DHB 2006/07 - Health Systems Trust

Section B: District and Province Profiles
North West DC37 Bojanala District Municipality
Bojanala has the largest population in the North
West, with approximately 1.3 million people. The
socio-economic development is average with 84%
of households having access to piped water and
52.2% of households living on an income of less
than R800 per month in 2005. Around 16% of
people had access to a medical aid.
The PHC expenditure was the lowest in the province
despite an increase of R69 per capita in 2006/07 to
R291. The utilisation rate of 2.5 visits per year has
been fairly static over the last four years. The nurse
clinical workload fluctuated significantly and
decreased from 47.1 patients per nurse per day in
2005/06 to 22.6 in 2006/07. This was probably due
to unreliable data. The clinic supervision rate was
44.9% meaning that less than one in two clinics was
regularly supervised which is inadequate for quality
improvement.
The bed utilisation rate has been consistently low
since 2003/4 and was 55.3% in 2006/07 with a
consistent average length of stay of four days.
The TB cure rate decreased from 57.5% in 2004 to
54% in 2005, although the smear conversion rate
increased marginally from 46.1% in 2005 to 47.3%
in 2006. These were inadequate results for a priority
health programme and much more managerial
attention is required for the TB control programme.
The proportion of pregnant women tested for HIV
increased from 37.7% to 57.9% in 2006/07. The
nevirapine uptake rates for HIV +ve pregnant women
and their babies fluctuated, thus making
interpretation difficult. The PMTCT programme
needs improved implementation and monitoring in
this district as it is a very important HIV prevention
programme.
The male condom distribution rate improved
fractionally to 7.1 condoms per male per year in
2006/07. This is another important HIV preventive
activity that requires greater prioritisation. The
stillbirth rate and perinatal mortality rates showed
more realistic figures in 2006/07 of 26.3 and 35.8
per 1000 births respectively, which were closer to
the national averages. The delivery rate in facilities
and the Caesarean section rate remained consistent
over the past two years.
Disappointingly, the immunisation coverage
decreased from 72.8% in 2005/06 to 61.7% in
2006/07, ranking Bojanala as having the 2 nd worst
coverage in the country. The immunisation drop
out rate of -0.6% for 2006/07 was probably due to
poor data quality.
DC37
Bojanala District Municipality
Year
District Rank
(1 = best)
National
value
Demographic and
socio-economic
Impact Outcome Output Process Input
1 247 125 1 261 012 1 271 534 47 844 347
28 415 29 082 28 479 1 062 504
69 39
12.9 16.0 18 13.7
84.1 84.3 30 84.9
3.00 2.57 26
3 3
52 30 47.2
189 234 291 15 256
11.1 7.1 4.7
29.9 48.7 43.6
0 795 954
127.4 80.9 47.1 22.6 26.9
3.8 4.0 4.0 4.0 24 4.4
56.4 55.6 54.7 55.3 46 65.4
44.9 20
5.3 6.2 6.7 7.1 35 11.1
72.3 73.9 72.8 61.7 51 84.7
12.6 13.7 6.7 -0.6 6 3.0
9.6 10.3 14.7
- 29.9 37.7 57.9 44 67.9
49.8 31.6 35.3 31.3 48 23.7
33.6 (30.9-36.3) 38 29.1
0.0 93.8 91.1 40.6 39 47.0
- 37.8 28.6 45.3 41 61.1
2.4 2.5 2.4 2.5 17 2.2
6.3 6.4 5.1 4.5 25 4.9
54.2 57.5 54.0 36 57.6
50.4 46.1 47.3 39 55.8
109.3 124.6 258.0 90.0 9 218.8
0.0 2.6 1.9 1.0 12 1.3
69.6 80.6 76.6 76.2 33 77.7
7.6 4.0 4.0 26.3 34 24.0
8.2 4.3 5.1 35.8 27 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) 114 14 24 5 0 1 0 0 1 227
Number of private sector facilities and beds (2007) 5 512
Beds
189