Health-e News Service - February 23, 2012
Six of the country's 10 most deprived districts are in
KwaZulu-Natal, with Umzinyathi and Umkhanyakude being the poorest
in the country.
Umkhanyakude, in the far north of KZN, also has the worst rate of
severely malnourished children, with 13 out of 1000 children
weighing less than 60% of what they should.
Seven of the 10 districts with the worst malnutrition rates are
in KZN, while there has been an increase in severe malnutrition
in the Eastern Cape and Limpopo.
This is according to the District Health Barometer (DHB), which
compares health outcomes in the country's 52 health districts. It
was released yesterday (23 Feb) by the Minister of Health.
"Deprivation" is defined as a combination of indictors including
unemployment rate, access to piped water and electricity,
female-headed households with many children and low education
levels, according to the Health Systems Trust, which produces the
The Eastern Cape's Alfred Nzo (Mbizana) and OR Tambo (Port St
Johns) districts, which used to be bottom of the pile, are also
among the most deprived areas in the country.
The chance of a patient dying in a district hospital is highest
in Alfred Nzo, where nine percent of patients die.
Alfred Nzo's immunisation rate of children under the age of a
year is also worst in the country, and has almost halved in the
past four years. Only 49% of the district's children have been
immunised while the national average is 87%.
But countrywide, the introduction of a rotavirus vaccine has
significantly reduced severe gastroenteritis and hospitalisation
of young children. The rate of children under five with diarrhoea
has more than halved since 2008. However, Limpopo's Vhembe and
Mopani districts had the worst rates in the country, double the
Meanwhile, there appear to be serious problems with maternal
health services in the Free State, with a high rate of
stillbirths and deaths of babies within a week of birth. This is
usually an indication of poor maternal services.
An average of 31 babies per 1000 births are born dead in the Free
State. There has also been a jump in perinatal mortality
(stillbirths plus deaths of babies within seven days) in the
province from 38 deaths per 1000 births to 43 per 1000 in two
In the worst district in the country, Fezile Dabi (Mafube), the
perinatal death rate leapt from 39.6 to 48.5 deaths per 1000 in
Gauteng has the best immunisation rate despite spending
relatively the lowest on primary health care of all the
provinces, with Ekuhruleni spending the least of all the
districts (R739 per person, compared to a country average of R1
100). But Gauteng's spending on hospitals was higher than
average, indicating that people are probably seeking healthcare
at hospitals rather than clinics.
It's no surprise that the wealthiest two provinces, Gauteng and
the Western Cape, have the best levels of clinic supervision. In
Gauteng, 81% of clinics get monthly visits from supervisors,
while the country's best district is Eden (Western Cape) where
all clinics get monthly visits.
In contrast, there is pathetic supervision in the Northern Cape,
with five of its districts having a supervision rate of less
than 20 percent.
The province with the lowest HIV rate (Western Cape) had by far
the best condom distribution rate, at 49 per man over 15 a year.
But eThekwini and uMgungundlovu, with the worst HIV rates in
country, were almost bottom dishing out a mere five condoms per
man for the year.