DHB 2006/07 - Health Systems Trust

Section B: District and Province Profiles
Free State DC17 Motheo District Municipality
Motheo district, centred around Bloemfontein
and with a population of over 790 000, is the
smallest and the most urban district in the
Free State. Almost all (95.8%) households have
access to running water. The district has a
large range of public health facilities, ranging
from clinics to tertiary and specialised hospitals,
together with a number of private facilities.
Non-hospital PHC spending per person rose
by some R30 (in real term values) to R292
since 2005/06, which is now above the SA
average. The proportion of the total district
budget spent on district hospitals remained
the highest in the province (46.8%), whilst the
amount spent on management is the lowest
in the province (2.8%).
The nurse clinical workload continued to
increase to over 29 patients per nurse per day
in 2006/07, although the PHC utilisation rate
has been constant at a low 1.9 of visits per
person per year. Clinic supervision was
consistently done in less than one in three
clinics (31.3%) in 2006/07.
Although the TB cure rate at 66.7% was the
same as in 2004, the TB smear conversion rate
improved by 7.8 percentage points in 2006.
However, much still needs to be done to
improve the TB control programme. There
was a marked improvement (to 71.1%) in the
proportion of pregnant women tested for HIV
in 2006/07. The nevirapine uptake rate data
for both HIV +ve mothers and their babies
needs to be scrutinized for data quality as the
figures fluctuate widely. The male condom
distribution rate remained low at 4.3 condoms
per man per year ranking Motheo as the 3 rd
lowest in the country. This is an extremely
low figure and highlights the need for
prioritisation of this activity. The incidence of
new STIs treated continued to improve in
2006/07.
The proportion of pregnant women delivering
in a facility dropped to 80.1% in 2006/07.
Although the stillbirth rate decreased slightly
(31.7 in 2005/06 to 28.1 in 2006/07), both it
and the perinatal mortality rate (40.1 per 1000
births) remained high in 2006/07, especially
for a mostly urban district. The immunisation
coverage improved marginally since 2005/06
to 81.6% in 2006/07, but the immunisation
drop out rate is good at almost zero.
DC17
Motheo District Municipality
Year
District Rank
(1 = best)
National
value
Demographic and
socio-economic
Impact Outcome Output Process Input
782 961 786 001 790 955 47 844 347
16 759 17 253 16 659 1 062 504
57 39
20.1 20.6 7 13.7
95.8 95.8 15 84.9
2.70 2.12 17
3 4
40 12 47.2
169 261 292 14 256
2.4 2.8 4.7
51.1 46.8 43.6
834 842 954
22.6 22.7 27.3 29.3 26.9
4.7 4.5 4.8 4.3 31 4.4
75.2 71.3 79.9 75.5 10 65.4
31.3 33
3.6 4.1 4.6 4.3 50 11.1
83.7 86.3 80.1 81.6 34 84.7
7.0 2.2 -5.2 0.2 9 3.0
14.2 17.1 14.7
48.4 51.8 44.5 71.1 33 67.9
28.8 28.2 25.8 24.4 34 23.7
30.5 (26.8-34.3) 30 29.1
94.3 101.3 100.7 62.3 14 47.0
10.3 36.0 54.5 29.1 47 61.1
2.0 2.0 1.9 1.9 42 2.2
3.7 3.5 3.2 2.9 11 4.9
62.7 66.8 66.7 17 57.6
59.3 59.9 67.7 14 55.8
156.2 151.8 151.7 118.5 18 218.8
2.3 2.3 1.9 2.0 38 1.3
90.6 89.0 85.9 80.1 24 77.7
34.3 31.0 31.7 28.1 39 24.0
42.1 38.8 39.6 40.1 39 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) 69 5 20 4 1 1 1 3 2 705
Number of private sector facilities and beds (2007) 6 820
144
Beds