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Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008

Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008. Presentation Overview. Background Indicators: Per capita Expenditure and Cost per PDE Nurse clinical workload Immunisation coverage HIV prevalence among antenatal clients tested

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Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008

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  1. Fiorenza Monticelli Gauteng District Health Systems Summit 22 August 2008

  2. Presentation Overview • Background • Indicators: • Per capita Expenditure and Cost per PDE • Nurse clinical workload • Immunisation coverage • HIV prevalence among antenatal clients tested • Proportion antenatal clients tested for HIV • Nevirapine uptake rate among pregnant HIV+ women • PHC utilisation rate • TB cure rate and Smear conversion rate • Rate of children under 5 years not gaining weight • Delivery rate in facility • Perinatal Mortality rate • Overall rankings • Conclusion Gauteng

  3. Background • 27 health, socioeconomic and financial indicators • Up to four years of data for monitoring trends • Profile for SA, 9 provinces and 52 districts • CD with full database, resources, references and original data files used for the report • A ‘live’ web-enabled GIS maps and indicators http://webgis.hst.org.za:8081/

  4. SA ave: R256 R497 R319 R167

  5. Expenditure by District

  6. Preliminary SA ave: R303 R418 R233

  7. SA ave: R954 R1 390 R952

  8. SA ave: 27 38.2 19.8

  9. * SA ave: 85% 101% 83% *Proxy for MDGs

  10. SA ave: 29.1% 26.5% 34.6%

  11. SA ave: 67.9% 95.2 93.9 48.6%

  12. * SA ave: 61.1% 91.3% 66.8% *Proxy for MDGs

  13. * SA ave: 57.6% 70.6% 57.8% *Proxy for MDGs

  14. 2003 2004 2005

  15. * TB cure rate per province *Proxy for MDGs

  16. Smear conversion rate per province * *Proxy for MDGs

  17. * (Under 5 years) SA ave: 1.3% 0.3% 1.3% *Proxy for MDGs

  18. SA ave: 77.7% 88.6% 66.5%

  19. * *Proxy for MDGs

  20. Spider graph illustrating rankings in 2006/07 Sedibeng

  21. Spider graph illustrating rankings in 2006/07 City of Johannesburg

  22. Performance/Overall rankings

  23. Performance/rankings

  24. Conclusion • More must be done to improve the following: • Proportion of antenatal clients tested for HIV, • Nevirapine uptake rate among pregnant HIV+ve women • HIV prevalence among ANC clients tested, • Delivery rate in facility, • PHC utilisation rate • TB cure rate • About 60% of the information in the DHB relies on data extracted from the DHIS. The quality of this data affects what you see in the District Health Barometer publication and also the managerial decisions informed by this data. • Where DHIS data differs with what districts have, is often an indication of a need for sub-district and facility level support. • Improving the quality of data may cause the district raking to deteriorate initially, however, the districts will then have accurate and reliable data to base decisions on and can begin to see a true improvement.

  25. THANK YOU! • We acknowledge the National Department of Health, Treasury and all other providers for access to and use of their data for this publication and Atlantic Philanthropies for funding the project. For more information, contact Fiorenza Monticelli at fiorenza@hst.org.za Or Elliot Sello at elliot@hst.org.za Telephone: (031) 307 2954

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