Chris Hani Baragwanath Hospital. Picture: BUSINESS DAY
Chris Hani Baragwanath Hospital. Picture: BUSINESS DAY

The huge disparities in the healthcare services available to people living in different parts of the country were laid bare in the latest District Health Barometer, released on Thursday.

The District Health Barometer, published by the Health Systems Trust, is an annual publication that is now in its 13th edition. It is used by the government, academics and policy makers to track trends in the country’s public health system.

It showed barely half (55.7%) the babies living in Sarah Baartman district in the Eastern Cape were fully immunised, compared to almost all (97.7%) living in KwaZulu-Natal’s eThekwini district in 2017-2018.

The gap looms large even within provinces: women in the Eastern Cape’s OR Tambo district were 10 times more likely to die during pregnancy or childbirth than those in Joe Gqabi district: the institutional maternal mortality rate was 198.7 per 100,000 live births in OR Tambo and 20.3 per 100,000 live births in Joe Gqabi. The institutional maternal mortality rate covers women who die during pregnancy, childbirth or within 42 days of delivery. 

The barometer showed district health service spending on HIV/AIDS programmes had steadily increased as a proportion of the total, from just 7.3% in 2004-2005 to just over a fifth (20.7%) in 2017-2019, reflecting the government’s steadily expanding treatment programme. SA has the world’s biggest HIV/AIDS epidemic, with about 4.2-million public-sector patients on treatment.

The report highlighted other overall improvements, such as a decline in mother to child transmission of HIV: the percentage of babies testing positive for HIV at 10 weeks fell from 1.3% in 2016-2017 to 0.9% in 201-2018. It also showed the proportion of pregnant women who made their first visit to an antenatal clinic before 20 weeks increased from 61.2% in 2015-2016 to 66.6% in 2017-2018. 

The increase is linked to the national health department’s introduction of MomConnect in 2014, said the report’s authors. MomConnect supports pregnant women and mothers of young children using cellphone technology.

Almost 13% of all hospital births were to children and teenagers aged between 10 and 19. Alfred Nzo in the Eastern Cape had the highest rate of delivery among 10 to 19 year olds, at 24.7%, while Johannesburg had the lowest, at 4.7%.