Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008.

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Presentation transcript:

Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008

Presentation Overview Background Indicators: –Per capita Expenditure and Cost per PDE –Nurse clinical workload –Immunisation coverage –HIV prevalence among antenatal clients tested –Proportion antenatal clients tested for HIV –Nevirapine uptake rate among pregnant HIV+ women –PHC utilisation rate –TB cure rate and Smear conversion rate –Rate of children under 5 years not gaining weight –Delivery rate in facility –Perinatal Mortality rate Overall rankings Conclusion Gauteng

Background 27 health, socioeconomic and financial indicators Up to four years of data for monitoring trends Profile for SA, 9 provinces and 52 districts CD with full database, resources, references and original data files used for the report A ‘live’ web-enabled GIS maps and indicators

R497 SA ave: R256 R167 R319

Expenditure by District

SA ave: R303 R233 R418 Preliminary

SA ave: R954 R1 390 R952

SA ave:

* *Proxy for MDGs SA ave: 85% 83% 101%

34.6% 26.5% SA ave: 29.1%

SA ave: 67.9% 48.6%

* *Proxy for MDGs SA ave: 61.1% 91.3% 66.8%

SA ave: 57.6% * *Proxy for MDGs 70.6% 57.8%

Province EC FS GP KZN LP MP NC NW WC SA TB cure rate per province * *Proxy for MDGs

Smear conversion rate per province Province EC FS GP KZN LP MP NC NW WC SA * *Proxy for MDGs

* SA ave: 1.3% (Under 5 years) 1.3% 0.3%

88.6% 66.5% SA ave: 77.7%

* *Proxy for MDGs

Spider graph illustrating rankings in 2006/07 Sedibeng

City of Johannesburg Spider graph illustrating rankings in 2006/07

DistrictTB Cure rate Smear conversion rate Non-Hosp PHC exp per capita Immuni- sation coverage < 1 year Clinic super- vision rate Nevirapine uptake rate among pregnant HIV+ women Not gaining weight under 5 years rate Perinatal mortality rate in facility (per 1000 births) / / / / / / / / /0 7 Sedibeng Metsweding West Rand Ekurhuleni Johannesburg Tshwane Performance/Overall rankings

Performance/rankings District Proportion ANC clients tested for HIV HIV prevalence among ANC clients tested (National survey)Utilisation rateDelivery rate in facility 2004/052005/062006/07Rank 2006/ / /062006/ /052005/062006/07 Sedibeng Metsweding West Rand Ekurhuleni Johannesburg Tshwane

 More must be done to improve the following: Proportion of antenatal clients tested for HIV, Nevirapine uptake rate among pregnant HIV+ve women HIV prevalence among ANC clients tested, Delivery rate in facility, PHC utilisation rate TB cure rate  About 60% of the information in the DHB relies on data extracted from the DHIS. The quality of this data affects what you see in the District Health Barometer publication and also the managerial decisions informed by this data.  Where DHIS data differs with what districts have, is often an indication of a need for sub-district and facility level support.  Improving the quality of data may cause the district raking to deteriorate initially, however, the districts will then have accurate and reliable data to base decisions on and can begin to see a true improvement. Conclusion

THANK YOU! We acknowledge the National Department of Health, Treasury and all other providers for access to and use of their data for this publication and Atlantic Philanthropies for funding the project. For more information, contact Fiorenza Monticelli at Or Elliot Sello at Telephone: (031)