DHB 2006/07 - Health Systems Trust

Section B: District and Province Profiles
Gauteng JHB City of Johannesburg
The City of Johannesburg has the most people
of any district in SA and is also the most
densely populated. It falls within the top 20%
of districts in terms of socio-economic
development and almost all households
(96.1%) have access to piped water. Some
18.4% of the population have access to a
medical aid. There is a large private sector
presence with 30 private hospitals which
provide more beds than the public sector.
The nurse clinical workload data has fluctuated
over the last four years, which is indicative of
poor data quality. The utilisation rate steadily
improved from 1.4 visits per person per year
in 2003/04 to 1.9 in 2006/07. The data
reflecting the clinic supervision rate of 1.2%
is incorrect and it is an indictment of the
monitoring and evaluation by management at
all levels, that these incorrect data have been
sent to the national level. The district hospital
bed utilisation rate and average length of stay
indicators have been stable over the past two
years and are average for the country.
The TB cure rate improved over the past two
years to 69.1% in 2005 and the smear
conversion rate improved to 69.4% in 2006.
Despite these very heartening improvements,
there is still much more to be done in the TB
programme. There was a slight improvement
in the number of pregnant women who were
tested for HIV in 2006/07. The nevirapine
uptake data has fluctuated and cannot be
interpreted with any confidence. Greater
priority needs to be placed on the PMTCT
programme. There was an increase in the
incidence of new STIs treated to 4.9% in
2006/07, while there was a small increase in
the condom distribution rate to 7.6 per male
in 2006/07. Much more could be done to
prevent HIV and the City of Cape Town has
set a good example for the City of
Johannesburg in this regard.
The facility delivery rate in Johannesburg
dropped to 66.5% in 2006/07 but is likely to
be due to poor data quality. The Caesarean
section rate doubled to 13.7%. The stillbirth
and perinatal mortality rates of 18.2 and 26
per 1000 births respectively, were stable and
relatively low when compared with the rest
of the country. Immunisation results have
continued to improve since 2003/04 and in
2006/07 the metro achieved an 88.9%
coverage and a 2.5% drop out rate.
JHB
City of Johannesburg
Year
District Rank
(1 = best)
National
value
Demographic and
socio-economic
Impact Outcome Output Process Input
3 176 946 3 240 413 3 288 132 47 844 347
72 520 76 028 73 583 1 062 504
1 999 39
20.8 18.4 11 13.7
97.0 96.1 12 84.9
2.37 1.60 8
5 5
31 8 47.2
451 305 307 12 256
6.2 7.2 4.7
7.8 7.6 43.6
777 952 954
23.2 18.8 17.7 24.8 26.9
4.1 3.8 4.4 4.1 25 4.4
49.2 51.1 68.0 68.9 19 65.4
1.2 45
2.0 12.5 6.5 7.6 29 11.1
79.0 83.6 87.9 88.9 19 84.7
5.1 5.2 2.9 2.5 20 3.0
6.7 13.7 14.7
30.1 60.4 63.8 64.8 36 67.9
25.7 29.4 29.6 29.2 43 23.7
30.6 (28.8-32.5) 31 29.1
73.0 97.8 105.1 27.1 46 47.0
2.1 6.9 44.1 87.5 4 61.1
1.4 1.5 1.6 1.9 41 2.2
4.5 3.8 3.6 4.9 30 4.9
57.4 62.5 69.1 13 57.6
56.2 63.3 69.4 9 55.8
66.0 102.6 116.1 135.9 22 218.8
0.4 0.5 0.3 0.3 1 1.3
75.2 78.9 77.8 66.5 43 77.7
22.9 19.8 18.9 18.2 6 24.0
30.4 29.6 29.3 26.0 6 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) 107 9 15 1 3 0 2 4 5 108
Number of private sector facilities and beds (2007) 30 5 743
Beds
149