DHB 2006/07 - Health Systems Trust

Section B: District and Province Profiles
Eastern Cape
Nonqaba Mzana
The Eastern Cape has the 3 rd largest population with close
on 7 million people and is the 2 nd poorest province in South
Africa. The household access to piped water of 65.4% is far
below the national average of 84.9% with less than half the
households in A. Nzo and OR Tambo having access. The
Eastern Cape has the 2 nd lowest percentage of people (10.2%)
with access to a medical aid in the country.
The per capita PHC expenditure increased to R231 in 2006/07,
slightly below the national average of R256. All districts,
except Amathole, had increased their PHC expenditure.
There was a steady increase in the nurse clinical workload
to an average of 28.9 patients per nurse per day in 2006/07,
above the national average of 26.9.
The PHC utilisation rate of 2.3 visits per person per year
has been steady for the past four years but conceals differences
from a high of 3.3 in Cacadu to a low of 1.7 visits per year
in A. Nzo. The national target is 3.5 visits per year.
The average length of stay (6.1 days) and the bed utilisation
rate (61.0%) remained steady over the past four years.
However both of these indicators were worse than the
national average with the ALOS close on two days longer
than the national average. It was also the longest ALOS in
the country. The BUR was below the national average of
65.4% in 2006/07.
cure rate has improved to 53.7% in 2005 while the TB smear
conversion has gone from 37.3% in 2004 to 49.9% in 2006.
However, there is still much room for further improvement.
Chris Hani and OR Tambo districts in particular have improved
their TB indicators.
The male condom distribution rate decreased to 9.8 condoms
per man per year in 2006/07 compared to 10.3 in 2005/06.
This is one of the important preventive approaches to HIV
and clearly this programme has not been prioritised. The
proportion of ANC clients tested for HIV was 75.5% in
2006/07, well above the national average of 67.9%. The
underlying data of the nevirapine uptake rate among pregnant
HIV +ve women and the nevirapine uptake rate of their
newborn babies need further investigation as the fluctuating
values make it difficult to interpret.
The immunisation coverage rate increased marginally from
72.7% in 2005/06 to 74.2% in 2006/07 but is still below the
national average of 84.7%. This indicator is very dependent
on the estimated number of children under one year of age,
which forms the population based denominator. The very
high values demonstrated in the DHB 2005/06 were as a
result of being based on largely incorrect population figures.
These have now been adjusted which has resulted in lower
rates both for 2005/06 and 2006/07. The immunisation drop
out rate improved from 6% to 4.2% in 2006/07.
The TB programme, although still showing poor outcomes
has shown significant improvements over the past year. Two
districts, Amathole and Nelson Mandela Metro were declared
‘TB crisis districts’ by the National Department of Health in
2005 and a TB crisis plan was put in place. Overall the TB
The facility delivery rate has been relatively stable. Both the
stillbirth rate and the perinatal mortality rates improved to
26.8% and 42.3% respectively in 2006/07.
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