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Durban – One of South Africa’s poorest districts, which is home to Nelson Mandela, has scored bottom of the class when it comes to health services.
This is according to the Health System Trust’s annual SA Health Review and District Health Barometer.
The report, which highlights trends in the health sector, were made public this week.
The
OR Tambo district in the Eastern Cape ranked bottom of the 52 districts when measuring the state of health in accordance with a set of indicators.
It has the worst rate of deaths among newborns in the country – double the number of newborns died in the district compared with the national average – 20.8 babies per 1 000 births compared with 10.2 nationally.
Almost triple the number of children under five died in the district’s facilities in comparison with the national average (11.4 percent), while it had the third-highest deaths of children under a year old.
The district also had the second-highest teenage pregnancy rate in the country (measured by how many births were to women under 18).
The Western Cape districts generally had the lowest child mortality in health institutions in the country, and three of the province’s districts recorded no maternal deaths.
Gauteng has managed to halve the number of deaths of babies under a year in its facilities, and almost halve deaths of children under five.
A number of Western Cape districts – particularly the Central Karoo and Overberg – slipped in regard to immunisation rates, particularly for measles and rotavirus. The Central Karoo also had the worst TB defaulter rate.
Cape Town’s district hospitals were the best used, maintaining high occupation rates.
In an SA Health Review chapter on HIV, Professor Francois Venter of the Wits Reproductive Health and HIV Institute warns that the state of many public health facilities threatens the expansion of the country’s antiretroviral treatment programme, particularly frequent ARV shortages and poor service delivery.
The Eastern Cape, Gauteng and Limpopo have been hard hit by frequently running out of stock of ARVs causing treatment interruptions – a situation that is life-threatening.
Venter points out that staff costs are the highest single cost of the treatment programme and there is an urgent need for the programme to be nurse-driven at a primary level.
The ARVs of stable patients could also be delivered to their homes to protect them from being exposed to TB and other diseases in hospital waiting rooms.
Sub-populatons
Venter adds that five “sub-populations” are not getting adequate access to HIV treatment – teenagers, foreigners, men who have sex with men, prostitutes and men.
In a chapter dealing with national health insurance, health director-general Malebona Matsoso and UK Department of International Development senior health adviser Dr Bob Fryatt acknowledge that, although few changes are visible to Citizen Average, the government has been involved in a wide variety of policy and institutional reforms in the past 18 months.
One of the big question marks hanging over the NHI is where all the extra health workers will come from to make it work.
South Africa has once again turned to Cuba to train 1 000 South Africans as doctors as well as to supply 95 Cuban doctors due to start work in 2013.
The government has also contracted 500 private doctors to start providing services in the NHI pilots in under-served places.
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