10 Eastern Cape Province

SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Buffalo City Metropolitan Municipality (BUF)

The Buffalo City Metropolitan Municipalitya is a Category A municipality situated on the east coast of the Eastern Cape Province. The boundaries of the newly established municipality now make up a large area characterised by very different features. Two former municipalities, Transitional Local Councils – that of East London and King William’s Town – have merged into one. Other areas that were previously not included in either of them are now part of Buffalo City. Cities/Towns: Beacon Bay, Berlin, Bisho, Breidbach, Dimbaza, East London, Kidd’s Beach, King William’s Town, Mdantsane, Phakamisa, Potsdam, Zwelitsha Area: 2 750km² Population (2019)b: 866 514

DistrictDistrict % percentagepopulation by ag populatione-gender group cbyom page-genderared to South Af grouprica compared to South Africa

EC, Buﬀalo City MM (BUF)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 1.9% 3.2% 2.0% 3.5% 2.9% 5.4%

60-64 years 1.6% 1.3% 1.7% 1.7% 2.7%

55-59 years 1.4% 1.8% 1.9% 2.6% 2.0% 3.0%

50-54 years 1.9% 2.1% 2.3% 3.2% 2.4% 3.2%

45-49 years 2.6% 3.3% 2.6% 3.5% 3.1% 3.4%

40-44 years 2.9% 3.9% 2.9% 3.6% 3.6% 3.6%

35-39 years 3.2% 4.1% 3.7% 3.9% 4.2% 4.0%

30-34 years 3.4% 4.2% 4.0% 4.1% 4.2% 4.0%

25-29 years 4.0% 4.4% 4.6% 4.3% 3.6% 3.4%

20-24 years 4.2% 4.7% 4.7% 4.7% 3.2% 3.0%

15-19 years 5.4% 5.4% 4.5% 4.5% 3.8% 3.7%

10-14 years 5.6% 5.5% 4.2% 4.0% 4.7% 4.6%

05-09 years 5.0% 5.0% 4.1% 4.0% 4.6% 4.4%

00-04 years 4.1% 4.0% 5.0% 4.9% 3.9% 3.8%

8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% District % of total population [Male | Female] - bars District % of total population [Male | Female] - bars District % of total population [Male | Female] - bars

Sex Gender (ZA) female female (ZA) male male (ZA)

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 2012–2017. The second part of the graph shows the 10 leading single causes of death within each age group and by gender for 2012–2017.

a Available from: https://municipalities.co.za/overview/7/buffalo-city-metropolitan-municipality. b Mid-year Population Estimates 2019, Stats SA.

297 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, Buffalo City MM: BUF, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 58% 7% 23% 12% 59% 7% 22% 12% causes and 5-14 18% 19% 34% 29% 16% 12% 22% 50% single leading 15-24 11% 45% 22% 22% 4%9% 14% 74% causes 25-64 8% 35% 51% 6% 6% 30% 45% 19% 65+ 7%5% 84% 3% 7% 8% 81% 4% Total 10% 21% 63% 6% 8% 21% 53% 18% Broadcause Injury NCD Rank Female Male 1 Lower respiratory infections (18.9%) Lower respiratory infections (21.1%) HIV and TB 2 Diarrhoeal diseases (11.8%) Diarrhoeal diseases (10.1%) Comm_mat_peri_nut 3 Preterm birth complications (9.2%) Preterm birth complications (8.9%)

s 4 Protein-energy malnutrition (5.7%) HIV/AIDS (5.2%) Prov, District 5 Birth asphyxia (4.8%) Birth asphyxia (5.0%) EC, Buffalo City MM: BUF y e a r 6 HIV/AIDS (4.5%) Protein-energy malnutrition (4.7%) Show history 5

< 7 Congenital heart anomalies (3.7%) Sepsis/other newborn infectious (3.6%) 8 Accidental threats to breathing (3.2%) Congenital heart anomalies (3.4%) Percentages are shown 9 Other congenital abnormalities (2.9%) Drowning (3.2%) according to all the deaths 10 Fires, hot substances (2.8%) Other congenital abnormalities (2.9%) within the age/gender 1 Tuberculosis (13.0%) Drowning (27.1%) category of each box, 2 HIV/AIDS (10.8%) Road injuries (8.9%) although only the leading 3 Road injuries (9.5%) HIV/AIDS (7.2%) 10 causes are displayed. 4 Fires, hot substances (8.3%) Tuberculosis (6.4%) 5 Drowning (7.2%) Other unintentional injuries (5.7%) 1 4

5 - 6 Accidental threats to breathing (6.5%) Accidental threats to breathing (5.1%) 7 Meningitis/encephalitis (6.5%) Lower respiratory infections (4.5%) 8 Lower respiratory infections (5.4%) Meningitis/encephalitis (4.5%) 9 Leukaemia (5.4%) Fires, hot substances (3.0%) 10 Diarrhoeal diseases (5.3%) Adverse effects medical/surgical (2.7%) 1 HIV/AIDS (27.2%) Interpersonal violence (36.8%) 2 Tuberculosis (20.2%) Accidental threats to breathing (11.8%) 3 Accidental threats to breathing (5.8%) Mechanical forces (9.8%) 4 Road injuries (4.1%) Fires, hot substances (5.3%)

2 4 5 Fires, hot substances (3.8%) Tuberculosis (4.8%)

1 5 - 6 Interpersonal violence (2.8%) HIV/AIDS (4.6%) 7 Lower respiratory infections (2.6%) Road injuries (4.5%) 8 Cardiomyopathy (2.3%) Drowning (3.4%) 9 Asthma (2.1%) Other unintentional injuries (2.0%) 10 Hypertension in pregnancy (1.8%) Adverse effects medical/surgical (1.8%) 1 HIV/AIDS (20.7%) Tuberculosis (16.0%) 2 Tuberculosis (14.3%) HIV/AIDS (14.3%) 3 Cerebrovascular disease (5.5%) Interpersonal violence (6.6%) 4 Diabetes mellitus (4.8%) Cerebrovascular disease (4.2%)

6 4 5 Hypertensive heart disease (4.1%) Ischaemic heart disease (4.0%)

2 5 - 6 Cervix (2.9%) COPD (3.9%) 7 Breast (2.8%) Accidental threats to breathing (3.2%) 8 Lower respiratory infections (2.7%) Mechanical forces (2.9%) 9 Ischaemic heart disease (2.6%) Hypertensive heart disease (2.9%) 10 Asthma (2.5%) Trachea/bronchi/lung (2.9%) 1 Cerebrovascular disease (15.0%) Cerebrovascular disease (10.4%) 2 Hypertensive heart disease (12.1%) COPD (9.1%) 3 Ischaemic heart disease (7.2%) Ischaemic heart disease (8.3%) 4 Diabetes mellitus (6.6%) Tuberculosis (7.3%) 5 COPD (6.3%) Hypertensive heart disease (7.2%)

6 5 + 6 Tuberculosis (4.3%) Prostate (5.3%) 7 Oesophagus (3.9%) Diabetes mellitus (4.6%) 8 Lower respiratory infections (3.9%) Oesophagus (4.0%) 9 Cardiomyopathy (2.9%) Lower respiratory infections (3.8%) 10 Asthma (2.7%) Trachea/bronchi/lung (3.8%)

Rank Maternal conditions All other causes 1 Hypertension in pregnancy (33.5%) n=34 HIV/AIDS (30.5%) n=2 281 2 Indirect maternal (29.1%) n=30 Tuberculosis (19.6%) n=1 467 3 Other maternal (19.4%) n=20 Lower respiratory infections (2.9%) n=220 4 Abortion (10.5%) n=11 Asthma (2.8%) n=209 e a l 4 9 5 Maternal haemorrhage (7.5%) n=8 Endocrine nutritional,blood, immune (2.5%) n=183

1 5 - 6 Cerebrovascular disease (2.2%) n=164 F e m 7 Cervix (2.2%) n=163 8 Diabetes mellitus (1.9%) n=145 9 Accidental threats to breathing (1.9%) n=143 10 Breast (1.9%) n=142

298 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20 Buffalo City: BUF Buffalo City: BUF e s n g l 13 i 51

80 80 o f a n i P r

p l 23 15 15 y

l TB DS client lost to i Couple year 25 60 60 follow up rate [both protection rate [ | 28 sexes all ages | 41 10 10 DHIS] ETR/Tier.Net] 1 _ F a m 40 40 32 18 49 5 22 5 e 10 c a r 13 7 7

y 10 20 v e r i TB DS death rate Antenatal 1st visit d e l 80 80 [both sexes all 12 coverage [female | ages | 6 6 a n d DHIS] ETR/Tier.Net]

12 43 40 44 60 60 10 e g n a c y 5 5 90 90 80 39 80 1 _ 2 P r 15 15 70 42 70 TB symptom 5 60 42 60 years and older Delivery in 10 to 19 50 50 years in facility rate 9 screened in facility rate [both sexes | 40 40 [female | DHIS] 10 10 6 DHIS] 30 30 20 40 20 10 10 3

43 200 200 80 37 80 50 TB symptom child under 5 years Maternal mortality 45 in facility ratio 150 45 150 screened in facility 60 60 [female | DHIS] 38 rate [both sexes | 41 DHIS] 40 40 100 32 100 47

18 18 e n t 50 11 48 m 90 90 e a t r 16 42 16 t Adult with viral V Neonatal death in I load suppressed rate 12 months 88 30 28 88 facility rate [both 35 sexes | DHIS] [both sexes 15+

14 14 2 _ H 36 years | DHIS] 39 86 86

12 12 o n

i 12

s a t 80 80 70 70

u n i Child with viral 33 21 m Immunisation load suppressed 30 m i under 1 year 37 rate 12 months 65 65

d 30 l coverage [both 40 [both sexes 0-14 h i sexes | DHIS] 70 70 years | DHIS] 60 60 47 1 _ 3 C 39 47

e n t 6 6 m 27 e a t r t Death in facility Clients remaining 60 60 d

l 47 16 on ART rate [both 44

h i years rate under 5 4 4 [both sexes | 14 sexes all ages | DHIS] DHIS] 43 1 _ 4 C 8 8 50 50 2 8 2 43 6

C 8 4 4 U

Pneumonia case 25 25 3 3 Antiretroviral 20 fatality under 5 effective coverage years rate [both 21 34 [both sexes 0-14 sexes <5 years | 2 2 years | DHIS-Tier] 20 21 DHIS] 20 20 1 11 11 1 43 8

e n t 10

m 85 85

e a t 40 40 r

t Antiretroviral 30 TB DS treatment 23 35 12 effective coverage 35 success rate [both 80 80 [both sexes 15+ sexes all ages | years | DHIS-Tier] 35 20 35 2 _ 1 T B ETR/Tier.Net] 75 75

52 30 30 70 70

2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 40 40 F Y F Y F Y F Y F Y F Y 30 Antiretroviral 35 effective coverage 35 Measure Names Rank [both sexes all 35 19 35 Prov av 1 52 ages | DHIS-Tier] ZA av Ind Value 30 30 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

299 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Buffalo City: BUF Buffalo City: BUF 9

C 82 82 3200 3200 U

Age-standardised n a c e 30 Expenditure per prevalence of 80 80 3000 3000 non-raised blood 31 patient day 4 _ 5 F i equivalent (district pressure (index) 78 33 78 hospitals) [ | BAS [both sexes 15+ 2800 2800 35 real 2019/20 years | NiDS prices] modelled] 76 35 76 2600 2600 36 74 74 e s e n t 50 50 51 50 47 44 2200 2200 a b e t

i Provincial & LG District Health Diabetes a n g e m 15 15 Services m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | 2000 2000 capita (uninsured) [ NiDS modelled] | BAS real 2019/20 prices] 10 10 1800 1800

1 0 40 40 C U Provincial & LG 1400 1400 Diabetes treatment 35 35 PHC expenditure coverage [both per capita sexes 15+ years | (uninsured) [ | BAS NiDS modelled] real 2019/20 1200 1200 30 30 prices] 49 50 49 48 45 42 1000 1000 o n i 8 7

e c t 500 500 60 6 11 60 Provincial & LG d e t Cervical cancer PHC expenditure screening per PHC

a n c e r coverage [female | 10 headcount [ | BAS 50 50 DHIS] real 2019/20 400 400 16 prices] 3 _ C 40 40

1 2 18 18 47 C U s e a d i

Tobacco 80 80 45 44 Percentage of 16 16 non-smoking o f prevalence (index) deaths garbage

d e n codes [both sexes [both sexes 15+ all ages | vital 14 14 years | NiDS 40 B u r 75 41 75 registration] modelled] 41 41 42 12 12 41 e n t i 2 20 20 2 2 a c e s n p a t

i 2 y 2

t 3

i Hospital beds per Percentage of l 10 000 target 30 30 deaths ill-defined 15 15 population [ | DHIS [both sexes all 2000-2030 public ages | vital

4 _ 1 F a c i sector] registration] 10 10 20 20 7 6 5 5 5 y t 80 80 2 2

d e n s i Percentage of 2 Medical YLLs due to

k e r 3 practitioners per 60 60 communicable, 15 15 o r

w 100 000 population maternal, perinatal, h

t [both sexes | public nutrition causes

e a l sector] 40 40 [both sexes | vital registration] 10 10 6 7 6 4 _ 2 H

3 2 3 30 30 20 20 Percentage of Pharmacists per 6 YLLs due to HIV 100 000 population 26 and TB [both [both sexes | public sexes | vital sector] 15 15 30 registration] 25 25

23 10 10 300 300 18 18 1 47 1 1 Professional 250 2 250 17 17 Percentage of 42 nurses per 100 YLLs due to 000 population 41 injuries [both sexes 16 16 [both sexes | public 200 200 | vital registration] sector] 15 15 150 150 n e s a n d 43

c i 50 50 C 41 e d i Percentage of

P H 40 40 m YLLs due to 43 Percentage Ideal non-communicable clinics [ | IC status] diseases [both 45 45 20 47 20 51 sexes | vital registration]

4 _ 3 A c e s 49 51 0 11 35 0 40 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

300 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Sarah Baartman District Municipality (DC10)

The Sarah Baartman District Municipalityc is a Category C municipality situated in the Eastern Cape Province. Sarah Baartman is the largest district in the province, making up approximately a third of its geographical area. It comprises seven local municipalities: Dr Beyers Naudé, Blue Crane Route, Makana, Ndlambe, Sundays River Valley, Kouga and Koukamma. Cities/Towns: Aberdeen, Addo, Adendorp, Alexandria, Alicedale, Bathurst, Boknes/Cannon Rocks, Bushmans River, Cape St Francis, Clarkson, Cookhouse, Graaff-Reinet, Hankey, Humansdorp, Jansenville, Jeffreys Bay, Joubertina, Kareedouw, Kendrew, Kenton-on-Sea, Kirkwood, Klipplaat, Krakeel River, Loerie, Louterwater, Makhanda (Grahamstown), Misgund, Nieu-Bethesda, Nompumelelo, Oyster Bay, Patensie, Paterson, Pearston, Petersburg, Port Alfred, Riebeek East, Rietbron, Sanddrif, Seafield, Sidbury, Somerset East, St Francis Bay, Steytlerville, Storms River, Thornhill, Waterford, Willowmore, Woodlands Area: 58 245km² Population (2019)d: 532 051

DistrictDistrict % percentagepopulation by ag epopulation-gender group cbyom page-genderared to South Af rgroupica compared to South Africa

EC, Sarah Baartman DM (DC10)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.7% 3.7% 2.8% 3.9% 3.0% 4.8%

60-64 years 1.7% 1.7% 1.4% 1.9% 1.5% 2.1%

55-59 years 1.8% 2.1% 1.8% 2.3% 1.8% 2.5%

50-54 years 2.0% 2.5% 2.1% 2.7% 2.3% 2.8%

45-49 years 2.6% 3.0% 2.6% 3.2% 2.9% 3.1%

40-44 years 2.8% 3.4% 3.0% 3.4% 3.3% 3.1%

35-39 years 3.3% 3.9% 3.6% 3.6% 4.4% 3.8%

30-34 years 3.6% 4.1% 3.7% 3.6% 4.9% 4.1%

25-29 years 3.8% 4.0% 4.4% 4.1% 4.2% 3.5%

20-24 years 3.5% 3.7% 4.7% 4.5% 3.5% 3.3%

15-19 years 4.9% 4.9% 4.5% 4.4% 4.0% 3.9%

10-14 years 5.7% 5.4% 4.4% 4.2% 4.9% 4.8%

05-09 years 5.1% 4.9% 4.5% 4.4% 4.8% 4.6%

00-04 years 4.6% 4.5% 5.3% 5.2% 4.1% 4.0%

Sex Gender (ZA) female female (ZA) male male (ZA)

c Available from: https://municipalities.co.za/overview/103/sarah-baartman-district-municipality. d Mid-year Population Estimates 2019, Stats SA.

301 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, Sarah Baartman DM: DC10, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 68% 8% 16% 8% 69% 6% 16% 9% causes and 5-14 21% 22% 16% 42% 14% 15% 20% 51% single leading 15-24 7% 50% 15% 28% 3%16% 12% 70% causes 25-64 6% 36% 51% 7% 5% 35% 42% 18% 65+ 8%4% 86% 2% 8% 7% 82% 3% Total 9% 21% 63% 6% 9% 24% 52% 15% Broadcause Injury NCD Rank Female Male 1 Lower respiratory infections (29.7%) Lower respiratory infections (25.5%) HIV and TB 2 Diarrhoeal diseases (11.0%) Diarrhoeal diseases (13.2%) Comm_mat_peri_nut 3 Preterm birth complications (10.8%) Preterm birth complications (12.8%)

s 4 Birth asphyxia (7.0%) Birth asphyxia (8.0%) Prov, District 5 Protein-energy malnutrition (5.6%) Protein-energy malnutrition (5.6%) EC, Sarah Baartman DM: DC10 y e a r 6 HIV/AIDS (5.1%) HIV/AIDS (3.3%) Show history 5

< 7 Congenital heart anomalies (3.9%) Tuberculosis (3.1%) 8 Other respiratory (3.3%) Other perinatal conditions (2.8%) Percentages are shown 9 Tuberculosis (3.1%) Other respiratory (2.7%) according to all the deaths 10 Accidental threats to breathing (2.8%) Sepsis/other newborn infectious (2.5%) within the age/gender 1 Road injuries (29.6%) Drowning (40.8%) category of each box, 2 HIV/AIDS (19.7%) Road injuries (12.5%) although only the leading 3 Drowning (14.3%) HIV/AIDS (11.0%) 10 causes are displayed. 4 Meningitis/encephalitis (11.1%) Tuberculosis (9.4%) 5 Tuberculosis (10.1%) Lower respiratory infections (8.4%) 1 4

5 - 6 Lower respiratory infections (6.2%) Accidental threats to breathing (5.8%) 7 Diarrhoeal diseases (5.2%) Fires, hot substances (4.2%) 8 Exposure to natural forces (3.9%) Endocrine nutritional,blood, immune (4.0%) 9 Epilepsy (3.8%) 10 1 HIV/AIDS (37.3%) Interpersonal violence (34.9%) 2 Tuberculosis (19.0%) Accidental threats to breathing (14.0%) 3 Interpersonal violence (9.0%) Tuberculosis (10.2%) 4 Road injuries (8.3%) Road injuries (8.7%)

2 4 5 Accidental threats to breathing (6.5%) Drowning (6.4%)

1 5 - 6 Lower respiratory infections (3.4%) HIV/AIDS (6.1%) 7 Endocrine nutritional,blood, immune (2.6%) Mechanical forces (4.4%) 8 Fires, hot substances (2.5%) Fires, hot substances (3.6%) 9 Adverse effects medical/surgical (2.1%) Epilepsy (2.0%) 10 Epilepsy (1.5%) Lower respiratory infections (1.9%) 1 HIV/AIDS (22.9%) Tuberculosis (18.2%) 2 Tuberculosis (13.3%) HIV/AIDS (17.2%) 3 Cerebrovascular disease (7.1%) Interpersonal violence (6.0%) 4 Hypertensive heart disease (6.1%) Ischaemic heart disease (4.9%)

6 4 5 Diabetes mellitus (4.7%) COPD (4.7%)

2 5 - 6 Ischaemic heart disease (3.6%) Cerebrovascular disease (4.2%) 7 COPD (3.5%) Road injuries (3.6%) 8 Lower respiratory infections (3.0%) Lower respiratory infections (3.3%) 9 Endocrine nutritional,blood, immune (3.0%) Accidental threats to breathing (3.2%) 10 Road injuries (3.0%) Trachea/bronchi/lung (3.2%) 1 Cerebrovascular disease (16.3%) Ischaemic heart disease (11.7%) 2 Hypertensive heart disease (16.1%) Cerebrovascular disease (11.6%) 3 Ischaemic heart disease (9.8%) COPD (9.2%) 4 Diabetes mellitus (6.9%) Hypertensive heart disease (8.8%) 5 COPD (5.5%) Prostate (6.6%)

6 5 + 6 Lower respiratory infections (4.9%) Tuberculosis (6.4%) 7 Tuberculosis (3.2%) Lower respiratory infections (5.5%) 8 Trachea/bronchi/lung (2.8%) Diabetes mellitus (4.7%) 9 Breast (2.7%) Trachea/bronchi/lung (4.4%) 10 Nephritis/nephrosis (2.1%) Asthma (2.1%)

Rank Maternal conditions All other causes 1 Other maternal (33.9%) n=10 HIV/AIDS (35.7%) n=1 445 2 Indirect maternal (32.5%) n=10 Tuberculosis (17.4%) n=704 3 Hypertension in pregnancy (18.2%) n=5 Road injuries (4.6%) n=187 4 Maternal haemorrhage (15.4%) n=5 Endocrine nutritional,blood, immune (3.7%) n=152 e a l 4 9 5 Interpersonal violence (3.5%) n=143

1 5 - 6 Lower respiratory infections (3.3%) n=135 F e m 7 Cerebrovascular disease (2.6%) n=105 8 Hypertensive heart disease (2.5%) n=102 9 Diabetes mellitus (1.9%) n=77 10 Ischaemic heart disease (1.8%) n=71

302 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20 Sarah Baartman: DC10 Sarah Baartman: DC10 e s n g l i 51 50

24 o f 70 70 a n i

P r 15 15

p l 17 25 y

l TB DS client lost to i 18 50 Couple year follow up rate [both protection rate [ | 60 60 35 sexes all ages | 49 DHIS] ETR/Tier.Net] 10 10 1 _ F a m 50 50 44 e 8 32 8 c a r

y 80 80 v e r i TB DS death rate Antenatal 1st visit d e l 42 [both sexes all coverage [female | 70 48 70 ages | 7 20 7

a n d DHIS] 44 ETR/Tier.Net] 42 20 60 60 16 46 45 e g n a c y 90 90 80 40 80 1 _ 2 P r 16 16 70 44 70 TB symptom 5 60 60 years and older 46 Delivery in 10 to 19 24 50 50 years in facility rate screened in facility [female | DHIS] rate [both sexes | 40 40 14 14 30 35 30 22 DHIS] 19 20 20 10 10

150 45 150 80 41 80 TB symptom child Maternal mortality 100 100 under 5 years 41 20 in facility ratio screened in facility [female | DHIS] rate [both sexes | 60 60 8 22 DHIS] 50 8 50 1 42

16 16 e n t 90 90 15 15 m 89 89 e a t

14 14 r t Adult with viral 88 88

13 13 V I load suppressed Neonatal death in 87 87 12 12 rate 12 months facility rate [both 24 86 86 sexes | DHIS] 11 11 [both sexes 15+ 16 21 2 _ H 85 85 10 14 10 years | DHIS] 45 84 84 9 9 41 83 38 83 8 10 8 40 70 70 o n i 80 80 s a t 40 60 34 60

u n i Child with viral

m Immunisation load suppressed 44 m i under 1 year 70 70 rate 12 months 50 50

d 43 l coverage [both 50 [both sexes 0-14 h i sexes | DHIS] years | DHIS] 50 40 40 60 52 60 1 _ 3 C 48 43 52 30 30

e n t 6 6

m 65 65 34 37 e a t r t Death in facility Clients remaining d l on ART rate [both 21 h i under 5 years rate 60 33 60 [both sexes | 4 4 sexes all ages | DHIS] DHIS] 12 1 _ 4 C 10 8 55 55 10 9 9 2 2 6 25 25 C

4 4 U 28

Pneumonia case Antiretroviral 20 29 20 fatality under 5 23 effective coverage years rate [both 2 2 [both sexes 0-14 sexes <5 years | years | DHIS-Tier] 15 40 15 DHIS]

7 6 9 42 3 6 10 10 0 0 e n t m 80 80 27

e a t 40 10 40 r

t Antiretroviral TB DS treatment 39 45 34 effective coverage success rate [both 45 [both sexes 15+ sexes all ages | years | DHIS-Tier] 35 35 2 _ 1 T B ETR/Tier.Net] 70 70 38

52 30 30

2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 40 28 40 10 F Y F Y F Y F Y F Y F Y Antiretroviral 34 effective coverage Measure Names Rank [both sexes all 35 35 Prov av 1 52 ages | DHIS-Tier] 38 ZA av Ind Value 30 30 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

303 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Sarah Baartman: DC10 Sarah Baartman: DC10 9

C 3300 3300

U 3200 3200 Age-standardised 80 80 n a c e Expenditure per 3100 3100 prevalence of non-raised blood patient day 3000 3000 4 _ 5 F i equivalent (district pressure (index) 2900 2900 75 75 hospitals) [ | BAS [both sexes 15+ 2800 2800 real 2019/20 years | NiDS 2700 2700 prices] modelled] 2600 2600 70 49 49 49 50 49 49 70 2500 2500

e s 3000 3000 e n t 42 a b e t i 42 Provincial & LG District Health Diabetes a n g e m 15 41 15 Services 2500 2500

m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | 39 capita (uninsured) [ NiDS modelled] 37 | BAS real 2019/20 37 prices] 2000 2000 10 10

1 0 40 40 C U 28 Provincial & LG 1200 1200 Diabetes treatment PHC expenditure coverage [both 35 32 35 per capita sexes 15+ years | 35 (uninsured) [ | BAS 1100 1100 NiDS modelled] 36 real 2019/20 prices] 30 38 30 37 1000 1000

o n 50 50 i

e c t 500 500 Provincial & LG d e t Cervical cancer 24 37 PHC expenditure 31 screening 40 40 per PHC a n c e r coverage [female | 36 headcount [ | BAS DHIS] real 2019/20 400 400 prices] 3 _ C 37 30 46 30

1 2 14 14 C U

80 80 s e a d i

Tobacco Percentage of non-smoking o f 12 12 prevalence (index) deaths garbage

d e n codes [both sexes [both sexes 15+ 19 all ages | vital years | NiDS 70 70 B u r registration] 10 10 10 modelled] 47 46 47 47 48 47 4 30 30 e n t i 5 20 20 6 9 6 5 5 a c e s n p a t i y t

i Hospital beds per Percentage of l 10 000 target 25 25 deaths ill-defined population [ | DHIS [both sexes all 15 15 2000-2030 public ages | vital

4 _ 1 F a c i sector] 20 20 registration] 22 10 23 20 10 y t

d e n s i Percentage of

Medical 30 30 YLLs due to k e r practitioners per communicable, 15 15 o r

w 100 000 population maternal, perinatal, h

t [both sexes | public nutrition causes

e a l sector] 25 25 [both sexes | vital 28 registration] 10 10 8 8 27 31 31 6 4 _ 2 H

2 5 36 4 30 30 20 20 Percentage of Pharmacists per 5 YLLs due to HIV 100 000 population 42 and TB [both 38 [both sexes | public sexes | vital sector] 15 15 registration] 25 25

10 10 200 6 200 7 16 16 Professional 180 180 Percentage of 34 nurses per 100 11 000 population 14 YLLs due to injuries [both sexes 34 [both sexes | public | vital registration] sector] 160 160 15 15

20 140 140 n e s a n d 28 39 60 60 39 c i C 35

e d i Percentage of P H m 40 17 40 YLLs due to Percentage Ideal non-communicable 45 40 45 clinics [ | IC status] 40 diseases [both 20 20 sexes | vital registration] 4 _ 3 A c e s 29 40 40 0 11 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

304 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Amathole District Municipality (DC12)

The Amathole District Municipalitye is a Category C municipality situated in the central part of the Eastern Cape. The district comprises six local municipalities: Mbhashe, Mnquma, Great Kei, Amahlathi, Ngqushwa and Raymond Mhlaba. Cities/Towns: Adelaide, Alice, Amatola Coastal, Bedford, Butterworth, Cathcart, Dutywa, Elliotdale, Fort Beaufort, Hamburg, Hogsback, Kei Mouth, Kei Road, Keiskammahoek, Kentani, Komga, Middeldrift, Morgan Bay, Ngqamakhwe, Peddie, Seymore, Stutterheim, Willowvale Area: 21 117km² Population (2019)f: 1 002 244

DistrictDistrict % ppercentageopulation by ag epopulation-gender group cbyomp age-genderared to South Af rgroupica compared to South Africa

EC, Amathole DM (DC12)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.7% 4.6% 2.8% 5.5% 2.6% 6.9%

60-64 years 1.5% 2.2% 1.9% 2.5%

55-59 years 1.8% 1.3% 2.3% 2.5%

50-54 years 1.4% 2.1% 1.5% 2.7% 2.3%

45-49 years 1.6% 2.5% 1.5% 2.7% 1.6% 2.2%

40-44 years 1.9% 3.0% 1.5% 2.4% 2.2% 2.2%

35-39 years 1.8% 3.0% 1.9% 2.4% 3.1% 2.8%

30-34 years 1.8% 2.8% 2.4% 2.4% 3.8% 3.3%

25-29 years 2.2% 2.9% 3.4% 3.1% 3.6% 3.1%

20-24 years 3.2% 3.5% 4.9% 4.7% 3.4% 3.0%

15-19 years 6.2% 6.1% 6.5% 6.2% 5.3% 4.8%

10-14 years 7.7% 7.7% 5.8% 5.5% 6.6% 6.2%

05-09 years 7.2% 7.1% 5.7% 5.4% 6.2% 5.9%

00-04 years 5.1% 4.9% 6.5% 6.3% 5.3% 5.1%

Sex Gender (ZA) female female (ZA) male male (ZA)

e Available from: https://municipalities.co.za/overview/102/amathole-district-municipality. f Mid-year Population Estimates 2019, Stats SA.

305 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, Amathole DM: DC12, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 67% 6% 17% 10% 65% 9% 13% 13% causes and 5-14 29% 18% 26% 28% 27% 12% 19% 43% single leading 15-24 14% 44% 18% 23% 6% 9% 14% 71% causes 25-64 12% 39% 43% 6% 10% 35% 36% 19% 65+ 12% 7% 79% 2% 11% 12% 73% 4% Total 14% 22% 58% 5% 13% 24% 46% 17% Broadcause Injury NCD Rank Female Male 1 Diarrhoeal diseases (24.1%) Diarrhoeal diseases (24.2%) HIV and TB 2 Lower respiratory infections (21.5%) Lower respiratory infections (20.5%) Comm_mat_peri_nut 3 Protein-energy malnutrition (9.2%) Protein-energy malnutrition (8.9%)

s 4 Preterm birth complications (5.6%) HIV/AIDS (6.5%) Prov, District 5 HIV/AIDS (4.7%) Preterm birth complications (4.5%) EC, Amathole DM: DC12 y e a r 6 Asthma (3.0%) Drowning (4.5%) Show history 5

< 7 Poisonings (including herbal) (2.8%) Birth asphyxia (3.2%) 8 Birth asphyxia (2.5%) Poisonings (including herbal) (2.7%) Percentages are shown 9 Congenital heart anomalies (2.4%) Tuberculosis (2.6%) according to all the deaths 10 Accidental threats to breathing (2.0%) Asthma (2.1%) within the age/gender 1 HIV/AIDS (15.5%) Drowning (20.1%) category of each box, 2 Diarrhoeal diseases (10.5%) Lower respiratory infections (10.2%) although only the leading 3 Lower respiratory infections (10.4%) Road injuries (7.4%) 10 causes are displayed. 4 Road injuries (9.7%) HIV/AIDS (7.0%) 5 Drowning (8.0%) Epilepsy (6.6%) 1 4

5 - 6 Epilepsy (7.9%) Accidental threats to breathing (6.0%) 7 Tuberculosis (4.9%) Tuberculosis (5.5%) 8 Meningitis/encephalitis (4.6%) Diarrhoeal diseases (4.9%) 9 Fires, hot substances (3.1%) Meningitis/encephalitis (4.8%) 10 Accidental threats to breathing (2.9%) Fires, hot substances (3.7%) 1 HIV/AIDS (27.2%) Interpersonal violence (35.2%) 2 Tuberculosis (18.1%) Accidental threats to breathing (14.8%) 3 Road injuries (7.7%) Road injuries (7.8%) 4 Lower respiratory infections (4.7%) Mechanical forces (6.4%)

2 4 5 Interpersonal violence (4.6%) HIV/AIDS (4.8%)

1 5 - 6 Diarrhoeal diseases (4.4%) Tuberculosis (4.6%) 7 Accidental threats to breathing (3.9%) Epilepsy (4.1%) 8 Epilepsy (3.4%) Lower respiratory infections (2.4%) 9 Endocrine nutritional,blood, immune (2.7%) Drowning (2.4%) 10 Meningitis/encephalitis (2.6%) Meningitis/encephalitis (1.9%) 1 HIV/AIDS (24.6%) Tuberculosis (18.7%) 2 Tuberculosis (15.0%) HIV/AIDS (15.9%) 3 Cerebrovascular disease (6.0%) Interpersonal violence (6.1%) 4 Hypertensive heart disease (5.8%) Lower respiratory infections (5.8%)

6 4 5 Lower respiratory infections (5.8%) Accidental threats to breathing (4.3%)

2 5 - 6 Diabetes mellitus (5.0%) Cerebrovascular disease (3.8%) 7 Diarrhoeal diseases (3.0%) COPD (3.2%) 8 Endocrine nutritional,blood, immune (2.9%) Epilepsy (3.1%) 9 Asthma (2.5%) Hypertensive heart disease (3.1%) 10 Cervix (2.0%) Road injuries (3.1%) 1 Hypertensive heart disease (18.0%) Hypertensive heart disease (11.2%) 2 Cerebrovascular disease (15.4%) Tuberculosis (10.8%) 3 Lower respiratory infections (7.5%) Cerebrovascular disease (10.4%) 4 Diabetes mellitus (7.3%) COPD (8.0%) 5 Tuberculosis (6.3%) Lower respiratory infections (7.9%)

6 5 + 6 Asthma (5.7%) Asthma (6.4%) 7 COPD (5.0%) Diabetes mellitus (5.1%) 8 Oesophagus (3.7%) Oesophagus (3.8%) 9 Cardiomyopathy (3.1%) Prostate (3.3%) 10 Ischaemic heart disease (2.7%) Ischaemic heart disease (3.1%)

Rank Maternal conditions All other causes 1 Indirect maternal (26.1%) n=19 HIV/AIDS (33.9%) n=3 249 2 Hypertension in pregnancy (21.5%) n=16 Tuberculosis (18.3%) n=1 752 3 Abortion (19.3%) n=14 Lower respiratory infections (5.8%) n=555 4 Other maternal (16.7%) n=12 Diarrhoeal diseases (3.9%) n=372 e a l 4 9 5 Maternal haemorrhage (16.5%) n=12 Endocrine nutritional,blood, immune (3.3%) n=316

1 5 - 6 Road injuries (2.9%) n=278 F e m 7 Cerebrovascular disease (2.3%) n=220 8 Meningitis/encephalitis (2.2%) n=211 9 Hypertensive heart disease (2.1%) n=203 10 Epilepsy (2.1%) n=199

306 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20 Amathole: DC12 Amathole: DC12 e s n g l 4 i 11 11 8 o f a n i P r 10 10 p l

y 9 9

l 80 80 TB DS client lost to i 17 Couple year follow up rate [both 8 8 protection rate [ | 12 sexes all ages | 7 7 DHIS] ETR/Tier.Net] 6 15 6 60 34 60 1 _ F a m 5 5 33 15 4 4 10 46 3 3 e 21

c a r 80 80 y 25 24 v e r i TB DS death rate 7.0 20 7.0 Antenatal 1st visit d e l [both sexes all coverage [female | 60 60 ages | a n d DHIS] 52 ETR/Tier.Net] 6.5 6.5 52 52 52 52 52 e g n a c y 40 40 18 18 100 21 100 36 38 17 38 10 1 _ 2 P r 14 TB symptom 5 Delivery in 10 to 19 16 16 years and older years in facility rate screened in facility 50 50 [female | DHIS] rate [both sexes | DHIS] 14 14

0 0 150 150 26 22 TB symptom child 80 80 Maternal mortality 100 100 under 5 years in facility ratio screened in facility 21 [female | DHIS] rate [both sexes | 16 13 DHIS] 5 11 60 60 50 50 4 7

e n t 90 90 15 15 m e a t r

t Adult with viral V Neonatal death in I load suppressed facility rate [both rate 12 months sexes | DHIS] 10 12 10 [both sexes 15+ 85 35 85

2 _ H 44 years | DHIS] 6 41 7 2 2 41 5 5

o n 10 i

s a t 80 80 Child with viral u n i 36 70 70 32 m Immunisation load suppressed m i under 1 year 70 70 rate 12 months d l coverage [both 45 44 [both sexes 0-14

h i 37 sexes | DHIS] years | DHIS] 60 60 60 60

1 _ 3 C 50 46 39 36

e n t 6 6 m 65 32 65 e a t r

t 18 41 Death in facility Clients remaining d 5 5 l on ART rate [both

h i under 5 years rate sexes all ages | 60 34 60 [both sexes | 14 DHIS] DHIS] 4 4

1 _ 4 C 12 32 12 12 55 55 3 11 3 6

C 30 14 2 30 U 6 4 4

Pneumonia case Antiretroviral 42 15 fatality under 5 effective coverage 25 25 years rate [both 3 3 [both sexes 0-14 30 33 sexes <5 years | 25 years | DHIS-Tier] DHIS] 20 20 2 2 23 16

50 14 50 e n t 85 13 85 m 13 21 e a t r

t Antiretroviral TB DS treatment 12 effective coverage success rate [both 24 [both sexes 15+ 40 40 sexes all ages | 80 80 years | DHIS-Tier] 2 _ 1 T B ETR/Tier.Net] 19

34 30 30 50 50 14 13 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 21 F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage 40 40 Measure Names Rank [both sexes all Prov av ages | DHIS-Tier] 1 52 16 ZA av Ind Value 30 30 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

307 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Amathole: DC12 Amathole: DC12 9

C 11

U 84 84 Age-standardised n a c e 83 15 83 Expenditure per prevalence of 82 82 3000 3000 non-raised blood 17 patient day 4 _ 5 F i equivalent (district pressure (index) 81 81 20 hospitals) [ | BAS [both sexes 15+ 80 80 real 2019/20 years | NiDS 79 22 79 prices] modelled] 78 78 2500 2500 25 77 77

e s 25 25 3000 3000 e n t 51 a b e t

i Provincial & LG 20 51 20 District Health Diabetes a n g e m Services 2500 2500 m prevalence [both 3 _ 2 D 49 expenditure per sexes 15+ years | 15 15 capita (uninsured) [ NiDS modelled] 35 | BAS real 2019/20 10 23 10 prices] 2000 2000 17

1 0 40 40 C

U 1400 1400 35 35 Provincial & LG Diabetes treatment PHC expenditure coverage [both 43 per capita sexes 15+ years | 30 46 30 (uninsured) [ | BAS 1200 1200 NiDS modelled] 47 real 2019/20 49 25 25 prices] 50 49 1000 1000 o n i 1 500 500 e c t 11 Provincial & LG

d e t 60 60 Cervical cancer 6 16 PHC expenditure screening per PHC 13 400 400 a n c e r coverage [female | 21 headcount [ | BAS DHIS] 50 50 real 2019/20 prices] 3 _ C 300 300 40 40

1 2 10 C 88 11 11 88 U 12 12 s e a

14 d i

Tobacco Percentage of 13 13 non-smoking o f 86 86 deaths garbage prevalence (index) 32

d e n codes [both sexes 32 [both sexes 15+ all ages | vital years | NiDS 84 84 B u r registration] modelled] 12 12 22 82 82

24 24 e n t

i 12 14 10 20 20 15 13 11 a c e s n p a t i

y 22 22 t

i Hospital beds per Percentage of l 10 000 target deaths ill-defined 18 18 population [ | DHIS [both sexes all 20 20 38 2000-2030 public ages | vital 16 43 16 4 _ 1 F a c i sector] registration] 18 18 14 14 29 y t 18 18

d e n s i 30 30 Percentage of Medical YLLs due to k e r practitioners per communicable, 16 16 o r

w 100 000 population maternal, perinatal, h t [both sexes | public 20 20 nutrition causes 14 14 14

e a l sector] [both sexes | vital registration] 14 48 48 10 49 49 12 12 4 _ 2 H 10 10 15 15 14 14 30 30 13 13 Percentage of 32 Pharmacists per 12 12 YLLs due to HIV 100 000 population 11 11 and TB [both [both sexes | public 25 10 31 10 sexes | vital 32 sector] 25 25 9 9 registration] 28 8 34 8 7 38 7

8 18 47 18 8 Professional 180 180 17 47 17 Percentage of 41 nurses per 100 9 YLLs due to 000 population 16 injuries [both sexes [both sexes | public 16 16 160 160 | vital registration] sector] 15 15 140 140 n e s a n d 46 33 46

c i

C 36

e d i Percentage of

P H 40 40 m 43 YLLs due to 44 44 Percentage Ideal non-communicable 27 clinics [ | IC status] 44 diseases [both 20 20 42 42 40 sexes | vital registration] 4 _ 3 A c e s 40 40 0 11 33 0 32 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

308 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Chris Hani District Municipality (DC13)

The Chris Hani District Municipalityg is a Category C municipality situated in the north-eastern part of the Eastern Cape, and is a linking node to all regions in the province. Chris Hani is the second-largest district in the province, making up almost a third of its geographical area. The district comprises six local municipalities: Inxuba Yethemba, Enoch Mgijima, Intsika Yethu, Engcobo, Sakhisizwe and Emalahleni. Cities/Towns: Cacadu (Lady Frere), Cala, Cofimvaba, Cradock, Dordrecht, Engcobo, Hofmeyr, Indwe, Khowa (Elliot), Komani (Queenstown), Middelburg, Molteno, Mount Zebra National Park, Sada, Sterkstroom, Tarkastad, Tsomo, Whittlesea Area: 36 407km² Population (2019)h: 822 087

DistrictDistrict % ppercentageopulation by ag epopulation-gender group cbyomp age-genderared to South Af rgroupica compared to South Africa

EC, C Hani DM (DC13)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.6% 4.3% 3.0% 5.3% 3.7% 7.6%

60-64 years 1.4% 2.2% 1.9% 2.5%

55-59 years 1.8% 1.4% 2.3% 1.3% 2.5%

50-54 years 1.4% 2.1% 1.5% 2.6% 1.3% 2.3%

45-49 years 1.7% 2.5% 1.5% 2.6% 1.7% 2.3%

40-44 years 1.9% 2.9% 1.6% 2.4% 2.0% 2.3%

35-39 years 1.8% 2.9% 1.9% 2.5% 3.0% 2.9%

30-34 years 1.9% 2.7% 2.3% 2.5% 3.7% 3.2%

25-29 years 2.3% 2.9% 3.3% 3.2% 3.4% 2.8%

20-24 years 2.9% 3.1% 5.0% 4.6% 3.3% 2.8%

15-19 years 6.5% 6.1% 6.6% 6.1% 5.1% 4.6%

10-14 years 8.3% 7.8% 5.9% 5.5% 6.3% 6.0%

05-09 years 7.4% 7.1% 5.6% 5.4% 6.0% 5.7%

00-04 years 5.4% 5.0% 6.2% 6.1% 5.3% 5.1%

Sex Gender (ZA) female female (ZA) male male (ZA)

g Available from: https://municipalities.co.za/overview/104/chris-hani-district-municipality. h Mid-year Population Estimates 2019, Stats SA.

309 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, C Hani DM: DC13, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 63% 8% 19% 10% 65% 10% 14% 12% causes and 5-14 30% 19% 19% 32% 15% 15% 20% 49% single leading 15-24 16% 46% 18% 19% 8% 12% 12% 68% causes 25-64 11% 39% 43% 6% 10% 37% 36% 17% 65+ 12% 7% 79% 2% 12% 12% 72% 3% Total 14% 24% 57% 5% 13% 26% 45% 16% Broadcause Injury NCD Rank Female Male 1 Diarrhoeal diseases (18.4%) Diarrhoeal diseases (20.7%) HIV and TB 2 Lower respiratory infections (15.7%) Lower respiratory infections (13.0%) Comm_mat_peri_nut 3 Protein-energy malnutrition (8.8%) Preterm birth complications (11.0%)

s 4 Preterm birth complications (8.8%) Protein-energy malnutrition (8.4%) Prov, District 5 HIV/AIDS (5.5%) HIV/AIDS (6.4%) EC, C Hani DM: DC13 y e a r 6 Birth asphyxia (4.5%) Birth asphyxia (5.0%) Show history 5

< 7 Accidental threats to breathing (2.9%) Poisonings (including herbal) (3.7%) 8 Poisonings (including herbal) (2.8%) Tuberculosis (3.5%) Percentages are shown 9 Other respiratory (2.8%) Accidental threats to breathing (3.3%) according to all the deaths 10 Other perinatal conditions (2.6%) Drowning (2.7%) within the age/gender 1 Lower respiratory infections (15.3%) Drowning (24.9%) category of each box, 2 HIV/AIDS (13.3%) Tuberculosis (10.4%) although only the leading 3 Tuberculosis (10.2%) Accidental threats to breathing (8.5%) 10 causes are displayed. 4 Meningitis/encephalitis (8.4%) Road injuries (8.3%) 5 Road injuries (7.6%) HIV/AIDS (6.9%) 1 4

5 - 6 Fires, hot substances (6.6%) Lower respiratory infections (5.6%) 7 Diarrhoeal diseases (6.5%) Diarrhoeal diseases (5.4%) 8 Drowning (6.4%) Epilepsy (4.9%) 9 Exposure to natural forces (5.0%) Interpersonal violence (3.6%) 10 Accidental threats to breathing (3.7%) Asthma (3.0%) 1 HIV/AIDS (30.3%) Interpersonal violence (40.6%) 2 Tuberculosis (18.2%) Accidental threats to breathing (10.8%) 3 Road injuries (6.0%) Tuberculosis (6.3%) 4 Lower respiratory infections (5.5%) HIV/AIDS (6.3%)

2 4 5 Interpersonal violence (4.6%) Road injuries (5.3%)

1 5 - 6 Accidental threats to breathing (4.2%) Mechanical forces (4.7%) 7 Endocrine nutritional,blood, immune (3.5%) Epilepsy (3.5%) 8 Diarrhoeal diseases (2.9%) Lower respiratory infections (2.8%) 9 Epilepsy (2.8%) Drowning (2.7%) 10 Meningitis/encephalitis (2.6%) Meningitis/encephalitis (2.4%) 1 HIV/AIDS (25.2%) HIV/AIDS (18.5%) 2 Tuberculosis (14.3%) Tuberculosis (18.3%) 3 Cerebrovascular disease (5.9%) Lower respiratory infections (6.3%) 4 Lower respiratory infections (5.8%) Interpersonal violence (6.1%)

6 4 5 Hypertensive heart disease (4.9%) Cerebrovascular disease (4.3%)

2 5 - 6 Diabetes mellitus (4.5%) Accidental threats to breathing (3.8%) 7 Endocrine nutritional,blood, immune (3.8%) Ischaemic heart disease (2.8%) 8 Diarrhoeal diseases (2.8%) Epilepsy (2.8%) 9 Ischaemic heart disease (2.5%) COPD (2.7%) 10 Asthma (2.2%) Asthma (2.6%) 1 Cerebrovascular disease (15.7%) Cerebrovascular disease (11.7%) 2 Hypertensive heart disease (14.6%) Tuberculosis (10.2%) 3 Diabetes mellitus (7.9%) Lower respiratory infections (9.1%) 4 Lower respiratory infections (7.3%) Hypertensive heart disease (8.8%) 5 Tuberculosis (6.0%) COPD (6.6%)

6 5 + 6 Cardiomyopathy (5.8%) Asthma (6.4%) 7 Asthma (5.3%) Diabetes mellitus (5.4%) 8 Ischaemic heart disease (3.6%) Cardiomyopathy (4.2%) 9 COPD (3.4%) Prostate (3.8%) 10 Oesophagus (2.6%) Ischaemic heart disease (3.5%)

Rank Maternal conditions All other causes 1 Maternal haemorrhage (29.0%) n=23 HIV/AIDS (35.2%) n=2 762 2 Indirect maternal (24.7%) n=19 Tuberculosis (18.1%) n=1 419 3 Hypertension in pregnancy (20.6%) n=16 Lower respiratory infections (5.8%) n=459 4 Abortion (13.7%) n=11 Endocrine nutritional,blood, immune (4.0%) n=313 e a l 4 9 5 Other maternal (11.9%) n=9 Diarrhoeal diseases (3.3%) n=261

1 5 - 6 Road injuries (2.8%) n=221 F e m 7 Cerebrovascular disease (1.9%) n=148 8 Epilepsy (1.8%) n=139 9 Hypertensive heart disease (1.8%) n=138 10 Interpersonal violence (1.7%) n=134

310 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20 C Hani: DC13 C Hani: DC13 e s

n g 12 12 l 12 i

o f 34 a n i P r

p l 80 16 80 10 10 y

l TB DS client lost to i 17 Couple year follow up rate [both 12 8 8 protection rate [ | sexes all ages | DHIS] 20 ETR/Tier.Net] 27 60 60 1 _ F a m 30 6 22 6 18 4 4 e 32 c a r 80 80 y

v e r 8 8 i 43 TB DS death rate Antenatal 1st visit 70 70 d e l [both sexes all coverage [female | ages | a n d DHIS] ETR/Tier.Net] 23 60 48 60 7 7 50 49 50 18 16 50 50 50 e g n a c y 6 6 18 18 90 33 90 39 80 31 80 1 _ 2 P r 70 29 70 37 34 TB symptom 5 60 22 60 16 16 years and older Delivery in 10 to 19 50 50 years in facility rate screened in facility [female | DHIS] rate [both sexes | 40 40 DHIS] 30 30 14 14 20 20 10 10

30 200 42 200 80 80 TB symptom child 35 Maternal mortality under 5 years 150 46 150 70 70 in facility ratio screened in facility [female | DHIS] rate [both sexes | 33 38 DHIS] 60 27 60 100 23 100 30 50 50

16 16 e n t 90 90 15 15 m 89 89 e a t

14 14 r t Adult with viral 88 88

13 13 V Neonatal death in 26 I load suppressed 87 87 12 28 12 rate 12 months facility rate [both 22 86 86 sexes | DHIS] 11 11 [both sexes 15+

2 _ H 85 85 10 17 10 years | DHIS] 84 38 84 9 9 48 83 37 83 42 8 8 8 82 82 o n i 10 90 90 s a t

u n i Child with viral

m Immunisation load suppressed 60 60 m i under 1 year 80 23 80 rate 12 months d 29 l coverage [both 29 [both sexes 0-14

h i 45 sexes | DHIS] years | DHIS] 40 45 70 34 70

1 _ 3 C 34 50 38 50

7 7 e n t 28 m

e a t 6 6 r t Death in facility Clients remaining 60 60 d 43 46 l on ART rate [both

h i under 5 years rate 5 5 sexes all ages | [both sexes | 20 DHIS] 19 DHIS] 42

1 _ 4 C 4 4 15 13 50 50 13 44 3 3 6 25 25 C 4 4 U

Pneumonia case 35 Antiretroviral 20 20 fatality under 5 effective coverage 31 3 3 years rate [both [both sexes 0-14 44 29 sexes <5 years | years | DHIS-Tier] 28 DHIS] 15 38 15 2 19 2 27 41 22

e n t 5 m

e a t 40 40 r

t 85 85 Antiretroviral TB DS treatment 12 effective coverage 33 38 success rate [both [both sexes 15+ 35 sexes all ages | years | DHIS-Tier] 35 35 2 _ 1 T B ETR/Tier.Net] 80 80 18 26 30 30 30

2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 40 40 F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage 33 38 Measure Names Rank [both sexes all 35 35 35 Prov av 1 50 ages | DHIS-Tier] ZA av 26 Ind Value 30 30 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

311 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

C Hani: DC13 C Hani: DC13

9 3200 3200 C 82 23 82 U

Age-standardised n a c e 24 Expenditure per prevalence of 3000 3000 patient day non-raised blood 80 25 80 4 _ 5 F i equivalent (district pressure (index) 25 hospitals) [ | BAS [both sexes 15+ 2800 2800 real 2019/20 years | NiDS 78 26 78 prices] modelled] 27 2600 2600

e s 12 12 3000 3000 e n t 27 a b e t

i Provincial & LG 11 25 11 District Health Diabetes a n g e m Services 2500 2500 m prevalence [both 26 3 _ 2 D expenditure per sexes 15+ years | 10 10 capita (uninsured) [ NiDS modelled] 24 | BAS real 2019/20 25 prices] 9 9 2000 2000 24

1 0 40 40

C 39 39 U 1400 1400 38 38 Provincial & LG Diabetes treatment 37 37 PHC expenditure coverage [both 36 36 per capita sexes 15+ years | 35 35 (uninsured) [ | BAS 24 1200 1200 NiDS modelled] 25 25 real 2019/20 34 36 32 34 33 40 33 prices] 32 32 31 31 1000 1000 o n i 2

e c t 60 60 500 500 14 Provincial & LG

d e t 8 Cervical cancer PHC expenditure screening 17 22 per PHC a n c e r coverage [female | 50 19 50 headcount [ | BAS DHIS] real 2019/20 400 400 prices] 3 _ C 40 40 1 2 C U s e a 13 13 d i

Tobacco Percentage of non-smoking 82.0 82.0 o f deaths garbage prevalence (index) 24 d e n codes [both sexes 12 12 [both sexes 15+ all ages | vital years | NiDS B u r 23 registration] modelled] 81.5 23 23 81.5 11 18 11 24 24 25 18 e n t

i 6 47 48 8 7 21 21 10 8 11 a c e s 20 20 n p a t i y 25 25 t

i Hospital beds per Percentage of l 19 19 10 000 target deaths ill-defined population [ | DHIS [both sexes all 18 18 2000-2030 public ages | vital 17 17

4 _ 1 F a c i sector] 20 20 registration] 16 16 15 33 15 14 14 y t 35 35 18 18

d e n s i Percentage of Medical 30 30 YLLs due to k e r practitioners per communicable, 16 16 o r

w 100 000 population maternal, perinatal, h

t [both sexes | public 25 25 nutrition causes 29 14 14 e a l sector] 30 [both sexes | vital 11 registration] 13 14 20 32 38 20 12 12 4 _ 2 H

10 45 15 15 Percentage of Pharmacists per 30 30 YLLs due to HIV 45 100 000 population and TB [both [both sexes | public sexes | vital sector] 10 27 10 33 registration] 25 25 36 41

3 3 16 31 16 Professional Percentage of nurses per 100 200 4 4 200 000 population YLLs due to 30 injuries [both sexes 35 [both sexes | public | vital registration] sector] 15 15 150 150

46 46 n e s a n d

c i 45 45 C

e d i Percentage of 44 44 P H 40 40 m YLLs due to 43 24 43 Percentage Ideal non-communicable 42 42 clinics [ | IC status] diseases [both 20 20 41 41 47 49 sexes | vital 43 48 40 40 registration] 4 _ 3 A c e s 39 39 0 11 35 0 38 26 38 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

312 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Joe Gqabi District Municipality (DC 14)

The Joe Gqabi District Municipalityi is a Category C municipality located within the Eastern Cape. It consists of three local municipalities: Elundini, Walter Sisulu and Senqu. Cities/Towns: Aliwal North, Barkly East, Burgersdorp, Jamestown, Lady Grey, Maclear, Mount Fletcher, Oviston, Rhodes, Rossouw, Sterkspruit, Steynsburg, Ugie, Venterstad. Area: 25 617km² Population (2019)j: 377 137

DistrictDistrict % percentagepopulation by ag epopulation-gender group cbyom page-genderared to South Af rgroupica compared to South Africa

EC, Joe Gqabi DM (DC14)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.5% 4.6% 2.8% 5.2% 3.1% 6.5%

60-64 years 1.7% 1.8% 2.1%

55-59 years 1.8% 2.1% 2.1%

50-54 years 1.4% 2.1% 1.4% 2.4% 1.4% 2.1%

45-49 years 1.6% 2.4% 1.5% 2.4% 1.7% 2.2%

40-44 years 1.7% 2.8% 1.6% 2.3% 2.3% 2.4%

35-39 years 1.8% 2.8% 2.0% 2.5% 3.2% 3.1%

30-34 years 2.0% 2.7% 2.6% 2.7% 3.9% 3.7%

25-29 years 2.4% 3.0% 3.7% 3.4% 3.7% 3.4%

20-24 years 3.4% 3.8% 5.2% 5.1% 3.6% 3.4%

15-19 years 6.2% 6.1% 6.3% 6.2% 5.1% 4.6%

10-14 years 7.7% 8.0% 5.8% 5.7% 6.1% 5.7%

05-09 years 7.0% 7.1% 5.6% 5.3% 6.1% 5.8%

00-04 years 5.4% 5.5% 6.3% 6.1% 5.4% 5.2%

Sex Gender (ZA) female female (ZA) male male (ZA)

i Available from: https://municipalities.co.za/overview/105/joe-gqabi-district-municipality. j Mid-year Population Estimates 2019, Stats SA.

313 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, Joe Gqabi DM: DC14, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 66% 10% 13% 10% 69% 13% 9% 9% causes and 5-14 32% 15% 30% 22% 27% 21% 9% 43% single leading 15-24 14% 50% 19% 17% 9% 14% 13% 64% causes 25-64 13% 43% 40% 5% 11% 40% 34% 16% 65+ 12% 6% 80% 2% 13% 13% 71% 3% Total 15% 25% 55% 5% 15% 28% 42% 14% Broadcause Injury NCD Rank Female Male 1 Lower respiratory infections (23.7%) Diarrhoeal diseases (21.2%) HIV and TB 2 Diarrhoeal diseases (18.7%) Lower respiratory infections (19.4%) Comm_mat_peri_nut 3 Protein-energy malnutrition (12.9%) HIV/AIDS (11.4%)

s 4 HIV/AIDS (7.7%) Protein-energy malnutrition (10.7%) Prov, District 5 Preterm birth complications (6.1%) Preterm birth complications (7.1%) EC, Joe Gqabi DM: DC14 y e a r 6 Birth asphyxia (3.6%) Birth asphyxia (4.4%) Show history 5

< 7 Tuberculosis (3.4%) Drowning (3.2%) 8 Poisonings (including herbal) (3.3%) Septicaemia (2.6%) Percentages are shown 9 Accidental threats to breathing (2.4%) Sepsis/other newborn infectious (2.4%) according to all the deaths 10 Fires, hot substances (2.2%) Other perinatal conditions (2.3%) within the age/gender 1 Road injuries (15.1%) Drowning (26.1%) category of each box, 2 HIV/AIDS (13.3%) Tuberculosis (12.8%) although only the leading 3 Meningitis/encephalitis (11.1%) HIV/AIDS (12.1%) 10 causes are displayed. 4 Tuberculosis (6.8%) Lower respiratory infections (7.6%) 5 Lower respiratory infections (5.6%) Diarrhoeal diseases (7.4%) 1 4

5 - 6 Diarrhoeal diseases (5.2%) Meningitis/encephalitis (6.8%) 7 Fires, hot substances (4.9%) Road injuries (5.5%) 8 Endocrine nutritional,blood, immune (4.8%) Accidental threats to breathing (5.1%) 9 Drowning (4.4%) Exposure to natural forces (4.1%) 10 Interpersonal violence (3.1%) 1 HIV/AIDS (34.3%) Interpersonal violence (33.1%) 2 Tuberculosis (19.9%) Accidental threats to breathing (11.3%) 3 Interpersonal violence (6.2%) HIV/AIDS (8.7%) 4 Lower respiratory infections (4.6%) Road injuries (8.5%)

2 4 5 Accidental threats to breathing (3.7%) Tuberculosis (6.6%)

1 5 - 6 Endocrine nutritional,blood, immune (3.5%) Mechanical forces (4.2%) 7 Meningitis/encephalitis (2.6%) Epilepsy (3.8%) 8 Diarrhoeal diseases (2.1%) Lower respiratory infections (3.3%) 9 Road injuries (2.1%) Drowning (3.0%) 10 Cerebrovascular disease (1.8%) Meningitis/encephalitis (2.2%) 1 HIV/AIDS (26.9%) Tuberculosis (20.2%) 2 Tuberculosis (15.9%) HIV/AIDS (19.5%) 3 Lower respiratory infections (7.0%) Lower respiratory infections (6.4%) 4 Cerebrovascular disease (5.6%) Interpersonal violence (5.4%)

6 4 5 Hypertensive heart disease (5.5%) Cerebrovascular disease (4.0%)

2 5 - 6 Diabetes mellitus (4.3%) Endocrine nutritional,blood, immune (3.6%) 7 Endocrine nutritional,blood, immune (2.7%) Road injuries (3.2%) 8 Ischaemic heart disease (2.7%) Ischaemic heart disease (3.0%) 9 Cervix (2.6%) Accidental threats to breathing (2.8%) 10 Diarrhoeal diseases (2.4%) Hypertensive heart disease (2.3%) 1 Hypertensive heart disease (17.1%) Tuberculosis (10.3%) 2 Cerebrovascular disease (16.7%) Hypertensive heart disease (10.2%) 3 Lower respiratory infections (6.9%) Cerebrovascular disease (10.1%) 4 Diabetes mellitus (6.6%) Lower respiratory infections (8.3%) 5 Ischaemic heart disease (6.3%) COPD (5.5%)

6 5 + 6 Tuberculosis (4.6%) Ischaemic heart disease (5.2%) 7 COPD (2.9%) Diabetes mellitus (4.7%) 8 Asthma (2.7%) Prostate (4.4%) 9 Diarrhoeal diseases (2.7%) Nephritis/nephrosis (3.5%) 10 Other circulatory diseases (2.4%) Asthma (3.0%)

Rank Maternal conditions All other causes 1 Maternal haemorrhage (23.7%) n=10 HIV/AIDS (36.0%) n=1 317 2 Other maternal (20.9%) n=9 Tuberculosis (20.6%) n=752 3 Indirect maternal (19.8%) n=8 Lower respiratory infections (7.2%) n=263 4 Hypertension in pregnancy (16.2%) n=7 Endocrine nutritional,blood, immune (3.3%) n=120 e a l 4 9 5 Abortion (10.0%) n=4 Diarrhoeal diseases (2.7%) n=98

1 5 - 6 Maternal sepsis (9.4%) n=4 Cerebrovascular disease (2.5%) n=91 F e m 7 Interpersonal violence (2.4%) n=86 8 Meningitis/encephalitis (2.0%) n=74 9 Diabetes mellitus (1.7%) n=62 10 Ischaemic heart disease (1.6%) n=58

314 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20 Joe Gqabi: DC14 Joe Gqabi: DC14 e s n g l 21 i 43 70 26 70 o f a n i P r p l y

l TB DS client lost to 10 10 i Couple year 60 29 60 follow up rate [both protection rate [ | 31 sexes all ages | DHIS] 38 ETR/Tier.Net] 22 1 _ F a m 50 50 5 5 47 12 14 e 43 c a r 80 80 y 10 10 41 v e r i TB DS death rate Antenatal 1st visit 39 d e l 70 46 70 [both sexes all coverage [female | ages |

a n d 29 DHIS] ETR/Tier.Net] 8 8 60 47 47 60 47 48 48 e g n a c y 6 6 21 47 21 25 29 22 1 _ 2 P r 20 44 20 19 19 TB symptom 5 20 Delivery in 10 to 19 18 18 years and older years in facility rate 17 17 screened in facility 50 50 34 [female | DHIS] 16 16 rate [both sexes | 15 15 DHIS] 14 14 13 13 0 0 150 150 22 21 TB symptom child 20 80 80 Maternal mortality 100 26 100 under 5 years in facility ratio screened in facility [female | DHIS] rate [both sexes | 8 7 DHIS] 50 50 60 29 60 11 3

16 16 e n t 90 90 15 15 m 20 e a t

14 14 r

t Adult with viral

13 13 V Neonatal death in I load suppressed 12 12 facility rate [both 25 24 rate 12 months 85 85 sexes | DHIS] 11 11 [both sexes 15+

23 2 _ H 10 16 10 years | DHIS] 9 9 51 8 6 8 80 49 45 80 o n

i 9

s a t 80 80 70 70

u n i Child with viral

m Immunisation load suppressed 31 m

i 33 under 1 year 43 rate 12 months 60 60

d 35 l coverage [both [both sexes 0-14 h i 70 70 sexes | DHIS] years | DHIS] 46 50 50

1 _ 3 C 45 49 41 50 8 8 e n t 46 29

m 65 65

e a t 38 r 7 7 t Death in facility Clients remaining d l on ART rate [both 30 h i under 5 years rate 24 60 60 [both sexes | 6 31 6 sexes all ages | DHIS] 29 DHIS] 1 _ 4 C 5 23 5 24 55 35 55 4 4 6

6 6 C 24 24

50 U 23 23 44 22 22 Pneumonia case Antiretroviral 4 4 21 18 21 fatality under 5 effective coverage 20 20 years rate [both 32 40 [both sexes 0-14 sexes <5 years | years | DHIS-Tier] 19 19 2 2 DHIS] 19 18 32 18 17 17 37 7 16 47 16 0 0

e n t 14 m 40 30 40 e a t r

t Antiretroviral TB DS treatment 80 29 80 effective coverage success rate [both 36 [both sexes 15+ 35 35 sexes all ages | years | DHIS-Tier] 2 _ 1 T B ETR/Tier.Net] 42 75 37 75 30 30 32 49

40 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 32 F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage 35 37 35 Measure Names Rank [both sexes all Prov av 1 50 ages | DHIS-Tier] 42 ZA av 30 30 Ind Value 32 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

315 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Joe Gqabi: DC14 Joe Gqabi: DC14 9 C

U 3200 3200 Age-standardised n a c e 80 80 Expenditure per prevalence of non-raised blood patient day 3000 3000 4 _ 5 F i equivalent (district pressure (index) hospitals) [ | BAS [both sexes 15+ real 2019/20 2800 2800 years | NiDS prices] modelled] 75 75 43 2600 2600 39 41 42 43 43

e s 3000 3000 e n t a b e t

i 10 10 Provincial & LG District Health Diabetes a n g e m Services 2500 2500 m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | capita (uninsured) [ NiDS modelled] 5 5 7 | BAS real 2019/20 6 prices] 3 2 2000 2000 2 2

1 0 40 16 40 C

U 16 1200 1200 Provincial & LG 20 Diabetes treatment PHC expenditure coverage [both 22 per capita 29 sexes 15+ years | 35 35 (uninsured) [ | BAS NiDS modelled] 34 real 2019/20 1000 1000 prices]

o n 60 60 i 15

e c t 500 500 Provincial & LG d e t Cervical cancer 50 50 PHC expenditure screening per PHC a n c e r coverage [female | 24 30 headcount [ | BAS DHIS] real 2019/20 400 400 40 26 40 35 prices] 3 _ C 46 30 30

1 2 82.5 82.5 C U s e a d i

Tobacco 82.0 82.0 Percentage of non-smoking 23 o f deaths garbage prevalence (index) 23 12 12

d e n codes [both sexes [both sexes 15+ 19 81.5 23 81.5 all ages | vital years | NiDS B u r 24 registration] modelled] 25 16 81.0 81.0 10 10 26 12 e n t

i 52 22 22 50 a c e s n p a t i

y 30 30 t

i Hospital beds per Percentage of 50 l 10 000 target 20 20 deaths ill-defined population [ | DHIS [both sexes all 2000-2030 public ages | vital 18 18 4 _ 1 F a c i sector] registration] 20 20 20 21 27 25 16 23 22 16 y t 18 18

d e n s i Percentage of

30 30 Medical YLLs due to k e r practitioners per communicable, 16 21 25 27 16 o r

w 100 000 population 28 maternal, perinatal, h t [both sexes | public 32 nutrition causes 14 14 e a l sector] 20 36 20 [both sexes | vital registration] 42 12 12 4 _ 2 H 35 35 15 15 48

Percentage of Pharmacists per YLLs due to HIV 30 30 100 000 population 26 and TB [both [both sexes | public 10 10 39 sexes | vital sector] 36 registration] 32 37 25 25 44 5 5 7 16 16 Professional 180 180 11 Percentage of nurses per 100 000 population YLLs due to injuries [both sexes [both sexes | public 160 22 160 | vital registration] 15 26 15 sector] 23 21

24 140 140 14 14 n e s a n d

c i 45 45 C 37

e d i 37 Percentage of 24 P H m 40 40 YLLs due to 20 Percentage Ideal 20 38 non-communicable clinics [ | IC status] 1 diseases [both 40 40 20 20 sexes | vital registration] 4 _ 3 A c e s 21 17 35 35 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

316 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

OR Tambo District Municipality (DC15)

The OR Tambo District Municipalityk is a Category C municipality located to the east of the Eastern Cape Province. It covers about 80% of what used to be marginalised homeland in the Transkei. The district is formed by five local municipalities: King Sabata Dalindyebo, Nyandeni, Mhlontlo, Port St Johns and Ingquza Hill. Cities/Towns: Flagstaff, Libode, Lusikisiki, Mqanduli, Mthatha (previously Umtata), Ngqeleni, Port St Johns, Qumbu, Tsolo Area: 12 141km² Population (2019)l: 1 511 733

DistrictDistrict % percentagepopulation by ag epopulation-gender group cbyom page-genderared to South Af rgroupica compared to South Africa

EC, OR Tambo DM (DC15)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.0% 3.4% 1.8% 3.8% 1.6% 4.0%

60-64 years 1.8% 1.3% 1.5%

55-59 years 1.3% 1.6% 1.7%

50-54 years 1.7% 2.0% 1.8%

45-49 years 2.0% 2.2% 2.0%

40-44 years 1.5% 2.6% 2.2% 1.8% 2.2%

35-39 years 1.6% 2.7% 1.7% 2.5% 2.7% 3.0%

30-34 years 1.6% 2.8% 2.3% 2.8% 3.9% 4.0%

25-29 years 2.2% 3.1% 3.3% 3.6% 4.3% 4.2%

20-24 years 3.2% 3.7% 4.9% 5.3% 4.1% 4.0%

15-19 years 6.0% 6.0% 6.8% 6.7% 5.4% 5.3%

10-14 years 8.2% 8.2% 6.5% 6.3% 6.3% 6.1%

05-09 years 8.7% 8.4% 6.6% 6.4% 6.7% 6.4%

00-04 years 6.7% 6.5% 7.4% 7.2% 6.8% 6.6%

Sex Gender (ZA) female female (ZA) male male (ZA)

k Available from: https://municipalities.co.za/overview/106/or-tambo-district-municipality. l Mid-year Population Estimates 2019, Stats SA.

317 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, OR Tambo DM: DC15, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 62% 11% 17% 10% 63% 11% 14% 12% causes and 5-14 26% 22% 26% 25% 23% 24% 18% 35% single leading 15-24 17% 45% 18% 20% 7% 13% 15% 65% causes 25-64 12% 48% 35% 5% 9% 42% 31% 19% 65+ 12% 12% 73% 3% 12% 18% 66% 4% Total 15% 31% 48% 6% 13% 31% 37% 19% Broadcause Injury NCD Rank Female Male 1 Diarrhoeal diseases (24.2%) Diarrhoeal diseases (24.1%) HIV and TB 2 Lower respiratory infections (16.9%) Lower respiratory infections (16.6%) Comm_mat_peri_nut 3 Protein-energy malnutrition (9.8%) Protein-energy malnutrition (10.3%)

s 4 HIV/AIDS (6.8%) HIV/AIDS (6.8%) Prov, District 5 Tuberculosis (4.5%) Tuberculosis (4.6%) EC, OR Tambo DM: DC15 y e a r 6 Poisonings (including herbal) (3.6%) Poisonings (including herbal) (3.6%) Show history 5

< 7 Preterm birth complications (3.2%) Preterm birth complications (3.4%) 8 Septicaemia (2.6%) Drowning (2.7%) Percentages are shown 9 Fires, hot substances (2.4%) Septicaemia (2.1%) according to all the deaths 10 Epilepsy (2.3%) Road injuries (2.0%) within the age/gender 1 Tuberculosis (12.8%) Tuberculosis (12.9%) category of each box, 2 HIV/AIDS (10.5%) Road injuries (12.1%) although only the leading 3 Road injuries (8.2%) Drowning (11.7%) 10 causes are displayed. 4 Drowning (7.9%) HIV/AIDS (11.3%) 5 Lower respiratory infections (7.4%) Lower respiratory infections (6.6%) 1 4

5 - 6 Diarrhoeal diseases (6.8%) Diarrhoeal diseases (6.2%) 7 Meningitis/encephalitis (6.1%) Meningitis/encephalitis (4.3%) 8 Asthma (3.5%) Accidental threats to breathing (3.8%) 9 Nephritis/nephrosis (2.7%) Epilepsy (2.3%) 10 Cardiomyopathy (2.6%) Other neurological conditions (1.9%) 1 HIV/AIDS (27.4%) Interpersonal violence (29.6%) 2 Tuberculosis (18.0%) Road injuries (10.4%) 3 Road injuries (6.9%) Accidental threats to breathing (9.2%) 4 Lower respiratory infections (4.0%) Mechanical forces (7.6%)

2 4 5 Accidental threats to breathing (3.7%) Tuberculosis (6.6%)

1 5 - 6 Meningitis/encephalitis (3.4%) HIV/AIDS (6.2%) 7 Diarrhoeal diseases (3.1%) Drowning (2.6%) 8 Interpersonal violence (3.0%) Adverse effects medical/surgical (2.5%) 9 Endocrine nutritional,blood, immune (2.5%) Lower respiratory infections (2.3%) 10 Mechanical forces (2.0%) Epilepsy (2.3%) 1 HIV/AIDS (30.4%) HIV/AIDS (23.0%) 2 Tuberculosis (17.2%) Tuberculosis (19.1%) 3 Cerebrovascular disease (4.5%) Interpersonal violence (5.9%) 4 Lower respiratory infections (4.0%) Road injuries (4.7%)

6 4 5 Diabetes mellitus (3.9%) Lower respiratory infections (3.9%)

2 5 - 6 Diarrhoeal diseases (3.5%) Cerebrovascular disease (3.5%) 7 Hypertensive heart disease (3.3%) Mechanical forces (3.3%) 8 Endocrine nutritional,blood, immune (2.2%) Accidental threats to breathing (2.7%) 9 Cervix (2.2%) Hypertensive heart disease (2.6%) 10 Cardiomyopathy (1.9%) Cardiomyopathy (2.2%) 1 Cerebrovascular disease (16.0%) Tuberculosis (15.1%) 2 Hypertensive heart disease (15.0%) Cerebrovascular disease (11.2%) 3 Tuberculosis (10.2%) Hypertensive heart disease (9.6%) 4 Lower respiratory infections (6.8%) Lower respiratory infections (7.4%) 5 Diabetes mellitus (6.6%) COPD (5.0%)

6 5 + 6 Asthma (3.4%) Diabetes mellitus (4.9%) 7 Oesophagus (3.4%) Cardiomyopathy (3.6%) 8 Diarrhoeal diseases (2.8%) Oesophagus (3.2%) 9 COPD (2.8%) Prostate (3.2%) 10 Cardiomyopathy (2.7%) HIV/AIDS (3.1%)

Rank Maternal conditions All other causes 1 Indirect maternal (29.0%) n=115 HIV/AIDS (37.3%) n=5 583 2 Hypertension in pregnancy (21.2%) n=84 Tuberculosis (19.8%) n=2 968 3 Other maternal (18.9%) n=75 Lower respiratory infections (4.1%) n=610 4 Maternal haemorrhage (15.1%) n=60 Diarrhoeal diseases (3.9%) n=582 e a l 4 9 5 Abortion (9.7%) n=38 Road injuries (3.0%) n=451

1 5 - 6 Maternal sepsis (6.1%) n=24 Meningitis/encephalitis (2.5%) n=367 F e m 7 Endocrine nutritional,blood, immune (2.4%) n=357 8 Cardiomyopathy (1.9%) n=280 9 Cerebrovascular disease (1.8%) n=269 10 Nephritis/nephrosis (1.7%) n=260

318 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20

OR Tambo: DC15 OR Tambo: DC15 e s n g l 18 i 40

80 17 80 o f a n i P r

p l 10 10 y

l TB DS client lost to i 70 70 Couple year follow up rate [both protection rate [ | sexes all ages | DHIS] 60 60 ETR/Tier.Net]

1 _ F a m 5 5 37 50 45 50 43 50 8 6 5 e 23

c a r 21 16 y 80 80 28

v e r 6 6 i TB DS death rate Antenatal 1st visit 30 d e l [both sexes all coverage [female | 70 32 70 ages |

a n d DHIS] 36 ETR/Tier.Net] 7 4 5 4 60 60 2 e g n a c y 100 100 21 47 21 22 20 45 20 30 1 _ 2 P r 44 19 19 TB symptom 5 Delivery in 10 to 19 18 18 years and older 40 years in facility rate 17 17 screened in facility 50 50 [female | DHIS] 16 16 rate [both sexes | 15 15 DHIS] 14 14 43 13 13 0 0 51 23

200 41 51 200 TB symptom child 80 30 80 49 under 5 years Maternal mortality 48 in facility ratio screened in facility rate [both sexes | [female | DHIS] 150 44 150 DHIS] 60 60

100 100 41

51 e n t m 90 29 90 e a t r

t Adult with viral 22 20 20 V 28 Neonatal death in I load suppressed 88 88 49 50 rate 12 months facility rate [both 49 sexes | DHIS] 48 [both sexes 15+ 31 2 _ H years | DHIS] 15 15 86 86 o n

i 20 11 18 19 70 70

s a t 13 24 u n i 80 80 Child with viral m Immunisation load suppressed 65 65 m i under 1 year rate 12 months d l coverage [both [both sexes 0-14 28 h i sexes | DHIS] 21 years | DHIS] 34 70 47 70 60 60 1 _ 3 C

29 e n t 52 28 m 52 65 65

e a t 15 15 r t Death in facility Clients remaining d 52 l 52 on ART rate [both h i under 5 years rate 60 60 [both sexes | sexes all ages | 10 10 DHIS] DHIS] 37 47 1 _ 4 C 41 55 55 5 5 37

6 25 25 8 8 C

50 U

20 20 Pneumonia case 6 6 Antiretroviral fatality under 5 47 51 50 49 effective coverage 30 years rate [both [both sexes 0-14 46 sexes <5 years | 47 15 15 4 4 years | DHIS-Tier] 43 DHIS]

2 2 10 48 10

90 90 e n t 2 2 25 m 40 40 36 e a t r

t Antiretroviral TB DS treatment 85 85 effective coverage success rate [both [both sexes 15+ sexes all ages | 46 years | DHIS-Tier] 30 30 2 _ 1 T B ETR/Tier.Net] 80 15 80

36 45 75 75

40 26 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 37 F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage Measure Names Rank [both sexes all 30 46 30 Prov av 1 52 ages | DHIS-Tier] ZA av Ind Value 46 20 20 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

319 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

OR Tambo: DC15 OR Tambo: DC15 9

C 5 3500 3500 U

Age-standardised 6 n a c e 85 85 Expenditure per prevalence of 6 non-raised blood 7 patient day 4 _ 5 F i equivalent (district pressure (index) 8 hospitals) [ | BAS 3000 3000 [both sexes 15+ 13 80 80 real 2019/20 years | NiDS prices] modelled] 2500 2500

e s 12 12 e n t 2200 2200 a b e t

i Provincial & LG District Health Diabetes 2000 2000 a n g e m 10 10 Services

m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | capita (uninsured) [ 1800 1800 NiDS modelled] 8 8 | BAS real 2019/20 14 prices] 15 14 1600 1600 18 17 15

1 0 11 C 10 9 10 U 9 10 1200 1200 Provincial & LG 40 40 Diabetes treatment PHC expenditure coverage [both per capita sexes 15+ years | (uninsured) [ | BAS 1000 1000 NiDS modelled] 35 35 real 2019/20 prices]

800 800 o n i 20 500 500 e c t 50 50 Provincial & LG d e t Cervical cancer 26 PHC expenditure screening per PHC 26 a n c e r coverage [female | headcount [ | BAS 400 400 DHIS] 29 real 2019/20 40 25 40 prices] 3 _ C 30 300 300

1 2 8 C 8 10 10 U 88 88 11 s e a 11 13 13 d i

Tobacco Percentage of non-smoking o f 86 86 deaths garbage prevalence (index) 12 12 d e n codes [both sexes [both sexes 15+ all ages | vital years | NiDS 84 84 B u r registration] modelled] 11 11 17 82 82 17 11 10 10 e n t

i 51 22 22 49 51 a c e s

n p a t 30 30 i y t

i Hospital beds per Percentage of l 10 000 target 20 20 deaths ill-defined population [ | DHIS [both sexes all 2000-2030 public 23 ages | vital 18 23 18

4 _ 1 F a c i 20 20 sector] 23 22 registration] 16 25 16 23 y t 17 18 18

d e n s i Percentage of 35 35 Medical 15 YLLs due to k e r practitioners per communicable, 16 16 o r

w 100 000 population 18 maternal, perinatal, 17 h

t [both sexes | public nutrition causes 30 30 14 14 e a l sector] [both sexes | vital 17 registration] 16 22 12 12 4 _ 2 H 25 25 11 51 35 35 15 13 15 Percentage of Pharmacists per 50 51 YLLs due to HIV 100 000 population 30 30 and TB [both [both sexes | public sexes | vital sector] 10 10 registration] 25 25 35 37

180 180 18 48 18 Professional Percentage of nurses per 100 46 000 population 22 YLLs due to 160 160 injuries [both sexes [both sexes | public 25 | vital registration] 16 16 sector] 140 140 30 31 n e s a n d

45 45 c i C

e d i Percentage of

P H 40 41 40 m YLLs due to 40 40 Percentage Ideal 42 non-communicable clinics [ | IC status] 30 diseases [both 20 46 20 8 sexes | vital 3 registration] 35 35 4 _ 3 A c e s 0 11 34 0 8 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

320 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Alfred Nzo District Municipality (DC44)

The Alfred Nzo District Municipalitym is a Category C municipality located in the north-eastern corner of the Eastern Cape Province. Alfred Nzo is the smallest district in the province, covering only 6% of the geographical area. The district comprises the Matatiele, Ntabankulu, Mbizana and Umzimvubu Local Municipalities. Cities/Towns: Bizana, Cedarville, KwaBhaca (Mount Frere), Matatiele, Tabankulu, eMaxesibeni (Mount Ayliff) Area: 10 731km² Population (2019)n: 879 284

DistrictDistrict % percentagepopulation by ag epopulation-gender group cbyom page-genderared to South Af rgroupica compared to South Africa EC, A Nzo DM (DC44)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.0% 3.9% 2.1% 4.4% 2.2% 5.1%

60-64 years 1.5% 1.5% 1.7%

55-59 years 1.6% 1.7% 1.8%

50-54 years 1.8% 2.0% 1.8%

45-49 years 2.0% 2.2% 2.0%

40-44 years 1.5% 2.5% 2.1% 1.3% 2.2%

35-39 years 1.6% 2.7% 1.4% 2.3% 1.9% 3.1%

30-34 years 1.6% 2.6% 1.8% 2.6% 2.7% 4.1%

25-29 years 2.1% 2.9% 2.7% 3.6% 3.0% 4.3%

20-24 years 3.2% 3.3% 4.7% 5.4% 3.5% 4.3%

15-19 years 6.1% 5.8% 7.2% 7.0% 5.1% 5.4%

10-14 years 8.6% 8.0% 7.0% 6.6% 6.6% 6.8%

05-09 years 8.8% 8.1% 6.2% 6.2% 7.0% 7.0%

00-04 years 7.1% 6.4% 7.2% 7.2% 6.9% 6.8%

Sex Gender (ZA) female female (ZA) male male (ZA)

m Available from: https://municipalities.co.za/overview/101/alfred-nzo-district-municipality. n Mid-year Population Estimates 2019, Stats SA.

321 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, A Nzo DM: DC44, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 76% 7% 9% 7% 75% 6% 11% 8% causes and 5-14 40% 20% 16% 24% 32% 14% 24% 30% single leading 15-24 16% 50% 17% 17% 6% 20% 13% 61% causes 25-64 17% 45% 34% 4% 14% 42% 29% 16% 65+ 18% 9% 71% 2% 17% 16% 63% 4% Total 21% 26% 48% 4% 19% 30% 36% 15% Broadcause Injury NCD Rank Female Male 1 Diarrhoeal diseases (28.0%) Diarrhoeal diseases (24.9%) HIV and TB 2 Lower respiratory infections (17.1%) Lower respiratory infections (21.4%) Comm_mat_peri_nut 3 Preterm birth complications (11.3%) Preterm birth complications (10.1%)

s 4 Protein-energy malnutrition (10.2%) Protein-energy malnutrition (8.6%) Prov, District 5 HIV/AIDS (5.1%) Birth asphyxia (4.9%) EC, A Nzo DM: DC44 y e a r 6 Birth asphyxia (4.6%) Tuberculosis (3.5%) Show history 5

< 7 Septicaemia (2.3%) Poisonings (including herbal) (3.3%) 8 Poisonings (including herbal) (2.2%) HIV/AIDS (2.8%) Percentages are shown 9 Tuberculosis (2.2%) Other respiratory (2.2%) according to all the deaths 10 Other respiratory (2.0%) Other perinatal conditions (2.2%) within the age/gender 1 Diarrhoeal diseases (17.6%) Diarrhoeal diseases (14.5%) category of each box, 2 HIV/AIDS (14.1%) Drowning (11.2%) although only the leading 3 Lower respiratory infections (12.7%) Lower respiratory infections (10.4%) 10 causes are displayed. 4 Tuberculosis (7.3%) Tuberculosis (9.0%) 5 Drowning (7.2%) Road injuries (7.5%) 1 4

5 - 6 Meningitis/encephalitis (6.9%) HIV/AIDS (6.4%) 7 Road injuries (6.0%) Epilepsy (5.4%) 8 Accidental threats to breathing (5.0%) Accidental threats to breathing (5.4%) 9 Septicaemia (4.4%) Meningitis/encephalitis (4.0%) 10 Fires, hot substances (2.9%) Other respiratory (2.8%) 1 HIV/AIDS (29.0%) Interpersonal violence (31.1%) 2 Tuberculosis (24.9%) Accidental threats to breathing (13.2%) 3 Road injuries (5.7%) HIV/AIDS (11.7%) 4 Lower respiratory infections (5.4%) Tuberculosis (9.8%)

2 4 5 Diarrhoeal diseases (5.2%) Road injuries (7.6%)

1 5 - 6 Accidental threats to breathing (4.2%) Mechanical forces (4.5%) 7 Interpersonal violence (3.4%) Epilepsy (4.3%) 8 Epilepsy (2.7%) Drowning (2.5%) 9 Nephritis/nephrosis (2.0%) Lower respiratory infections (1.9%) 10 Cardiomyopathy (1.7%) Meningitis/encephalitis (1.6%) 1 HIV/AIDS (28.1%) Tuberculosis (21.4%) 2 Tuberculosis (16.9%) HIV/AIDS (20.3%) 3 Lower respiratory infections (6.9%) Lower respiratory infections (6.2%) 4 Diarrhoeal diseases (5.0%) Interpersonal violence (5.5%)

6 4 5 Cerebrovascular disease (5.0%) Diarrhoeal diseases (4.4%)

2 5 - 6 Diabetes mellitus (4.1%) Cerebrovascular disease (3.4%) 7 Hypertensive heart disease (3.2%) Road injuries (3.3%) 8 Endocrine nutritional,blood, immune (2.3%) Accidental threats to breathing (3.0%) 9 Cervix (2.2%) Hypertensive heart disease (1.9%) 10 Meningitis/encephalitis (2.1%) Epilepsy (1.9%) 1 Cerebrovascular disease (16.3%) Tuberculosis (13.6%) 2 Hypertensive heart disease (14.4%) Lower respiratory infections (9.7%) 3 Lower respiratory infections (9.2%) Hypertensive heart disease (9.6%) 4 Tuberculosis (7.3%) Cerebrovascular disease (9.5%) 5 Diabetes mellitus (6.9%) Diabetes mellitus (5.2%)

6 5 + 6 Diarrhoeal diseases (6.1%) Diarrhoeal diseases (5.1%) 7 Ischaemic heart disease (3.4%) COPD (4.6%) 8 Asthma (3.1%) Ischaemic heart disease (4.2%) 9 Other respiratory (2.4%) Asthma (3.2%) 10 COPD (2.3%) HIV/AIDS (2.9%)

Rank Maternal conditions All other causes 1 Indirect maternal (25.0%) n=17 HIV/AIDS (35.1%) n=1 836 2 Abortion (18.7%) n=13 Tuberculosis (20.5%) n=1 071 3 Other maternal (17.1%) n=12 Lower respiratory infections (7.0%) n=366 4 Hypertension in pregnancy (15.2%) n=10 Diarrhoeal diseases (5.2%) n=270 e a l 4 9 5 Maternal sepsis (12.4%) n=8 Meningitis/encephalitis (2.8%) n=147

1 5 - 6 Maternal haemorrhage (11.5%) n=8 Endocrine nutritional,blood, immune (2.1%) n=111 F e m 7 Road injuries (2.0%) n=105 8 Nephritis/nephrosis (1.8%) n=96 9 Cerebrovascular disease (1.6%) n=86 10 Interpersonal violence (1.5%) n=80

322 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20

A Nzo: DC44 A Nzo: DC44 e s

n g 12 12 l i o f a n i P r

p l 10 10

y 60 60

l TB DS client lost to i Couple year follow up rate [both protection rate [ | sexes all ages | 8 8 DHIS] 51 ETR/Tier.Net]

1 _ F a m 40 50 40 51 6 27 6 6 52 13 52 52 16 e 44 c a r 10 10 y 80 80 40 v e r i 35 TB DS death rate Antenatal 1st visit 39 d e l [both sexes all 35 coverage [female | 70 40 70 ages | 8 8 a n d DHIS] ETR/Tier.Net] 39 22 60 44 44 60

e g n a c y 6 6 90 90 25 52 25 52 52 80 38 80 1 _ 2 P r 70 70 TB symptom 5 45 60 60 years and older 45 Delivery in 10 to 19 20 20 50 50 years in facility rate screened in facility [female | DHIS] rate [both sexes | 40 40 DHIS] 30 30 39 15 15 20 20 10 10

150 150 80 80 44 TB symptom child Maternal mortality under 5 years 100 100 60 60 in facility ratio screened in facility 46 [female | DHIS] rate [both sexes | 19 DHIS] 13 13 9 40 40 50 50 5 12 48

16 16 e n t

15 15 m 90 16 90 e a t

14 14 r

t Adult with viral

13 13 V

I load suppressed Neonatal death in 29 88 29 88 12 12 rate 12 months facility rate [both 30 sexes | DHIS] 11 11 [both sexes 15+ 39

19 2 _ H 10 19 10 years | DHIS] 9 9 86 86 8 8 3 8 o n i 22 20 s a t 65 34 65

u n i 80 80 Child with viral

m Immunisation 26 load suppressed m i under 1 year rate 12 months 60 32 60 d l coverage [both 27 [both sexes 0-14 h i sexes | DHIS] 46 41 70 24 70 years | DHIS] 55 55

1 _ 3 C 41

70 26 70 e n t 48 25 m 10 10 e a t

r 21

t 65 65 Death in facility Clients remaining d 47 l 47 on ART rate [both h i under 5 years rate 8 8 [both sexes | sexes all ages | 42 DHIS] 60 60 DHIS] 33 29 1 _ 4 C 6 33 6 55 55 4 4 6 30 30 C 15

52 U 8 8 9 25 25 Pneumonia case 52 Antiretroviral fatality under 5 6 47 6 effective coverage years rate [both [both sexes 0-14 20 20 sexes <5 years | 44 48 years | DHIS-Tier] DHIS] 4 4 35 42 15 15 2 2 42 23 e n t 85 5 85 m 40 40

e a t 30 r

t Antiretroviral TB DS treatment 17 effective coverage 40 success rate [both [both sexes 15+ 35 35 sexes all ages | 80 80 years | DHIS-Tier] 2 _ 1 T B ETR/Tier.Net] 41 27 30 30 33

23 40 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 31 F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage 35 40 35 Measure Names Rank [both sexes all Prov av 1 52 ages | DHIS-Tier] ZA av 30 30 Ind Value 35 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

323 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

A Nzo: DC44 A Nzo: DC44 9

C 20 U 14 18 Age-standardised 82 12 82 n a c e 10 Expenditure per 3000 3000 prevalence of 8 non-raised blood patient day 4 _ 5 F i equivalent (district pressure (index) 80 80 hospitals) [ | BAS [both sexes 15+ real 2019/20 years | NiDS 78 78 prices] 2500 2500 modelled] e s e n t 2200 2200 a b e t

i 10 10 Provincial & LG District Health Diabetes a n g e m Services 2000 2000

m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | capita (uninsured) [ NiDS modelled] 5 8 5 4 | BAS real 2019/20 1800 1800 1 prices] 1 1 1 1600 1600

1 0 40 40 C

U 1200 1200 Provincial & LG Diabetes treatment 35 35 PHC expenditure 38 coverage [both per capita 1000 1000 sexes 15+ years | 42 (uninsured) [ | BAS NiDS modelled] 30 43 30 real 2019/20 43 prices] 44 800 800 25 45 25

o n 50 50 i 32 500 500 e c t 31 Provincial & LG d e t

40 40 Cervical cancer PHC expenditure screening per PHC 400 400 a n c e r coverage [female | 30 30 headcount [ | BAS DHIS] real 2019/20 51 prices] 3 _ C 52 20 50 20 300 300 52

1 2 14 14 7 C 7 7

U 9 88 9 10 88 s e a d i

Tobacco Percentage of 12 12 non-smoking o f prevalence (index) 86 86 deaths garbage

d e n codes [both sexes [both sexes 15+ all ages | vital 10 10 years | NiDS B u r 84 84 registration] 8 6 modelled] 8 8 82 82 2 e n t i 53 53 53 a c e s n p a t i y 20 20 t

i Hospital beds per Percentage of l 10 000 target deaths ill-defined 40 40 population [ | DHIS [both sexes all 2000-2030 public ages | vital

4 _ 1 F a c i sector] 15 15 registration] 20 20 40 43 44 44 44 43 y t 37 30 30

d e n s i Percentage of 20 20 Medical YLLs due to 32

k e r 31 practitioners per communicable, o r

w 100 000 population 20 20 maternal, perinatal, h

t [both sexes | public nutrition causes 15 15

e a l sector] [both sexes | vital 10 51 50 10 registration] 52 52 4 _ 2 H 35 35 15 15 49

Percentage of 49 Pharmacists per YLLs due to HIV 30 30 100 000 population 10 10 and TB [both [both sexes | public sexes | vital 41 sector] registration] 25 25 5 52 51 5 52 52 200 200 16 16 Professional Percentage of nurses per 100 150 150 24 000 population YLLs due to 15 15 injuries [both sexes [both sexes | public 22 | vital registration] sector] 38 38 14 14 100 42 42 100 17 n e s a n d

45 45 c i C

e d i Percentage of

P H 40 40 m YLLs due to 40 40 Percentage Ideal non-communicable 9 clinics [ | IC status] diseases [both 20 20 4 50 sexes | vital 35 35 49 registration] 4 _ 3 A c e s 50 52 0 11 35 0 6 30 30 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

324 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Nelson Mandela Bay Metropolitan (NMA)

The Nelson Mandela Bay Metropolitan Municipalityo is a Category A municipality. As a major seaport and automotive manufacturing centre located on the south-eastern coast of Africa, it is the economic powerhouse of the Eastern Cape. The Metropolitan Municipality comprises three health sub-districts, namely: Nelson Mandela A, Nelson Mandela B and Nelson Mandela C. Cities/Towns: Bethelsdorp, Bloemendal, Blue Horizon Bay, Clarendon Marine, Despatch, KwaNobuhle, Motherwell, Port Elizabeth, Summerstrand, Swartkops, Uitenhage Area: 1 957km² Population (2019)p: 1 320 576

DistrictDistrict % percentagepopulation by ag epopulation-gender group cbyom page-genderared to South Af rgroupica compared to South Africa

EC, N Mandela Bay MM (NMA)

2000/01 2010/11 2020/21

South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines South Africa % of total population [Male | Female] - lines

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.0% 3.1% 2.4% 3.7% 3.5% 5.6%

60-64 years 1.3% 1.5% 1.5% 2.0% 1.8% 2.6%

55-59 years 1.6% 2.0% 2.1% 2.6% 2.2% 3.0%

50-54 years 2.2% 2.7% 2.5% 3.2% 2.6% 3.2%

45-49 years 2.8% 3.3% 2.9% 3.6% 3.2% 3.6%

40-44 years 3.2% 3.9% 3.2% 3.7% 3.6% 3.8%

35-39 years 3.6% 4.2% 3.8% 4.1% 4.2% 4.2%

30-34 years 3.8% 4.2% 4.0% 4.1% 4.3% 4.2%

25-29 years 4.1% 4.3% 4.3% 4.3% 3.6% 3.4%

20-24 years 4.1% 4.3% 4.3% 4.5% 3.0% 3.1%

15-19 years 5.0% 4.9% 4.1% 4.1% 3.4% 3.5%

10-14 years 5.2% 5.1% 3.9% 3.8% 4.1% 4.3%

05-09 years 4.8% 4.5% 3.9% 4.0% 4.2% 4.2%

00-04 years 4.1% 4.0% 4.7% 4.7% 3.8% 3.7%

Sex Gender (ZA) female female (ZA) male male (ZA)

o Available from: https://municipalities.co.za/overview/1/nelson-mandela-bay-metropolitan-municipality. p Mid-year Population Estimates 2019, Stats SA.

325 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

Percentage of deaths by broad cause and leading causes, 2012–2017 EC, N Mandela Bay MM: NMA, 2012 - 2017 Percentage of AgeGrp Female Male deaths by broad <5 years 63% 7% 22% 8% 63% 7% 21% 9% causes and 5-14 19% 22% 39% 19% 17% 14% 34% 34% single leading 15-24 10% 55% 20% 15% 3% 17% 13% 67% causes 25-64 5% 35% 55% 5% 5% 33% 45% 17% 65+ 7%3% 87% 2% 6%6% 85% 4% Total 9% 21% 66% 5% 8% 23% 54% 15% Broadcause Injury NCD Rank Female Male 1 Preterm birth complications (16.0%) Preterm birth complications (18.2%) HIV and TB 2 Lower respiratory infections (12.8%) Lower respiratory infections (13.8%) Comm_mat_peri_nut 3 Sepsis/other newborn infectious (7.3%) Birth asphyxia (7.6%)

s 4 Congenital heart anomalies (6.7%) Sepsis/other newborn infectious (6.5%) Prov, District 5 Birth asphyxia (6.5%) Diarrhoeal diseases (5.6%) EC, N Mandela Bay MM: NMA y e a r 6 Diarrhoeal diseases (6.3%) Congenital heart anomalies (5.2%) Show history 5

< 7 Other perinatal conditions (5.4%) Other perinatal conditions (5.0%) 8 HIV/AIDS (4.3%) HIV/AIDS (4.6%) Percentages are shown 9 Protein-energy malnutrition (4.3%) Protein-energy malnutrition (3.9%) according to all the deaths 10 Septicaemia (3.4%) Accidental threats to breathing (2.4%) within the age/gender 1 Tuberculosis (14.4%) Drowning (13.2%) category of each box, 2 HIV/AIDS (13.2%) Road injuries (9.9%) although only the leading 3 Lower respiratory infections (6.9%) HIV/AIDS (9.2%) 10 causes are displayed. 4 Fires, hot substances (6.3%) Tuberculosis (6.6%) 5 Epilepsy (5.2%) Lower respiratory infections (4.8%) 1 4

5 - 6 Other malignant neoplasms (4.6%) Fires, hot substances (4.4%) 7 Hypertensive heart disease (4.3%) Leukaemia (3.7%) 8 Mechanical forces (4.3%) Endocrine nutritional,blood, immune (3.1%) 9 Congenital heart anomalies (3.8%) Accidental threats to breathing (2.9%) 10 Road injuries (3.7%) Mechanical forces (2.8%) 1 HIV/AIDS (36.3%) Mechanical forces (31.4%) 2 Tuberculosis (21.4%) Interpersonal violence (19.2%) 3 Interpersonal violence (3.7%) Tuberculosis (10.2%) 4 Mechanical forces (3.6%) HIV/AIDS (7.8%)

2 4 5 Road injuries (3.4%) Accidental threats to breathing (7.3%)

1 5 - 6 Endocrine nutritional,blood, immune (2.8%) Road injuries (5.5%) 7 Diarrhoeal diseases (2.5%) Fires, hot substances (3.4%) 8 Accidental threats to breathing (2.2%) Drowning (2.2%) 9 Asthma (2.2%) Epilepsy (1.1%) 10 Hypertension in pregnancy (2.0%) Lower respiratory infections (1.1%) 1 HIV/AIDS (22.6%) HIV/AIDS (16.5%) 2 Tuberculosis (12.1%) Tuberculosis (16.3%) 3 Cerebrovascular disease (7.1%) Mechanical forces (5.8%) 4 Hypertensive heart disease (6.7%) Cerebrovascular disease (4.9%)

6 4 5 Diabetes mellitus (6.0%) Ischaemic heart disease (4.2%)

2 5 - 6 Breast (3.4%) Hypertensive heart disease (3.9%) 7 Ischaemic heart disease (3.1%) Interpersonal violence (3.9%) 8 Endocrine nutritional,blood, immune (2.9%) Trachea/bronchi/lung (3.5%) 9 Cervix (2.4%) Diabetes mellitus (3.3%) 10 Lower respiratory infections (2.2%) Asthma (2.4%) 1 Cerebrovascular disease (15.5%) Ischaemic heart disease (11.7%) 2 Hypertensive heart disease (14.2%) Cerebrovascular disease (11.0%) 3 Diabetes mellitus (9.7%) Hypertensive heart disease (9.0%) 4 Ischaemic heart disease (9.7%) Diabetes mellitus (6.5%) 5 Lower respiratory infections (4.3%) COPD (5.3%)

6 5 + 6 COPD (4.1%) Prostate (5.2%) 7 Trachea/bronchi/lung (3.0%) Tuberculosis (5.0%) 8 Alzheimer’s and other dementias (3.0%) Trachea/bronchi/lung (4.8%) 9 Breast (2.5%) Lower respiratory infections (3.7%) 10 Asthma (2.4%) Nephritis/nephrosis (2.7%)

Rank Maternal conditions All other causes 1 Hypertension in pregnancy (30.9%) n=33 HIV/AIDS (35.6%) n=3 004 2 Other maternal (22.3%) n=24 Tuberculosis (17.3%) n=1 462 3 Indirect maternal (19.4%) n=21 Cerebrovascular disease (3.4%) n=283 4 Abortion (15.0%) n=16 Endocrine nutritional,blood, immune (3.3%) n=276 e a l 4 9 5 Maternal haemorrhage (8.2%) n=9 Hypertensive heart disease (3.0%) n=250

1 5 - 6 Maternal sepsis (4.3%) n=5 Breast (2.4%) n=204 F e m 7 Diabetes mellitus (2.4%) n=202 8 Lower respiratory infections (2.4%) n=200 9 Cervix (1.9%) n=163 10 Asthma (1.7%) n=140

326 SectionSection B:B: ProfileNational Eastern and DistrictCape Province Profiles

Annual trends, 2015/16–2019/20

N Mandela Bay: NMA N Mandela Bay: NMA e s

n g 12 12 l i o f

a n i 70 70 P r p l 30 44 44 29 y 10 10 l TB DS client lost to i Couple year follow up rate [both 44 protection rate [ | 60 33 60 sexes all ages | DHIS] 32 ETR/Tier.Net] 8 8 1 _ F a m 37 43 44 50 50 6 6 e

c a r 80 80 y 7.0 7.0

v e r 18 i TB DS death rate Antenatal 1st visit 70 70 d e l [both sexes all coverage [female | 50 ages | 22 a n d DHIS] 60 60 ETR/Tier.Net] 50 6.5 6.5 18 51 50 51 50 16 51 51 e g n a c y 90 90 36 80 35 80 1 _ 2 P r 15 15 70 70 TB symptom 5 60 60 years and older 44 Delivery in 10 to 19 50 50 years in facility rate screened in facility [female | DHIS] rate [both sexes | 40 40 30 30 10 6 10 DHIS] 36 20 20 5 10 10 5 160 160 90 31 90 46 80 80 140 140 TB symptom child 33 38 under 5 years Maternal mortality 24 70 70 in facility ratio 120 120 screened in facility [female | DHIS] rate [both sexes | 30 DHIS] 60 60 100 100

25 31 50 37 50 80 80

17 45 17 e n t 90 90 m 16 16 89 89 e a t r 15 15 t Adult with viral 88 88

41 V 14 14 I load suppressed Neonatal death in 87 87 13 13 rate 12 months facility rate [both 32 86 86 sexes | DHIS] 12 12 [both sexes 15+ 42 2 _ H 85 85 11 26 11 years | DHIS] 84 38 84 10 10 36 83 83 9 11 9 41 o n i 80 80 31 s a t 65 65

u n i Child with viral

m Immunisation load suppressed

m 60 60 i under 1 year 70 70 rate 12 months d l coverage [both 51 45 [both sexes 0-14 36 h i sexes | DHIS] years | DHIS] 51 55 35 55 60 52 51 60 1 _ 3 C 45 49 50 50

e n t 6 6

m 65 65 e a t r t Death in facility 5 5 Clients remaining d l on ART rate [both 60 60

h i under 5 years rate sexes all ages | [both sexes | 13 DHIS] 4 15 4 DHIS] 48

1 _ 4 C 13 55 55 14 39 51 3 3 13 8 45 6

5 5 C

42 U 44 26 4 4 Pneumonia case Antiretroviral 20 20 fatality under 5 effective coverage years rate [both 43 [both sexes 0-14 36 sexes <5 years | 3 3 years | DHIS-Tier] 37 36 DHIS] 28 15 39 15 2 2 40 e n t

m 40 40 82 82 e a t r

t 16 Antiretroviral TB DS treatment 27 effective coverage success rate [both 80 80 [both sexes 15+ 41 sexes all ages | 30 years | DHIS-Tier] 30 28 43 30 2 _ 1 T B ETR/Tier.Net] 78 25 78 44 76 76

40 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0

F Y F Y F Y F Y F Y F Y Antiretroviral effective coverage 41 Measure Names Rank [both sexes all 30 30 Prov av 1 52 ages | DHIS-Tier] 28 42 ZA av Ind Value 44 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y

327 Section B: NationalProfile Eastern and District Cape ProvinceProfiles

N Mandela Bay: NMA N Mandela Bay: NMA 9

C 4000 4000 U

Age-standardised n a c e 80 80 Expenditure per prevalence of non-raised blood patient day 3500 3500 4 _ 5 F i equivalent (district pressure (index) hospitals) [ | BAS [both sexes 15+ real 2019/20 years | NiDS 75 75 3000 3000 prices] modelled] 46 47 48 44 44 44 2500 2500 e s e n t 46 2200 2200 46 43 a b e t

i Provincial & LG 14 37 35 14 33 District Health Diabetes 2000 2000 a n g e m Services

m prevalence [both 3 _ 2 D expenditure per sexes 15+ years | 12 12 capita (uninsured) [ NiDS modelled] 1800 1800 | BAS real 2019/20 prices] 10 10 1600 1600

1 0 40 40 C U 1300 1300 Provincial & LG Diabetes treatment 35 35 PHC expenditure coverage [both per capita 1200 1200 sexes 15+ years | (uninsured) [ | BAS NiDS modelled] 44 real 2019/20 30 45 30 45 prices] 1100 1100 44 42 43 1000 1000

o n 50 50 i

e c t 500 500 Provincial & LG d e t

45 45 Cervical cancer PHC expenditure screening 27 per PHC a n c e r coverage [female | 40 33 40 headcount [ | BAS 400 400 DHIS] 36 42 real 2019/20 prices] 3 _ C 35 35 31 38 1 2

C 82 82 U s e a d i

Tobacco Percentage of 13 13 non-smoking o f prevalence (index) deaths garbage

d e n codes [both sexes [both sexes 15+ 80 80 all ages | vital years | NiDS 34 B u r 33 registration] 12 12 modelled] 33 34 26 23 34 25 78 36 78 e n t i 7 10 8 7 20 20 9 9 a c e s

n p a t 25 25 i y t

i Hospital beds per Percentage of l 10 000 target deaths ill-defined 15 15 population [ | DHIS [both sexes all 2000-2030 public ages | vital 10 10 4 _ 1 F a c i sector] 20 20 registration]

5 3 5 3 5 y t 4 5

d e n s i Percentage of 50 5 50 Medical YLLs due to

k e r 4 15 15 practitioners per communicable, o r

w 100 000 population maternal, perinatal, 40 40 h

t [both sexes | public nutrition causes

e a l sector] [both sexes | vital 10 9 10 registration] 30 30 4 2 4 _ 2 H

20 6 20 7 8 8 30 30 Percentage of 33 Pharmacists per YLLs due to HIV 100 000 population and TB [both [both sexes | public 15 15 36 sexes | vital 31 sector] registration] 25 25

10 10

200 4 5 200 5 5 16 16 Professional Percentage of nurses per 100 180 180 000 population YLLs due to 15 15 injuries [both sexes [both sexes | public | vital registration] 21 sector] 160 160 19 14 14 19 140 140 80 80 n e s a n d 20 44

c i 70 70 45 C 50 50 e d i 60 32 60 Percentage of P H m YLLs due to 50 50 44 Percentage Ideal 40 40 non-communicable clinics [ | IC status] 30 34 30 diseases [both 45 45 23 sexes | vital 20 20 registration] 4 _ 3 A c e s 10 25 10 0 11 0 40 40 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y F Y

328