Since 1992, the Health Systems Trust has contributed to the development of a health system that can meet the needs of all South Africans, including the most disadvantaged. We will continue to work with all stakeholders in order to improve health care, particularly in areas most underserved and in need.

District Health Barometer 2008/09 draft chapters live online.
2010-02-03

District health managers and policy makers across South Africa and world-wide will can now enjoy internet access to draft chapters of the District Health Barometer 2008/09.

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Outcome Indicators
HST
2010-03-01

Tuberculosis

South Africa is at the centre of the concurrent human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics. The country has the largest number of people living with HIV infection in the world (about 5.5 million people) and in 2007 South Africa accounted for 17% of the global burden of HIV infection.¹ The incidence of TB continues to rise and the 2007 incidence rate of 805 per 100 000 led to South Africa being ranked fifth in the list of 22 high burden TB countries in 2009.² In 2007, 73% of those with TB were co-infected with HIV.²

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Input Indicators
Health Systems Trust
2010-02-16

In 2008/09 the District Health Services Programme (Programme 2) spent R31.4 billion¹ on health care according to Treasury's Provincial Budgets and Expenditure Review². This is up from R18.4 billion in 2005/06 and is estimated to reach R41 billion in 2011/12 the significant growth attributable to the increased spending on primary health care and HIV/AIDS. In the sections of this chapter that follow, pertinent finance indicators are highlighted and the R31.5¹ billion expenditure is broken down, per district, within South Africa.

The District Health Barometer (DHB) reflects only financial data from Programme 2 (District Health Services). Table 1, Budget programme structure for provincial health expenditure, depicts what is included in Programme 2 and also lists the sub-programmes. The per capita cost of delivering Primary Health Care services at district level provides insights into equity and efficiency of the country's health services, as well as providing a useful measure of comparison. In the first two sections of this input indicators' chapter, per capita expenditure (PCE) is looked at in two ways - one including all District Health Services expenditure (total PCE) and the other, a subset of the first, is based on selected non-hospital³ expenditure (non-hospital PCE). Both types of PCE include nett Local Government expenditure on PHC.

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Proportion of District Health Services Expenditure on District Management
Health Systems Trust
2010-02-16

The proportion of total district expenditure for management activities during the 2008/09 financial year, including the management of district hospitals, was 5.6%. This proportion is the highest over the past four years the lowest being 4.7% in 2006/07.
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Proportion of District Health Services Expenditure on District Hospitals
Health Systems Trust
2010-02-16

This indicator shows the proportion of total district expenditure on hospitals and is helpful in assessing the focus of service delivery in the district. The proportion of total district expenditure on district hospitals during 2008/09 was 41.8% and this proportion has been in an annual and steady decline from 44.9% in 2005/06. This is partly due to the corresponding rise in the proportion spent on district management teams but is more likely due to increased expenditure on HIV/AIDS via conditional grants, an expenditure which was 11.9% in 2008/09 compared with 9.2% in 2005/06 (see Table 1).
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