DHB 2006/07 - Health Systems Trust

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Section B: District and Province Profiles North West Province Kalay Moodley The North West province has a population of around 3.1 million people with 85.2% of households having access to piped water in 2005. It is the 3 rd poorest province in the country evidenced by a poverty rate of 56%, with these households spending less than R800 per month. Around 13.5% of people belonged to medical aids in 2006. The per capita expenditure on PHC of R308 per person was the 2 nd highest in the country in 2006/07. There was good intra-provincial equity with all four districts fairly closely clustered around a R300 per capita expenditure. The nurse clinical workload decreased drastically from 50.1 patients per nurse per day in 2005/06 to 27.3 in 2006/07, probably reflecting improved data quality. The utilisation of public health facilities remained constant at 2.5 visits per person per year. In 2006/07, 43.5% of the total district health services expenditure was spent on district hospitals, up from 35.7% in 2005/06. However, the bed utilisation rate in district hospitals decreased in 2006/07 to 56.4% and the average length of stay remained unchanged at around four days. The cost per PDE was below the national average at R884. The TB cure rate decreased from 59.8% in 2003 to 57.6% in 2005 (the same as the national average), while the smear conversion rate of 48.1% had also not improved in the last two years and was below the national average. This is an indictment of management that the priority TB control programme showed no improvement in the key indicators and this requires greater attention. women and their babies has fluctuated making interpretation difficult. This important HIV prevention programme needs improved implementation and monitoring. The male condom distribution rate remained unchanged at 5.9 condoms per man per year for the past two years. This is another important HIV prevention activity that requires greater managerial attention. The incidence of STIs has steadily dropped from 5.8% in 2003/04 to 4.2% in 2006/07. The delivery rate in facilities has been steady at around 73% for the past three years. Although the Caesarean section rate increased from 10.9% in 2005/06 to 14.5% in 2006/07 there were wide differences among the districts. These range from 4.5% in Southern to 19.2% in Central district. * The reason for such wide scale differences requires further investigation. The indicators of the stillbirth rate and perinatal mortality rate in 2006/07, of 25 and 35.6 per 1000 deliveries respectively, seem far more accurate than the figures presented in the preceding years. The immunisation coverage dropped to 70.7% which was the lowest provincial average in the country in 2006/07. However the drop-out rate improved and was a low 1.3%. *The Central district has undergone a name change to Ngaka Modiri Molema District Municipality. The Municipal demarcation board will change the name officially pending a process of final official notification from the district. There has been a steady increase in the proportion of ANC clients tested for HIV since 2004/05 to 74.3% in 2006/07. However the uptake rates of nevirapine by HIV +ve pregnant 187
Section B: District and Province Profiles North West Province Province Year District Rank (1 = best) National value Demographic and socio-economic Impact Outcome Output Process Input 3 098 713 3 125 513 3 139 835 47 844 347 72 804 73 881 72 780 1 062 504 29 39 11.1 13.5 13.7 86.2 85.2 84.9 - - - - 56 47.2 269 284 308 256 9.8 9.0 4.7 35.7 43.5 43.6 0 884 954 296.2 61.2 50.1 27.3 26.9 3.8 4.0 4.0 3.9 4.4 55.2 56.1 58.8 56.4 65.4 46.3 5.3 5.7 5.9 5.9 11.1 75.0 76.0 77.4 70.7 84.7 6.0 7.4 5.3 1.3 3.0 10.9 13.6 14.7 - 34.7 47.9 74.3 67.9 42.2 27.2 27.5 26.4 23.7 29 (26.9-31.1) 29.1 0.0 102.0 99.4 47.9 47.0 0.0 32.0 34.6 52.1 61.1 2.4 2.5 2.5 2.5 2.2 5.8 5.5 4.7 4.2 4.9 59.8 56.6 57.6 57.6 48.4 47.7 48.1 55.8 166.4 208.6 298.4 110.6 218.8 0.0 2.6 2.2 1.4 1.3 67.6 72.7 73.1 73.3 77.7 5.7 4.0 4.0 25.0 24.0 5.9 4.7 5.2 35.6 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) 286 51 94 19 0 4 0 2 4 849 Number of private sector facilities and beds (2007) 17 1 922 Beds 188
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Team for the Preparation of the Dis
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Section B - District and province p
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Foreword The District Health Barome
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Variables included in the analysis
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Data quality varies for a number of
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DHB 2006/07 - Health Systems Trust

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