Health district dunces
Health Systems Trust has just released its latest District Health Barometer report. Health-e takes a look at some of the country’s worst district health performers.
Children under the age of five are most likely to go hungry in the Pixley ka Seme district around De Aar in the Northern Cape, which has the highest rate of severe malnutrition (18 cases out of 1000 children). Children were also least likely to get Vitamin A supplements in this district, with only one-fifth getting the micronutrient which is essential for healthy eyes, growth and immune function.
The district also has a relatively high rate of children under five with severe diarrhoea, the biggest killer of young children.
But young children with severe diarrhoea and dehydration were most likely to die in OR Tambo district, around Mthatha in the Eastern Cape. Some 15 percent of babies diagnosed with severe diarrhoea died in the district, the highest rate in the country and triple the national average, according to the latest District Health Barometer.
Neighbouring Alfred Nzo was second worst (11,6%) for child deaths from diarrhoea. Alfred Nzo also had one of the worst immunisation rates for babies (around 70%), the country’s worst performer alongside Dr Kenneth Kaunda district in North West.
Testing babies for HIV is also a problem in Alfred Nzo district, where only a third of babies born to HIV-positive mothers were tested by eight weeks, the lowest rate in the country.
Perhaps one of the reasons that Alfred Nzo performs so poorly is that it spends the least per capita on non-hospital related primary healthcare. The district spends only R458 per person on services such as health clinics or campaigns. The national average for this type of healthcare provision is R780 per person..
Meanwhile, almost four percent of babies in OR Tambo were HIV-positive at eight weeks, which indicates that the province’s prevention of mother-to-child HIV transmission programme is performing far below the national average. Nationally, about 2.5 percent of babies born to women living with HIV contract the disease from their mothers during or after birth.
The OR Tambo region also has the second-worst stillbirth rate in the country with about 3 percent of babies in the district dying before birth.
In addition, less than a quarter of women are screened for cervical cancer in this district while nationally a little more than half of women eligible women are screened for this type of cancer.
Cervical cancer is the second most common form of cancer among South African women after breast cancer. South Africa’s rates of cervical cancer are almost twice as high as the global average.
Despite a high teen pregnancy rate, only about a quarter of women in Alfred Nzo district had access to contraception – the lowest coverage rate in the country.
KwaZulu-Natal’s Ugu district had the worst HIV infection rate amongst pregnant women, with 44 percent of pregnant women living with HIV (compared to a national average of 27 percent).
Ugu also had the highest cases of pneumonia in children under five in the country,
with 178 cases per 1000 children under five (national average 66,8 cases). Pneumonia is the second biggest killer of children this age.
Meanwhile, pregnant women should avoid Capricorn in Limpopo, which has the highest maternal death rate in the country. About 292 mothers die each year for every 100,000 deliveries. At double the national average, Capricorn’s maternal mortality figures indicate a serious problem with antenatal care and midwifery in this district. – Health-e News Service.