DHB 2006/07 - Health Systems Trust

Section B: District and Province Profiles
Eastern Cape NMA Nelson Mandela Metropolitan Municipality
Nelson Mandela metro has the 3 rd largest
population of the Eastern Cape and the best
socio-economic status in the province,
although the lowest as compared to the
other metros. Almost everyone (98.1%) had
access to piped water and 29% belonged to
a medical aid. The high access to water may
have played a role in the low incidence of
diarrhoeal disease which continues to be
one of the lowest in the country.
The per capita expenditure on PHC
increased to being close to the national
average of R256 in 2006/07. The PHC facility
utilisation rate decreased in 2006/07 although
this was well above the national average of
2.2 visits per person per year. The hospital
bed utilisation rate has continued to decline
while the ALOS remained remarkably stable
at 3.3 days. There was a massive increase
in the cost per patient day equivalent in
2006/07 to R1530. The nurse clinical
workload at 46.8, although stable was much
higher than the national average. Sadly, clinic
supervision rate data were not available.
Nelson Mandela metro is one of two districts
in the Eastern Cape that was declared a ‘TB
crisis district’ by the national Department
of Health. The TB cure rate improved to
52.7% in 2005 and there was a corresponding
improvement in the TB smear conversion
rate from 44.5% in 2005 to 55% in 2006.
The proportion of ANC clients tested for
HIV in 2006/07 was 75.1%, which is a great
improvement compared to previous years.
The PMTCT indicators have fluctuated and
because of the issues around data quality it
is difficult to interpret these indicators. The
condom distribution rate of 6.5 condoms
per man per year in 2006/07 is concerning
as it is obvious that this important preventive
measure against HIV is not being prioritised.
However, the STI incidence remained stable.
The stillbirth and perinatal mortality rate
indicators were more realistic in 2006/07
than in previous years. However, because
the data have fluctuated so much it will
require another year before these can be
interpreted with confidence.
NMA
Nelson Mandela Metropolitan Municipality
Year
District Rank
(1 = best)
National
value
Demographic and
socio-economic
Impact Outcome Output Process Input
1 116 378 1 121 373 1 131 016 47 844 347
24 815 26 563 24 156 1 062 504
577 39
25.8 29.0 2 13.7
98.7 98.1 5 84.9
2.37 2.05 16
5 4
30 5 47.2
170 227 248 24 256
2.5 2.8 4.7
30.6 30.1 43.6
1 054 1 530 954
41.3 43.7 48.4 46.8 26.9
5.1 3.4 3.3 3.3 19 4.4
100.2 82.3 76.8 71.5 13 65.4
-
7.1 8.2 6.4 6.5 37 11.1
121.2 107.0 65.9 71.2 47 84.7
4.9 6.2 7.0 4.4 36 3.0
23.1 21.2 14.7
12.4 35.8 52.6 75.1 27 67.9
27.0 24.7 22.8 23.6 30 23.7
31.9 (28.6-35.3) 33 29.1
- 11.0 77.0 57.9 21 47.0
69.1 75.4 98.5 57.0 33 61.1
3.0 3.1 3.3 3.1 9 2.2
3.3 3.3 3.5 3.1 12 4.9
72.6 45.4 52.7 39 57.6
45.5 44.5 55.0 27 55.8
75.7 34.0 18.4 23.1 2 218.8
1.5 1.1 1.0 0.9 9 1.3
126.0 82.1 83.0 79.2 27 77.7
28.4 39.6 56.4 25.5 29 24.0
37.0 53.7 91.2 40.6 41 33.8
Number of Health facilities and beds Clinic CHCs
Mobile
Service
District
Hospital
Regional
Hospital
Provincial
Tertiary
Hospital
Central
Hospital
Specialised
Hospital
Private
Hospitals
Number of public sector facilities (2007) and beds (2005) 43 7 9 1 3 0 0 4 2 092
Number of private sector facilities and beds (2007) 7 955
Beds
137