17 kwazulu-natal province - health systems trust health... · 17 kwazulu-natal province ugu...

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Section B: National and District Profiles 401 Section B: Profile KwaZulu-Natal Province 401 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has a population of 750 214, with a population density of 148.6 people per km 2 . The district comprises six sub-districts, namely Vulamehlo, Umdoni, uMzumbe, Hibiscus Coast, Ezinqoleni and uMuziwabantu, and falls in socio-economic Quintile 2. Estimated medical scheme coverage is 7.3%. Number of facilities by level, 2015/16 Clinic CHC District Hospital Regional Hospital Central/Tertiary Hospitals Other Hospitals 54 2 3 1 0 2 Headcount and deaths, 2013/14 – 2015/16 Data element 2013/14 2014/15 2015/16 PHC headcount under 5 years 397 883 396 618 417 218 PHC headcount 5 years and older 2 451 122 2 532 251 2 542 248 Patient day equivalent 497 652 482 994 467 783 Deaths – total 3 286 3 246 3 178 Still births 336 313 304 Early neonatal deaths 155 138 113 Late neonatal deaths 69 39 29 Child under 5 years with diarrhoea death 41 22 17 Child under 5 years with pneumonia death 35 30 32 Child under 5 years with severe acute malnutrition death 46 34 32 Burden of disease profile For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non- communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Page 1: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Section B: National and District Profiles

401

Section B: Profile KwaZulu-Natal Province

401

17 KwaZulu-Natal Province

Ugu District Municipality (DC21)

Ugu District is situated in KwaZulu-Natal Province and has a population of 750 214, with a population density of 148.6 people per km2. The district comprises six sub-districts, namely Vulamehlo, Umdoni, uMzumbe, Hibiscus Coast, Ezinqoleni and uMuziwabantu, and falls in socio-economic Quintile 2. Estimated medical scheme coverage is 7.3%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

54 2 3 1 0 2

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 397 883 396 618 417 218PHC headcount 5 years and older 2 451 122 2 532 251 2 542 248Patient day equivalent 497 652 482 994 467 783Deaths – total 3 286 3 246 3 178Still births 336 313 304Early neonatal deaths 155 138 113Late neonatal deaths 69 39 29Child under 5 years with diarrhoea death 41 22 17Child under 5 years with pneumonia death 35 30 32Child under 5 years with severe acute malnutrition death 46 34 32

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

Page 2: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 20%

12%

18%

23%

36%

73%

30%

6%

47%

53%

29%

12%

46%

80%

31%

13%

20%

9%

4%

3%

4%

12%

16%

6%

20%

12%

16%

12%

30%

71%

33%

10%

44%

24%

30%

12%

34%

74%

26%

12%

19%

9%

13%

4%

14%

52%

22%

8%

KZN, Ugu: DC21, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Sepsis/other newborn infectious (4.1%)

Poisonings (including herbal) (2.2%)

Birth asphyxia (6.6%)Protein-energy malnutrition (5.8%)

Preterm birth complications (10.0%)

Septicaemia (2.4%)

Diarrhoeal diseases (24.9%)Lower respiratory infections (14.2%)

HIV/AIDS (7.9%)

Tuberculosis (4.6%)

Drowning (5.9%)

Epilepsy (2.8%)

Asthma (4.1%)Meningitis/encephalitis (4.2%)

Accidental threats to breathing (3.0%)

Road injuries (4.3%)

Diarrhoeal diseases (15.5%)

Lower respiratory infections (10.1%)HIV/AIDS (12.9%)

Tuberculosis (16.9%)

Epilepsy (2.2%)Meningitis/encephalitis (3.0%)

Mechanical forces (3.7%)

Interpersonal violence (8.0%)Accidental threats to breathing (9.5%)

Road injuries (3.2%)

Diarrhoeal diseases (4.8%)Lower respiratory infections (7.0%)

HIV/AIDS (18.3%)Tuberculosis (21.6%)

Asthma (2.0%)Accidental threats to breathing (2.1%)

Diabetes mellitus (3.0%)Hypertensive heart disease (2.5%)Ischaemic heart disease (2.3%)

Diarrhoeal diseases (5.4%)Cerebrovascular disease (5.0%)

Lower respiratory infections (8.3%)HIV/AIDS (20.8%)

Tuberculosis (24.6%)

Asthma (3.1%)

COPD (3.5%)Nephritis/nephrosis (3.6%)

Diabetes mellitus (7.5%)

Hypertensive heart disease (10.0%)Ischaemic heart disease (7.7%)

Diarrhoeal diseases (3.2%)

Cerebrovascular disease (22.3%)

Lower respiratory infections (7.0%)Tuberculosis (6.0%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, Ugu: DC21

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

402

Section B: National and District Profiles

402

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: Ugu (DC21)

Page 3: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Section B: National and District Profiles

403

Section B: Profile KwaZulu-Natal Province

403

Indicator performance: Ugu (DC21)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 8.9 19 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

35.7 6 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 5.9 5.7 5.7 36 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

1 915.1 1 960.1 2 218.0 18 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 72.0 69.4 66.3 24 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.0 5.9 5.9 36 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 15.4 27.0 41.1 16 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 36.3 37.5 39.2 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 10.6 10.0 9.4 41 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 10.1 9.6 8.7 18 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 161.0 111.7 92.4 19 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 60.1 60.3 63.6 33 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 24.0 21.4 22.9 33 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 58.4 61.6 65.8 19 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 91.3 98.0 98.3 8 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 1.0 15 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 4.3 2.5 2.3 31 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 3.1 2.2 2.6 29 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

12.5 9.1 9.4 33 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 5.9 4.7 4.1 16 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 7.2 20.4 19.4 32 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 41.9 49.1 58.0 23 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 73.8 78.3 82.9 29 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 69.6 72.9 84.9 20 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

87.8 80.1 73.4 10 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 41.9 47.0 52.3 27 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 48.5 46.4 43.0 7 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 34.3 38.1 54.3 15 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.8 1.7 2.1 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 30.1 22.4 19.9 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

26.8 13 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

0.0 23 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

1 042.2 996.3 810.0 44 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

8.3 8.0 7.3 41 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 73.7 80.1 76.6 29 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 74.7 77.8 71.6 43 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 8.0 7.3 5.7 15 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

4.7 4.2 3.8 12 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

59.2 11 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

84.8 92.1 92.0 45 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

60.8 82.0 92.7 15 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 35.6 31.7 32 26.2 28.2

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404

Section B: National and District Profiles

404

Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

31.3 31.3 34.1 19 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 37.5 35.7 33.7 43 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

20.3 18.9 17.7 18 19.9 21.2

Percentage of deaths garbage codes [Percentage] 13.5 13.9 14.9 40 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 10.9 14.1 14.5 35 13.1 13.6

Percentage of deaths ill-defined [Percentage] 11.6 9.8 9.3 20 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

Page 5: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Annual indicators for district: Ugu: DC21Va

lue

1000

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014

01_DHS exp per capita

600

800

1000

1200

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

20

30

40

50

60

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

60

65

70

75

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

30

35

40

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7

8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

4

6

8

10

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

250

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

20

21

22

23

24

25

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

100

150

200

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

2008 2010 2012 2014

06_Child <5 diar fat rate

2

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

25

30

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

4.5

5.0

5.5

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

405

Section B: Profile KwaZulu-Natal Province

405

Annual indicators for district: Ugu (DC21)

Page 6: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Annual indicators for district: Ugu: DC21

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2008 2010 2012 2014

07_Measles 2nd cov yy

40

60

80

100

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

4

6

8

10

2010 2012 2014 2016

09_RIF resistance rate

0

20

40

60

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

0

500

1000

1500

2006 2008 2010 2012 2014

09_TB inc all TB

50

60

70

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

45

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.6

1.8

2.0

2.2

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

26

28

30

32

34

36

2008 2010 2012 2014 2016

11_Hypertension prevalence

13

14

15

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

406

Section B: National and District Profiles

406

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: Ugu (DC21)

Page 7: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Section B: National and District Profiles

407

Section B: Profile KwaZulu-Natal Province

407

uMgungundlovu District Municipality (DC22)

uMgungundlovu District, one of the 11 National Health Insurance (NHI) pilot districts, is situated in the midlands of KwaZulu-Natal Province and comprises seven sub-districts, namely Impendle, Mkhambathini, Mooi Mpofana, Msunduzi, Richmond, uMngeni, and uMshwathi. The district has a population of 1 087 086, with a population density of 114.3 people per km2, and falls in socio-economic Quintile 3. Estimated medical scheme coverage is 15.7%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

50 3 2 1 1 10

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 435 725 482 082 487 314PHC headcount 5 years and older 2 941 215 3 169 491 3 000 317Patient day equivalent 1 189 164 1 147 256 1 137 614Deaths – total 4 182 4 484 4 476Still births 533 510 450Early neonatal deaths 208 163 177Late neonatal deaths 67 65 64Child under 5 years with diarrhoea death 38 24 16Child under 5 years with pneumonia death 21 22 33Child under 5 years with severe acute malnutrition death 28 20 17

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

Page 8: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

B road age.. F emale Male

<5 years

5-14

15-24

25-64

65+

T otal 18%

11%

17%

22%

33%

66%

24%

3%

37%

47%

27%

13%

53%

83%

41%

17%

22%

15%

5%

3%

5%

14%

19%

6%

17%

10%

15%

9%

26%

68%

28%

6%

38%

20%

26%

11%

41%

80%

33%

14%

21%

14%

14%

4%

14%

57%

28%

7%

KZN, uMgungundlovu: DC22, 2009-14

R ank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (3.7%)S epsis/other newborn infectious (4.9%)B irth asphyxia (5.1%)

P rotein-energy malnutrition (2.9%)

P reterm birth complications (11.8%)

S epticaemia (2.9%)

Diarrhoeal diseases (19.1%)Lower respiratory infections (14.5%)

HIV /AIDS (8.1%)

T uberculos is (3.6%)

Drowning (7.2%)

E pilepsy (2.6%)

F ires , hot substances (4.0%)Meningitis /encephalitis (3.9%)

Accidental threats to breathing (5.9%)

R oad injuries (3.4%)

Diarrhoeal diseases (11.4%)

Lower respiratory infections (9.6%)

HIV /AIDS (17.1%)

T uberculos is (10.6%)

F ires , hot substances (1.9%)Meningitis /encephalitis (2.5%)

Mechanical forces (6.6%)

Interpersonal violence (11.8%)Accidental threats to breathing (8.3%)

R oad injuries (1.8%)

Diarrhoeal diseases (4.6%)Lower respiratory infections (4.7%)

HIV /AIDS (16.7%)T uberculos is (16.8%)

Interpersonal violence (2.7%)Nephritis /nephros is (2.5%)

Diabetes mellitus (3.5%)

Hypertens ive heart disease (2.4%)

Ischaemic heart disease (3.6%)

Diarrhoeal diseases (5.4%)C erebrovascular disease (4.9%)

Lower respiratory infections (6.8%)HIV /AIDS (18.2%)

T uberculos is (19.3%)

T rachea/bronchi/lung (1.8%)C OP D (2.5%)

Nephritis /nephros is (4.9%)

Diabetes mellitus (8.6%)Hypertens ive heart disease (9.0%)

Ischaemic heart disease (11.5%)

Diarrhoeal diseases (3.1%)

C erebrovascular disease (16.9%)

Lower respiratory infections (5.5%)

T uberculos is (3.2%)

P erc entage of deaths by broad c aus e and leading c aus es , 2009-2014P rov, Dis tric tK ZN, uMgungundlovu: . .

S how History

B roadc aus eInjury

NC D

HIV and T B

C omm_mat_peri_nut

408

Section B: National and District Profiles

408

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: uMgungundlovu (DC22)

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Section B: National and District Profiles

409

Section B: Profile KwaZulu-Natal Province

409

Indicator performance: uMgungundlovu (DC22)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 23.1 10 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

34.6 8 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 5.2 5.6 5.4 29 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 047.3 1 949.1 2 034.0 32 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 74.6 79.6 80.5 4 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 5.1 5.5 5.6 28 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 29.7 44.1 35.7 13 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 31.1 31.7 33.1 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 9.1 8.6 8.2 30 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 13.2 9.1 10.3 29 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 208.3 185.9 191.7 49 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 63.5 66.8 65.1 30 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 32.4 27.9 25.5 40 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 58.8 59.9 68.7 11 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 102.9 98.7 97.2 14 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.7 8 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 3.4 2.5 1.8 22 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 1.6 2.1 2.5 28 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

6.8 7.0 6.1 14 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 9.4 6.7 6.1 35 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 6.2 18.6 20.5 31 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 36.9 58.5 56.0 26 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 96.3 91.2 72.9 48 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 65.1 75.2 69.4 50 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

78.9 73.3 71.4 14 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 110.7 152.9 62.9 7 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 28.2 37.1 41.3 12 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 153.4 216.8 73.4 6 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.9 2.2 4.0 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 19.4 26.3 30.5 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

30.8 9 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

0.0 23 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

853.4 775.6 678.1 34 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

6.1 6.4 6.4 37 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 83.4 83.4 86.5 7 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 81.0 82.9 83.0 8 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 7.3 6.4 5.8 17 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

5.2 4.7 4.5 17 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

59.2 10 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

96.1 98.5 98.7 1 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

77.9 93.4 98.8 3 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 34.3 30.4 28 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

38.5 40.6 41.5 38 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 31.6 29.2 28.6 32 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

17.1 17.3 16.4 13 19.9 21.2

Percentage of deaths garbage codes [Percentage] 14.2 14.3 12.8 20 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 12.8 12.9 13.5 31 13.1 13.6

Percentage of deaths ill-defined [Percentage] 13.1 11.9 10.6 26 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: uMgungundlovu: DC22Va

lue

1000

1200

1400

1600

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.2

5.4

5.6

5.8

2010 2012 2014 2016

03_Crude death rate

1500

2000

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

30

40

50

60

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

60

65

70

75

80

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

30

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

0

5

10

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

250

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

80

2008 2010 2012 2014 2016

04_Postnatal mother <6d

22

24

26

28

30

32

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

70

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

100

150

200

2008 2010 2012 2014 2016

05_ANC initiate ART rate

0

50

100

150

2008 2010 2012 2014

06_Child <5 diar fat rate

2

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5

6

7

8

9

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

411

Section B: Profile KwaZulu-Natal Province

411

Annual indicators for district: uMgungundlovu (DC22)

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Annual indicators for district: uMgungundlovu: DC22

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

20

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

70

80

90

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

65

70

75

80

85

90

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

90

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

50

100

150

2006 2008 2010 2012 2014

08_Couple year protect rate

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6

8

10

12

14

16

18

2010 2012 2014 2016

09_RIF resistance rate

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

0

50

100

150

200

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

60

80

100

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

100

2010 2012 2014 2016

10_TB/HIV on ART

1.5

2.0

2.5

3.0

3.5

4.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

26

28

30

32

34

2008 2010 2012 2014 2016

11_Hypertension prevalence

13.0

13.5

14.0

14.5

15.0

15.5

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

412

Section B: National and District Profiles

412

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: uMgungundlovu (DC22)

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Section B: National and District Profiles

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Section B: Profile KwaZulu-Natal Province

413

uThukela District Municipality (DC23)

uThukela District is located on the western boundary of Kwazulu-Natal Province. It consists of five sub-districts: Indaka, Emnambithi/Ladysmith, uMtshezi, Okhahlamba and Imbabazane. The district has a population of 695  671, with a population density of 61.4 people per km2 and falls in socio-economic Quintile 1, among the poorest districts. Estimated medical scheme coverage is 7.0%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

37 1 2 1 0 0

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 320 711 309 466 331 771PHC headcount 5 years and older 1 700 282 1 794 366 1 837 583Patient day equivalent 369 502 343 224 333 282Deaths – total 2 769 2 583 2 482Still births 296 345 344Early neonatal deaths 119 104 99Late neonatal deaths 30 47 36Child under 5 years with diarrhoea death 42 27 14Child under 5 years with pneumonia death 16 25 19Child under 5 years with severe acute malnutrition death 33 37 22

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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B road age.. F emale Male

<5 years

5-14

15-24

25-64

65+

T otal 26%

15%

24%

27%

40%

77%

26%

4%

41%

45%

24%

9%

44%

79%

31%

16%

17%

8%

4%

2%

4%

12%

19%

6%

23%

15%

18%

12%

33%

79%

31%

9%

41%

21%

20%

8%

33%

72%

27%

14%

18%

7%

14%

4%

14%

54%

30%

6%

KZN, uThukela: DC23, 2009-14

R ank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.0%)S epsis/other newborn infectious (2.4%)

B irth asphyxia (5.7%)

P rotein-energy malnutrition (5.3%)

P reterm birth complications (13.2%)

Meningitis /encephalitis (1.4%)

Diarrhoeal diseases (29.2%)Lower respiratory infections (17.3%)

HIV /AIDS (5.5%)

T uberculos is (3.4%)

P oisonings (including herbal) (2.3%)

Drowning (3.3%)F ires , hot substances (2.3%)

Meningitis /encephalitis (5.7%)Accidental threats to breathing (5.9%)

R oad injuries (4.1%)

Diarrhoeal diseases (13.8%)

Lower respiratory infections (12.2%)HIV /AIDS (9.3%)

T uberculos is (13.1%)

Meningitis /encephalitis (4.3%)

Mechanical forces (6.4%)Interpersonal violence (7.4%)

Accidental threats to breathing (9.1%)

R oad injuries (2.4%)

Diarrhoeal diseases (6.1%)

C erebrovascular disease (2.2%)

Lower respiratory infections (6.4%)

HIV /AIDS (16.4%)T uberculos is (17.6%)

Meningitis /encephalitis (2.6%)Nephritis /nephros is (2.1%)

Diabetes mellitus (2.6%)

Hypertens ive heart disease (2.1%)

Ischaemic heart disease (3.7%)

Diarrhoeal diseases (7.0%)C erebrovascular disease (5.3%)

Lower respiratory infections (9.1%)HIV /AIDS (19.8%)

T uberculos is (21.4%)

C ardiomyopathy (1.7%)Asthma (1.7%)

Nephritis /nephros is (3.7%)

Diabetes mellitus (7.5%)

Hypertens ive heart disease (11.2%)Ischaemic heart disease (12.9%)

Diarrhoeal diseases (5.4%)

C erebrovascular disease (20.0%)

Lower respiratory infections (7.6%)

T uberculos is (4.4%)

P erc entage of deaths by broad c aus e and leading c aus es , 2009-2014P rov, Dis tric tK ZN, Uthukela: DC 23

S how History

B roadc aus eInjury

NC D

HIV and T B

C omm_mat_peri_nut

414

Section B: National and District Profiles

414

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: uThukela (DC23)

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Section B: Profile KwaZulu-Natal Province

415

Indicator performance: uThukela (DC23)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 27.0 8 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

37.8 5 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 5.3 5.4 5.5 32 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 199.8 2 146.2 2 383.1 3 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 63.4 63.7 61.7 35 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.4 6.1 6.0 38 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 42.9 52.8 47.3 19 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 23.0 21.5 26.1 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 9.3 8.8 8.7 33 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 9.0 8.2 8.3 14 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 123.0 175.8 160.0 44 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 67.1 75.8 77.0 7 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 23.7 26.8 28.2 49 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 54.4 57.0 61.3 35 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 98.9 95.9 98.6 7 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.6 6 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 3.3 2.8 1.8 23 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 2.6 3.4 2.9 35 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

19.9 14.9 8.9 31 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 5.0 5.8 4.4 18 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 11.8 15.5 24.8 26 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 33.9 52.4 83.6 3 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 76.5 86.0 84.7 27 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 70.2 84.7 82.5 28 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

63.8 61.8 82.7 4 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 53.1 57.7 53.6 22 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 35.7 33.0 26.3 45 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 60.5 70.5 61.6 10 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 0.8 0.7 1.9 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 15.6 15.4 21.4 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

37.8 5 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

0.0 23 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

711.0 601.8 533.0 22 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

8.6 7.8 8.0 44 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 76.9 84.9 78.2 24 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 74.1 84.5 75.1 33 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 8.8 9.9 7.3 27 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

3.4 1.1 1.3 3 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

63.0 5 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

93.0 94.7 93.8 37 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

87.7 90.1 86.4 25 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 29.5 23.2 8 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

28.4 29.7 32.6 14 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 34.1 34.0 35.4 45 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

27.6 23.3 21.4 30 19.9 21.2

Percentage of deaths garbage codes [Percentage] 15.8 15.7 15.1 42 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 9.9 13.0 10.6 6 13.1 13.6

Percentage of deaths ill-defined [Percentage] 10.7 6.4 4.2 2 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: uThukela: DC23Va

lue

1000

1200

1400

1600

2006 2008 2010 2012 2014

01_DHS exp per capita

600

800

1000

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

20

30

40

50

60

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

55

60

65

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

80

2008 2010 2012 2014 2016

04_Postnatal mother <6d

22

24

26

28

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

2008 2010 2012 2014

06_Child <5 diar fat rate

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

4.5

5.0

5.5

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

417

Section B: Profile KwaZulu-Natal Province

417

Annual indicators for district: uThukela (DC23)

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Annual indicators for district: uThukela: DC23

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

20

40

60

80

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

70

75

80

85

90

95

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

65

70

75

80

85

90

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

08_Couple year protect rate

2

4

6

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6

8

10

12

2010 2012 2014 2016

09_RIF resistance rate

65

70

75

80

85

2008 2010 2012 2014 2016

09_TB cure rate new sm+

6

7

8

9

10

2008 2010 2012 2014 2016

09_TB deaths all TB

0

200

400

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

70

75

80

85

2008 2010 2012 2014 2016

09_TB success all TB

30

35

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

20

40

60

80

2006 2008 2010 2012 2014

10_Male cond dist cov yy

60

70

80

90

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

24

26

28

30

32

2008 2010 2012 2014 2016

11_Hypertension prevalence

14

15

16

17

18

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

418

Section B: National and District Profiles

418

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: uThukela (DC23)

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Section B: Profile KwaZulu-Natal Province

419

uMzinyathi District Municipality (DC24)

uMzinyathi District is situated in the north-central region of KwaZulu-Natal Province and includes four sub-districts, namely Endumeni, Nquthu, Msinga and uMvoti. The district has a total population of 522 803, with a population density of 60.9 people per km2 and falls into socio-economic Quintile 1, among the poorest districts, and has an estimated medical scheme coverage of 7.0%. uMzinyathi is one of the 11 National Health Insurance (NHI) pilot districts.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

51 1 4 0 0 1

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 303 980 293 324 319 663PHC headcount 5 years and older 1 557 375 1 552 544 1 632 000Patient day equivalent 332 357 322 410 326 214Deaths – total 2 624 2 326 2 234Still births 209 202 178Early neonatal deaths 123 106 130Late neonatal deaths 24 26 20Child under 5 years with diarrhoea death 41 30 14Child under 5 years with pneumonia death 38 15 21Child under 5 years with severe acute malnutrition death 31 35 24

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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B road age.. F emale Male

<5 years

5-14

15-24

25-64

65+

T otal 25%

17%

20%

22%

40%

76%

29%

6%

47%

55%

23%

10%

41%

74%

28%

10%

17%

8%

5%

3%

4%

14%

19%

6%

25%

19%

18%

12%

35%

76%

33%

12%

44%

22%

23%

9%

29%

66%

24%

9%

12%

8%

13%

4%

13%

57%

30%

7%

KZN, u Mzinyathi: DC24, 2009-14

R ank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.3%)S epsis/other newborn infectious (1.6%)P oisonings (including herbal) (1.6%)

B irth asphyxia (9.4%)P rotein-energy malnutrition (8.5%)

P reterm birth complications (15.7%)Diarrhoeal diseases (21.4%)

Lower respiratory infections (14.0%)

HIV /AIDS (6.8%)T uberculos is (3.0%)

E xposure to natural forces (2.1%)Other neurological conditions (2.5%)

Drowning (8.1%)

E pilepsy (3.2%)Meningitis /encephalitis (4.6%)

R oad injuries (8.9%)

Diarrhoeal diseases (13.5%)Lower respiratory infections (15.0%)

HIV /AIDS (12.2%)T uberculos is (11.7%)

S elf-inflicted injuries (3.5%)Meningitis /encephalitis (3.0%)

Mechanical forces (8.5%)

Interpersonal violence (6.6%)

Accidental threats to breathing (4.5%)

R oad injuries (7.4%)

Diarrhoeal diseases (5.4%)Lower respiratory infections (5.6%)

HIV /AIDS (18.4%)T uberculos is (21.6%)

Meningitis /encephalitis (2.0%)

Mechanical forces (2.6%)

R oad injuries (1.9%)

Diabetes mellitus (2.6%)Ischaemic heart disease (2.5%)

Diarrhoeal diseases (6.0%)C erebrovascular disease (4.8%)

Lower respiratory infections (9.0%)HIV /AIDS (20.6%)

T uberculos is (25.1%)

S epticaemia (2.2%)C OP D (2.0%)

Nephritis /nephros is (2.7%)

Diabetes mellitus (7.6%)Hypertens ive heart disease (8.7%)

Ischaemic heart disease (9.5%)

Diarrhoeal diseases (5.4%)

C erebrovascular disease (22.0%)

Lower respiratory infections (9.2%)

T uberculos is (6.7%)

P erc entage of deaths by broad c aus e and leading c aus es , 2009-2014P rov, Dis tric tK ZN, Umzinyathi: DC 24

S how History

B roadc aus eInjury

NC D

HIV and T B

C omm_mat_peri_nut

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Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: uMzinyathi (DC24)

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421

Indicator performance: uMzinyathi (DC24)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 34.6 4 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

34.6 8 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 6.1 6.1 6.1 45 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 303.8 2 347.8 2 326.4 1 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 63.6 53.6 54.4 45 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.6 6.2 5.8 31 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 70.4 61.7 55.9 22 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 20.6 23.2 24.4 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 10.0 9.8 8.8 34 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 11.4 9.4 12.0 40 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 71.6 79.6 101.3 27 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 66.9 72.1 76.4 8 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 18.4 17.6 16.1 8 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 59.6 60.9 68.4 12 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 93.5 98.3 95.5 21 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.6 4 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 5.6 3.8 2.0 27 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 6.1 2.4 3.1 37 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

12.7 12.4 8.7 29 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 6.0 5.9 5.6 31 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 7.2 14.2 18.5 34 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 51.4 60.3 71.2 7 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 77.2 81.5 92.2 13 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 80.1 85.0 95.2 8 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

102.2 71.6 109.2 1 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 59.9 76.7 85.2 1 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 60.6 62.5 52.0 4 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 85.3 113.4 136.3 1 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.1 0.9 1.5 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 20.0 20.0 20.6 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

34.6 6 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

0.0 23 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

682.6 615.9 518.0 20 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

10.2 8.4 8.3 46 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 79.6 88.1 87.2 4 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 77.0 82.9 78.3 23 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 11.1 11.5 9.1 36 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

1.9 1.4 3.2 6 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

64.7 2 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

96.6 95.0 96.6 8 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

89.1 92.1 91.4 19 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 27.3 27.5 23 26.2 28.2

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District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

25.5 27.4 30.1 8 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 37.1 32.2 33.3 42 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

26.8 27.4 24.6 38 19.9 21.2

Percentage of deaths garbage codes [Percentage] 12.2 13.1 14.2 32 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 10.6 12.9 12.0 14 13.1 13.6

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: uMzinyathi: DC24Va

lue

1000

1500

2000

2500

2006 2008 2010 2012 2014

01_DHS exp per capita

600

800

1000

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016

03_Crude death rate

1500

2000

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

50

55

60

65

70

75

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

55

60

65

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

10.0

2006 2008 2010 2012 2014

04_Deliv in fac <18

2

4

6

8

10

12

2006 2008 2010 2012 2014

04_IP early neo death rate

50

100

150

200

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

15

20

25

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

70

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

100

150

200

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

2008 2010 2012 2014

06_Child <5 diar fat rate

3

4

5

6

7

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

25

30

35

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5.0

5.5

6.0

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

423

Section B: Profile KwaZulu-Natal Province

423

Annual indicators for district: uMzinyathi (DC24)

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Annual indicators for district: uMzinyathi: DC24

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

20

30

40

50

60

70

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

80

85

90

95

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2008 2010 2012 2014

07_Measles 2nd cov yy

40

60

80

100

120

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

40

60

80

2006 2008 2010 2012 2014

08_Couple year protect rate

2

4

6

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6

7

8

9

10

2010 2012 2014 2016

09_RIF resistance rate

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

7

8

9

10

11

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

40

50

60

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

0

50

100

2006 2008 2010 2012 2014

10_Male cond dist cov yy

20

40

60

80

100

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

35

2010 2012 2014 2016

11_Hypertension inci yy

30

35

2008 2010 2012 2014 2016

11_Hypertension prevalence

10

11

12

13

14

15

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

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424

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: uMzinyathi (DC24)

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425

Amajuba District Municipality (DC25)

Amajuba District is located in the north-western corner of KwaZulu-Natal Province and comprises three sub-districts, namely Dannhauser, Emadlangeni and Newcastle. The district has a population of 522 638, with a population density of 75.6 people per km2 and falls into socio-economic Quintile 3. Estimated medical scheme coverage is 9.4%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

25 1 1 2 0 0

Headcounts and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 187 364 194 978 202 275PHC headcount 5 years and older 1 217 741 1 321 245 1 197 090Patient day equivalent 377 249 389 178 357 377Deaths – total 2 166 2 145 2 175Still births 261 315 229Early neonatal deaths 84 109 90Late neonatal deaths 16 32 28Child under 5 years with diarrhoea death 5 16 6Child under 5 years with pneumonia death 3 5 8Child under 5 years with severe acute malnutrition death 16 20 12

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 29%

15%

29%

34%

35%

75%

23%

4%

34%

39%

23%

6%

44%

80%

33%

16%

23%

13%

4%

2%

4%

11%

19%

6%

28%

19%

26%

16%

35%

75%

25%

7%

33%

16%

20%

6%

35%

71%

29%

14%

20%

11%

12%

3%

12%

54%

26%

7%

KZN, Amajuba: DC25, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.4%)

Sepsis/other newborn infectious (2.9%)

Birth asphyxia (6.1%)Protein-energy malnutrition (3.3%)

Other respiratory (2.9%)

Preterm birth complications (16.6%)

Diarrhoeal diseases (20.6%)Lower respiratory infections (20.4%)

HIV/AIDS (3.1%)Tuberculosis (3.3%)

Drowning (6.5%)

Fires, hot substances (4.0%)Other respiratory (3.9%)

Meningitis/encephalitis (4.5%)

Accidental threats to breathing (3.3%)

Road injuries (8.3%)

Diarrhoeal diseases (11.6%)

Lower respiratory infections (18.1%)

HIV/AIDS (9.0%)

Tuberculosis (13.2%)

Drowning (2.5%)

Meningitis/encephalitis (3.6%)Mechanical forces (2.8%)

Interpersonal violence (7.8%)Accidental threats to breathing (8.2%)

Road injuries (7.3%)Diarrhoeal diseases (4.0%)

Lower respiratory infections (14.8%)HIV/AIDS (10.0%)

Tuberculosis (18.9%)

Meningitis/encephalitis (2.6%)Road injuries (2.7%)Diabetes mellitus (2.7%)

Hypertensive heart disease (2.5%)Ischaemic heart disease (2.4%)

Diarrhoeal diseases (6.1%)Cerebrovascular disease (4.5%)

Lower respiratory infections (16.9%)HIV/AIDS (13.2%)

Tuberculosis (20.7%)

Cardiomyopathy (1.9%)COPD (1.9%)

Nephritis/nephrosis (4.4%)

Diabetes mellitus (7.7%)

Hypertensive heart disease (12.9%)

Ischaemic heart disease (6.5%)

Diarrhoeal diseases (3.9%)

Cerebrovascular disease (18.6%)

Lower respiratory infections (10.2%)

Tuberculosis (4.3%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, Amajuba: DC25

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

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426

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: Amajuba (DC25)

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427

Indicator performance: Amajuba (DC25)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 34.6 4 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

34.6 8 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 3.7 4.8 4.4 4 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 011.1 2 070.3 2 692.3 35 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 44.3 62.6 60.8 37 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.3 6.0 5.8 32 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 40.0 43.8 48.4 20 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 22.9 28.9 29.4 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 9.8 8.9 8.3 31 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 9.2 7.8 10.4 32 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 109.8 143.2 161.7 46 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 79.1 50.1 71.9 17 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 27.9 14.6 25.8 42 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 59.5 52.8 58.5 42 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 92.4 94.2 92.6 26 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.4 2 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 0.9 3.0 1.3 15 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 0.8 0.9 1.5 15 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

10.3 11.0 6.5 16 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 4.8 6.3 4.2 17 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 14.6 25.2 16.3 38 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 34.7 50.2 52.7 36 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 70.3 79.2 80.9 34 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 59.2 98.8 87.3 17 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

53.0 62.8 57.5 25 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 34.9 51.9 50.8 28 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 46.2 48.4 39.0 17 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 22.0 52.9 55.9 13 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.1 0.8 0.8 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 13.7 14.8 13.6 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

38.5 3 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

3.8 9 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

510.4 527.4 484.3 17 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

9.4 8.5 8.3 47 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 71.0 76.1 73.3 36 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 76.2 79.1 79.3 20 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 11.4 11.2 11.7 47 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

4.3 5.1 4.8 23 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

60.3 7 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

96.9 97.9 96.6 9 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

62.8 76.5 67.3 49 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 27.2 25.9 18 26.2 28.2

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428

Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

30.3 31.9 33.6 18 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 28.1 33.5 19.8 4 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

31.0 24.2 28.3 45 19.9 21.2

Percentage of deaths garbage codes [Percentage] 17.3 13.9 13.8 30 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 10.6 10.4 18.3 47 13.1 13.6

Percentage of deaths ill-defined [Percentage] 7.5 5.5 6.8 5 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the countr

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Annual indicators for district: Amajuba: DC25Va

lue

800

1000

1200

1400

1600

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

3.0

3.5

4.0

4.5

5.0

5.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

40

45

50

55

60

65

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

40

45

50

55

60

65

2006 2008 2010 2012 2014

03_Usable bed util (DH)

0

5

10

15

20

25

30

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

10.0

2006 2008 2010 2012 2014

04_Deliv in fac <18

0

2

4

6

8

10

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

80

2008 2010 2012 2014 2016

04_Postnatal mother <6d

20

30

40

50

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

10

2008 2010 2012 2014

06_Child <5 diar fat rate

1

2

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

4.5

5.0

5.5

6.0

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

429

Section B: Profile KwaZulu-Natal Province

429

Annual indicators for district: Amajuba (DC25)

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Annual indicators for district: Amajuba: DC25

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

20

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

100

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

08_Couple year protect rate

3

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

0

2

4

6

8

2010 2012 2014 2016

09_RIF resistance rate

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

8

10

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

45

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

20

40

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

26

28

30

32

34

36

2008 2010 2012 2014 2016

11_Hypertension prevalence

14

16

18

20

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

430

Section B: National and District Profiles

430

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: Amajuba (DC25)

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Section B: National and District Profiles

431

Section B: Profile KwaZulu-Natal Province

431

Zululand District Municipality (DC26)

Zululand District is situated in the north-eastern part of KwaZulu-Natal Province. It is primarily a rural district and comprises five sub-districts, namely Nongoma, Ulundi, eDumbe, uPhongolo and Abaqulusi. The district has a population of 844 531, with a population density of 57.1 people per km2, and falls into socio-economic Quintile 1, among the poorest districts. Estimated medical scheme coverage is 6.5%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

72 1 5 0 0 5

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 380 404 399 484 399 164PHC headcount 5 years and older 2 139 221 2 266 105 2 239 755Patient day equivalent 496 638 485 428 462 629Deaths – total 3 387 3 213 3 008Still births 367 267 296Early neonatal deaths 123 169 111Late neonatal deaths 16 34 24Child under 5 years with diarrhoea death 52 52 34Child under 5 years with pneumonia death 30 32 31Child under 5 years with severe acute malnutrition death 42 47 22

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 26%

18%

21%

25%

34%

72%

33%

9%

49%

53%

31%

13%

36%

71%

26%

12%

18%

7%

5%

2%

4%

11%

17%

8%

25%

17%

19%

13%

32%

73%

37%

17%

48%

26%

26%

11%

27%

63%

22%

12%

18%

8%

12%

3%

11%

49%

24%

9%

KZN, Zululand: DC26, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.3%)Poisonings (including herbal) (3.8%)

Birth asphyxia (7.4%)

Protein-energy malnutrition (5.7%)

Preterm birth complications (11.0%)

Septicaemia (1.5%)

Diarrhoeal diseases (25.5%)Lower respiratory infections (15.7%)

HIV/AIDS (6.8%)

Tuberculosis (5.3%)

Other neurological conditions (1.7%)

Drowning (7.6%)

Epilepsy (3.6%)

Meningitis/encephalitis (6.9%)

Accidental threats to breathing (2.5%)

Road injuries (6.3%)

Diarrhoeal diseases (12.5%)

Lower respiratory infections (10.0%)HIV/AIDS (10.9%)

Tuberculosis (18.3%)

Epilepsy (1.9%)

Meningitis/encephalitis (4.6%)Mechanical forces (3.3%)

Interpersonal violence (6.3%)

Accidental threats to breathing (7.2%)

Road injuries (6.5%)

Diarrhoeal diseases (5.0%)

Lower respiratory infections (7.1%)

HIV/AIDS (16.3%)Tuberculosis (26.2%)

Meningitis/encephalitis (3.2%)

Road injuries (2.1%)Diabetes mellitus (2.5%)

Hypertensive heart disease (1.9%)Ischaemic heart disease (1.7%)

Diarrhoeal diseases (6.5%)Cerebrovascular disease (3.7%)

Lower respiratory infections (8.0%)HIV/AIDS (18.4%)

Tuberculosis (30.2%)

Endocrine nutritional,blood, immune (1.9%)Nephritis/nephrosis (3.0%)

Diabetes mellitus (7.9%)

Hypertensive heart disease (11.7%)

Ischaemic heart disease (6.4%)Diarrhoeal diseases (5.2%)

Cerebrovascular disease (17.7%)

Lower respiratory infections (10.1%)

HIV/AIDS (1.7%)

Tuberculosis (10.1%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, Zululand: DC26

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

432

Section B: National and District Profiles

432

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: Zululand (DC26)

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Section B: National and District Profiles

433

Section B: Profile KwaZulu-Natal Province

433

Indicator performance: Zululand (DC26)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 33.8 6 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

33.8 12 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 6.2 5.9 5.8 37 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 084.0 2 157.1 2 233.8 14 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 67.5 67.0 62.7 33 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.1 5.7 5.5 27 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 61.7 35.6 37.2 14 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 25.4 24.8 25.0 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 10.2 10.1 9.8 42 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 7.6 10.2 7.3 8 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 123.3 60.3 85.2 16 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 51.2 58.3 59.1 38 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 21.9 15.8 19.0 17 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 58.1 60.7 67.0 16 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 85.6 98.1 99.3 4 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.7 7 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 5.1 4.7 3.0 39 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 6.5 4.5 3.8 42 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

26.9 20.3 7.8 22 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 7.9 7.3 4.4 19 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 23.0 22.7 38.7 16 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 48.3 54.3 54.7 30 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 80.6 87.9 78.1 40 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 70.3 88.9 72.6 45 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

78.0 60.9 80.6 5 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 37.0 43.2 58.0 15 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 40.4 37.9 31.9 31 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 33.6 41.3 72.6 7 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.4 0.9 1.9 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 12.8 13.9 14.5 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

33.8 8 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

4.2 8 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

936.8 783.5 682.7 35 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

15.6 12.0 9.5 51 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 81.1 83.3 86.2 8 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 77.5 80.5 81.4 11 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 10.2 9.0 6.7 23 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

3.8 3.4 4.1 13 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

56.8 14 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

97.2 97.3 97.4 6 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

89.2 86.0 78.3 40 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 30.0 24.7 16 26.2 28.2

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434

Section B: National and District Profiles

434

Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

24.5 24.1 27.4 2 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 37.1 41.4 36.1 47 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

27.5 23.8 24.3 36 19.9 21.2

Percentage of deaths garbage codes [Percentage] 12.5 13.0 13.6 28 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 10.9 10.7 12.2 19 13.1 13.6

Percentage of deaths ill-defined [Percentage] 15.5 12.7 11.8 31 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

Page 35: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

Annual indicators for district: Zululand: DC26Va

lue

1000

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

6.0

6.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

35

40

45

50

55

60

65

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

55

60

65

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7

8

9

10

2006 2008 2010 2012 2014

04_Deliv in fac <18

2

4

6

8

10

12

14

2006 2008 2010 2012 2014

04_IP early neo death rate

100

200

300

400

500

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

16

18

20

22

24

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

5

10

15

2008 2010 2012 2014

06_Child <5 diar fat rate

4

6

8

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

25

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5

6

7

8

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

435

Section B: Profile KwaZulu-Natal Province

435

Annual indicators for district: Zululand (DC26)

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Annual indicators for district: Zululand: DC26

Valu

e

10

15

20

25

30

35

40

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

78

80

82

84

86

88

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

10

15

20

25

2010 2012 2014 2016

09_RIF resistance rate

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

7

8

9

10

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

20

40

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

26

28

30

32

2008 2010 2012 2014 2016

11_Hypertension prevalence

11

12

13

14

15

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

436

Section B: National and District Profiles

436

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: Zululand (DC26)

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Section B: National and District Profiles

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Section B: Profile KwaZulu-Natal Province

437

uMkhanyakude District Municipality (DC27)

uMkhanyakude District is located in the far north of KwaZulu-Natal Province and borders with Swaziland and Mozambique. The district comprises five sub-districts, namely Hlabisa, Jozini, Mtubatuba, The Big 5 False Bay and uMhlabuyalingana. The district has a population of 649 645, with a population density of 46.9 people per km2 and falls in socio-economic Quintile 1, among the poorest districts. Estimated medical scheme coverage is 3.9%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

57 0 5 0 0 0

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 415 911 419 021 422 897PHC headcount 5 years and older 2 290 996 2 196 876 2 253 400Patient day equivalent 386 777 374 543 345 035Deaths – total 2 295 2 219 2 071Still births 248 260 246Early neonatal deaths 59 84 103Late neonatal deaths 12 19 21Child under 5 years with diarrhoea death 45 44 12Child under 5 years with pneumonia death 26 27 13Child under 5 years with severe acute malnutrition death 32 29 24

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

Page 38: 17 KwaZulu-Natal Province - Health Systems Trust Health... · 17 KwaZulu-Natal Province Ugu District Municipality (DC21) Ugu District is situated in KwaZulu-Natal Province and has

B road age.. F emale Male

<5 years

5-14

15-24

25-64

65+

T otal 17%

14%

12%

17%

32%

64%

39%

9%

60%

60%

33%

19%

39%

74%

24%

13%

19%

8%

5%

3%

4%

10%

16%

9%

17%

12%

10%

10%

24%

64%

42%

17%

57%

27%

31%

17%

29%

67%

21%

15%

22%

9%

12%

4%

12%

49%

23%

10%

KZN, u Mkhanyakude: DC27, 2009-14

R ank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (3.2%)S epsis/other newborn infectious (1.9%)

P oisonings (including herbal) (3.4%)

B irth asphyxia (7.1%)

P rotein-energy malnutrition (8.2%)P reterm birth complications (8.0%)

Diarrhoeal diseases (23.0%)

Lower respiratory infections (9.4%)HIV /AIDS (13.0%)

T uberculos is (4.9%)

Drowning (8.8%)

F ires , hot substances (1.9%)

Meningitis /encephalitis (4.8%)

Accidental threats to breathing (2.4%)R oad injuries (4.0%)

Nephritis /nephros is (2.0%)

Diarrhoeal diseases (11.5%)

Lower respiratory infections (7.5%)

HIV /AIDS (17.9%)T uberculos is (15.0%)

Drowning (2.0%)Meningitis /encephalitis (2.6%)

Mechanical forces (4.8%)

Interpersonal violence (5.4%)Accidental threats to breathing (7.1%)

R oad injuries (5.1%)

Diarrhoeal diseases (3.8%)Lower respiratory infections (3.5%)

HIV /AIDS (26.2%)T uberculos is (20.6%)

Mechanical forces (2.0%)

Accidental threats to breathing (1.6%)R oad injuries (1.6%)

Diabetes mellitus (2.1%)

Hypertens ive heart disease (1.8%)

Diarrhoeal diseases (4.2%)

C erebrovascular disease (3.5%)Lower respiratory infections (3.8%)

HIV /AIDS (35.7%)T uberculos is (22.9%)

P rostate (2.1%)Nephritis /nephros is (3.3%)

Diabetes mellitus (5.4%)

Hypertens ive heart disease (13.9%)

Ischaemic heart disease (5.4%)

Diarrhoeal diseases (4.4%)

C erebrovascular disease (20.5%)

Lower respiratory infections (6.1%)

HIV /AIDS (3.7%)

T uberculos is (8.1%)

P erc entage of deaths by broad c aus e and leading c aus es , 2009-2014P rov, Dis tric tK ZN, Umkhanyakude: D..

S how History

B roadc aus eInjury

NC D

HIV and T B

C omm_mat_peri_nut

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Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: uMkhanyakude (DC27)

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Section B: Profile KwaZulu-Natal Province

439

Indicator performance: uMkhanyakude (DC27)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 35.1 3 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

35.1 7 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 5.5 6.0 5.8 38 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 153.9 2 305.1 2 606.5 26 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 60.7 60.2 56.0 43 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 4.7 4.9 4.8 16 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 50.3 46.9 45.7 18 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 21.6 20.4 21.4 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 11.3 11.1 10.9 50 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 4.0 5.5 7.3 9 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 53.6 59.4 85.2 17 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 87.4 73.1 79.8 3 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 16.3 16.8 17.2 11 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 61.2 59.3 66.4 17 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 73.1 90.0 98.8 6 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.6 5 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 4.5 4.8 1.6 18 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 2.9 3.0 1.9 20 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

12.2 10.8 7.9 23 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 5.3 5.4 4.9 24 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 7.7 10.7 21.9 29 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 39.4 47.5 62.4 15 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 74.3 83.0 87.5 21 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 69.8 87.2 82.3 29 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

51.4 43.8 72.2 13 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 32.6 41.0 46.3 33 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 37.1 35.8 25.9 48 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 22.0 35.8 49.1 25 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 0.8 0.8 1.0 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 22.1 22.0 18.7 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

26.3 14 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

1.8 19 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

907.0 732.4 577.4 26 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

16.2 13.2 12.4 52 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 75.7 80.9 79.4 20 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 74.4 84.0 79.8 17 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 8.3 6.9 2.8 2 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

3.6 1.3 0.1 1 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

61.9 6 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

87.8 93.0 92.4 44 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

52.4 80.5 99.4 2 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 24.3 24.2 12 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

26.1 27.3 28.8 5 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 45.1 43.5 40.2 52 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

18.9 17.7 17.6 17 19.9 21.2

Percentage of deaths garbage codes [Percentage] 11.4 11.9 13.2 25 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 9.9 11.5 13.5 29 13.1 13.6

Percentage of deaths ill-defined [Percentage] 14.7 13.5 13.2 36 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: uMkhanyakude: DC27Va

lue

1000

1500

2000

2500

2006 2008 2010 2012 2014

01_DHS exp per capita

600

800

1000

1200

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

5

6

7

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

35

40

45

50

55

60

65

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

60

65

70

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7

8

9

10

11

12

2006 2008 2010 2012 2014

04_Deliv in fac <18

4

6

8

10

2006 2008 2010 2012 2014

04_IP early neo death rate

50

100

150

200

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

80

2008 2010 2012 2014 2016

04_Postnatal mother <6d

16

18

20

22

24

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

0

5

10

15

2008 2010 2012 2014

06_Child <5 diar fat rate

2

3

4

5

6

7

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

25

30

35

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

4.8

5.0

5.2

5.4

5.6

5.8

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

441

Section B: Profile KwaZulu-Natal Province

441

Annual indicators for district: uMkhanyakude (DC27)

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Annual indicators for district: uMkhanyakude: DC27

Valu

e

10

15

20

25

2010 2012 2014 2016 2018

06_School G1 screen cov yy

20

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

20

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

0

2

4

6

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

0

5

10

15

20

2010 2012 2014 2016

09_RIF resistance rate

40

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

3

4

5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

85

2006 2008 2010 2012 2014

09_TB success all TB

30

35

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

100

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

24

26

28

30

32

2008 2010 2012 2014 2016

11_Hypertension prevalence

10

12

14

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

442

Section B: National and District Profiles

442

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: uMkhanyakude (DC27)

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uThungulu District Municipality (DC28)

uThungulu District lies in the north-eastern area of KwaZulu-Natal Province and includes six sub-districts, namely uMlalazi, Mthonjaneni, Nkandla, Mbonambi, Ntambanana and uMhlathuze. The district has a population of approximately 947 926, with a population density of 115.4 people per km2 and falls in socio-economic Quintile 2, among the poorer districts. Estimated medical scheme coverage is 7.0%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

63 1 6 1 1 0

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 503 307 514 933 518 623PHC headcount 5 years and older 2 762 539 2 864 288 2 762 385Patient day equivalent 648 887 665 510 637 126Deaths – total 4 714 4 452 4 194Still births 562 506 500Early neonatal deaths 260 253 263Late neonatal deaths 123 83 89Child under 5 years with diarrhoea death 34 48 21Child under 5 years with pneumonia death 34 53 43Child under 5 years with severe acute malnutrition death 33 64 33

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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B road age.. F emale Male

<5 years

5-14

15-24

25-64

65+

T otal 22%

13%

17%

23%

31%

71%

32%

6%

48%

49%

29%

12%

41%

78%

30%

15%

26%

11%

5%

3%

4%

13%

14%

5%

20%

13%

14%

11%

29%

72%

34%

12%

46%

21%

29%

10%

31%

71%

25%

12%

18%

11%

15%

4%

15%

55%

25%

7%

KZN, uThungulu: DC28, 2009-14

R ank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (3.1%)

S epsis/other newborn infectious (7.6%)

B irth asphyxia (8.2%)

P rotein-energy malnutrition (5.1%)

P reterm birth complications (17.8%)

S epticaemia (2.6%)

Diarrhoeal diseases (14.6%)Lower respiratory infections (10.6%)

HIV /AIDS (8.1%)

T uberculos is (3.3%)

Drowning (4.2%)E pilepsy (3.2%)

Asthma (2.6%)

Meningitis /encephalitis (7.1%)

Accidental threats to breathing (2.4%)

R oad injuries (7.4%)

Diarrhoeal diseases (10.0%)Lower respiratory infections (8.5%)

HIV /AIDS (14.8%)T uberculos is (14.8%)

Drowning (1.5%)Meningitis /encephalitis (3.3%)

Mechanical forces (7.6%)Interpersonal violence (8.0%)

Accidental threats to breathing (4.0%)

R oad injuries (8.5%)

Diarrhoeal diseases (3.9%)

Lower respiratory infections (5.5%)

HIV /AIDS (20.5%)T uberculos is (15.6%)

Mechanical forces (2.4%)

R oad injuries (3.4%)

Nephritis /nephros is (2.4%)Diabetes mellitus (3.1%)

Hypertens ive heart disease (2.4%)

Diarrhoeal diseases (4.5%)C erebrovascular disease (4.1%)

Lower respiratory infections (6.4%)

HIV /AIDS (24.6%)T uberculos is (22.5%)

Asthma (1.6%)

Nephritis /nephros is (4.0%)

Diabetes mellitus (8.2%)Hypertens ive heart disease (16.6%)

Ischaemic heart disease (6.1%)

Diarrhoeal diseases (4.0%)

C erebrovascular disease (17.7%)

Lower respiratory infections (6.8%)

HIV /AIDS (1.7%)

T uberculos is (6.5%)

P erc entage of deaths by broad c aus e and leading c aus es , 2009-2014P rov, Dis tric tK ZN, uThungulu: DC 28

S how History

B roadc aus eInjury

NC D

HIV and T B

C omm_mat_peri_nut

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444

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: uThungulu (DC28)

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Section B: Profile KwaZulu-Natal Province

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Indicator performance: uThungulu (DC28)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 21.7 12 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

28.3 14 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 6.1 6.2 6.6 52 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 214.0 2 082.2 2 244.8 10 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 47.2 50.0 46.9 51 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.3 6.4 6.5 45 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 62.6 64.2 62.9 31 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 28.8 28.7 28.6 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 8.0 7.9 8.5 32 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 14.9 12.4 14.0 46 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 186.6 216.5 153.8 41 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 60.1 70.0 67.7 26 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 26.8 24.3 25.8 43 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 57.1 58.3 63.1 28 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 94.0 96.5 99.3 5 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 1.1 23 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 3.3 3.8 1.9 24 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 5.1 5.3 5.6 52 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

11.7 16.9 8.4 26 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 7.3 7.2 6.8 39 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 19.9 29.8 23.5 28 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 41.7 51.3 54.5 31 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 81.2 88.5 81.5 32 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 76.1 86.6 88.9 15 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

68.0 64.3 68.5 18 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 36.0 45.8 37.9 45 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 43.3 41.5 29.1 38 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 28.8 38.4 38.6 35 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.4 1.1 2.8 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 22.9 18.3 16.9 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

28.3 10 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

3.3 12 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

1 100.1 959.8 859.4 48 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

10.0 9.6 8.6 48 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 93.8 95.7 96.1 1 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 88.0 90.1 76.7 28 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 4.3 3.1 4.9 9 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

0.5 0.2 0.4 2 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

52.9 18 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

85.2 93.0 95.7 20 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

65.2 92.4 91.5 18 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 33.8 24.0 11 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

27.7 29.4 33.4 16 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 39.2 35.3 32.1 38 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

21.7 23.0 20.5 28 19.9 21.2

Percentage of deaths garbage codes [Percentage] 13.8 14.6 14.2 33 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 11.4 12.4 14.0 33 13.1 13.6

Percentage of deaths ill-defined [Percentage] 11.2 8.6 8.2 15 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: uThungulu: DC28Va

lue

1000

1200

1400

1600

1800

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

6.0

6.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

35

40

45

50

55

60

65

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

50

55

60

65

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014

04_IP early neo death rate

100

200

300

400

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

22

24

26

28

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

5

10

15

20

25

30

2008 2010 2012 2014

06_Child <5 diar fat rate

10

20

30

2008 2010 2012 2014 2016

06_Child <5 pneumo death

8

10

12

14

16

18

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

447

Section B: Profile KwaZulu-Natal Province

447

Annual indicators for district: uThungulu (DC28)

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Annual indicators for district: uThungulu: DC28

Valu

e

10

15

20

25

30

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

80

90

100

2008 2010 2012 2014

07_Measles 2nd cov yy

20

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

20

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

0

2

4

6

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6

8

10

12

14

2010 2012 2014 2016

09_RIF resistance rate

60

70

80

90

2006 2008 2010 2012 2014

09_TB cure rate new sm+

3

4

5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

0

500

1000

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

85

90

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

60

80

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.5

2.0

2.5

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

35

2010 2012 2014 2016

11_Hypertension inci yy

24

26

28

30

32

34

2008 2010 2012 2014 2016

11_Hypertension prevalence

13.0

13.5

14.0

14.5

15.0

15.5

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

448

Section B: National and District Profiles

448

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: uThungulu (DC28)

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Section B: Profile KwaZulu-Natal Province

449

iLembe District Municipality (DC29 )

iLembe District is situated on the east coast of KwaZulu-Natal Province; it is the smallest of the province’s districts and includes four sub-districts, namely Mandeni, KwaDukuza, Maphumulo and Ndwedwe. It has a population of 651  445, with a population density of 199.30 people per km2 and falls in socio-economic Quintile 2, among the poorer districts. Estimated medical scheme coverage is 7.3%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

34 2 3 1 0 1

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 333 047 353 902 364 010PHC headcount 5 years and older 2 016 413 2 033 823 2 059 710Patient day equivalent 334 773 334 046 315 473Deaths – total 2 255 2 053 2 102Still births 257 268 230Early neonatal deaths 128 132 120Late neonatal deaths 15 25 20Child under 5 years with diarrhoea death 21 11 12Child under 5 years with pneumonia death 8 8 11Child under 5 years with severe acute malnutrition death 12 28 25

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 21%

13%

17%

20%

44%

75%

31%

6%

48%

55%

25%

11%

43%

78%

31%

13%

17%

9%

5%

3%

5%

12%

14%

6%

19%

11%

14%

12%

40%

75%

34%

12%

46%

24%

24%

10%

32%

73%

26%

11%

12%

9%

14%

4%

14%

53%

24%

7%

KZN, iLembe: DC29, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Sepsis/other newborn infectious (6.1%)

Poisonings (including herbal) (2.5%)

Birth asphyxia (9.2%)

Protein-energy malnutrition (5.7%)

Preterm birth complications (11.4%)

Septicaemia (3.5%)

Diarrhoeal diseases (23.1%)Lower respiratory infections (11.9%)

HIV/AIDS (6.7%)

Tuberculosis (3.6%)

Drowning (5.2%)

Epilepsy (1.9%)

Asthma (2.3%)

Meningitis/encephalitis (6.5%)Road injuries (5.7%)

Diarrhoeal diseases (21.6%)

Cerebrovascular disease (2.0%)

Lower respiratory infections (11.3%)HIV/AIDS (11.1%)

Tuberculosis (14.3%)

Epilepsy (1.6%)Meningitis/encephalitis (3.2%)

Mechanical forces (6.6%)Interpersonal violence (4.3%)

Accidental threats to breathing (7.3%)Road injuries (9.5%)

Diarrhoeal diseases (6.9%)

Lower respiratory infections (3.6%)

HIV/AIDS (19.0%)Tuberculosis (22.6%)

Mechanical forces (2.3%)

Road injuries (2.5%)

Nephritis/nephrosis (2.3%)

Diabetes mellitus (2.4%)

Ischaemic heart disease (2.8%)

Diarrhoeal diseases (7.1%)Cerebrovascular disease (5.4%)

Lower respiratory infections (4.0%)

HIV/AIDS (19.7%)Tuberculosis (26.8%)

Asthma (2.4%)COPD (1.8%)

Nephritis/nephrosis (4.1%)

Diabetes mellitus (7.5%)Hypertensive heart disease (9.3%)

Ischaemic heart disease (10.5%)

Diarrhoeal diseases (5.1%)

Cerebrovascular disease (23.2%)

Lower respiratory infections (5.3%)Tuberculosis (6.9%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, iLembe: DC29

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

450

Section B: National and District Profiles

450

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: iLembe (DC29)

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Section B: National and District Profiles

451

Section B: Profile KwaZulu-Natal Province

451

Indicator performance: iLembe (DC29

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 22.2 11 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

33.3 13 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 6.3 6.0 6.4 51 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 620.3 2 774.2 3 078.9 46 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 56.7 56.5 56.9 41 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 4.8 4.1 4.4 11 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 84.9 66.5 66.7 37 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 28.1 31.4 30.9 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 10.7 10.1 9.8 45 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 11.8 11.7 11.7 37 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 194.1 151.2 116.7 32 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 158.4 70.2 74.2 12 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 23.2 23.3 21.9 28 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 52.1 57.6 65.9 18 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 96.2 100.3 100.0 2 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.9 11 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 2.5 1.9 2.4 32 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 1.1 1.2 1.8 17 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

3.2 6.7 7.7 20 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 6.4 7.4 5.0 27 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 3.6 18.0 30.0 22 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 52.5 58.0 74.3 5 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 75.2 81.0 77.6 42 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 73.4 79.5 75.1 44 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

53.2 65.4 79.0 6 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 32.7 36.2 40.9 40 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 33.9 32.1 29.6 37 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 16.3 24.2 40.5 33 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 1.0 1.5 1.1 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 17.9 17.5 15.4 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

27.8 11 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

2.8 13 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

932.6 875.0 800.7 42 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

9.9 8.1 9.3 50 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 86.4 88.6 87.3 3 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 77.9 79.5 69.8 46 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 6.1 5.3 4.6 7 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

2.9 2.0 3.0 5 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

53.3 16 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

89.4 93.0 94.4 33 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

53.4 90.7 81.3 32 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 20.1 32.3 34 26.2 28.2

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452

Section B: National and District Profiles

452

Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

29.0 28.0 35.3 23 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 36.8 38.6 31.9 37 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

23.4 19.6 20.1 26 19.9 21.2

Percentage of deaths garbage codes [Percentage] 17.4 18.8 19.7 50 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 10.8 13.9 12.7 24 13.1 13.6

Percentage of deaths ill-defined [Percentage] 11.0 8.8 7.2 7 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: iLembe: DC29Va

lue

1000

1200

1400

1600

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

5

6

7

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

4.5

5.0

5.5

2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

3000

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

50

60

70

80

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

58

60

62

64

66

68

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

30

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7

8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

250

300

2008 2010 2012 2014

04_Maternal Mort ratio

0

50

100

150

2008 2010 2012 2014 2016

04_Postnatal mother <6d

22

24

26

28

30

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

10

2008 2010 2012 2014

06_Child <5 diar fat rate

1

2

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

5

10

15

20

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5.0

5.5

6.0

6.5

7.0

7.5

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

453

Section B: Profile KwaZulu-Natal Province

453

Annual indicators for district: iLembe (DC29)

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Annual indicators for district: iLembe: DC29

Valu

e

5

10

15

20

25

30

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

70

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

80

90

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

2

3

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

10

15

20

25

2010 2012 2014 2016

09_RIF resistance rate

40

60

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

400

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.0

1.5

2.0

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

20

25

30

2008 2010 2012 2014 2016

11_Hypertension prevalence

14

16

18

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

454

Section B: National and District Profiles

454

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: iLembe (DC29)

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Section B: National and District Profiles

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Section B: Profile KwaZulu-Natal Province

455

Harry Gwala District Municipality (DC43)

Harry Gwala District (previously known as Sisonke) is situated in the south of KwaZulu-Natal Province and comprises five sub-districts, namely Ingwe, KwaSani, uMzimkhulu, Greater Kokstad and Ubuhlebezwe. The district has a population of 485 308, with a population density of 46.0 people per km2 and falls in socio-economic Quintile 1, among the poorest districts in South Africa. Estimated medical scheme coverage is 6.3%

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

39 1 4 0 3

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 250 035 252 714 280 736PHC headcount 5 years and older 1 342 220 1 404 242 1 457 778Patient day equivalent 344 617 344 500 339 072Deaths – total 1 956 1 827 1 716Still births 153 139 140Early neonatal deaths 120 143 87Late neonatal deaths 10 20 22Child under 5 years with diarrhoea death 30 24 13Child under 5 years with pneumonia death 28 12 11Child under 5 years with severe acute malnutrition death 23 23 17

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 22%

14%

18%

21%

46%

77%

30%

7%

46%

54%

23%

10%

44%

77%

33%

15%

18%

9%

4%

2%

4%

10%

13%

4%

21%

14%

16%

13%

36%

75%

35%

14%

46%

24%

27%

10%

33%

69%

28%

14%

16%

9%

11%

3%

11%

49%

21%

6%

KZN, Harry Gwala: DC43, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.1%)

Sepsis/other newborn infectious (3.6%)

Poisonings (including herbal) (2.1%)

Birth asphyxia (8.3%)

Protein-energy malnutrition (5.2%)

Preterm birth complications (12.6%)

Diarrhoeal diseases (23.5%)Lower respiratory infections (17.6%)

HIV/AIDS (7.0%)

Tuberculosis (3.3%)

Exposure to natural forces (1.7%)

Drowning (5.8%)

Epilepsy (2.0%)Asthma (3.1%)

Meningitis/encephalitis (5.7%)

Road injuries (6.7%)

Diarrhoeal diseases (19.5%)

Lower respiratory infections (11.5%)HIV/AIDS (12.4%)

Tuberculosis (13.5%)

Self-inflicted injuries (6.3%)

Meningitis/encephalitis (3.1%)

Mechanical forces (3.2%)

Interpersonal violence (6.5%)

Accidental threats to breathing (3.1%)

Road injuries (5.1%)Diarrhoeal diseases (4.8%)

Lower respiratory infections (6.5%)

HIV/AIDS (18.6%)Tuberculosis (23.1%)

Asthma (2.7%)

Meningitis/encephalitis (2.4%)Road injuries (2.1%)

Diabetes mellitus (3.5%)

Hypertensive heart disease (2.5%)

Diarrhoeal diseases (5.7%)Cerebrovascular disease (4.9%)

Lower respiratory infections (6.8%)HIV/AIDS (19.5%)

Tuberculosis (26.2%)

Oesophagus (1.7%)

Asthma (6.2%)

Nephritis/nephrosis (3.3%)

Diabetes mellitus (9.8%)Hypertensive heart disease (12.0%)

Ischaemic heart disease (2.9%)

Diarrhoeal diseases (4.1%)

Cerebrovascular disease (20.4%)

Lower respiratory infections (8.0%)Tuberculosis (8.4%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, Harry Gwala: DC43

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

456

Section B: National and District Profiles

456

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: Harry Gwala (DC43)

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Section B: Profile KwaZulu-Natal Province

457

Indicator performance: Harry Gwala (DC43)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 25.0 9 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

27.5 15 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 5.5 5.1 5.0 16 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

2 136.9 2 258.1 2 199.9 20 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 66.8 64.9 63.6 31 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 6.1 5.4 5.0 18 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 69.1 78.0 74.9 46 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 25.8 26.7 29.0 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 10.0 9.7 9.9 46 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 14.4 16.4 10.9 35 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 84.0 137.9 99.9 26 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 65.1 72.0 72.8 16 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 18.0 15.6 17.2 12 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 53.5 57.1 64.6 21 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 96.3 97.6 93.4 25 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.8 10 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 3.4 3.1 2.5 33 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 4.3 1.8 2.4 26 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

7.3 8.7 8.2 25 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 7.0 6.9 5.0 26 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 9.6 32.3 48.7 7 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 51.3 49.4 64.2 13 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 80.9 77.0 68.5 50 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 80.2 79.1 75.2 43 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

79.7 77.2 73.4 11 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 51.7 54.1 60.4 11 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 52.8 46.3 40.2 14 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 57.1 59.9 78.5 2 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 2.6 1.3 2.0 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 37.7 25.8 27.1 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

27.5 12 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

10.0 1 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

937.7 814.8 677.7 33 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

8.5 7.2 7.3 42 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 83.1 78.6 80.6 17 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 71.9 74.3 77.2 25 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 7.0 8.8 7.7 29 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

4.9 4.8 5.1 26 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

59.5 9 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

92.6 95.2 95.4 23 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

65.2 83.9 80.4 35 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 18.2 30.3 27 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

30.0 31.8 31.7 11 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 37.8 35.9 36.4 49 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

22.4 21.7 19.8 24 19.9 21.2

Percentage of deaths garbage codes [Percentage] 12.7 11.7 11.0 12 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 9.9 10.6 12.1 16 13.1 13.6

Percentage of deaths ill-defined [Percentage] 17.7 15.1 17.5 45 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: Harry Gwala: DC43Va

lue

1000

1500

2000

2006 2008 2010 2012 2014

01_DHS exp per capita

600

800

1000

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

50

55

60

65

70

75

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

58

60

62

64

66

68

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7

8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

16

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

16

18

20

22

24

26

2006 2008 2010 2012 2014

04_Stillbirth rate

20

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

10

12

2008 2010 2012 2014

06_Child <5 diar fat rate

2

4

6

8

2008 2010 2012 2014 2016

06_Child <5 pneumo death

10

15

20

25

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

5.0

5.5

6.0

6.5

7.0

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

459

Section B: Profile KwaZulu-Natal Province

459

Annual indicators for district: Harry Gwala (DC43)

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Annual indicators for district: Harry Gwala: DC43

Valu

e

10

20

30

40

50

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

2008 2010 2012 2014

07_Measles 2nd cov yy

20

40

60

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

08_Couple year protect rate

4

5

6

7

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6

8

10

12

14

2010 2012 2014 2016

09_RIF resistance rate

40

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6

7

8

9

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

50

60

70

80

2006 2008 2010 2012 2014

09_TB success all TB

25

30

35

40

45

50

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

20

40

60

80

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.4

1.6

1.8

2.0

2.2

2.4

2.6

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

35

2010 2012 2014 2016

11_Hypertension inci yy

20

25

30

2008 2010 2012 2014 2016

11_Hypertension prevalence

10

11

12

13

14

15

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

460

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460

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: Harry Gwala (DC43)

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Section B: Profile KwaZulu-Natal Province

461

eThekwini Metropolitan Municipality (ETH)

eThekwini Metro is situated in KwaZulu-Natal Province and has a population of 3 520 558, with a population density of 1 536.5 people per km2. The metro falls into socio-economic Quintile 5, placing it among the wealthiest districts in South Africa. Estimated medical scheme coverage is 19.2%.

Number of facilities by level, 2015/16

Clin

ic

CH

C

Dis

tric

t Hos

pita

l

Reg

iona

l H

ospi

tal

Cen

tral

/Ter

tiary

H

ospi

tals

Oth

er H

ospi

tals

113 8 4 5 2 13

Headcount and deaths, 2013/14 – 2015/16

Data element 2013/14 2014/15 2015/16PHC headcount under 5 years 1 584 544 1 448 998 1 450 647PHC headcount 5 years and older 11 233 519 10 099 651 9 889 431Patient day equivalent 3 053 601 3 023 244 2 890 931Deaths – total 11 882 12 107 12 272Still births 1 316 1 339 1 281Early neonatal deaths 544 682 696Late neonatal deaths 118 182 187Child under 5 years with diarrhoea death 32 50 62Child under 5 years with pneumonia death 57 71 86Child under 5 years with severe acute malnutrition death 39 67 53

Burden of disease profile

For the percentage of deaths by broad cause, deaths are classified into four groups, namely: (i) injuries; (ii) non-communicable diseases; (iii) HIV and TB; and (iv) communicable diseases together with maternal, perinatal and nutritional conditions. Data are given by gender and age group for the period 2009–2014. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2009–2014 combined.

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Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 18%

10%

17%

23%

35%

71%

25%

3%

39%

47%

23%

10%

52%

85%

40%

15%

25%

13%

5%

2%

5%

14%

18%

6%

16%

9%

13%

9%

29%

70%

25%

5%

35%

17%

22%

9%

42%

82%

35%

12%

22%

14%

16%

3%

17%

62%

28%

7%

KZN, eThekwini: ETH, 2009-14

Rank.. 2009-14

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Congenital heart anomalies (2.2%)

Sepsis/other newborn infectious (4.5%)

Birth asphyxia (7.9%)

Protein-energy malnutrition (3.2%)

Preterm birth complications (15.5%)

Septicaemia (2.9%)

Diarrhoeal diseases (19.3%)

Lower respiratory infections (13.2%)

HIV/AIDS (5.8%)

Tuberculosis (3.6%)

Other unintentional injuries (3.2%)

Drowning (5.2%)

Fires, hot substances (2.6%)

Meningitis/encephalitis (4.9%)Accidental threats to breathing (3.9%)

Road injuries (5.2%)

Diarrhoeal diseases (11.4%)Lower respiratory infections (11.4%)

HIV/AIDS (10.5%)

Tuberculosis (11.7%)

Drowning (1.7%)Meningitis/encephalitis (3.1%)

Mechanical forces (13.2%)

Interpersonal violence (7.1%)Accidental threats to breathing (9.5%)

Road injuries (4.0%)Diarrhoeal diseases (3.9%)

Lower respiratory infections (5.5%)

HIV/AIDS (12.8%)

Tuberculosis (18.8%)

Mechanical forces (4.5%)

Accidental threats to breathing (2.3%)

Nephritis/nephrosis (3.4%)Diabetes mellitus (3.0%)

Ischaemic heart disease (5.8%)

Diarrhoeal diseases (4.2%)

Cerebrovascular disease (4.5%)

Lower respiratory infections (6.4%)HIV/AIDS (14.8%)

Tuberculosis (22.0%)

Trachea/bronchi/lung (2.5%)COPD (2.9%)

Nephritis/nephrosis (5.7%)

Diabetes mellitus (6.8%)Hypertensive heart disease (6.0%)

Ischaemic heart disease (17.3%)

Diarrhoeal diseases (2.1%)

Cerebrovascular disease (15.6%)

Lower respiratory infections (5.5%)Tuberculosis (3.1%)

Percentage of deaths by broad cause and leading causes, 2009-2014Prov, DistrictKZN, eThekwini: ETH

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

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462

Section B: Profile KwaZulu-Natal Province

Percentage of deaths by broad cause and leading causes, 2009–2014: eThekwini (ETH)

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463

Section B: Profile KwaZulu-Natal Province

463

Indicator performance: eThekwini (ETH)

District value

District ranking

Provincial average

National average

National target

Category Indicator 2013/14 2014/15 2015/16 2015/16 2015/16 2015/16 2015/16Management PHC

Percentage ideal clinics [Percentage] 10.6 18 23.5 9.2

Percentage of fixed PHC facilities with patients that have access to a medical practitioner [Percentage]

18.6 27 30.7 18.1

Management Inpatients

Average length of stay (district hospitals) [Days] 6.1 6.1 5.3 26 5.7 4.5

Expenditure per patient day equivalent (district hospitals) [Rand (real 2015/16 prices)]

1 865.0 1 710.6 1 626.9 45 2 240.9 2 342.2

Inpatient bed utilisation rate (district hospitals) [Percentage] 83.2 74.5 68.5 22 60.2 65.3 78.6

Inpatient crude death rate [Percentage] 4.4 4.2 4.4 9 5.2 5.0

OPD new client not referred rate (district hospitals) [Percentage] 50.1 68.4 30.3 9 47.7 58.3

Delivery Delivery by caesarean section rate (district hospitals) [Percentage] 40.6 36.4 35.8 28.8 24.1

Delivery in facility under 18 years rate [Percentage] 8.0 7.6 7.5 26 8.7 7.1

Inpatient early neonatal death rate [per 1 000 live births] 9.8 11.4 12.4 41 10.8 10.5 10.0

Maternal mortality in facility ratio [per 100 000 live births] 174.4 100.1 106.9 29 121.1 119.1 120.0

Mother postnatal visit within 6 days rate [Percentage] 69.9 66.4 69.5 20 69.8 68.5 85.0

Stillbirth in facility rate [per 1 000 births] 21.9 21.9 22.3 32 22.3 21.1

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage] 53.5 54.1 63.8 23 64.8 61.2 60.0

Antenatal client initiated on ART rate [Percentage] 72.9 92.1 97.4 13 97.6 93.0 88.0

Percentage of PCR tests positive at birth [Percentage] 0.7 9 0.7 1.1

Child Health Child under 5 years diarrhoea case fatality rate [Percentage] 1.6 1.8 2.3 30 2.2 2.2 3.2

Child under 5 years pneumonia case fatality rate [Percentage] 3.2 2.6 2.5 27 2.7 2.3 3.0

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

5.8 7.2 6.4 15 7.7 8.9 10.0

Inpatient death under 5 year rate [Percentage] 4.3 5.1 5.4 28 5.2 4.7

School Grade 1 screening coverage (annualised) [Percentage] 2.1 21.2 9.2 47 22.1 28.9 25.0

Vitamin A dose 12-59 months coverage (annualised) [Percentage] 60.9 58.3 67.9 9 63.8 57.0

Immunisation Immunisation coverage under 1 year [Percentage] 104.7 106.5 97.6 9 85.0 89.2 90.0

Measles 2nd dose coverage (annualised) [Percentage] 92.3 94.3 87.1 18 82.6 84.8 83.0

Reproductive health

Cervical cancer screening coverage (annualised) [Percentage of women 30+ /10]

81.0 76.7 67.0 19 72.7 56.6 60.0

Couple year protection rate (annualised) [Percentage] 30.4 42.2 47.7 30 52.1 48.2 60.0

HIV HIV testing coverage (including ANC) [Percentage] 30.8 35.0 37.2 21 36.0 34.5

Male condom distribution coverage [Condoms per male 15+] 14.6 27.7 39.3 34 54.6 44.4

Non-communicable diseases

Diabetes incidence (annualised) [per 1 000 population] 2.6 2.3 2.5 2.2 1.7

Hypertension incidence (annualised) [per 1 000 population 40+] 23.5 17.9 15.9 18.6 16.8

Human Resources

Percentage of fixed PHC facilities with performance management agreement for all staff [Percentage]

18.6 25 28.5 16.3

Percentage of fixed PHC facilities with staffing in line with WISN [Percentage]

3.5 10 2.7 1.5

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

TB case finding Incidence (diagnosed cases) of TB (ETR.net) [Cases per 100 000 population]

1 093.9 871.3 698.4 38 685.2 519.8

TB Rifampicin resistance confirmed client rate [Percentage]

7.7 7.6 6.8 39 7.8 6.1

TB treatment outcomes

TB cure rate (new sm+) [Percentage] 75.9 79.5 71.6 44 78.7 77.4

TB treatment success rate (ETR.net) [Percentage] 78.3 80.9 67.9 48 73.8 77.2 83.0

TB death rate (ETR.net) [Percentage] 5.7 5.0 4.1 5 5.4 6.7

New smear positive pulmonary TB loss to follow up rate [Percentage]

7.6 6.2 5.6 33 4.0 5.6

TB MDR treatment success rate (EDRWeb) [Percentage]

55.9 15 57.3 47.2 55.0

HIV Percentage of TB cases with known HIV status (ETR.net) [Percentage]

84.9 90.0 91.7 47 94.2 94.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

57.7 69.0 69.6 48 82.2 84.5

NCDs Hypertension prevalence rate (crude) [Percentage] 34.5 24.4 14 26.2 28.2

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Section B: Profile KwaZulu-Natal Province

District value

District ranking

Provincial average

National average

National target

Category Indicator 20122013 & 2013/14

2014 & 2014/15 2015 2015* 2015* 2015* 2015*

Burden of disease

Percentage of YLLs due to non-communicable diseases [Percentage]

38.6 39.7 38.5 33 34.7 38.2

Percentage of YLLs due to HIV and TB [Percentage] 29.9 27.3 30.3 34 32.3 27.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

16.9 17.1 18.0 20 19.9 21.2

Percentage of deaths garbage codes [Percentage] 19.0 19.2 19.1 49 15.3 14.6

Percentage of YLLs due to injuries [Percentage] 14.7 16.0 13.2 27 13.1 13.6

Percentage of deaths ill-defined [Percentage] 12.4 13.3 11.7 30 10.0 13.8

* – value for most recent year which ranges from 2013 to 2015

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

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Annual indicators for district: eThekwini: ETHVa

lue

1000

1200

1400

1600

2006 2008 2010 2012 2014

01_DHS exp per capita

500

600

700

800

900

1000

1100

2006 2008 2010 2012 2014

01_PHC exp per capita

200

250

300

350

2006 2008 2010 2012 2014

01_PHC exp per headcount

4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

4.5

5.0

5.5

2010 2012 2014 2016

03_Crude death rate

1000

1500

2000

2006 2008 2010 2012 2014

03_Expenditure per PDE (DH)

30

40

50

60

70

80

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

60

65

70

75

80

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

30

35

40

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

7.0

7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

250

2008 2010 2012 2014

04_Maternal Mort ratio

20

40

60

2008 2010 2012 2014 2016

04_Postnatal mother <6d

21

22

23

24

25

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

80

100

120

140

160

2008 2010 2012 2014 2016

05_ANC initiate ART rate

2

4

6

8

2008 2010 2012 2014

06_Child <5 diar fat rate

1

2

3

4

5

6

2008 2010 2012 2014 2016

06_Child <5 pneumo death

5

10

15

20

2008 2010 2012 2014 2016

06_Child <5 sev mal fata

4.5

5.0

5.5

2010 2012 2014 2016 2018

06_Inpat death <5 rate

District value Provincial average ZA (national) average

Section B: National and District Profiles

465

Section B: Profile KwaZulu-Natal Province

465

Annual indicators for district: eThekwini (ETH)

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Annual indicators for district: eThekwini: ETH

Valu

e

5

10

15

20

25

30

2010 2012 2014 2016 2018

06_School G1 screen cov yy

30

40

50

60

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

70

80

90

100

110

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2008 2010 2012 2014

07_Measles 2nd cov yy

30

40

50

60

70

80

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

2006 2008 2010 2012 2014

08_Couple year protect rate

4

6

8

10

2008 2010 2012 2014 2016

09_New pulmonary TB LTF rate

6.0

6.5

7.0

7.5

8.0

8.5

9.0

2010 2012 2014 2016

09_RIF resistance rate

40

50

60

70

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

4

5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

55

60

65

70

75

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

60

80

2008 2010 2012 2014 2016

10_TB known HIV status

20

40

60

80

2010 2012 2014 2016

10_TB/HIV on ART

1.4

1.6

1.8

2.0

2.2

2.4

2.6

2010 2012 2014 2016 2018

11_Diabetes incidence yy

15

20

25

30

2010 2012 2014 2016

11_Hypertension inci yy

24

26

28

30

32

34

2008 2010 2012 2014 2016

11_Hypertension prevalence

14

15

16

17

18

19

2008 2010 2012 2014

13_Garbage codes

District value Provincial average ZA (national) average

466

Section B: National and District Profiles

466

Section B: Profile KwaZulu-Natal Province

Annual indicators for district: eThekwini (ETH)