(Sneak preview)

City of Johannesburg

Spider Graphs – a different way to view district performance

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

The closer to the centre the better

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

The further from the centre, the worse

Ekhuruleni (GP)

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

Metsweding (GP)

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

Sedibeng(GP)

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

City of Johannesburg(GP)

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

Tshwane (GP)

0

10

20

30

40

50

60Access to piped w ater (%)

Deprivation index

PHC expenditure per capita

Average length of stay

Useable bed utilisation rate

Male condom distribution rate

Immunisation coverage < 1 year

Immunisation drop out rate (DTP1-3)

Proportion ANC clients tested for HIV

HIV prevalence among ANC clients testedNevirapine uptake babiesNevirapine uptake w omen

Utilisation rate

Incidence of STI treated - new

TB cure rate

TB smear conversion rate

Diarrhoea incidence under 5 years

Not gaining w eight under 5 years

Delivery rate

Stillbirth rate

Perinatal mortality rate

District Rank

Average

Immunisation coverage 2005/06

0 20 40 60 80 100 120 140

Metsw eding DMWaterberg DMWest Rand DMNamakw a DMEhlanzeni DM

Central DMG Sibande DMSouthern DM

West Coast DMZululand DM

Overberg DMUthukela DMXhariep DM

Cape Winelands DMBojanala Platinum DM

Amajuba DMeThekw ini MMEkurhuleni MMNkangala DM

Lejw eleputsw a DMSiyanda DM

Bophirima DMEden DM

Ukhahlamba DMJohannesburg MM

Gr Sekhukhune DMUmzinyathi DMBohlabela DM

T Mofutsanyane DMMotheo DM

Cape Tow n MMMopani DM

Sedibeng DMCacadu DM

Central Karoo DMCapricorn DMKgalagadi DM

Umkhanyakude DMFezile Dabi DMTshw ane MM

iLembe DMUthungulu DMAmathole DM

Pixley ka Seme DMVhembe DMO Tambo DMSisonke DM

A Nzo DMN Mandela MM

Frances Baard DMuMgungundlovu DM

Ugu DMC Hani DM

South Africa

Percentage

EC

FS

GP

KZN

LP

MP

NC

NW

WC

SA

Immunisation Coverage 2005/06

SA ave = 90%

WR = 69.5 % Mtsw = 65.5%

94.7%

Immunisation drop out rate (DTP1-3), 2005/06

-5 0 5 10 15

Sedibeng DMuMgungundlovu DM

O Tambo DMeThekwini MM

Xhariep DMCape Town MMWest Rand DMBohlabela DMN Mandela MM

Amajuba DMBojanala Platinum DM

Southern DMKgalagadi DM

Cacadu DMCentral DM

Cape Winelands DMSisonke DM

Uthukela DMMopani DMiLembe DM

Lejweleputswa DMUmkhanyakude DM

Waterberg DMPixley ka Seme DM

Zululand DMUkhahlamba DM

West Coast DMT Mofutsanyane DM

Amathole DMEden DM

Vhembe DMFrances Baard DM

Ekurhuleni MMA Nzo DM

Gr Sekhukhune DMUthungulu DM

Siyanda DMUmzinyathi DMFezile Dabi DM

Johannesburg MMEhlanzeni DM

Metsweding DMNkangala DM

Bophirima DMCapricorn DMOverberg DM

Namakwa DMG Sibande DM

C Hani DMCentral Karoo DM

Tshwane MMUgu DM

Motheo DMSouth Africa

Percentage

EC

FS

GP

KZN

LP

MP

NC

NW

WC

SA

Immunisation drop-out rate (DTP1-3)

2005/06

Demonstration on raw data table

What to expect in the DHB 2006/07• Socioeconomic data

Population, Access to water, updated Deprivation Index using GHS 2005, poverty rate and socio-economic quintiles

• Financial data • Health indicators - 3 financial years

• New indicator – Supervision rate– District hospital data (by nr of beds 0-49, 50-

99, 100-149, 150-200, 200+)• Average length of stay• Bed utilisation rate• Caesarean section rate• Cost per patient day equivalent

• District profiles • Web-GIS interface

• Release the final draft October/November 2007,

• Raw data table will be made available to NDHSC members on CD to scrutinize and work with

• Launch of hard copy publication and CD with data early February 2008

DHB 2006/07

THANK YOU