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Health System Trust South African Health Review and District Health Barometer Monitoring Health & Advising Policy. Fiorenza Monticelli ANC Health and Education PEC sub-committee meeting 29 April 2010. Presentation outline. Primary Health Care Indicators 2008/09
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Health System TrustSouth African Health Review and District Health Barometer Monitoring Health & Advising Policy Fiorenza Monticelli ANC Health and Education PEC sub-committee meeting 29 April 2010
Presentation outline • Primary Health Care Indicators 2008/09 The good and the not so good (District Health Barometer) • Health policy recommendations (South African Health Review & related research) All available at www.hst.org.za
The good: TB Cure Rate MDG Goal 6: Combat HIV and AIDS, malaria & other diseases South Africa Percent Percent Gauteng is ranked second best of all the provinces after Western Cape
TB cure rate by district, 2007 Ekurhuleni 79.5% Johannesburg 76.1% Tshwane 72.6% West Rand 72.4% Sedibeng 71.7% Metsweding 71.5%
TB cure rate - District trends Percentage City of Johannesburg Ekurhuleni City of Tshwane West Rand Sedibeng Metsweding
The good: Immunisation coverage <1MDG Goal 4: Reduce child mortality South Africa Percent Percent Gauteng is ranked second best of all the provinces after Western Cape
Immunisation coverage <1 year District trends Percentage City of Johannesburg Ekurhuleni City of Tshwane Sedibeng Metsweding West Rand
Needing attention: Primary Health Care Utilisation Rate South Africa Gauteng has the lowest PHC utilisation rate of all the provinces
PHC utilisation rate by district 2008/09 SA average = 2.4 Metro average = 2.3 Gauteng average = 2.0
Not so good: HIV testing rate of pregnant womenMDG Goal 4: Reduce child mortality & MDG Goal 5: Improve maternal health Proportion ANC clients tested for HIV South Africa Trend by Province Percentage
Proportion of ANC clients tested for HIV 2008/09 SA average = 86.7% Metro average = 78.5% Gauteng average = 78.4%
Health Policy Recommendations • “ Tackle inequitable distribution of resources” • “ Efficiency and outcomes need attention...” • “ Improve management and governance of clinics and hospitals….” • “ Measure the problem and its solutions through improving the health information system....as it is essential to be able to monitor progress and inequities” Bradshaw D. Determinants of Health and Health Trends. In: Barron P, Roma-Reardon J, editors. South African Health Review 2008. Durban: Health Systems Trust; 2008. Blecher MS, Day C, Dove S, Cairns R. Primary Health Care Financing in the Public Sector. In: Barron P, Roma-Reardon J, editors. South African Health Review 2008. Durban: Health Systems Trust; 2008. Padarath A, Freedman I. The state of clinic committees in primary level public health sector facilities in South Africa. Durban: Health systems Trust ; 2007.
Tackle inequitable distribution of resourcesProportion of District Health Services Expenditure on District Hospitals
Tackle inequitable distribution of resources Proportion of District Health Services Expenditure on District Management ”
Cost per patient visit to a PHC facility 2008/09 “ Efficiency and outcomes need attention...”
Improve management and governance of clinics and hospitals • Research done on the status of clinic committees in primary level public health sector facilities recommends: • Develop a comprehensive framework for clinic committees. • Guidelines on what governance structures are meant to do, how they should be constituted & operate • Develop & implement capacity development programme for clinic committee members • Training programme – roles & responsibilities, procedural issues related to functioning & community health related issues.
