Report reveals primary healthcare status in SA

Speaking at the launch of the report, which presents snapshots of how the country's health districts provide primary care to the population, Motsoaledi said it confirmed progress in a number of government policies and interventions.

The DHB, which is issued annually by the Health Systems Trust, a research NGO, does not provide any form of complex analysis or in-depth research but rather points to districts that need improvement and support while identifying those doing well.

Albeit far from the WHO target, the report indicated that the country's districts were making progress in HIV testing and prevention, prevention of mother-to-child transmission, TB cure, malnutrition and communicable diseases.

However, this largely depends on where one lives in the country's 52 districts. For example, a man living in Cape Town received an average of 48 free condoms in 2010/2011 while a man living in Dr Kenneth Kaunda in North West only received four condoms.

Another inequality presented by the report was the spending in the districts. Districts in the Western Cape were spending more on primary care while districts in the Free State were spending far less.

On the upside, there is progress on the country's maternal and child health by ensuring that pregnant mothers get tested for HIV to prevent mother-to-child transmissions.

The country's districts have also made progress in saving children as severe malnutrition has decreased and rates of diarrhoea among children of under the age of five have also come down. However, about 25 districts were still characterised by a high burden of maternal deaths.

On the fight against communicable diseases, the report noted significant progress in the management, treatment and control of TB. This was indicated by the TB cure rate increasing from a baseline of 51%in 2004 to 71% in 2009, which is the last reporting period because TB data lags a year behind other indicators.

Dr Tanya Doherty of South Africa's Medical Research Council said other themes that stood out on the barometer included the major contributors to the years of life lost. These were morbidity resulting from injuries related to transport accidents, interpersonal violence and non-communicable diseases such as strokes, diabetes and hypertension.

Motsoaledi said while progress had been made in many areas, there were some areas that needed more attention.

"Over the coming financial year and during the [medium term expenditure framework], we are going to introduce interventions that will strengthen districts focusing on partnerships and collaborations to address the social determinants of health."

He said additional interventions would include boosting the management capacity of district officials, who in turn would ensure quality service levels while correcting anomalies related to skills levels and competences of managers at public hospitals.

"From now on, our hospitals will be managed by the qualified and competent managers at an appropriate designation," he said, adding that in order to have a successful implementation of the National Health Insurance, they needed to address these anomalies and up the services.

He said the process had started and they would advertise about 92 CEO positions at DDG level this weekend.

The minister also hoped that the team of experts who would be dispatched to four districts, including Motheo and Zululand in the next few weeks to support supervision and clinical governance, would go a long way in addressing some of the challenges identified by the DHB.

Other proposals included dividing public hospitals into districts, regional, tertiary, central and specialised - which would have special services offered at each level.

Another proposal was to expedite the finalisation of the National Health Act, which was passed in 2003. Motsoaledi hoped that some sections of the Act, which come into effect on 1 March, would enable government to bring about the necessary changes that would ensure that the health landscape performed optimally.