Transcript ANC Health and Education PEC sub

Health System Trust
South African Health Review and
District Health Barometer
Monitoring Health & Advising Policy
Fiorenza Monticelli
ANC Health and Education PEC sub-committee
meeting
29 April 2010
Presentation outline
 Primary Health Care Indicators 2008/09
The good and the not so good
(District Health Barometer)
 Health policy recommendations
(South African Health Review & related research)
All available at www.hst.org.za
The good: TB Cure Rate
MDG Goal 6: Combat HIV and AIDS, malaria & other diseases
Gauteng
South Africa
Percent
Percent
80
75.6
70
71.1
66.7
60
61.3
62.6
50
40
2003
2004
2005
2006
Gauteng is ranked second best of all the provinces after
Western Cape
2007
TB cure rate by district, 2007
Ekurhuleni 79.5%
Johannesburg 76.1%
Tshwane 72.6%
West Rand 72.4%
Sedibeng 71.7%
Metsweding 71.5%
TB cure rate - District trends
City of Johannesburg
Sedibeng
Percentage
Ekurhuleni
Metsweding
City of Tshwane
West Rand
The good: Immunisation coverage <1
MDG Goal 4: Reduce child mortality
Percent
South Africa
Gauteng
Percent
110
100
101.5
90
88.9
91.1
91.6
80
79.2
78.6
70
60
50
2003 2004 2005 2006 2007 2008
Gauteng is ranked second best of all the provinces after
Western Cape
Immunisation coverage <1 year
District trends
Percentage
City of Johannesburg
Sedibeng
Ekurhuleni
City of Tshwane
Metsweding
West Rand
Needing attention:
Primary Health Care Utilisation Rate
South Africa
Gauteng
2.6
2.4
2.2
2
1.8
1.6
1.4
2.0
1.9
1.6
1.5
1.7
1.5
1.2
1
2003 2004 2005 2006 2007 2008
Gauteng has the lowest PHC utilisation rate of all the provinces
PHC utilisation rate by
district 2008/09
SA average = 2.4
Metro average = 2.3
Gauteng average = 2.0
West Rand
City of Johannesburg
City of Tshwane
Sedibeng
Ekurhuleni
Metsweding
2.2
2.1
2.1
1.9
1.7
1.6
Not so good: HIV testing rate of
pregnant women
MDG Goal 4: Reduce child mortality & MDG Goal 5: Improve
maternal health
Proportion ANC clients tested for HIV
South Africa
Trend by Province
110
100
Eastern Cape
90
Free State
80
Gauteng
KwaZulu-Natal
70
Limpopo
60
Mpumalanga
50
Northern Cape
40
North West
Western Cape
30
20
2005/06 2006/07 2007/08 2008/09
Percentage
Proportion of ANC
clients tested for
HIV 2008/09
SA average = 86.7%
Metro average = 78.5%
Gauteng average = 78.4%
Sedibeng
City of Johannesburg
City of Tshwane
West Rand
Ekurhuleni
Metsweding
92.3%
81.2%
78.1%
77.7%
72.3%
72.2%
Health Policy Recommendations




“ Tackle inequitable distribution of resources”
“ Efficiency and outcomes need attention...”
“ Improve management and governance of clinics
and hospitals….”
“ Measure the problem and its solutions through
improving the health information system....as it
is essential to be able to monitor progress and
inequities”
Bradshaw D. Determinants of Health and Health Trends. In: Barron P, Roma-Reardon J,
editors. South African Health Review 2008. Durban: Health Systems Trust; 2008.
Blecher MS, Day C, Dove S, Cairns R. Primary Health Care Financing in the Public Sector.
In: Barron P, Roma-Reardon J, editors. South African Health Review 2008. Durban:
Health Systems Trust; 2008.
Padarath A, Freedman I. The state of clinic committees in primary level public health
sector facilities in South Africa. Durban: Health systems Trust ; 2007.
Tackle inequitable distribution of resources
Proportion of District Health Services Expenditure on District Hospitals
45
40
SA ave
35
Sedibeng
30
25
West Rand
20
Ekurhuleni
15
City of
Johannesburg
10
City of Tshwane
5
0
2005/06
2006/07
2007/08
2008/09
Tackle inequitable distribution of resources
Proportion of District Health Services Expenditure on District
Management
40
35
30
Sedibeng
25
Metsweding
20
West Rand
15
Ekurhuleni
10
City of Johannesburg
City of Tshwane
5
SA ave
0
2005/06
”
2006/07
2007/08
2008/09
Cost per patient visit
to a PHC facility
2008/09
Metsweding
R 222.8
City of Johannesburg
R 175.0
Sedibeng
R 133.8
Ekurhuleni
R 130.0
West Rand
R 117.6
City of Tshwane
R 103.2
“ Efficiency and outcomes need attention...”
Improve management and
governance of clinics and hospitals

1.
Research done on the status of clinic committees
in primary level public health sector facilities
recommends:
Develop a comprehensive framework for clinic
committees.

2.
Guidelines on what governance structures are meant to
do, how they should be constituted & operate
Develop & implement capacity development
programme for clinic committee members

Training programme – roles & responsibilities,
procedural issues related to functioning & community
health related issues.
Thank you