DHB 2006/07 - Health Systems Trust

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Section B: District and Province Profiles Western Cape Kalay Moodley The Western Cape has a population of approximately 4.9 million people. It has the best socio-economic development in SA and the highest proportion of households with access to piped water (98.3%) in 2005. Only 22.1% of households were classified as poor with an income of less than R800 per month. Medical aid coverage in 2006 ranged from 8.8% in the Central Karoo to 24.5% in the City of Cape Town and the average medical aid coverage of 18.8% in 2006 was the 2 nd highest in the country. The per capita expenditure on PHC was the highest in the country at R354 per person in 2006/07. However, this concealed wide differences between the West Coast with a per capita expenditure on PHC of R454 and the Overberg with a per capita expenditure on PHC of R246. This intra-provincial inequity has increased over the past year. The utilisation rate of the Western Cape facilities was 2.7 visits per year which was the 2 nd highest rate in SA. Utilisation improved in all of the Western Cape districts with the exception of Cape Town. The bed utilisation rate in district hospitals was 81.2%, which was the highest in SA, while the average length of stay increased to 3.1 days in 2006/7 below the average in the country of 4.4 days. The province generally performed well in the management of priority diseases, compared to the rest of the country. The TB cure rate at 71.9% was the highest in the country and this was coupled with a smear conversion rate of 66.9%. However, there is a long way to go to reach the WHO targets. The province did very well with the testing of antenatal clients for HIV. All districts tested well over 95% of clients with the exception of Cape Town which brought the average rate down to 93.7%. This was by far the best rate in SA and of those tested, 14.1% were found to be HIV +ve which was the 2 nd lowest prevalence of HIV in the country (DHIS data) and the lowest in SA at 15.1% (antenatal survey). However the uptake rate of nevirapine in HIV +ve pregnant mothers decreased from 69.2% in 2005/6 to 65.7% in 2006/7. There was also a significant decrease in the nevirapine given to babies. This province is in a position to achieve targets of over 95% overall and eliminate HIV in children. The Western Cape distributed 33.9 condoms per male in 2006/07 which was by far the highest number in the country. This was largely due to the efforts in the City of Cape Town which had far greater distribution rates than any other district in the country. This probably impacted on the incidence of STIs which was the lowest in the country (3%). The Caesarean section rate increased to 19.8% and the delivery rate of 94.5% was the highest in the country and almost 20% greater than the national average. The stillbirth rate has fluctuated over the years and was 19.6 per 1000 births in 2006/07 while the perinatal mortality rate of 25.4 per 1000 births was the lowest in SA. The immunisation programme improved and with a coverage of 99.6% in 2006/07 was the highest in SA. This high rate and the high delivery rates in facility are probably partly due to official underestimates of the under one year old population which form the denominators for these indicators. The immunisation drop out rate of 4.7% was the highest in country. 193
Section B: District and Province Profiles Western Cape Province Province Year District Rank (1 = best) National value Demographic and socio-economic Impact Outcome Output Process Input 4 646 393 4 745 473 4 850 324 47 844 347 89 592 89 887 91 295 1 062 504 37 39 22.4 18.8 13.7 98.3 98.3 84.9 - - - - 22 47.2 418 356 354 256 5.4 4.9 4.7 25.7 23.8 43.6 662 843 954 - - - 43.3 26.9 2.7 2.7 2.8 3.1 4.4 62.8 71.0 72.6 81.2 65.4 30.8 10.6 15.1 19.2 33.9 11.1 86.0 85.7 93.5 99.6 84.7 3.6 6.0 6.3 4.7 3.0 14.3 19.8 14.7 - - 100.6 93.7 67.9 - - 12.7 14.1 23.7 15.1 (11.6-18.7) 29.1 - - 97.1 79.9 47.0 - - 69.2 65.7 61.1 2.7 2.8 2.7 2.7 2.2 2.4 3.0 2.7 3.0 4.9 71.9 70.1 71.9 57.6 58.0 60.7 66.9 55.8 92.2 111.1 106.0 111.9 218.8 0.8 0.7 0.8 1.5 1.3 84.0 88.2 88.4 94.5 77.7 17.7 19.2 18.3 19.6 24.0 23.2 26.1 24.6 25.4 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) 263 64 98 35 5 0 3 18 10 021 Number of private sector facilities and beds (2007) 35 4 222 Beds 194
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DHB 2006/07 - Health Systems Trust

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