The District Health Barometer
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Transcript of The District Health Barometer
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