The good, bad and ugly in district health

The good, bad and ugly in district healthPilani10_A Rural nurse in the eastern cape

The SA Health Review and District Health Barometer, produced annually by Health Systems Trust, was launched by Health Director General Precious Matsoso last night. Important gains have been made, but huge challenges remain.

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Teen mothers face a difficult road
The country recorded 71 583 teen pregnancies in 2014/15. (File photo)

In the past year, over 90 percent of pregnant women with HIV started antiretroviral medicine – a leap of 15 percent in a year – and this helped to drive the mother-to-child HIV transmission to its lowest level ever, a mere 1,5 percent.

One in 14 births was to a girl under the age of 18, with a total of 71 583 teen pregnancies.

This was almost 2 500 lower than last year, with Johannesburg having the lowest teen pregnancy rate (4% of births) and the Eastern Cape’s Alfred Nzo District having the highest (12,8%).

There was a total of 964 901 births, 17 506 more than in 2013/14.

There has been a slight one percent decrease in the national maternal mortality rate (now 132.5 deaths per 100 000 live births). This is some way away from the national target of 100. Provincially, the Western Cape performed the best (54) while the Northern Cape was the worst (254).

There was also a slight improvement of less than one percent in stillbirths (20.7 deaths per 1 000 total births). Again, the Western Cape performed best (17.2) and the Northern Cape was worst (25.5)

The Eastern Cape’s OR Tambo and Alfred Nzo districts in the former Transkei were consistently poor performers, as they have been year after year. But two new delinquent districts have emerged with consistently poor indicators: Mopani (Phalaborwa) in Limpopo and Ehlanzeni (Nelspruit) in Mpumalanga.

[quote float= right]More than 90 percent of pregnant women with HIV started ARVs and this helped to drive the mother-to-child HIV transmission to its lowest level ever, a mere 1,5 percent

Children under five were most likely to die of diarrhoea in OR Tambo (9.6% of cases), Mopani (7.9%) and Free State’s Mangaung (6,9%).

Meanwhile, pneumonia was most likely to kill pre-schoolers in Alfred Nzo (6.7% of cases), Ehlanzeni (6%) and Mopani (6%).

The Under Fives were most likely to die of malnutrition in Mpumalanga’s Gert Sibande (22% of cases), Free State’s Lejwelepuntswa (21,5%) and Mopani (21%).

Mpumalanga had the worst death rate for kids with malnutrition (19.1%) while the national fatality rate was 11.6 percent – much higher than the national target of 8 percent . The Western Cape was the only province that achieved the national target.

The TB cure rate has inched up by one percent to 76.8 percent. The Western Cape had the best cure rate (82.6%) and Limpopo had the worst (57.6%). Vhembe, Capricorn and Sekhukhune, all in Limpopo, had the lowest tuberculosis (TB) treatment rates.

TB patients were most likely to die in the Free State (11%) and least likely to die in the Western Cape (4%). Meanwhile, KwaZulu-Natal’s uMkhanyekude and Zululand districts had the worst rates of drug-resistant TB.

Some 90 percent of one-year-olds were immunised, with Gauteng recording the best rate and Mpumalanga, the lowest. – Health-e News.

An edited version of this story also appeared in The Star newspaper