DHB 2006/07 - Health Systems Trust

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Section A: Indicator Comparisons by District 4.4.4 Nevirapine uptake rate among babies born to HIV+ve pregnant women The nevirapine uptake rate among babies measures the percentage of babies of HIV+ve mothers who received nevirapine within 72 hours of birth, out of the number of live births in facilities to HIV+ve women. The denominator used to calculate this indicator generally gives an inflated picture of nevirapine coverage to babies as far fewer deliveries to HIV+ve women are recorded each month compared with the number of women testing HIV+ve. This suggests that either many HIV+ve women are delivering at home and are therefore not recorded in facility delivery records, or that HIV+ve women are not identified in labour and are therefore not recorded as such in delivery registers. The first explanation is unlikely given that in South Africa overall 92% of births are assisted by a trained health care provider (SADHS 2003). Given this situation it would be more accurate to use the denominator of women testing HIV+ve to calculate this indicator rather than live births to HIV+ve women. The infant component of the antiretroviral regimen is also due to change shortly to include one week of AZT to infants in addition to the single dose of nevirapine. In addition to lowering the HIV transmission rate, this regimen change may also improve uptake for infants because recording of coverage will occur at the one week postnatal clinic visit as well as in the labour ward. District View There was a large variation across districts ranging from 9% in Chris Hani (EC) to 88% in Pixley ka Seme (NC). The highest coverage for infant nevirapine was found in the Western Cape with all districts above 65%. The low coverage provinces were notably Gauteng and Mpumalanga with all districts below 50% coverage. Much more attention needs to be given to this component of the PMTCT programme with 23 districts having coverage of less than 50%. South Africa as a whole should be achieving well over 90% for this HIV preventive intervention. Map 15: Nevirapine uptake rate among babies born to HIV+ve women in South Africa, 2006/07 Nevirapine uptake rate among babies born to HIV+ve women, 2006/07 Legend NVPB_06 under 40 % 40 - 49 % 50 - 59 % 60 - 69 % 70 % and above THE DHIS INDICATORS PRESENTED HERE ARE AS RECEIVED FROM THE NATIONAL DHIS AND HAVE NOT BEEN ALTERED BY THE AUTHORS OR HST 79
Section A: Indicator Comparisons by District Figure 74: Nevirapine uptake rate among babies born to HIV+ve women by district, 2006/07 Nevirapine uptake rate among babies born to HIV+ve women, 2006/07 South Africa Pixley ka Seme Siyanda City of Cape Town Cape Winelands Eden West Coast Frances Baard Overberg Uthukela Central Karoo Kgalagadi Amathole eThekwini Motheo Ugu iLembe Uthungulu Central Xhariep Mopani Nelson Mandela Bay Thabo Mofutsanyane Zululand Capricorn Vhembe Waterberg Southern Cacadu Umzinyathi Ehlanzeni Fezile Dabi Greater Sekhukhune Sisonke Bophirima Umkhanyakude Ekurhuleni Namakwa Sedibeng Bojanala Lejweleputswa UMgungundlovu O.R. Tambo Nkangala Gert Sibande Amajuba City of Johannesburg West Rand City of Tshwane Metsweding Ukhahlamba Alfred Nzo Chris Hani EC FS GP KZN LP MP NC NW WC SA 0 10 20 30 40 50 60 70 80 90 100 Percentage 80 THE DHIS INDICATORS PRESENTED HERE ARE AS RECEIVED FROM THE NATIONAL DHIS AND HAVE NOT BEEN ALTERED BY THE AUTHORS OR HST
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Variables included in the analysis
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Appendices Appendix 2 Deprivation I
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DHB 2006/07 - Health Systems Trust

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