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District wellness statistics provide barometer to gauge nation's shape

By unknown | Feb 16, 2007 | COMMENTS [ 0 ]

Kerry Cullinan

Kerry Cullinan

The former Transkei has emerged as the country's poorest region, and the living is easy on the West Coast.

The Eastern Cape's OR Tambo district in the Transkei is officially the most miserable and socially deprived area in the country.

This is according to the District Health Barometer, which ranks the country's 53 health districts by comparing factors such as unemployment and access to clean water and electricity.

By comparing health statistics from the 53 districts for 2005-06, the Barometer provides the most up-to-date and comprehensive snapshot of the nation's health.

"The Barometer is a tool for district health managers to pick up weaknesses in their areas so that they can prioritise and plan to address these," says Barometer co-editor Fiorenza Monticelli, from Health Systems Trust, a health care research NGO.

Unfortunately, one of the weaknesses is that some of the data - three-quarters of which comes from the Department of Health - is inaccurate.

"There are some inaccuracies because of weaknesses in data collection in the districts," says Monticelli. "But we estimate that about 80percent of the information is true."

Besides, she says, by highlighting the data irregularities, the Barometer also forces managers to confront skills weaknesses in their districts.

Monticelli praised the Department of Health for "opening up and providing us with real data," saying that the information would help to ensure better and more equal service delivery.

Referring to graphs and tables, it is easy to see at a glance where poverty is at its worst and which districts have poor management systems and health services.

OR Tambo, where only a quarter of the population have access to clean water, is rivalled for the bottom spot by its neighbouring Alfred Nzo district.

By contrast, the five districts with the least social deprivation are all from the Western Cape, with the top scoring West Coast being closely followed by Overberg and the Cape Wine lands.

All Gauteng's districts were in the top one-third.

The poorest one-third of the districts were made up almost entirely by those from the Eastern Cape, KwaZulu- Natal and Limpopo - with the addition of the Northern Cape's Kgalagadi district.

Interestingly, some of these poorer districts, particularly those in KwaZulu-Natal, spend a fair bit on health a head yet this does not translate into better health outcomes. For example, KwaZulu-Natal's Umkhanyakude district forks out as much a person as does the West Coast (more than R300 a person), yet it is the fourth poorest district in the country.

North West's Bophirima spends the most a head on health in the country - R416 - yet its TB cure rate has plummeted by 10 percent in the space of a year.

But Limpopo's Greater Sekhukhune spends the least a head and has poor health indicators to match.

Some of the indicators are shocking. Mpumalanga's Nkangala district, for example, has a TB cure rate of only 12 percent.

Nkangala also distributed the lowest number of male condoms in the year under review - with every man getting a yearly allotment of half a condom.

Pregnant women could also do well to avoid Zululand, where there are 64 stillbirths per 1000 babies born. The national average is 25.

The stillbirth rate is usually a good indicator of the quality of care during labour and the health and nutritional status of mothers.

The incidence of diarrhoea in children under five was extremely high in most districts in KwaZulu-Natal and Limpopo, probably highlighting a lack of access to clean water and poor sanitation. Data from many Eastern Cape districts was, however, missing.

The number of cases of diarrhoea in eThekwini was almost double that of the national average, with every second child in the metro reported to have suffered from the disease.

A shocking eight out of 10 children in Kgalagadi in the Northern Cape had diarrhoea.

The Barometer also picked up serious weaknesses in the country's programme aimed at preventing HIV-positive mothers passing the virus on to their babies - the mother-to-child prevention programme (PMTCT).

In six provinces, less than half of all pregnant women were tested for HIV. Mpumalanga was the worst, with less than one in three women being tested.

The level of HIV-positive pregnant women taking nevirapine was unimpressively low in all provinces except the Western Cape which indicates that the PMTCT programme is not being promoted actively enough.

The Barometer was presented to a meeting of provincial health officials on Thursday last week. -Health-e News


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