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PHC Financing at District level Data, Equity & Analysis. June 2008 Candy Day Health Systems Trust. Is there progress in equitable allocation of resources?. Research in 2001 indicated extreme inequity in public sector PHC financing and according to need (deprivation)
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PHC Financing at District level Data, Equity & Analysis June 2008 Candy Day Health Systems Trust
Is there progress in equitable allocation of resources? • Research in 2001 indicated extreme inequity in public sector PHC financing and according to need (deprivation) Stephen Thomas et alCh 4, South African Health Review 2002 PHC Financing – district level
DI vs PCE, 2001 PHC Financing – district level
Health expenditure data • Data generally poorly coded for facility- or district-level analysis • Published data don’t match well with National Treasury data • Calculation of useful indicators requires integration with other data sources PHC Financing – district level
Measurement of Deprivation • Deprivation index (DI) is a measure of relative deprivation across districts in SA • Based on work done by HEU • Normalised DI = 1 (least deprived) PHC Financing – district level
Variables for DI – Proportion: • children<5 • of population Black • female headed households • household head with no schooling • unemployed • traditional/informal dwelling • no piped water • pit/bucket toilet or no toilet • no access to electricity or solar PHC Financing – district level
Non-hospital PHC expenditure per capita Treasury BAS/ Walker StatsSA GHS DHIS from StatsSA PHC Financing – district level
Treasury Budget Programmes PHC Financing – district level
Selected issues • Quality of coding • Geography • Budget programmes • Facilities • Cross-boundary areas • Trend analysis – inflation • Data quality PHC Financing – district level
Data comparison 2005/6 PHC Financing – district level
Selected results • Non-hospital PHC expenditure per capita increased from R222 in 2001/2 to R256 in 2006/7 PHC Financing – district level
General improvement in equity PHC Financing – district level
Metros vs ISRDP PHC Financing – district level
Expenditure in relation to need PHC Financing – district level
Acknowledgements Thanks to others in the team who worked with this data:Peter Barron, Mark Blecher, Fiorenza Monticelli and Elliot Sello PHC Financing – district level