The OR Tambo district, a territory that includes Mthatha and Port St Johns in the old Pondoland area of the Eastern Cape, remains the basket-case of South Africa, ranking bottom of the 52 districts in the most important indicators.

It has the worst rate of newborn deaths in the country ‘€“ usually an indicator of poor healthcare. Double the number of newborns died in the district than the national average ‘€“ 20.8 babies per 1000 births compared to 10.2 nationally.

Almost triple the number of children under five died in the district’€™s facilities in comparison to the national average (11.4%), while it had the third highest deaths of children under a year.

OR Tambo district also had the second highest teen pregnancy rate in the country (measured by how many births are 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 its deaths of babies under a year in its facilities, and almost halve deaths of children under five.

Capricorn in Limpopo recorded the most maternal deaths, with a shocking 354 mothers dying per 100 000 births. Free State had the worst provincial rate, while Ethekwini had the highest maternal deaths of the metros (251 per 100 000) while Cape Town (30) had the lowest metro rate.

Surprisingly a number of Western Cape districts ‘€“ particularly the Central Karoo and Overberg ‘€“ have slipped in regard to immunisation rates, particularly for measles and rotavirus. Central Karoo also had the worst TB defaulter rate.

Johannesburg had the best immunisation rates

While Nelson Mandela Bay (Port Elizabeth) was the biggest spender per patient per day, it has precious little to show for its money as its health outcomes are generally poor and it had the second highest newborn deaths in the country.

Ten of KwaZulu-Natal’€™s 11 districts spent the least on district management, while the Eastern Cape spent the most ‘€“ yet KZN’€™s health outcomes are substantially better, perhaps because its districts spent their money on district hospitals rather than on bureaucracy.

The KZN districts were best at testing pregnant women for HIV, while the Northern Cape was the worst.

But the KZN districts had some of the worst diarrhoea rates in the country for children under the age of five. Worst of all were two Limpopo districts, Vhembe and Mopani ‘€“ indicating a likely problem with water supply.

Two Free State districts ‘€“ Lejweleputswa and Mangaung ‘€“ had very bad stillbirth rates, along with Nkangala in Mpumalanga. Both KZN and Gauteng recorded a rise in stillbirths, which is the number of babies born dead per 1000 births and is often an indicator of poor care.

Cape Town’€™s district hospitals were the best used, maintaining high occupation rates.

Meanwhile, despite the huge distances, the people of the sparse Northern Cape, visited the clinics the most ‘€“ particularly in the greater De Aar area (Pixley ka Seme district). This is despite the fact that the PHC facilities in that province had the worst supervision rate.

Teen pregnancy is highest in the Eastern Cape and KZN, where over one in 10 births are to mothers under the age of 18. Siyanda in the Northern Cape had a huge jump in teen pregnancies, and – with 16.3% of births to teens ‘€“ had the worst teen pregnancy rate. Gauteng had the lowest rate of teen mothers (5.7%). ‘€“ Health-e News.