23 (Section B) North West Province

SectionSection B: B: National Profile North and District West Province Profiles

23 North West Province

Bojanala District Municipality (DC37)

Bojanala District is situated in North West Province and comprises five health sub-districts, namely Kgetlengrivier, Madibeng, Moses Kotane, Moretele and Rustenburg. The district has a population of 1 665 222, with a population density of 90.8 persons per km2 and falls in the mid socio-economic quintile, Quintile 3. Estimated medical scheme coverage is 14.6%.

Social determinants of healtha Population per selected category

Unemployment ratea 30.7% Population category 2017 2018 2019 2020 Youth unemployment rate (15-34 years)a 39.1% under 1 year 29 738 30 140 31 757 33 842 No schooling 5.5% under 5 years 167 006 166 174 167 048 169 233 Matric 32.5% 05-09 years 170 639 171 918 171 260 169 973 Higher education 6.5% 10-14 years 139 312 146 800 154 757 161 726 Households 611 144 15-19 years 123 395 125 152 127 125 129 995 Female-headed households 30.1% 20-24 years 137 733 137 002 136 214 135 363 Formal dwellings 70.6% 25-29 years 163 677 162 604 161 596 160 691 Flush toilet connected to sewerage 34.8% 30-34 years 148 353 155 893 164 108 172 350 Weekly refuse removal 57.2% 35-39 years 134 186 136 479 137 993 139 145 Piped water inside dwellings 19.5% 40-44 years 113 924 117 491 121 160 124 778 Electricity for lighting 87.6% 45-49 years 95 266 97 832 100 601 103 584 Blue Drop water score 55.1% 50-54 years 80 087 82 008 83 987 86 030 55-59 years 67 199 68 562 69 873 71 288 Source: StatsSA. 2014 Blue Drop Report. 60-64 years 51 020 53 259 55 444 57 458 65-69 years 34 133 35 810 37 642 39 523 70-74 years 23 823 23 965 24 295 24 961 75-79 years 15 171 16 152 16 861 17 223 80 years and older 14 804 15 113 15 453 15 818 Total 1 679 721 1 712 216 1 745 419 1 779 141 Estimated pregnant women* 31 820 32 250 33 980 36 211 Source: Mid-Year Population Estimates 2016 StatsSA. * Under 1 year population X 1.07.

Population distribution sub-district boundaries and health facility locations

a Statistics South Africa. Census 2011 Municipal fact sheet. Report No. 03-01-58. Pretoria: Statistics SA; 2012.

703 Section B: NationalProfile North and WestDistrict Province Profiles

Number of facilities by level, 2016/17

Ward based Central/ outreach District Regional Tertiary Other teams Clinic CHC Hospital Hospital Hospitals Hospitals Kgetleng Rivier SD 6 3 1 1 0 0 0 Madibeng SD 33 22 2 1 0 0 1 Moretele SD 30 22 0 0 0 0 0 Moses Kotane SD 34 47 3 1 0 0 0 Rustenburg SD 30 21 3 0 0 1 6 Bojanala 133 115 9 3 0 1 7 Source: DHIS.

Human resources – filled posts, 2016

Community Speech Health Nursing Enrolled Professional Medical Dental Occupational Therapy and Workers assistants nurse nurse practitioners Pharmacists practitioners therapy Physiotherapy Audiology Bojanala 1 212 642 270 1 297 207 67 16 19 22 8 Source: Persal, DHIS.

Management and efficiency indicators for the service delivery platform, 2016/17

PHC Management Output Process & input Provincial and LG Percentage of District Health Provincial Provincial assessed PHC Services and LG PHC and LG PHC facilities with expenditure expenditure expenditure Percentage 90% of tracer per capita per capita per PHC PHC utilisation Ideal clinics medicines (uninsured) (uninsured) headcount rate (No) (%) available (%) (Rand) (Rand) (Rand) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Kgetleng Rivier SD Indicator 1.9 - - - - - Numerator 107 138 - - - - - Denominator 689 994 - - - - - Madibeng SD Indicator 1.8 - - - - - Numerator 934 670 - - - - - Denominator 6 332 490 - - - - - Moretele SD Indicator 2.5 - - - - - Numerator 521 831 - - - - - Denominator 2 521 080 - - - - - Moses Kotane SD Indicator 2.4 - - - - - Numerator 648 879 - - - - - Denominator 3 260 118 - - - - - Rustenburg SD Indicator 1.9 - - - - - Numerator 1 126 090 - - - - - Denominator 7 272 786 - - - - - Bojanala Indicator 2.0 15.1 52.1 1 321 904 385 Numerator 3 338 608 18 61 1 879 676 120 1 286 115 938 1 286 115 938 Denominator 20 076 468 119 117 1 422 540 1 422 540 3 338 608 North West Indicator 2.1 29.3 74.2 1 551 1 064 434 South Africa Indicator 2.3 29.8 78.4 1 726 1 054 389 Source: DHIS.

704 SectionSection B: B: National Profile North and District West Province Profiles 0 0 ------0.0 0.0 Annual trends 10.8 20.3 NW, DC37, Bojanala Platinum District Municipality, SEQ 3 8 803 8 803

(%) 8 Measure Names

OPD new IndValue client not not client referred rate rate referred Inpatient crude 6 Prov_av ------death rate ZA_av 1_Impact 6.4 5.4 6.4 6.2 4 1 069 1 069 1_Management 16 748 16 748 2 8 rate (%) Inpatient Inpatient

crude death 6 Average length ------of stay (district 4 hospitals) 79.1 79.1 84.3 82.5 2 113 807 113 807 (%) 4K utilisation rate - total Inpatient bed

2_Outcome Expenditure per patient day 3K ------equivalent Tertiary/Central Hospital (district 2K 2 821 3 789 4 227 3 789 hospitals) 146 082 143 826 146 082 143 826

day 1K (Rand) equivalent equivalent 553 520 413 553 520 413 per patient Expenditure ------Inpatient bed 100 6.8 6.9 6.8 6.8 utilisation rate (district 16 748 16 748 113 807 113 807 hospitals) 50 (Days) Average length of of length stay - total 100 3_Output ------OPD new client 37.2 15.7 not referred rate 50 (district (%) hospitals) OPD new client not not client

referred rate rate referred 0 100 ------5.4 Percentage 50 Ideal clinics rate (%) Inpatient Inpatient crude death 0 ------Provincial and 3K 78.3 5.0 90.5 LG District Health Services (%) 2K expenditure per Hospital utilisation rate - total capita Inpatient bed (uninsured) 1K Regional Hospital Regional ------2 739 2 894 Provinc ial and 1500

4_Process_input LG PHC day

(Rand) expenditure per 1000 equivalent equivalent per patient

Expenditure capita (uninsured) ------500 5.3

Provincial and 400 (Days)

Average LG PHC length of of length stay - total expenditure per PHC headcount -

- 200 - 51.9 30.7 56.4 5.4 59.3 46.3 63.8 1 073 2 256 1 683 7 884 7 11 213 15 177 24 200 2008 2010 2012 2014 2016 2018 (%) Year OPD new client not not client

referred rate rate referred Measure Names - - - IndValue 5.1 8.1 7.2 6.7 5.8 8.9 201 796 549 P rov_av 9 410 2 271 9 789 7 340 1 546

21 470 ZA_av rate (%) Inpatient Inpatient crude death - - - 67.4 74.3 75.8 84.8 65.8 58.5 53 177 47 455 71 548 40 220 40 137 255 104 072 (%) utilisation rate - total Inpatient bed District Hospital District - - - 2 748 3 129 2 631 2 840 2 568 2 488 18 645 18 252 58 807 150 795 150 day (Rand) equivalent equivalent per patient 184 031 695 192 968192 989 428 236 756 Expenditure - - - 4.7 4.7 4.4 4.8 5.4 4.3 9 410 2 271 9 789 73 342 21 470 10 67510 236 51 072 675 10 53 177 40 220 40 104 072 (Days) Average length of of length stay - total Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator Indicator Indicator Denominator Denominator Numerator Numerator Indicator D

Bojanala Bojanala Rustenburg SD Rustenburg Moses Kotane SD Kotane Moses South Africa South North West Madibeng SD Madibeng Kgetleng Rivier SD Rivier Kgetleng Source: HIS and BAS.

705 Section B: NationalProfile North and WestDistrict Province Profiles

Deaths and Patient day equivalent 2014/15 – 2016/17 17 15 56 22 33 35 119 180 458 2 615 20 001 Total 296 885 District District 11 12 19 20 33 130 106 228 146 082 tertiary Central/ hospital - - - 4 490 ------2016/17 Hospital Regional Regional 13 13 15 10 23 50 154 5 473 150 795 150 District District Hospital - - - - - 6------8 1 3 6 - 6 76 10 038 / MOU PHC / CHC 37 37 32 60 30 34 124 172 477 2 425 2 19 886 304 144 304 Total District District 12 15 18 24 22 99 30 216 130 205 4 118 150 029 150 tertiary Central/ Hospital - 1 206 2 862 - 1 546 - 1 069 ------2015/16 Hospital Regional Regional 17 37 25 25 42 175 192 1 641 5 692 - 151 886 District District Hospital - 7 ------8 - 5 2 8 - 15 69 2 229 2 045 2 10 076 / MOU PHC / CHC 57 37 67 42 33 35 54 522 200 3 180 3 095 21 080 325 070 Total District District 21 21 25 20 44 141 220 229 4 651 1 242 155 900 tertiary Central/ Hospital ------2014/15 Hospital Regional Regional 51 51 16 23 22 22 30 181 310 5 198 1 676 152 632 District District Hospital - - - 6 2 6 - 8 3 13 112 177 2 650 11 231 16 538 / MOU* PHC / CHC

Death in facility 8-28 days Death in facility 0-7days Death in facility months 29 days - 11 Death in facility – 59 months 12

natal natal

Neo-

year) (under 1 1 (under

D Infant Infant

years) Child (under 5 5 (under Child ata Element ata Inpatient death total Patient day equivalent day Patient Still birthsStill Pneumonia death under 5 years Severe acute malnutrition death under 5 years Diarrhoea death under 5 years TB Deaths D (Number) Maternal deaths deaths Maternal Live births Source: HIS. *MOU – Maternal Obstetric Unit.

706 SectionSection B: B: National Profile North and District West Province Profiles

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 2010–2015. The second part of the graph shows the 10 leading single causes of death within each age group (both genders) for 2010–2015 combined.

PercentageNW, Bojanala: of deaths DC37, by 2010 broad - cause2015 and leading causes 2010–2015 Percentage of AgeGroup.. Female Male deaths by broad <5 years 76% 9% 10%5% 76% 8% 11% 6% causes and 5-14 36% 24% 22% 19% 28% 20% 19% 32% single leading 15-24 26% 38% 20% 17% 14% 12% 15% 59% causes 25-64 21% 34% 40% 5% 16% 34% 34% 16% 65+ 11%3% 84% 2% 12% 8% 77% 3% Broadcause 23% 21% 52% 4% 21% 24% 42% 14% Total Injury NCD Rank.. Female Male 1 Diarrhoeal diseases (26.0%) Diarrhoeal diseases (26.3%) HIV and TB 2 Lower respiratory infections (20.2%) Lower respiratory infections (17.0%) Comm_mat_peri_nut 3 Preterm birth complications (9.8%) Preterm birth complications (11.7%) 4 HIV/AIDS (7.2%) Birth asphyxia (6.3%) Prov, District 5 Birth asphyxia (5.9%) HIV/AIDS (6.0%) NW, Bojanala: DC37 6 Protein-energy malnutrition (5.1%) Protein-energy malnutrition (5.4%) Show history

<5 years <5 7 Sepsis/other newborn infectious (3.0%) Sepsis/other newborn infectious (3.6%) 8 Other perinatal conditions (2.5%) Other perinatal conditions (2.8%) Percentages are shown 9 Tuberculosis (2.2%) Other respiratory (2.2%) according to all the deaths 10 Septicaemia (1.8%) Tuberculosis (1.9%) within the age/gender 1 Diarrhoeal diseases (15.4%) Drowning (14.5%) category of each box, 2 Lower respiratory infections (14.3%) Lower respiratory infections (12.9%) although only the leading 3 Tuberculosis (13.8%) HIV/AIDS (11.6%) 10 causes are displayed. 4 HIV/AIDS (12.6%) Tuberculosis (11.2%) 5 Road injuries (5.9%) Diarrhoeal diseases (9.8%)

5-14 6 Accidental threats to breathing (4.9%) Road injuries (7.6%) 7 Meningitis/encephalitis (4.6%) Accidental threats to breathing (4.9%) 8 Fires, hot substances (3.5%) Other respiratory (3.2%) 9 Drowning (2.2%) Endocrine nutritional,blood, immune (2.9%) 10 Cardiomyopathy (2.1%) Meningitis/encephalitis (2.4%) 1 HIV/AIDS (22.0%) Accidental threats to breathing (18.3%) 2 Tuberculosis (16.9%) Interpersonal violence (17.3%) 3 Lower respiratory infections (12.3%) Road injuries (9.9%) 4 Accidental threats to breathing (5.1%) Lower respiratory infections (7.3%) 5 Diarrhoeal diseases (4.8%) HIV/AIDS (6.5%)

15-24 6 Road injuries (4.2%) Tuberculosis (6.1%) 7 Interpersonal violence (3.5%) Mechanical forces (6.1%) 8 Septicaemia (2.4%) Epilepsy (2.8%) 9 Epilepsy (2.1%) Fires, hot substances (2.7%) 10 Meningitis/encephalitis (2.0%) Diarrhoeal diseases (2.7%) 1 HIV/AIDS (20.1%) HIV/AIDS (17.4%) 2 Tuberculosis (14.0%) Tuberculosis (16.4%) 3 Lower respiratory infections (11.4%) Lower respiratory infections (9.8%) 4 Hypertensive heart disease (5.7%) Accidental threats to breathing (4.5%) 5 Cerebrovascular disease (4.8%) Ischaemic heart disease (4.4%)

25-64 6 Diarrhoeal diseases (4.2%) Cerebrovascular disease (4.1%) 7 Diabetes mellitus (4.2%) Mechanical forces (3.4%) 8 Ischaemic heart disease (2.8%) Diarrhoeal diseases (3.1%) 9 Nephritis/nephrosis (2.5%) Interpersonal violence (3.0%) 10 Septicaemia (2.3%) Hypertensive heart disease (2.9%) 1 Hypertensive heart disease (22.6%) Cerebrovascular disease (17.4%) 2 Cerebrovascular disease (17.5%) Hypertensive heart disease (9.8%) 3 Diabetes mellitus (10.0%) Ischaemic heart disease (7.8%) 4 Ischaemic heart disease (6.5%) Lower respiratory infections (7.8%) 5 Lower respiratory infections (6.0%) Diabetes mellitus (6.7%)

65+ 6 Nephritis/nephrosis (3.6%) Tuberculosis (6.2%) 7 Cardiomyopathy (3.4%) COPD (5.2%) 8 Diarrhoeal diseases (2.9%) Nephritis/nephrosis (4.0%) 9 COPD (2.6%) Prostate (3.3%) 10 Tuberculosis (2.2%) Cardiomyopathy (3.0%)

Rank.. Maternal conditions All other causes 1 Indirect maternal (31.1%) n=77 HIV/AIDS (25.5%) n=3 250 2 Hypertension in pregnancy (22.7%) n=57 Tuberculosis (17.0%) n=2 171 3 Other maternal (19.6%) n=49 Lower respiratory infections (13.7%) n=1 745 4 Abortion (10.1%) n=25 Diarrhoeal diseases (4.9%) n=618 5 Maternal haemorrhage (9.2%) n=23 Hypertensive heart disease (2.5%) n=324

15-49 6 Maternal sepsis (7.3%) n=18 Septicaemia (2.4%) n=309 Female 7 Cerebrovascular disease (2.3%) n=291 8 Nephritis/nephrosis (2.0%) n=260 9 Cardiomyopathy (2.0%) n=250 10 Endocrine nutritional,blood, immune (1.8%) n=234

707 Section B: NationalProfile North and WestDistrict Province Profiles

Maternal and Women’s Health

Impact Outcome Output Maternal Antenatal Delivery in Cervical Mother mortality in client initiated facility under Antenatal 1st cancer Couple year postnatal visit facility ratio on ART rate 18 years rate visit before 20 screening protection rate within 6 days (per100K) (%) (%) weeks rate (%) coverage (%) (WHO) (%) rate (%) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Kgetleng Rivier SD Indicator - 99.3 7.7 74.7 93.7 94.3 66.2 Numerator - 133 56 660 1 113 12 278 481 Denominator 723 134 727 883 14 255 156 228 727 Madibeng SD Indicator 17.0 94.7 9.0 50.7 50.3 53.9 91.6 Numerator 1 1 458 525 62 41 5 496 68 663 5 323 Denominator 5 899 1 539 5 812 12 310 131 025 1 527 951 5 812 Moretele SD Indicator 104.6 91.6 3.4 67.8 73.7 94.8 247.4 Numerator 1 361 32 2 084 3 364 44 712 2 343 Denominator 956 394 947 3 072 54 741 566 223 947 Moses Kotane SD Indicator 139.7 96.4 4.9 71.9 57.1 77.8 66.3 Numerator 5 624 179 2 751 3 498 48 269 2 425 Denominator 3 578 647 3 657 3 824 73 470 744 897 3 657 Rustenburg SD Indicator 90.4 100.6 3.8 64.4 63.5 43.1 69.2 Numerator 8 2 155 337 6 819 7 561 65 590 6 136 Denominator 8 845 2 142 8 873 10 593 142 901 1 826 469 8 873 Bojanala Indicator 75.0 97.4 5.6 60.5 60.6 59.6 83.5 Numerator 15 4 731 1 129 18 555 21 032 239 512 16 708 Denominator 20 001 4 856 20 016 30 682 416 392 4 821 768 20 016 North West Indicator 138.9 95.9 6.5 63.7 69.3 60.2 74.4 South Africa Indicator 116.9 95.1 6.8 65.2 61.5 70.2 70.3 Source: DHIS.

Annual NW,trends DC37, Bojanala Platinum District Municipality, SEQ 3

800 Measure Names 600 IndValue Maternal Prov_av mortality in 400 facility ratio ZA_av 1_Impact 200 0 80

Antenatal 1st 60 visit before 20 weeks rate 40 2_Maternal and women's health women's and 2_Maternal 20

200 Couple year protection rate (WHO) 100

15 2_Outcome Delivery in facility under 18 10 years rate 5

200 Mother postnatal visit within 6 days 100 rate

0 200

Antenatal client 150 initiated on ART rate 100

3_Output 150 Cervical cancer screening 100 coverage 50

2009 2010 2011 2012 2013 2014 2015 2016 Year

708 SectionSection B: B: National Profile North and District West Province Profiles

Child and School Health 41.5 49.3 58.0 30.8 48.9 48.9 35.5 43.5 4 072 14 728 31 108 18 538 46 344 46 114 790 112 380 574 650 455 100 3 319 872 3 319 1 050 750 months Vitamin A dose 12-59 coverage (%) coverage 4.3 169 876 270 794 74.0 14.3 19.8 16.8 23.4 38.7 34.0 5 010 6 109 3 324 1 235 3 894 7 330 992 1 126 257 412 8 screening coverage (%) coverage School Grade 357 74.6 53.1 24.6 45.4 28.3 35.0 33.0 44.2 6 210 5 186 8 324 8 487 1 020 1 469 1 1 835 2 460 2 085 11 956 11 324 708 1 screening coverage (%) coverage School Grade Output 835 71.4 95.6 60.6 73.3 83.0 68.8 96.2 4 117 6 571 8 581 51 67551 4 042 13 002 23 973 67 485 67 140 517 130 107 dose nd Measles Measles 2 coverage (%) coverage

rd 297 784 37.1 41.6 37.9 77.1 68.1 18.0 56.7 40.8 45.5 7 110 3 374 3 447 4 030 9 433 9 8 384 8 Infant Infant DTaP-IPV- exclusively exclusively Hib-HBV 3 breastfed at dose rate (%) 462 73.7 45.7 66.7 68.0 60.9 82.3 93.8 64.2 6 514 12 129 46 917 63 372 139 851 128 301 390 570 23 099 402 786 (%) coverage under 1 year Immunisation Immunisation 1 3 6692 2 348 3 592 1 252 3 869 6 7 487 1 506 2 13 24 21 724 91 1.1 1.3 1.5 0.7 0.7 0.3 0.8 2.2 613 140 891 2 911 1 176 (%) Outcome around 10 Infant PCR weeks rate test positive positive test - - 13 18 32 3.1 8.9 213 150 17.0 12.1 12.4 10.6 18.0 (per1K) neonatal neonatal Inpatient Inpatient death rate 9 - - 12 29 8.1 1.5 9.0 9.9 130 180 723 723 956 956 14.7 10.0 16.6 3 578 3 578 5 899 5 899 8 8458 845 8 20 001 20 001 (per1K) Inpatient Inpatient death rate early neonatal neonatal early - - - 19 27 53 4.4 9.8 6.3 8.3 2.8 142 976 289 636 388 13.1 13.4 2 198 Inpatient Inpatient year rate (%) death under 5 - - - 15 21 40 46 7.1 7.9 6.3 297 232 256 332 17.4 17.2 16.2 32.6 1 471 2 046 3 952 Impact Inpatient Inpatient year rate (%) death under 1 1 8 2 6 - - 19 91 53 22 35 9.1 6.6 8.0 271 104 15.1 10.6 12.9 18.3 5 years rate (%) Child under case fatality fatality case malnutrition malnutrition severe acute 4 3 3 - - - 12 23 22 4.1 1.3 3.0 2.0 2.5 3.2 135 234 296 688 13.0 5 years rate (%) pneumonia pneumonia Child under case fatality fatality case 1 1 8 4 - - - 11 17 6.1 2.4 2.0 0.8 3.6 3.2 170 179 120 477 12.5 5 years 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 rate (%) diarrhoea diarrhoea Child under case fatality fatality case Indicator Denominator Numerator Denominator Indicator Denominator Numerator Denominator Numerator Indicator Indicator Indicator Numerator Indicator Denominator Numerator Numerator Indicator Denominator Indicator D

Moses Kotane SD Kotane Moses Rustenburg SD Rustenburg North West South Africa South Moretele SD Moretele Kgetleng Rivier SD Rivier Kgetleng Madibeng SD Madibeng Bojanala Bojanala Source: HIS.

709 Section B: NationalProfile North and WestDistrict Province Profiles

Annual trends Child and School Health NW, DC37, Bojanala Platinum District Municipality, SEQ 3

Measure Names 100 IndValue Child under 5 Prov_av years diarrhoea 50 case fatality rate ZA_av

30 Child under 5

3_Child and school health school and 3_Child years 20 pneumonia case fatality rate 10

0 60 1_Impact Child under 5 years severe 40 acute malnutrition 20 case fatality rate 0

Inpatient early 20 neonatal death rate 10

0 150

Immunisation coverage under 100 1 year

Infant 80 exclusively breastfed at 60 DTaP-IPV-Hib- HBV 3rd dose 40 rate 20

3_Output 150

Measles 2nd dose coverage 100

100 School Grade 1 screening 50 cover age

0 2009 2010 2011 2012 2013 2014 2015 2016 Year

Annual NW,trends DC37, HIVBojanala Platinum District Municipality, SEQ 3

60 Measure Names IndValue 4_HIV HIV testing Prov_av coverage 40 (including ANC) ZA_av 20

200

Male condom distribution 100 coverage 4_Process_input

80 60 Medical male circumcision 40 rate 20 0 2009 2010 2011 2012 2013 2014 2015 2016 Year

710 SectionSection B: B: National Profile North and District West Province Profiles

HIV 5.1 269 396 11.2 19.0 24.4 16.4 15.8 15.5 18.2 3 710 4 251 2 549 11 175 11 287 673 936 585 2 714 925 2 714 8 482 263 (per1K) 2016/17 Medical male male Medical circumcision rate rate circumcision 47.5 64.1 29.4 48.7 52.3 36.6 22.5 33.8 784 149 249 048 2 421 213 5 590 620 5 928 000 7 503 603 503 7 1 086 000 2016/17 distribution distribution Male condom condom Male coverage (No) 47.1 31.1 31.4 27.3 31.9 28.8 42.9 35.9 12 128 39 972 4 357 736 44 579 200 4 186 77 770 77 101 435 101 (%) 90-90-90 2016/17 coverage st HIV testing 1 Process & input (including ANC) - - - - - 292 1 136 - 4 232 340 2 975 331 3 290 037 - 1 526 601 1 073 862 1 253 043 - - 163 3 413 - - - - 338 859 - - 7.4 8.7 8.2 26 797 275 884 556 148 21 307 526 647 255 10 (%) 2016/17 and older rate client years 15 (including ANC) HIV test positive ------45.0 55.0 46.9 98 816 219 823 2016/17 on ART rate (%) Clients remaining - 70 62 29 22 119 119 161 130 154 105 533 438 77.3 80.7 75.9 88.6 79.2 82.2 88.2 2015 90-90-90 Output nd months (%) 2 on ART after 12 Child percentage ------861 79.4 75.0 76.0 78.4 72.4 69.5 5 746 2 341 7 756 3 523 2015 months (%) on ART after 12 Adult percentageAdult 6 - 74 19 13 47 52 42 32 36 64 150 235 59.4 59.3 65.6 69.2 63.8 63.5 46.2 (%) 2015 rate months 12 Child with viral load suppressed suppressed load ------339 89.4 89.4 83.4 88.0 85.8 88.2 2 810 1 127 1 428 3 629 (%) 2015 90-90-90 Outcome rd 3 rate months 12 Adult with viral load suppressed suppressed load - 74 13 52 93 32 20 63 44 64 113 235 333 72.7 70.6 65.7 65.0 82.5 65.5 68.8 (%) 2015 Child with viral load completion completion load rate at months 12 ------479 77.9 77.8 81.5 70.3 70.8 69.9 75.1 3 611 5 165 1 382 1 833 (%) 2015 Adult with viral load completion completion load rate at months 12 Numerator Denominator Indicator Denominator Indicator Denominator Indicator Numerator Indicator Denominator Numerator Numerator Indicator Indicator Numerator Denominator Numerator Denominator Indicator Indicator

Bojanala Bojanala Moretele SD Moretele Moses Kotane SD Kotane Moses Rustenburg SD Rustenburg Madibeng SD Madibeng Kgetleng Rivier SD Rivier Kgetleng North West South Africa South Source: HIS.

711 Section B: NationalProfile North and WestDistrict Province Profiles

TB Annual trends NW, DC37, Bojanala Platinum District Municipality, SEQ 3

Measure Names 15 IndValue 5_TB 27.1 47.8 51.6 59.7 24.2 42.4 39.9 53.9 TB death rate Prov_av 42 792 89 495 10 749 531 426 019 148 981 925 140 224 029 447 805 549 883 549 (ETR.net) ZA_av 5 2016/17

screened in 60 TB symptom 5 facility rate (%) rate facility years and older Process & input 1_Impact TB DR client 40 ------229 796 ------death rate

47.4 (EDRWeb) 20 50.6 72.8 1 872 1 093 403 3 696 068 2 740 0 15 2016 Output rate (%) TB client lost to 10 on treatment treatment on follow up rate TB client initiated (ETR.Net) 5 58 90 0 175 619 156 138 276 364 77.4 63.4 64.4 86.5 82.9 58.8 88.5 88.3 1 615 2 132 1 397 2 756 80 TB client treatment 2016 success rate 60 Net) (%) Net)

TB/HIV co- (ETR.net)

ART rate (ETR. 40 infected client on 40 ------94 210 80.6 68.0 44.8 TB DR client loss to follow up 20 rate (EDRWeb) 2016 0 treatment treatment TB Rifampicin Rifampicin TB

resistant clients clients resistant 60 2_Outcome initiation rate (%) rate initiation TB DR treatment 40 ------success rate 5.1 5.7 6.2 210 (EDRWeb) 20 3 696 0 2016

rate (%) TB Rifampicin 20 resistance resistance resistance TB Rifampicin Rifampicin TB

confirmed client confirmed client confirmed client 10 rate 2 ------0 58.4 50.5 100

TB/HIV co-infected

2014 client on ART 50

Outcome rate (ETR.Net) success rate rate success (EDRWeb) (%)

TB DR treatment treatment DR TB 0 100 2 ------TB symptom 5 17.9 10.9 years and older screened in 50 facility rate 4_Process_input 2014 0 2009 2010 2011 2012 2013 2014 2015 2016 (EDRWeb) (%)

to follow up rate Year TB DR client loss Measure Names IndValue 570 196 359 965 458 395 59.1 81.0 69.7 64.7 78.4 59.0 49.6 69.0 3 270 1 163 2 279 1 970 4 567 7 058 P rov_av ZA_av 2015 TB client client TB treatment treatment success rate rate success (ETR.net) (%) 31 43 33 7.1 7.3 7.8 7.2 6.8 4.5 6.4 6.3 143 232 965 458 395 482 3 270 1 970 7 058 2015 TB client loss (ETR.Net) (%) (ETR.Net) to follow up rate 1 2 ------50.0 23.0 25.3 2014 death rate TB DR client (EDRWeb) (%) Impact 47 86 38 7.8 7.8 9.0 6.9 8.9 6.6 8.3 153 551 227 965 458 395 11.9 3 270 1 970 7 058 2015 TB death rate (ETR.net) (%) Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator Numerator Denominator Indicator Indicator Indicator Numerator Denominator D

Bojanala Bojanala Rustenburg SD Rustenburg Moses Kotane SD Kotane Moses Moretele SD Moretele Madibeng SD Madibeng North West South Africa South Kgetleng Rivier SD Rivier Kgetleng Source: HIS.

712 SectionSection B: B: National Profile North and District West Province Profiles

Non-communicable diseases

Outcome Diabetes Hypertension incidence incidence (per1K) (per1K) 2016/17 2016/17 Kgetleng Rivier SD Indicator 1.4 15.5 Numerator 79 270 Denominator 689 994 209 214 Madibeng SD Indicator 1.2 9.6 Numerator 650 1 454 Denominator 6 332 490 1 819 734 Moretele SD Indicator 0.8 10.1 Numerator 166 605 Denominator 2 521 080 721 611 Moses Kotane SD Indicator 1.0 17.0 Numerator 279 1 409 Denominator 3 260 118 996 963 Rustenburg SD Indicator 0.6 11.9 Numerator 339 2 045 Denominator 7 272 786 2 057 727 Bojanala Indicator 0.9 12.0 Numerator 1 513 5 783 Denominator 20 076 468 5 805 249 North West Indicator 1.4 16.0 South Africa Indicator 2.5 18.9 Source: DHIS.

Annual NW,trends DC37, Bojanala Platinum District Municipality, SEQ 3

Measure Names IndValue Prov_av 6_NCDs Diabetes 5 incidence ZA_av

2_Outcome 40 Hypertension incidence 20

2010 2011 2012 2013 2014 2015 2016 2017 Year

Sub-district value in red – improvement strategies are urgently needed Value highlighted in yellow – performance is ranked among the 10 best in the country Value highlighted in red – performance is ranked among the 10 worst in the country

713 Section B: NationalProfile North and WestDistrict Province Profiles

Ngaka Modiri Molema District Municipality (DC38)

Ngaka Modiri Molema District is situated in North West Province and comprises five health sub-districts, namely Ditsobotla, Mahikeng, Ramotshere Moiloa, Ratlou and Tswaing. It borders Botswana to the north. The district has a population of 878 238, with a population density of 31.1 persons per km2 and falls into socio-economic Quintile 2. Estimated medical scheme coverage is 11.0%.

Social determinants of healtha Population per selected category

Unemployment ratea 33.7% Population category 2017 2018 2019 2020 Youth unemployment rate (15-34 years)a 44.1% under 1 year 17 612 17 814 18 367 18 956 No schooling 11.6% under 5 years 96 357 95 453 95 039 94 974 Matric 25.7% 05-09 years 102 115 101 597 100 438 99 163 Higher education 7.1% 10-14 years 94 484 97 000 99 579 101 540 Households 269 977 15-19 years 90 059 89 671 89 755 90 671 Female-headed households 41.2% 20-24 years 93 658 92 680 91 539 90 376 Formal dwellings 82.7% 25-29 years 96 305 96 483 96 377 95 867 Flush toilet connected to sewerage 30.0% 30-34 years 81 161 85 444 89 840 94 208 Weekly refuse removal 37.4% 35-39 years 66 029 68 431 70 463 72 117 Piped water inside dwellings 19.5% 40-44 years 50 153 52 272 54 689 57 242 Electricity for lighting 89.4% 45-49 years 41 906 42 378 42 904 43 722 Blue Drop water score 30.4% 50-54 years 34 586 35 413 36 277 37 035 55-59 years 29 203 29 382 29 555 29 841 Source: StatsSA. 2014 Blue Drop Report. 60-64 years 22 897 23 480 24 063 24 568 65-69 years 16 789 17 026 17 314 17 644 70-74 years 12 789 12 627 12 479 12 412 75-79 years 7 944 8 408 8 738 8 880 80 years and older 6 828 6 866 6 915 6 969 Total 943 258 954 615 965 968 977 227 Estimated pregnant women* 18 845 19 061 19 653 20 283 Source: Mid-Year Population Estimates 2016 StatsSA. * Under 1 year population X 1.07.

Population distribution sub-district boundaries and health facility locations

a Statistics South Africa. Census 2011 Municipal fact sheet. Report No. 03-01-58. Pretoria: Statistics SA; 2012.

714 SectionSection B: B: National Profile North and District West Province Profiles

Number of facilities by level, 2016/17

Ward based Central/ outreach District Regional Tertiary Other teams Clinic CHC Hospital Hospital Hospitals Hospitals Ditsobotla SD 31 16 2 2 0 0 0 Mahikeng SD 40 27 4 1 1 0 1 R Moiloa SD 20 18 4 2 0 0 0 Ratlou SD 18 12 2 0 0 0 0 Tswaing SD 15 7 4 0 0 0 0 NM Molema 124 80 16 5 1 0 1 Source: DHIS.

Human resources – filled posts, 2016

Community Speech Health Nursing Enrolled Professional Medical Dental Occupational Therapy and Workers assistants nurse nurse practitioners Pharmacists practitioners therapy Physiotherapy Audiology NM Molema 2 354 564 198 1 120 161 64 16 8 15 1 Source: Persal, DHIS.

Management and efficiency indicators for the service delivery platform, 2016/17

PHC Management Output Process & input Provincial and LG Percentage of District Health Provincial Provincial assessed PHC Services and LG PHC and LG PHC facilities with expenditure expenditure expenditure Percentage 90% of tracer per capita per capita per PHC PHC utilisation Ideal clinics medicines (uninsured) (uninsured) headcount rate (No) (%) available (%) (Rand) (Rand) (Rand) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Ditsobotla SD Indicator 2.2 - - - - - Numerator 392 903 - - - - - Denominator 2 135 004 - - - - - Mahikeng SD Indicator 2.0 - - - - - Numerator 629 468 - - - - - Denominator 3 706 686 - - - - - R Moiloa SD Indicator 2.6 - - - - - Numerator 406 689 - - - - - Denominator 1 882 533 - - - - - Ratlou SD Indicator 2.9 - - - - - Numerator 318 440 - - - - - Denominator 1 303 170 - - - - - Tswaing SD Indicator 2.5 - - - - - Numerator 320 628 - - - - - Denominator 1 536 681 - - - - - NM Molema Indicator 2.3 22.8 83.1 1 804 1 238 468 Numerator 2 068 128 21 74 1 409 615 537 967 125 150 967 125 150 Denominator 10 564 074 92 89 781 500 781 500 2 068 128 North West Indicator 2.1 29.3 74.2 1 551 1 064 434 South Africa Indicator 2.3 29.8 78.4 1 726 1 054 389 Source: DHIS.

715 Section B: NationalProfile North and WestDistrict Province Profiles ------AnnualNW, DC38, trends Ngaka Modiri Molema District Municipality, SEQ 2 (deprived) 10.8 20.3

(%) 8 Measure Names OPD new

client not not client IndValue referred rate rate referred Inpatient crude 6 Prov_av ------death rate ZA_av 5.4 6.2 1_Impact 4

1_Management 2

rate (%) 8 Inpatient Inpatient crude death 6 Average length ------of stay (district 4 84.3 82.5 hospitals)

(%) 2 utilisation rate - total 4K Inpatient bed

2_Outcome Expenditure per ------patient day 3K Tertiary/Central Hospital equivalent 2 821 4 227 (district 2K day hospitals) (Rand) 1K equivalent equivalent per patient Expenditure ------6.9 6.8 Inpatient bed 100 utilisation rate (district (Days) Average

length of of length hospitals) stay - total 50 ------100 17.6 17.6 3_Output 37.2 15.7 2 315 2 315 13 179 13 179 OPD new client (%) not referred rate 50 OPD new

client not not client (district

referred rate rate referred hospitals) ------0 5.4 6.0 6.0 100 1 611 1 611 26 691 26 691 rate (%)

Inpatient Inpatient Percentage 50 crude death Ideal clinics ------78.3 5.0 90.5 0 104.6 104.6 128 616 128 616 134 487 134 487 (%) Provincial and 3K

Hospital LG District utilisation rate - total

Inpatient bed Health Services 2K Regional Hospital Regional expenditure per ------capita (uninsured) 2 739 2 658 2 894 2 658 1K 173 942 173 942 day (Rand) equivalent equivalent per patient 462 391 150 462 391 150 Provinc ial and Expenditure 1500

4_Process_input LG PHC ------expenditure per 1000 5.0 5.0 5.3 capita (uninsured) 26 691 26 691 134 487 134 487 500 (Days) Average length of of length stay - total

Provincial and 400 LG PHC 51.5 56.4 5.4 59.9 59.3 62.3 68.2 expenditure per 8 777 8 43 413 19 845 19 19 049 31 803 69 676 PHC headcount (%) 200 OPD new client not not client referred rate rate referred 2008 2010 2012 2014 2016 2018 Year 7.1 7.6 7.3 5.1 6.7 6.4 611 519 4 519 449 7 140 1 579 Measure Names 22 177 IndValue rate (%)

Inpatient Inpatient P rov_av crude death ZA_av 67.4 59.1 56.4 64.3 65.8 46.3 28 719 36 713 57 068 6 985 29 096 38 880 38 104 312 184 984 184 (%) utilisation rate - total Inpatient bed District Hospital District 2 198 2 568 2 336 2 398 2 488 2 665 2 49 958 49 44 546 65 829 139 397 139 day (Rand) 97 912 242 97 912 equivalent equivalent 116 682 666 682 116 per patient 119 635 438119 334 230 347 Expenditure 4.7 4.7 4.4 5.4 5.3 3.6 7 140 8 052 44 893 62 087 8 052 6 985 28 719 36 713 22 177 38 880 38 104 312 (Days) Average length of of length stay - total Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Indicator Numerator Indicator Denominator Numerator Indicator D

NM Molema R Moiloa SD Mahikeng SD Mahikeng South Africa South North West Ditsobotla SD Ditsobotla Source: HIS and BAS.

716 SectionSection B: B: National Profile North and District West Province Profiles

Deaths and Patient day equivalent 2014/15 – 2016/17 70 52 20 32 94 30 44 157 339 3 190 14 593 313 566 Total District District ------tertiary Central/ hospital 11 12 27 26 43 36 185 104 1 611 4 016 173 942 2016/17 Hospital Regional Regional 41 51 15 15 53 94 43 5 427 139 397 139 District District Hospital - - - 8 - - 8 - - - 1 579 4 2 60 227 5 150 / MOU PHC / CHC 42 26 56 22 65 60 34 157 332 3 139 14 548 Total 299 002 District District ------1 790------tertiary Central/ Hospital 17 17 20 29 38 30 116 159 161 170 2015/16 Hospital Regional Regional 41 14 13 13 31 42 23 20 39 106 136 008 District District Hospital - - - - - 4 - - 1 4 67 1 740 1 824 5 252 5 426 3 870 - / MOU PHC / CHC 81 24 39 66 43 54 45 167 293 1 910 15 606 319 155 Total District District ------tertiary Central/ Hospital 1 - 11 14 12 10 20 40 34 141 124 3 841 172 551 2014/15 Hospital Regional Regional 70 29 65 85 33 38 98 44 1 708 1 684 - 3 426 2 1 569 1 568 - 143 800 District District Hospital - - - - - 5 - 4 - 5 54 34 1 785 2 804 6 008 5 757 / MOU* PHC / CHC

Death in facility – 59 months 12 Death in facility months 29 days - 11 Death in facility 8-28 days Death in facility 0-7days

natal natal

Neo-

year) (under 1 1 (under

D Infant Infant

years) Child (under 5 5 (under Child ata Element ata Diarrhoea death under 5 years Pneumonia death under 5 years Maternal deaths deaths Maternal D (Number) TB Deaths Severe acute malnutrition death under 5 years Inpatient death total Live births Patient day equivalent day Patient Still birthsStill Source: HIS. *MOU – Maternal Obstetric Unit.

717 Section B: NationalProfile North and WestDistrict Province Profiles

PercentageNW, NM Molema: of deaths DC38, by broad 2010 cause - 2015 and leading causes 2010–2015 Percentage of AgeGroup.. Female Male deaths by broad <5 years 80% 7% 9%4% 80% 7% 9%4% causes and 5-14 37% 20% 21% 22% 27% 22% 20% 32% single leading 15-24 33% 35% 19% 13% 18% 16% 14% 52% causes 25-64 26% 33% 37% 3% 21% 35% 33% 11% 65+ 11%3% 84% 1% 14% 7% 76% 3% Broadcause 28% 21% 48% 4% 26% 24% 41% 10% Total Injury NCD Rank.. Female Male 1 Lower respiratory infections (21.7%) Diarrhoeal diseases (21.3%) HIV and TB 2 Diarrhoeal diseases (21.7%) Lower respiratory infections (17.3%) Comm_mat_peri_nut 3 Preterm birth complications (12.7%) Preterm birth complications (14.7%) 4 Protein-energy malnutrition (7.0%) Birth asphyxia (9.3%) Prov, District 5 Birth asphyxia (6.7%) Protein-energy malnutrition (7.4%) NW, NM Molema: DC38 6 Sepsis/other newborn infectious (4.2%) Tuberculosis (4.1%) Show history

<5 years <5 7 Tuberculosis (3.7%) Sepsis/other newborn infectious (4.1%) 8 HIV/AIDS (3.4%) HIV/AIDS (3.2%) Percentages are shown 9 Septicaemia (3.1%) Septicaemia (3.0%) according to all the deaths 10 Other perinatal conditions (2.5%) Other perinatal conditions (2.2%) within the age/gender 1 Tuberculosis (17.1%) Road injuries (15.6%) category of each box, 2 Road injuries (16.3%) Tuberculosis (15.2%) although only the leading 3 Diarrhoeal diseases (13.2%) Lower respiratory infections (14.0%) 10 causes are displayed. 4 Lower respiratory infections (12.4%) Drowning (10.6%) 5 HIV/AIDS (6.0%) HIV/AIDS (8.6%)

5-14 6 Endocrine nutritional,blood, immune (4.3%) Diarrhoeal diseases (7.0%) 7 Protein-energy malnutrition (4.2%) Meningitis/encephalitis (3.3%) 8 Meningitis/encephalitis (4.1%) Epilepsy (2.7%) 9 Drowning (3.4%) Accidental threats to breathing (2.6%) 10 Epilepsy (2.5%) Septicaemia (2.2%) 1 Tuberculosis (21.4%) Road injuries (18.0%) 2 Lower respiratory infections (19.5%) Interpersonal violence (14.2%) 3 HIV/AIDS (15.4%) Lower respiratory infections (10.9%) 4 Road injuries (6.2%) Tuberculosis (10.5%) 5 Diarrhoeal diseases (4.5%) Accidenta l threats to breathing (9.2%)

15-24 6 Endocrine nutritional,blood, immune (3.7%) HIV/AIDS (6.0%) 7 Septicaemia (3.0%) Self-inflicted injuries (3.6%) 8 Epilepsy (2.5%) Meningitis/encephalitis (3.2%) 9 Interpersonal violence (2.3%) Drowning (3.2%) 10 Accidental threats to breathing (2.2%) Epilepsy (3.0%) 1 Tuberculosis (16.7%) Tuberculosis (20.6%) 2 HIV/AIDS (16.5%) HIV/AIDS (14.7%) 3 Lower respiratory infections (16.3%) Lower respiratory infections (14.3%) 4 Cerebrovascular disease (5.7%) Cerebrovascular disease (4.8%) 5 Hypertensive heart disease (4.6%) Road injuries (4.4%)

25-64 6 Diarrhoeal diseases (4.3%) Hypertensive heart disease (3.2%) 7 Diabetes mellitus (4.1%) Ischaemic heart disease (3.1%) 8 Ischaemic heart disease (2.4%) Diarrhoeal diseases (3.0%) 9 Endocrine nutritional,blood, immune (2.4%) Diabetes mellitus (2.2%) 10 Asthma (2.3%) Nephritis/nephrosis (2.1%) 1 Cerebrovascular disease (23.5%) Hypertensive heart disease (14.8%) 2 Hypertensive heart disease (20.4%) Cerebrovascular disease (14.3%) 3 Diabetes mellitus (7.7%) Lower respiratory infections (9.6%) 4 Ischaemic heart disease (7.0%) Ischaemic heart disease (8.2%) 5 Lower respiratory infections (6.6%) Tuberculosis (6.1%)

65+ 6 Diarrhoeal diseases (2.9%) Diabetes mellitus (4.8%) 7 Nephritis/nephrosis (2.9%) COPD (4.2%) 8 Asthma (2.4%) Nephritis/nephrosis (4.1%) 9 Tuberculosis (2.4%) Asthma (3.3%) 10 Cardiomyopathy (2.0%) Prostate (3.2%)

Rank.. Maternal conditions All other causes 1 Indirect maternal (31.8%) n=49 Tuberculosis (20.8%) n=2 108 2 Hypertension in pregnancy (24.6%) n=38 HIV/AIDS (20.1%) n=2 029 3 Other maternal (16.8%) n=26 Lower respiratory infections (19.6%) n=1 987 4 Maternal haemorrhage (14.9%) n=23 Diarrhoeal diseases (4.6%) n=460 5 Abortion (6.8%) n=10 Cerebrovascular disease (2.8%) n=281

15-49 6 Maternal sepsis (5.1%) n=8 Endocrine nutritional,blood, immune (2.8%) n=279 Female 7 Road injuries (2.4%) n=239 8 Septicaemia (2.4%) n=238 9 Meningitis/encephalitis (2.1%) n=215 10 Asthma (2.0%) n=197

718 SectionSection B: B: National Profile North and District West Province Profiles

Maternal and Women’s Health

Impact Outcome Output Maternal Antenatal Delivery in Cervical Mother mortality in client initiated facility under Antenatal 1st cancer Couple year postnatal visit facility ratio on ART rate 18 years rate visit before 20 screening protection rate within 6 days (per100K) (%) (%) weeks rate (%) coverage (%) (WHO) (%) rate (%) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Ditsobotla SD Indicator 40.2 100.0 9.1 70.3 65.6 59.9 71.9 Numerator 1 435 228 2 066 2 560 29 395 1 804 Denominator 2 487 435 2 509 2 938 46 853 589 251 2 509 Mahikeng SD Indicator 407.0 88.9 6.9 67.1 80.1 58.9 44.4 Numerator 29 737 493 3 693 5 591 55 879 3 191 Denominator 7 126 829 7 194 5 504 83 768 1 138 263 7 194 R Moiloa SD Indicator - 94.9 4.5 60.5 65.9 66.7 67.0 Numerator - 282 108 1 550 2 484 28 876 1 599 Denominator 2 418 297 2 387 2 563 45 220 519 699 2 387 Ratlou SD Indicator - 96.4 7.9 63.1 107.5 67.0 145.3 Numerator - 265 100 1 323 2 568 19 198 1 848 Denominator 1 272 275 1 272 2 097 28 663 343 890 1 272 Tswaing SD Indicator 155.0 82.5 7.0 64.3 57.8 53.9 96.3 Numerator 2 236 86 1 191 1 562 18 628 1 177 Denominator 1 290 286 1 222 1 852 32 401 414 555 1 222 NM Molema Indicator 219.3 92.1 7.0 65.7 74.8 60.7 66.0 Numerator 32 1 955 1 015 9 823 14 765 151 976 9 619 Denominator 14 593 2 122 14 584 14 954 236 905 3 005 658 14 584 North West Indicator 138.9 95.9 6.5 63.7 69.3 60.2 74.4 South Africa Indicator 116.9 95.1 6.8 65.2 61.5 70.2 70.3 Source: DHIS.

AnnualNW, DC38, trends Ngaka Modiri Molema District Municipality, SEQ 2 (deprived)

800 Measure Names 600 IndValue Maternal Prov_av mortality in 400 facility ratio ZA_av 1_Impact 200 0 80

Antenatal 1st 60 visit before 20 weeks rate 40 2_Maternal and women's health women's and 2_Maternal 20

200 Couple year protection rate (WHO) 100

15 2_Outcome Delivery in facility under 18 10 years rate 5

200 Mother postnatal visit within 6 days 100 rate

0 200

Antenatal client 150 initiated on ART rate 100

3_Output 150 Cervical cancer screening 100 coverage 50

2009 2010 2011 2012 2013 2014 2015 2016 Year

719 Section B: NationalProfile North and WestDistrict Province Profiles

Child and School Health 51.8 59.3 58.0 66.6 48.9 58.3 56.2 62.2 12 516 12 824 11 085 13 028 22 180 71 633 213 702 473 484 263 526 263 297 054 1 473 2341 473 months Vitamin A dose 12-59 coverage (%) coverage 736 685 64.1 19.8 24.8 38.7 54.8 86.6 93.8 25.2 8 418 2 241 2 715 3 050 107 748 8 screening coverage (%) coverage School Grade 77.1 57.0 53.1 33.1 70.5 33.0 45.6 36.5 2 074 2 215 1 475 1 706 9 737 9 3 889 2 967 3 235 2 660 225 468 151 644 1 screening coverage (%) coverage School Grade Output 94.1 89.3 83.0 80.0 93.5 96.2 2 524 2 375 2 320 1 824 109.3 102.3 4 357 14 177 27 372 27 32 382 32 26 085 3 290 2 589 180 720 dose nd Measles Measles 2 coverage (%) coverage

rd 991 989 41.6 47.2 49.7 40.0 56.8 44.8 45.5 2 214 1 731 1 991 6 595 2 580 13 982 Infant Infant DTaP-IPV- exclusively exclusively Hib-HBV 3 breastfed at dose rate (%) 81.6 73.7 98.7 48.7 79.8 96.7 75.5 82.3 85.3 3 741 2 018 31 143 12 321 56 277 4 330 58 554 6 264 5 564 26 202 25 035 34 584 2 867 36 327 4 527 173 241 (%) coverage under 1 year Immunisation Immunisation 5 2 562 1 256 4 2 352 1 628 3 097 1 653 7 4 1 648 19 39 1.3 1.5 1.3 4.3 0.8 2.3 2.5 2.8 474 320 254 200 446 1 694 1 (%) Outcome around 10 Infant PCR weeks rate test positive positive test 1 - - - - 11 4.4 0.4 189 201 12.1 12.4 13.8 26.5 (per1K) neonatal neonatal Inpatient Inpatient death rate 1 - - - - 11 4.4 0.4 9.9 157 145 10.0 10.8 20.3 2 418 2 418 7 126 7 126 2 487 2 487 14 593 14 593 (per1K) Inpatient Inpatient death rate early neonatal neonatal early - - - 1 272 1 272 - - - 1 290 1 290 41 10 5.1 1.9 4.4 6.6 6.3 5.2 619 347 525 296 5 692 6 836 Inpatient Inpatient year rate (%) death under 5 5 ------22 7.9 2.1 4.4 4.5 6.3 214 243 253 226 10.3 5 134 5 591 Impact Inpatient Inpatient year rate (%) death under 1 3 6 1 - - - - - 61 70 66 85 9.1 8.0 3.5 578 426 12.1 14.3 10.6 5 years rate (%) Child under case fatality fatality case malnutrition malnutrition severe acute 3 ------17 81 20 3.1 3.7 2.0 2.6 2.5 127 764 556 5 years rate (%) pneumonia pneumonia Child under case fatality fatality case 4 ------26 93 30 96 3.1 3.4 4.3 2.0 3.2 768 957 5 years 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 rate (%) diarrhoea diarrhoea Child under case fatality fatality case Denominator Indicator Indicator Numerator Denominator Indicator Numerator Indicator Numerator Indicator Denominator Numerator Denominator Indicator Numerator Denominator Indicator Numerator Denominator Indicator D

R Moiloa SD South Africa South Ditsobotla SD Ditsobotla North West Mahikeng SD Mahikeng Ratlou SD Ratlou Tswaing SD Tswaing NM Molema Source: HIS.

720 SectionSection B: B: National Profile North and District West Province Profiles

AnnualNW, DC38, trends Ngaka ChildModiri Molema and School District Municipality, Health SEQ 2 (deprived)

Measure Names 100 IndValue Child under 5 Prov_av years diarrhoea 50 case fatality rate ZA_av

30 Child under 5

3_Child and school health school and 3_Child years 20 pneumonia case fatality rate 10

0 60 1_Impact Child under 5 years severe 40 acute malnutrition 20 case fatality rate 0

Inpatient early 20 neonatal death rate 10

0 150

Immunisation coverage under 100 1 year

Infant 80 exclusively breastfed at 60 DTaP-IPV-Hib- HBV 3rd dose 40 rate 20

3_Output 150

Measles 2nd dose coverage 100

100 School Grade 1 screening 50 cover age

0 2009 2010 2011 2012 2013 2014 2015 2016 Year

Annual trends HIV NW, DC38, Ngaka Modiri Molema District Municipality, SEQ 2 (deprived)

60 Measure Names IndValue 4_HIV HIV testing Prov_av coverage 40 (including ANC) ZA_av 20

200

Male condom distribution 100 coverage 4_Process_input

80 60 Medical male circumcision 40 rate 20 0 2009 2010 2011 2012 2013 2014 2015 2016 Year

721 Section B: NationalProfile North and WestDistrict Province Profiles

HIV 962 546 17.0 13.1 18.1 15.4 19.0 13.5 18.2 26.3 6 251 1 696 1 044 2 003 927 081 772 878 498 978 638 094 638 1 564 548 (per1K) 2016/17 Medical male male Medical circumcision rate rate circumcision 47.5 34.1 39.4 35.4 42.6 36.6 45.9 40.2 701 331 437 337 849 495 849 568 503 568 1 674 0001 674 1 433 085 433 1 2 490 000 4 800 000 800 4 2016/17 distribution distribution Male condom condom Male coverage (No) 31.9 35.4 29.5 39.8 35.4 35.9 32.8 33.8 31 474 18 651 57 327 25 459 148 1 616 42 365 2 508 000 175 276175 088 13 148 682 653 682 6 226 836 3 989 751 4 401 579 (%) 90-90-90 2016/17 coverage st HIV testing 1 Process & input (including ANC) - - - 1 277 250 - - - - 2 335 026 - - 1 067 901 - - - - 864 006 - - 7.4 5.7 8.2 10 726 186 606 (%) 2016/17 and older rate client years 15 (including ANC) HIV test positive ------47.5 55.0 46.9 50 137 105 640 2016/17 on ART rate (%) Clients remaining - 41 51 47 49 46 53 60 39 43 33 256 206 76.7 76.7 83.7 88.7 76.5 79.2 80.5 2015 90-90-90 Output nd months (%) 2 on ART after 12 Child percentage ------71.8 72.4 75.8 72.0 72.5 69.8 1 183 1 243 1 737 1 1 777 1 1 335 1 2015 months (%) on ART after 12 Adult percentageAdult - 14 12 18 12 19 10 31 23 29 22 66 124 58.1 52.6 59.3 54.5 48.3 52.2 53.2 (%) 2015 rate months 12 Child with viral load suppressed suppressed load ------743 470 756 698 509 67.2 72.1 77.2 64.6 83.4 69.2 (%) 2015 90-90-90 Outcome rd 3 rate months 12 Adult with viral load suppressed suppressed load - 19 31 23 29 25 39 32 22 30 38 124 164 74.4 81.6 76.7 76.0 75.6 65.7 68.8 (%) 2015 Child with viral load completion completion load rate at months 12 ------702 729 850 67.7 87.4 67.0 71.3 69.9 69.8 1 031 1 060 (%) 2015 Adult with viral load completion completion load rate at months 12 Numerator Denominator Indicator Indicator Numerator Indicator Denominator Numerator Denominator Indicator Numerator Denominator Denominator Indicator Indicator Indicator Numerator Indicator Denominator Numerator

Ditsobotla SD Ditsobotla Mahikeng SD Mahikeng R Moiloa SD South Africa South Ratlou SD Ratlou NM Molema North West Tswaing SD Tswaing Source: HIS.

722 SectionSection B: B: National Profile North and District West Province Profiles

TB Annual trends NW, DC38, Ngaka Modiri Molema District Municipality, SEQ 2 (deprived)

Measure Names 15 IndValue 5_TB 27.3 51.6 50.6 42.4 40.5 49.5 36.9 23.2 TB death rate Prov_av

70 442 10 121 465 103 766 161 832 256 521 169 345 257 866 257

326 950 326 (ETR.net) 334 433 334 ZA_av 5 2016/17

screened in 60 TB symptom 5 facility rate (%) rate facility 1_Impact years and older Process & input TB DR client 40 ------522 549 - - - - - death rate (EDRWeb) 20 47.4 72.8 64.2 2 302 626 850 3 584 1 698 319 0 15 2016 Output rate (%) TB client lost to 10 on treatment treatment on follow up rate

TB client initiated (ETR.Net) 5

0 314 314 196 224 245 681 236 280 266 596 87.5 94.9 80.0 95.0 82.9 90.9 88.3 1 756 100.0 1 596 80 TB client treatment

2016 success rate 60

Net) (%) Net) (ETR.net) TB/HIV co- 40 ART rate (ETR. infected client on 40 ------79 TB DR client 130 80.6 68.0 60.8 loss to follow up 20 rate (EDRWeb)

2016 0 treatment treatment 60 TB Rifampicin Rifampicin TB 2_Outcome

resistant clients clients resistant TB DR initiation rate (%) rate initiation treatment 40 success rate ------

5.1 (EDRWeb) 20 3.6 6.2 130

3 584 0

2016 TB Rifampicin 20 rate (%) resistance resistance resistance confirmed client TB Rifampicin Rifampicin TB 10 confirmed client confirmed client rate - - 0 1 ------100 58.4 50.5 TB/HIV co-infected client on ART 50 2014 rate (ETR.Net) Outcome

success rate rate success 0 (EDRWeb) (%)

TB DR treatment treatment DR TB 100 TB symptom 5 1 ------years and older

17.9 50 10.9 screened in facility rate

4_Process_input 0 2014 2009 2010 2011 2012 2013 2014 2015 2016 Year (EDRWeb) (%) to follow up rate TB DR client loss Measure Names IndValue 741 617 614 618 832 732 453 946 77.4 74.3 81.0 P rov_av 73.4 78.8 69.0 82.9 83.3 1 021 1 226 4 362 3 438 ZA_av 2015 TB client client TB treatment treatment success rate rate success (ETR.net) (%) 74 29 35 69 54 5.7 5.7 6.0 6.4 5.6 8.9 3.9 6.3 741 617 261 832 946 1 226 4 362 2015 TB client loss (ETR.Net) (%) (ETR.Net) to follow up rate 1 ------23.0 25.3 2014 death rate TB DR client (EDRWeb) (%) Impact 61 61 81 79 99 8.1 8.7 9.9 9.5 9.0 6.6 8.6 8.2 741 617 381 832 946 1 226 4 362 2015 TB death rate (ETR.net) (%) Indicator Denominator Numerator Indicator Denominator Numerator Indicator Numerator Indicator Denominator Denominator Indicator Numerator Denominator Numerator Indicator Indicator Indicator Numerator Denominator D

NM Molema Tswaing SD Tswaing Ratlou SD Ratlou R Moiloa SD Mahikeng SD Mahikeng North West Africa South Ditsobotla SD Ditsobotla Source: HIS.

723 Section B: NationalProfile North and WestDistrict Province Profiles

Non-communicable diseases

Outcome Diabetes Hypertension incidence incidence (per1K) (per1K) 2016/17 2016/17 Ditsobotla SD Indicator 1.5 14.2 Numerator 263 711 Denominator 2 135 004 599 811 Mahikeng SD Indicator 2.8 30.1 Numerator 859 2 476 Denominator 3 706 686 988 386 R Moiloa SD Indicator 1.9 22.7 Numerator 301 1 064 Denominator 1 882 533 561 438 Ratlou SD Indicator 1.5 28.1 Numerator 165 835 Denominator 1 303 170 356 460 Tswaing SD Indicator 4.1 13.1 Numerator 520 460 Denominator 1 536 681 421 029 NM Molema Indicator 2.4 22.7 Numerator 2 108 5 546 Denominator 10 564 074 2 927 124 North West Indicator 1.4 16.0 South Africa Indicator 2.5 18.9 Source: DHIS.

Annual trends NW, DC38, Ngaka Modiri Molema District Municipality, SEQ 2 (deprived)

Measure Names IndValue Prov_av 6_NCDs Diabetes 5 incidence ZA_av

2_Outcome 40 Hypertension incidence 20

2010 2011 2012 2013 2014 2015 2016 2017 Year

724 SectionSection B: B: National Profile North and District West Province Profiles

Ruth Segomotsi Mompati District Municipality (DC39)

Ruth Segomotsi Mompati District is situated in North West Province and comprises five health sub-districts, namely Greater Taung, Kagisano-Molopo, Lekwa-Teemane, Mamusa and Naledi. It borders Botswana to the north. The district has a population of 479 535, with a population density of 11.0 persons per km2 and falls into socio-economic Quintile 1, the poorest in the province. Estimated medical scheme coverage is 9.9%.

Social determinants of healtha Population per selected category

Unemployment ratea 35.8% Population category 2017 2018 2019 2020 Youth unemployment rate (15-34 years)a 46.0% under 1 year 11 185 11 008 10 827 10 557 No schooling 15.5% under 5 years 59 631 58 401 56 985 55 419 Matric 22.7% 05-09 years 61 279 61 143 60 702 60 122 Higher education 4.6% 10-14 years 55 117 56 636 58 133 59 299 Households 127 103 15-19 years 48 171 47 965 48 410 49 553 Female-headed households 43.5% 20-24 years 46 003 45 028 43 788 42 581 Formal dwellings 89.9% 25-29 years 42 654 42 839 42 762 42 302 Flush toilet connected to sewerage 34.6% 30-34 years 32 898 34 702 36 561 38 347 Weekly refuse removal 32.7% 35-39 years 26 255 26 892 27 397 27 819 Piped water inside dwellings 14.3% 40-44 years 20 289 20 884 21 580 22 295 Electricity for lighting 87.6% 45-49 years 17 531 17 472 17 440 17 509 Blue Drop water score 30.1% 50-54 years 15 464 15 507 15 542 15 542 55-59 years 13 527 13 463 13 405 13 365 Source: StatsSA. 2014 Blue Drop Report. 60-64 years 11 638 11 586 11 528 11 472 65-69 years 9 291 9 262 9 242 9 205 70-74 years 7 745 7 518 7 289 7 096 75-79 years 5 197 5 496 5 687 5 732 80 years and older 4 031 4 099 4 170 4 250 Total 476 719 478 895 480 611 481 907 Estimated pregnant women* 11 968 11 779 11 585 11 296 Source: Mid-Year Population Estimates 2016 StatsSA. * Under 1 year population X 1.07.

Population distribution sub-district boundaries and health facility locations

a Statistics South Africa. Census 2011 Municipal fact sheet. Report No. 03-01-58. Pretoria: Statistics SA; 2012.

725 Section B: NationalProfile North and WestDistrict Province Profiles

Number of facilities by level, 2016/17

Ward based Central/ outreach District Regional Tertiary Other teams Clinic CHC Hospital Hospital Hospitals Hospitals Greater Taung SD 28 25 3 1 0 0 0 Kagisano-Molopo SD 15 13 5 1 0 0 0 Lekwa-Teemane SD 7 5 1 1 0 0 0 Mamusa SD 8 5 1 1 0 0 0 Naledi SD 8 2 2 0 1 0 1 RS Mompati 66 50 12 4 1 0 1 Source: DHIS.

Human resources – filled posts, 2016

Community Speech Health Nursing Enrolled Professional Medical Dental Occupational Therapy and Workers assistants nurse nurse practitioners Pharmacists practitioners therapy Physiotherapy Audiology RS Mompati 1 330 429 141 619 77 31 14 3 9 1 Source: Persal, DHIS.

Management and efficiency indicators for the service delivery platform, 2016/17

PHC Management Output Process & input Provincial and LG Percentage of District Health Provincial Provincial assessed PHC Services and LG PHC and LG PHC facilities with expenditure expenditure expenditure Percentage 90% of tracer per capita per capita per PHC PHC utilisation Ideal clinics medicines (uninsured) (uninsured) headcount rate (No) (%) available (%) (Rand) (Rand) (Rand) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Greater Taung SD Indicator 2.6 - - - - - Numerator 480 010 - - - - - Denominator 2 199 870 - - - - - Kagisano-Molopo SD Indicator 3.6 - - - - - Numerator 387 353 - - - - - Denominator 1 304 760 - - - - - Lekwa-Teemane SD Indicator 2.7 - - - - - Numerator 149 468 - - - - - Denominator 667 944 - - - - - Mamusa SD Indicator 1.7 - - - - - Numerator 109 207 - - - - - Denominator 752 742 - - - - - Naledi SD Indicator 2.4 - - - - - Numerator 169 071 - - - - - Denominator 836 961 - - - - - RS Mompati Indicator 2.7 30.2 87.5 2 156 1 289 430 Numerator 1 295 109 19 49 931 947 116 557 026 704 557 026 704 Denominator 5 762 277 63 56 432 241 432 241 1 295 109 North West Indicator 2.1 29.3 74.2 1 551 1 064 434 South Africa Indicator 2.3 29.8 78.4 1 726 1 054 389 Source: DHIS.

726 SectionSection B: B: National Profile North and District West Province Profiles ------10.8 20.3 (%) OPD new client not not client referred rate rate referred ------5.4 6.2 rate (%) Inpatient Inpatient crude death ------84.3 82.5 (%) utilisation rate - total Inpatient bed ------Tertiary/Central Hospital 2 821 4 227 day (Rand) equivalent equivalent per patient Expenditure ------6.9 6.8 (Days) Average length of of length stay - total ------37.2 15.7 21.8 21.8 5 765 5 765 26 465 26 465 (%) OPD new client not not client referred rate rate referred ------5.4 311 311 7 861 7 861 rate (%) Inpatient Inpatient crude death ------78.3 5.0 84.9 4.0 84.9 4.0 90.5 37 194 37 194 43 805 43 43 805 43 (%) Hospital utilisation rate - total Inpatient bed Regional Hospital Regional ------2 739 2 894 2 994 2 2 994 2 60 108 60 108 day (Rand) equivalent equivalent 179 970 923179 179 970 923179 per patient Expenditure ------4.7 4.7 5.3 7 861 7 861 37 194 37 194 (Days) Average length of of length stay - total - - - 56.4 5.4 70.0 59.3 28.4 56.3 54.5 5 105 8 521 2 979 1 245 5 964 5 1 684 4 384 4 11 872 21 098 (%) OPD new client not not client referred rate rate referred - - - 5.1 8.1 6.7 5.4 58.4 8.4 5.9 136 292 635 1 627 3 594 3 088 3 990 10 811 20 022 rate (%) Inpatient Inpatient crude death - - - 67.4 65.4 6.4 59.8 65.7 65.8 66.9 66.5 14 414 214 14 559 14 602 21 537 61 329 21 902 93 359 151 400 (%) utilisation rate - total Inpatient bed District Hospital District - - - 2 618 2 223 2 429 2 568 2 488 2 340 2 056 19 614 13 482 77 668 77 131 732 day (Rand) 49 069 747 51 35551 723 equivalent equivalent per patient 159 658 158 Expenditure - - - 4.1 4.7 4.4 4.9 5.4 5.7 3.6 1 627 8 736 186 32 746 8 736 3 594 20 967 3 990 14 414 10 811 14 559 61 329 99 037 292 829 814 99 037 1 277 20 022 (Days) Average length of of length stay - total Indicator Indicator Numerator Denominator Indicator Denominator Indicator Numerator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator D

South Africa South North West RS Mompati Naledi SD Mamusa SD Mamusa Lekwa-Teemane SD Lekwa-Teemane Kagisano-Molopo SD Greater SD Taung Source: HIS and BAS.

727 Section B: NationalProfile North and WestDistrict Province Profiles

Annual trends Management and efficiency indicatorsNW, DC39, Dr forRuth theSegomotsi service Mompati delivery District Municipality, platform, SEQ 2016/171 (most deprived)

8 Measure Names IndValue Inpatient crude 6 Prov_av death rate ZA_av

1_Impact 4

1_Management 2 8 6 Average length of stay (district 4 hospitals) 2

2_Outcome Expenditure per patient day 3K equivalent (district 2K hospitals) 1K

Inpatient bed 100 utilisation rate (district hospitals) 50

100 3_Output OPD new client not referred rate 50 (district hospitals)

0 100

Percentage 50 Ideal clinics

Provincial and 3K LG District Health Services 2K expenditure per capita (uninsured) 1K

Provinc ial and 1500

4_Process_input LG PHC expenditure per 1000 capita (uninsured) 500

Provincial and 400 LG PHC expenditure per PHC headcount 200

2008 2010 2012 2014 2016 2018 Year

728 SectionSection B: B: National Profile North and District West Province Profiles

Deaths and Patient day equivalent 2014/15 – 2016/17 11 14 15 18 16 69 30 242 100 8 921 192 162 Total District District - - - - - 1 588 - tertiary Central/ hospital 4 - 3 - 3 - 79 22 46 311 1 762 60 108 2016/17 Hospital Regional Regional 13 12 47 26 54 127 4 424 131 732 District District Hospital ------6 8 - - 9 9 - 36 322 / MOU PHC / CHC 11 12 28 29 50 22 110 243 186 179 Total District District - - 9 207 2 735 - - - -- 1 635 1 605 - - 1 277 - - - - - tertiary Central/ Hospital -- -- 13 12 61 89 105 327 1 614 53 333 53 2015/16 Hospital Regional Regional 17 37 28 49 22 114 365 132 846 District District Hospital - - - - - 4 8 - - - 1 278 - 1 3 3 - 7 - 5 6 - 40 1 165 / MOU PHC / CHC 17 12 19 20 55 33 120 244 1 871 1 665 1 194 656 Total District District - - 9 293 3 266 4 327 ------tertiary Central/ Hospital -- -- 8 - 10 92 50 50 384 1 547 51 205 2014/15 Hospital Regional Regional 17 10 10 10 32 68 45 115 335 4 194 1 437 140 276 District District Hospital -- 2 6 - 8 - 6 5 - - - 1 1 1 8 3 - 2 37 50 3 175 3 552 1 280 / MOU* PHC / CHC

Death in facility – 59 months 12 Death in facility 8-28 days Death in facility months 29 days - 11 Death in facility 0-7days

natal natal

Neo-

year) (under 1 1 (under

D Infant Infant

years) Child (under 5 5 (under Child ata Element ata Still birthsStill TB Deaths Inpatient death total Live births Diarrhoea death under 5 years Pneumonia death under 5 years Severe acute malnutrition death under 5 years Maternal deaths deaths Maternal D (Number) Patient day equivalent day Patient Source: HIS. *MOU – Maternal Obstetric Unit.

729 Section B: NationalProfile North and WestDistrict Province Profiles

730 SectionSection B: B: National Profile North and District West Province Profiles

Maternal and Women’s Health

Impact Outcome Output Maternal Antenatal Delivery in Cervical Mother mortality in client initiated facility under Antenatal 1st cancer Couple year postnatal visit facility ratio on ART rate 18 years rate visit before 20 screening protection rate within 6 days (per100K) (%) (%) weeks rate (%) coverage (%) (WHO) (%) rate (%) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Greater Taung SD Indicator 99.1 96.4 11.6 62.9 60.4 43.1 92.5 Numerator 3 295 364 1 878 2 321 20 294 2 914 Denominator 3 026 306 3 149 2 986 46 120 564 963 3 149 Kagisano-Molopo SD Indicator 91.6 94.1 10.8 61.6 78.4 43.7 80.7 Numerator 2 270 237 1 335 1 686 12 169 1 769 Denominator 2 183 287 2 191 2 168 25 815 334 518 2 191 Lekwa-Teemane SD Indicator - 99.1 3.8 73.4 72.3 57.2 83.9 Numerator - 112 26 761 808 8 240 575 Denominator 631 113 685 1 037 13 410 172 935 685 Mamusa SD Indicator - 97.5 7.4 59.0 84.6 54.7 74.9 Numerator - 117 86 722 954 8 849 867 Denominator 1 129 120 1 157 1 223 13 537 194 172 1 157 Naledi SD Indicator 307.4 96.1 8.9 60.5 86.6 71.6 47.1 Numerator 6 196 182 947 1 228 13 421 967 Denominator 1 952 204 2 054 1 566 17 017 224 967 2 054 RS Mompati Indicator 123.3 96.1 9.7 62.8 72.4 50.7 76.8 Numerator 11 990 895 5 643 6 997 62 972 7 092 Denominator 8 921 1 030 9 236 8 980 115 899 1 491 555 9 236 North West Indicator 138.9 95.9 6.5 63.7 69.3 60.2 74.4 South Africa Indicator 116.9 95.1 6.8 65.2 61.5 70.2 70.3 Source: DHIS.

AnnualNW, DC39, trends Dr Ruth Segomotsi Mompati District Municipality, SEQ 1 (most deprived) 800 Measure Names 600 IndValue Maternal Prov_av mortality in 400 facility ratio ZA_av 1_Impact 200 0 80

Antenatal 1st 60 visit before 20 weeks rate 40 2_Maternal and women's health women's and 2_Maternal 20

200 Couple year protection rate (WHO) 100

15 2_Outcome Delivery in facility under 18 10 years rate 5

200 Mother postnatal visit within 6 days 100 rate

0 200

Antenatal client 150 initiated on ART rate 100

3_Output 150 Cervical cancer screening 100 coverage 50

2009 2010 2011 2012 2013 2014 2015 2016 Year

731 Section B: NationalProfile North and WestDistrict Province Profiles

Child and School Health 47.1 59.4 58.6 58.0 56.3 48.9 53.8 62.2 5 254 5 308 11 115 18 309 46 299 46 247 956 247 102 378 133 728 127 596 986 688 986 months Vitamin A dose 12-59 coverage (%) coverage 714 213 6 313 207 585 900 17.0 18.7 19.8 15.3 38.7 52.0 23.0 69.3 1 137 1 081 2 079 197 940 8 screening coverage (%) coverage School Grade 482 449 87.3 67.5 53.1 33.1 25.7 26.7 33.0 29.2 3 122 2 108 1 276 1 357 1 030 1 535 5 655 2 800 1 653 1 340 254 460 1 screening coverage (%) coverage School Grade Output 834 89.1 91.8 86.7 93.0 83.0 96.9 80.2 96.2 1 189 2 424 1 183 9 321 3 691 16 011 16 371 12 477 31 263 45 720 4 970 3 833 375 030 121 842 dose nd Measles Measles 2 coverage (%) coverage 513 717 928 535 47.4 41.6 57.5 55.8 55.3 55.3 55.5 45.5 1 128 3 281 1 291 8 967 4 958 4 2 339 1 305 1 888 1 dose rd Infant Infant rate (%) exclusively exclusively breastfed at HBV 3 DTaP-IPV-Hib- 961 933 77.9 74.9 91.9 73.7 78.8 75.2 84.8 82.3 1 189 2 797 7 925 2 045 2 31 518 15 330 16 833 44 790 44 120 657 (%) coverage under 1 year Immunisation Immunisation 8 1 4 - - 10 23 1.7 2.1 1.6 1.5 1.3 3.0 0.5 213 120 12 186 188 495 330 1 346 (%) Outcome around 10 Infant PCR weeks rate test positive positive test 2 5 18 35 54 7.9 1.8 8.2 114 11.6 27.7 12.1 12.4 12.8 (per1K) neonatal neonatal Inpatient Inpatient death rate 1 4 17 32 46 7.8 9.9 0.9 6.3 100 631 631 11.2 10.6 10.0 23.6 1 129 1 129 2 183 2 183 1 952 1 952 (per1K) Inpatient Inpatient death rate early neonatal neonatal early 13 13 61 35 38 4.4 2.4 5.9 6.3 3.2 122 160 408 309 430 10.7 14.2 12.3 2 721 8 921 8 921 1 452 3 026 3 026 Inpatient Inpatient year rate (%) death under 5 8 11 32 58 35 64 7.9 5.1 4.7 6.3 141 172 144 198 693 11.4 17.2 22.7 29.3 1 268 Impact Inpatient Inpatient year rate (%) death under 1 4 74 17 16 10 75 69 22 9.1 5.4 8.0 8.9 8.3 159 248 762 206 10.1 10.6 13.3 5 years rate (%) Child under case fatality fatality case malnutrition malnutrition severe acute 2 3 - - - - 17 15 10 73 42 2.7 4.0 2.0 2.0 2.8 2.5 150 248 5 years rate (%) pneumonia pneumonia Child under case fatality fatality case 4 4 1 9 - - 12 18 75 62 1.6 4.0 2.0 5.3 6.9 2.3 3.2 176 130 455 530 5 years 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 rate (%) diarrhoea diarrhoea Child under case fatality fatality case Denominator Indicator Denominator Indicator Numerator Indicator Numerator Denominator Indicator Numerator Indicator Indicator Denominator Numerator Denominator Numerator Indicator Denominator Numerator Indicator D

Kagisano-Molopo SD Lekwa-Teemane Lekwa-Teemane SD South Africa South North West Greater SD Taung Naledi SD Mamusa SD Mamusa RS Mompati Source: HIS.

732 SectionSection B: B: National Profile North and District West Province Profiles

AnnualNW, DC39, trends Dr Ruth Child Segomotsi and Mompati School District Health Municipality, SEQ 1 (most deprived) Measure Names 100 IndValue Child under 5 Prov_av years diarrhoea 50 case fatality rate ZA_av

30 Child under 5

3_Child and school health school and 3_Child years 20 pneumonia case fatality rate 10

0 60 1_Impact Child under 5 years severe 40 acute malnutrition 20 case fatality rate 0

Inpatient early 20 neonatal death rate 10

0 150

Immunisation coverage under 100 1 year

Infant 80 exclusively breastfed at 60 DTaP-IPV-Hib- HBV 3rd dose 40 rate 20

3_Output 150

Measles 2nd dose coverage 100

100 School Grade 1 screening 50 cover age

0 2009 2010 2011 2012 2013 2014 2015 2016 Year AnnualNW, DC39, trends Dr Ruth HIV Segomotsi Mompati District Municipality, SEQ 1 (most deprived)

60 Measure Names IndValue 4_HIV HIV testing Prov_av coverage 40 (including ANC) ZA_av 20

200

Male condom distribution 100 coverage 4_Process_input

80 60 Medical male circumcision 40 rate 20 0 2009 2010 2011 2012 2013 2014 2015 2016 Year

733 Section B: NationalProfile North and WestDistrict Province Profiles

HIV 98 85 1.5 4.7 5.7 3.7 8.0 113 523 229 13.1 19.0 18.2 1 048 274 509 291 372 291 345 471 477 399 801 690 (per1K) 2016/17 Medical male male Medical circumcision rate rate circumcision 47.5 25.1 42.4 29.0 32.0 23.8 28.5 36.6 673 191 242 769 249 300 798 934 592 400 403 485 403 648 000 648 1 080 412 1 410 000 1 410 4 529 746 2016/17 distribution distribution Male condom condom Male coverage (No) 27.4 31.9 31.9 30.1 28.6 30.9 32.8 35.9 8 852 10 918 10 019 17 451 77 131 29 891 477 612 306 126 657 147 371 652 399 408 399 2 998 443 871 1 874 2 190 441 (%) 90-90-90 2016/17 coverage st HIV testing 1 Process & input (including ANC) ------1 092 624 - - - - 7.4 5.8 8.2 4 805 83 168 (%) 2016/17 and older rate client years 15 (including ANC) HIV test positive ------54.7 55.0 46.9 53 515 29 295 29 2016/17 on ART rate (%) Clients remaining - 17 21 21 21 57 37 25 39 40 22 120 180 81.0 66.7 84.0 59.5 68.4 52.5 79.2 2015 90-90-90 Output nd months (%) 2 on ART after 12 Child percentage ------815 739 908 61.0 70.4 73.4 72.4 75.5 66.3 1 661 1 292 2015 months (%) on ART after 12 Adult percentageAdult 3 5 6 7 4 2 0 1 3 5 - 11 25 0.0 71.4 50.0 44.0 59.3 40.0 33.3 (%) 2015 rate months 12 Child with viral load suppressed suppressed load ------136 236 359 208 386 81.6 91.3 83.7 83.4 80.2 85.2 (%) 2015 90-90-90 Outcome rd 3 rate months 12 Adult with viral load suppressed suppressed load 6 7 5 4 3 - 17 13 12 21 25 22 85 29.4 18.2 65.7 25.0 23.8 35.3 53.8 (%) 2015 Child with viral load completion completion load rate at months 12 ------521 447 560 533 338 64.1 61.5 72.4 30.4 69.9 45.3 (%) 2015 Adult with viral load completion completion load rate at months 12 Indicator Numerator Denominator Indicator Denominator Numerator Denominator Indicator Indicator Denominator Numerator Denominator Numerator Indicator Numerator Indicator Numerator Denominator Indicator Indicator

Naledi SD RS Mompati Kagisano-Molopo SD Lekwa-Teemane SD Lekwa-Teemane Mamusa SD Mamusa Greater SD Taung North West South Africa South Source: HIS.

734 SectionSection B: B: National Profile North and District West Province Profiles

TB AnnualNW, DC39, Drtrends Ruth Segomotsi TB Mompati District Municipality, SEQ 1 (most deprived) Measure Names 15 IndValue 5_TB 21.1 51.6 37.5 15.6 42.4 66.0 25.2 22.2 TB death rate Prov_av 59 441 28 327 86 278

56 922 10 65 296 46 968 381 810 125 256 125 134 361

256 954 256 (ETR.net) ZA_av 5 2016/17

screened in 60 TB symptom 5 facility rate (%) rate facility 1_Impact years and older Process & input TB DR client 40 ------293 972 ------death rate (EDRWeb) 20 47.4 63.1 72.8 1 670 2 648 1 021 677 0 15 2016 Output rate (%) TB client lost to 10 on treatment treatment on follow up rate

TB client initiated (ETR.Net) 5 56 82 46 0 129 162 324 282 337 258 363 909 87.0 82.1 80.4 63.6 82.9 92.8 62.8 88.3 1 130 80 TB client treatment

2016 success rate 60

Net) (%) Net) (ETR.net) TB/HIV co- 40 ART rate (ETR. infected client on 40 ------90

131 TB DR client 68.7 80.6 68.0 loss to follow up 20 rate (EDRWeb)

2016 0 treatment treatment 60 2_Outcome TB Rifampicin Rifampicin TB

resistant clients clients resistant TB DR initiation rate (%) rate initiation treatment 40

- - success rate ------

5.1 (EDRWeb) 20 4.9 6.2 131

2 648 0

2016 TB Rifampicin 20 rate (%) resistance resistance resistance confirmed client TB Rifampicin Rifampicin TB 10 confirmed client confirmed client rate - - 0 ------

73 100 114 58.4 64.0 50.5 TB/HIV co-infected client on ART 50 2014 rate (ETR.Net) Outcome

success rate rate success 0 (EDRWeb) (%)

TB DR treatment treatment DR TB 100 - - TB symptom 5 ------

10 years and older 8.8 114

17.9 50 10.9 screened in facility rate

4_Process_input 0 2014 2009 2010 2011 2012 2013 2014 2015 2016 Year (EDRWeb) (%) to follow up rate TB DR client loss Measure Names IndValue 970 391 727 755 254 734 532 358 630 434

71.1 P rov_av 81.6 81.0 74.9 69.0 83.4 65.0 48.8 2 403 3 382 ZA_av 2015 TB client client TB treatment treatment success rate rate success (ETR.net) (%) 13 24 21 97 20 2.7 6.4 4.5 6.3 2.8 3.3 5.2 175 970 391 755 734 532 10.0 3 382 2015 TB client loss (ETR.Net) (%) (ETR.Net) to follow up rate ------28 114 24.6 23.0 25.3 2014 death rate TB DR client (EDRWeb) (%) Impact 82 33 53 36 7.2 9.7 9.0 8.4 6.6 6.8 125 970 391 755 329 734 532 10.9 12.9 3 382 2015 TB death rate (ETR.net) (%) Numerator Numerator Indicator Denominator Indicator Denominator Indicator Numerator Denominator Indicator Numerator Denominator Indicator Indicator Denominator Numerator Indicator Numerator Indicator Denominator D

Greater SD Taung Lekwa-Teemane SD Lekwa-Teemane Kagisano-Molopo SD Mamusa SD Mamusa Naledi SD Africa South RS Mompati North West Source: HIS.

735 Section B: NationalProfile North and WestDistrict Province Profiles

Non-communicable diseases

Outcome Diabetes Hypertension incidence incidence (per1K) (per1K) 2016/17 2016/17 Greater Taung SD Indicator 1.4 19.7 Numerator 253 905 Denominator 2 199 870 551 550 Kagisano-Molopo SD Indicator 0.5 14.3 Numerator 53 369 Denominator 1 304 760 309 363 Lekwa-Teemane SD Indicator 0.3 15.5 Numerator 17 215 Denominator 667 944 166 965 Mamusa SD Indicator 1.4 19.1 Numerator 88 261 Denominator 752 742 163 944 Naledi SD Indicator 0.3 18.2 Numerator 21 320 Denominator 836 961 210 510 RS Mompati Indicator 0.9 17.7 Numerator 432 2 070 Denominator 5 762 277 1 402 332 North West Indicator 1.4 16.0 South Africa Indicator 2.5 18.9 Source: DHIS.

AnnualNW, DC39, trends Dr Ruth Segomotsi Mompati District Municipality, SEQ 1 (most deprived) Measure Names IndValue Prov_av 6_NCDs Diabetes 5 incidence ZA_av

2_Outcome 40 Hypertension incidence 20

2010 2011 2012 2013 2014 2015 2016 2017 Year

736 SectionSection B: B: National Profile North and District West Province Profiles

Dr Kenneth Kaunda District Municipality (DC40)

Dr Kenneth Kaunda District is situated in North West Province and comprises four health sub-districts, namely Maquassi Hills, Matlosana, Tlokwe and Ventersdorp. The district has a population of 734 774, with a population density of 50.2 persons per km2 and falls into socio-economic Quintile 4, and has an estimated medical scheme coverage of 14.6%. Dr K Kaunda is one of the 11 National Health Insurance (NHI) pilot districts.

Social determinants of healtha Population per selected category

Unemployment ratea 29.7% Population category 2017 2018 2019 2020 Youth unemployment rate (15-34 years)a 39.2% under 1 year 15 249 15 478 15 462 15 205 No schooling 8.9% under 5 years 75 551 75 953 75 968 75 649 Matric 30.7% 05-09 years 74 001 74 323 74 785 75 478 Higher education 9.6% 10-14 years 70 817 72 426 73 607 74 385 Households 240 543 15-19 years 63 228 65 189 67 237 69 224 Female-headed households 37.0% 20-24 years 64 433 64 140 64 405 65 237 Formal dwellings 86.4% 25-29 years 69 385 68 847 68 118 67 330 Flush toilet connected to sewerage 87.7% 30-34 years 61 782 64 386 67 105 69 779 Weekly refuse removal 79.9% 35-39 years 54 372 55 411 56 190 56 707 Piped water inside dwellings 45.9% 40-44 years 46 324 47 224 48 285 49 434 Electricity for lighting 91.1% 45-49 years 41 727 41 866 42 020 42 319 Blue Drop water score 65.7% 50-54 years 36 380 36 934 37 452 37 864 55-59 years 30 553 30 963 31 341 31 736 Source: StatsSA. 2014 Blue Drop Report. 60-64 years 23 438 24 195 24 920 25 572 65-69 years 16 165 16 707 17 281 17 875 70-74 years 10 633 10 811 11 023 11 303 75-79 years 5 651 6 017 6 319 6 535 80 years and older 3 496 3 571 3 652 3 740 Total 747 931 758 963 769 700 780 166 Estimated pregnant women* 16 316 16 561 16 544 16 269 Source: Mid-Year Population Estimates 2016 StatsSA. * Under 1 year population X 1.07.

Population distribution sub-district boundaries and health facility locations

a Statistics South Africa. Census 2011 Municipal fact sheet. Report No. 03-01-58. Pretoria: Statistics SA; 2012.

737 Section B: NationalProfile North and WestDistrict Province Profiles

Number of facilities by level, 2016/17

Ward based Central/ outreach District Regional Tertiary Other teams Clinic CHC Hospital Hospital Hospitals Hospitals Maquassi Hills SD 13 6 2 1 0 0 0 MatlosanaSD 36 13 4 0 0 1 5 Tlokwe SD 26 7 2 0 1 0 3 Ventersdorp SD 9 5 2 0 0 0 0 Dr K Kaunda 84 31 10 1 1 1 8 Source: DHIS.

Human resources – filled posts, 2016

Community Speech Health Nursing Enrolled Professional Medical Dental Occupational Therapy and Workers assistants nurse nurse practitioners Pharmacists practitioners therapy Physiotherapy Audiology Dr K Kaunda 970 890 267 1 123 281 75 13 23 19 13 Source: Persal, DHIS.

Management and efficiency indicators for the service delivery platform, 2016/17

PHC Management Output Process & input Provincial and LG Percentage of District Health Provincial Provincial assessed PHC Services and LG PHC and LG PHC facilities with expenditure expenditure expenditure Percentage 90% of tracer per capita per capita per PHC PHC utilisation Ideal clinics medicines (uninsured) (uninsured) headcount rate (No) (%) available (%) (Rand) (Rand) (Rand) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Maquassi Hills SD Indicator 2.5 - - - - - Numerator 203 962 - - - - - Denominator 983 280 - - - - - Matlosana SD Indicator 1.6 - - - - - Numerator 683 359 - - - - - Denominator 5 076 324 - - - - - Tlokwe SD Indicator 1.6 - - - - - Numerator 281 843 - - - - - Denominator 2 069 766 - - - - - Ventersdorp SD Indicator 2.1 - - - - - Numerator 126 856 - - - - - Denominator 715 851 - - - - - Dr K Kaunda Indicator 1.8 85.0 100.0 1 339 1 057 512 Numerator 1 296 020 34 40 840 333 845 663 152 883 663 152 883 Denominator 8 845 221 40 40 627 438 627 438 1 296 020 North West Indicator 2.1 29.3 74.2 1 551 1 064 434 South Africa Indicator 2.3 29.8 78.4 1 726 1 054 389 Source: DHIS.

738 SectionSection B: B: National Profile North and District West Province Profiles - - - - - Annual trends NW, DC40, Dr Kenneth Kaunda District Municipality, SEQ 4 (well off) 12.5 10.8 12.5 20.3 6 968 6 968 55 648 55 648

(%) 8 Measure Names

OPD new IndValue client not not client referred rate rate referred Inpatient crude 6 Prov_av - - - - - death rate ZA_av 5.4 6.2 1_Impact 4 1_Management 36 413 36 413 2

rate (%) 8 Inpatient Inpatient crude death 6 Average length - - - - - of stay (district 4 84.1 6.1 84.1 6.1 84.3 82.5 hospitals) 295 165 248 329 2 224 295 165 248 329 2 224

(%) 2 utilisation rate - total 4K Inpatient bed

2_Outcome Expenditure per - - - - - patient day 3K Tertiary/Central Hospital equivalent 2 821 2 437 4 227 2 437 (district 2K 369 189 369 189 day hospitals) (Rand) 1K equivalent equivalent per patient 899 845 525 899 845 525 Expenditure - - - - - 6.8 6.9 6.8 6.8 Inpatient bed 100 36 413 36 413 utilisation rate 248 329 248 329 (district (Days) Average

length of of length hospitals) stay - total 50 - - - - - 100 648 648 3_Output 37.2 15.7 OPD new client 15 906 15 906

(%) not referred rate 50

OPD new (district client not not client

referred rate rate referred hospitals) - - - - - 0 5.1 4.1 5.1 4.1 5.4 753 753 100 14 771 14 771 rate (%)

Inpatient Inpatient Percentage 50 crude death Ideal clinics - - - - - 77.6 77.6 78.3 5.0 90.5 0 94 946 94 94 946 94

(%) Provincial and 3K

Hospital LG District utilisation rate - total

Inpatient bed Health Services 2K

Regional Hospital Regional expenditure per - - - - - capita (uninsured) 2 730 2 739 2 730 2 894 1K 128 808 122 288 128 808 122 288 day (Rand) equivalent equivalent per patient 351 643351 077 351 643351 077 Provinc ial and

Expenditure 1500

4_Process_input LG PHC - - - - - expenditure per 1000 6.4 6.4 5.3 capita (uninsured) 14 771 14 771 94 946 94 94 946 94 500 (Days) Average length of of length stay - total

Provincial and ------400 LG PHC 384 384 10.5 10.5 56.4 5.4 59.3 expenditure per 3 661 3 661 PHC headcount

(%) 200 OPD new client not not client referred rate rate referred 2008 2010 2012 2014 2016 2018 ------Year 5.1 6.7 5.2 5.2 371 371 7 196 7 196 Measure Names IndValue rate (%)

Inpatient Inpatient P rov_av crude death ZA_av ------67.4 78.2 78.2 65.8 32 124 32 124 25 123 25 25 123 25 (%) utilisation rate - total Inpatient bed District Hospital District ------2 311 2 311 2 568 2 488 day (Rand) 72 068 730 72 068 730 equivalent equivalent per patient Expenditure ------4.7 4.4 3.5 3.5 7 196 31 188 7 196 31 188 25 123 25 251 223 251 (Days) Average length of of length stay - total Indicator Denominator Numerator Indicator Denominator Numerator Indicator Denominator Numerator Indicator Numerator Denominator Indicator Indicator D

Dr K Kaunda Tlokwe SD Tlokwe Matlosana SD Matlosana Maquassi Hills SD Hills Maquassi South Africa South North West Source: HIS and BAS.

739 Section B: NationalProfile North and WestDistrict Province Profiles

Deaths and Patient day equivalent 2014/15 – 2016/17 19 25 26 30 117 290 3 389 10 337 531 276 Total District District 17 14 19 16 73 34 44 157 4 137 2 224 369 189 tertiary Central/ hospital 70 32 753 2 298 128 808 2016/17 Hospital Regional Regional 30 371 1 091 31 188 District District Hospital - 1 8 1 9 1 1 4 1 1 7 1 6 4 1 2 - 3 3 4 3 9 41 33 2 811 2 091 / MOU PHC / CHC 10 23 20 30 35 33 112 224 1 060 - - - - - 10 764 Total 530 348 District District 12 13 24 20 54 117 132 4 208 361 587 tertiary Central/ Hospital - 4 32 43 112 759 2 329 3 730 2 314 125 021 2015/16 Hospital Regional Regional 14 12 24 39 152 447 1 032 30 427 District District Hospital - - 2 9 9 1 9 1 1 1 3 6 2 25 195 664 3 210 13 313 / MOU PHC / CHC 32 28 50 53 48 142 289 3 352 2 084 11 578 Total 380 034 District District 12 19 27 26 38 150 771 108 1 424 214 244 tertiary Central/ Hospital 6 7 10 21 73 747 192 2 290 4 552 124 191 2014/15 Hospital Regional Regional 11 13 32 172 385 1 167 29 111 District District Hospital -2-46-4--432-38 3 4 - 1 3 8 2 5 1 2 24 9 1 7 7 1 2 6 8 5 34 181 1 564 3 569 12 488 / MOU* PHC / CHC

Death in facility months 29 days - 11 Death in facility – 59 months 12 Death in facility 8-28 days Death in facility 0-7days

natal natal

Neo-

year) (under 1 1 (under

D Infant Infant

years) Child (under 5 5 (under Child ata Element ata Patient day equivalent day Patient Inpatient death total TB Deaths Severe acute malnutrition death under 5 years Pneumonia death under 5 years Diarrhoea death under 5 years Live births D (Number) Still birthsStill Maternal deaths deaths Maternal Source: HIS. *MOU – Maternal Obstetric Unit.

740 SectionSection B: B: National Profile North and District West Province Profiles

PercentageNW, Dr K Kaunda: of deaths DC40, by broad 2010 cause - 2015 and leading causes 2010–2015 Percentage of AgeGroup.. Female Male deaths by broad <5 years 73% 10% 11% 7% 75% 9% 10%6% causes and 5-14 31% 31% 17% 20% 28% 25% 18% 30% single leading 15-24 16% 48% 18% 18% 6% 19% 15% 60% causes 25-64 12% 42% 41% 5% 10% 41% 35% 13% 65+ 12% 5% 81% 2% 10% 7% 80% 3% Broadcause 18% 27% 50% 5% 16% 29% 43% 12% Total Injury NCD Rank.. Female Male 1 Diarrhoeal diseases (19.7%) Diarrhoeal diseases (18.0%) HIV and TB 2 Lower respiratory infections (15.9%) Lower respiratory infections (15.1%) Comm_mat_peri_nut 3 Preterm birth complications (11.3%) Preterm birth complications (13.6%) 4 Protein-energy malnutrition (6.8%) Protein-energy malnutrition (7.7%) Prov, District 5 Sepsis/other newborn infectious (6.3%) Birth asphyxia (7.1%) NW, Dr K Kaunda: DC40 6 Birth asphyxia (6.3%) Sepsis/other newborn infectious (6.5%) Show history

<5 years <5 7 HIV/AIDS (6.0%) HIV/AIDS (6.3%) 8 Tuberculosis (3.8%) Septicaemia (2.8%) Percentages are shown 9 Septicaemia (2.6%) Tuberculosis (2.7%) according to all the deaths 10 Other perinatal conditions (2.3%) Other perinatal conditions (2.3%) within the age/gender 1 HIV/AIDS (20.2%) Tuberculosis (15.0%) category of each box, 2 Tuberculosis (17.6%) Drowning (14.4%) although only the leading 3 Lower respiratory infections (10.4%) HIV/AIDS (14.4%) 10 causes are displayed. 4 Fires, hot substances (9.0%) Lower respiratory infections (13.1%) 5 Meningitis/encephalitis (7.2%) Diarrhoeal diseases (6.8%)

5-14 6 Drowning (6.5%) Accidental threats to breathing (6.5%) 7 Diarrhoeal diseases (6.3%) Meningitis/encephalitis (4.0%) 8 Accidental threats to breathing (3.2%) Road injuries (3.5%) 9 Septicaemia (3.1%) Fires, hot substances (3.3%) 10 Endocrine nutritional,blood, immune (3.1%) Septicaemia (2.8%) 1 HIV/AIDS (25.7%) Interpersonal violence (23.3%) 2 Tuberculosis (24.8%) Accidental threats to breathing (18.5%) 3 Fires, hot substances (4.4%) Tuberculosis (11.0%) 4 Accidental threats to breathing (3.7%) HIV/AIDS (9.1%) 5 Interpersonal violence (3.7%) Fires, hot substances (5.0%)

15-24 6 Lower respiratory infections (3.4%) Mechanical forces (4.7%) 7 Road injuries (2.9%) Road injuries (4.4%) 8 Diarrhoeal diseases (2.8%) Drowning (3.5%) 9 Indirect maternal (2.4%) Lower respiratory infections (2.3%) 10 Meningitis/encephalitis (2.2%) Epilepsy (1.7%) 1 HIV/AIDS (23.0%) Tuberculosis (21.2%) 2 Tuberculosis (19.5%) HIV/AIDS (20.3%) 3 Lower respiratory infections (6.0%) Lower respiratory infections (5.6%) 4 Cerebrovascular disease (4.9%) Cerebrovascular disease (3.9%) 5 Cervix (3.5%) Accidental threats to breathing (3.7%)

25-64 6 Nephritis/nephrosis (3.2%) Ischaemic heart disease (3.0%) 7 Breast (2.6%) Interpersonal violence (2.7%) 8 Diabetes mellitus (2.5%) Nephritis/nephrosis (2.6%) 9 Diarrhoeal diseases (2.3%) Fires, hot substances (2.0%) 10 Hypertensive heart disease (2.0%) COPD (2.0%) 1 Cere brovascular disease (15.5%) Cerebrovascular disease (11.4%) 2 Ischaemic heart disease (9.7%) Ischaemic heart disease (10.9%) 3 Hypertensive heart disease (8.6%) COPD (6.6%) 4 Lower respiratory infections (7.0%) Lower respiratory infections (6.4%) 5 Diabetes mellitus (5.1%) Prostate (5.4%)

65+ 6 Nephritis/nephrosis (4.7%) Tuberculosis (5.3%) 7 COPD (3.9%) Nephritis/nephrosis (4.6%) 8 Tuberculosis (3.3%) Hypertensive heart disease (4.5%) 9 Breast (2.9%) Diabetes mellitus (4.3%) 10 Diarrhoeal diseases (2.3%) Trachea/bronchi/lung (3.6%)

Rank.. Maternal conditions All other causes 1 Indirect maternal (36.3%) n=67 HIV/AIDS (30.5%) n=2 332 2 Other maternal (27.0%) n=50 Tuberculosis (24.4%) n=1 863 3 Hypertension in pregnancy (21.3%) n=39 Lower respiratory infections (6.5%) n=496 4 Maternal sepsis (6.1%) n=11 Diarrhoeal diseases (2.8%) n=211 5 Abortion (5.2%) n=10 Cerebrovascular disease (2.6%) n=198

15-49 6 Maternal haemorrhage (4.1%) n=8 Cervix (2.5%) n=188 Female 7 Nephritis/nephrosis (2.4%) n=182 8 Fires, hot substances (2.1%) n=163 9 Diabetes mellitus (1.5%) n=115 10 Breast (1.5%) n=113

741 Section B: NationalProfile North and WestDistrict Province Profiles

Maternal and Women’s Health

Impact Outcome Output Maternal Antenatal Delivery in Cervical Mother mortality in client initiated facility under Antenatal 1st cancer Couple year postnatal visit facility ratio on ART rate 18 years rate visit before 20 screening protection rate within 6 days (per100K) (%) (%) weeks rate (%) coverage (%) (WHO) (%) rate (%) 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 Maquassi Hills SD Indicator 156.1 98.3 8.1 72.8 95.7 77.1 118.0 Numerator 2 233 111 1 151 1 718 16 456 1 609 Denominator 1 281 237 1 363 1 581 21 551 256 026 1 363 Matlosana SD Indicator 225.6 96.2 4.8 68.0 71.3 58.7 56.3 Numerator 17 1 056 359 4 136 7 331 68 036 4 251 Denominator 7 535 1 098 7 550 6 086 123 380 1 389 807 7 550 Tlokwe SD Indicator - 94.5 4.6 74.0 80.4 65.1 69.3 Numerator - 329 113 1 746 3 490 32 615 1 704 Denominator 2 467 348 2 460 2 359 52 095 601 161 2 460 Ventersdorp SD Indicator - 100.0 4.9 77.8 104.5 115.5 88.3 Numerator - 111 33 609 1 354 17 115 595 Denominator 624 111 674 783 15 549 177 897 674 Dr K Kaunda Indicator 159.6 96.4 5.1 70.7 78.4 66.4 67.7 Numerator 19 1 729 616 7 642 13 893 134 222 8 159 Denominator 11 907 1 794 12 047 10 809 212 575 2 424 891 12 047 North West Indicator 138.9 95.9 6.5 63.7 69.3 60.2 74.4 South Africa Indicator 116.9 95.1 6.8 65.2 61.5 70.2 70.3 Source: DHIS.

AnnualNW, DC40,trends Dr Kenneth Kaunda District Municipality, SEQ 4 (well off)

800 Measure Names 600 IndValue Maternal Prov_av mortality in 400 facility ratio ZA_av 1_Impact 200 0 80

Antenatal 1st 60 visit before 20 weeks rate 40 2_Maternal and women's health women's and 2_Maternal 20

200 Couple year protection rate (WHO) 100

15 2_Outcome Delivery in facility under 18 10 years rate 5

200 Mother postnatal visit within 6 days 100 rate

0 200

Antenatal client 150 initiated on ART rate 100

3_Output 150 Cervical cancer screening 100 coverage 50

2009 2010 2011 2012 2013 2014 2015 2016 Year

742 SectionSection B: B: National Profile North and District West Province Profiles

Child and School Health Annual trends NW, DC40, Dr Kenneth Kaunda District Municipality, SEQ 4 (well off)

Measure Names 100 IndValue 51.4 59.7 45.7 54.0 58.0 48.9 68.2 6 686 6 8 054 Child under 5

11 191 Prov_av 52 164 26 233 117 690 161 988 248 544 688 830 688 years diarrhoea 50 ZA_av 1 217 052 1 217 case fatality rate months Vitamin A dose 12-59 coverage (%) coverage 0

30 659 19.8 38.7 39.6 56.8 43.3 Child under 5 1 116 6 119 1 414 107.3 1 147 1 318 2 647 6 100 169.3 2 423 2

3_Child and school health school and 3_Child years 20 128 916 pneumonia case fatality rate 10 8 screening coverage (%) coverage School Grade 0 60 1_Impact Child under 5 71.3 53.1 85.6 86.0 33.0 98.5 3 371 1 240 104.0 2 481 7 991 1 289 2 403 6 838 years severe 40 12 973

180 996 acute malnutrition 20 case fatality rate 1 screening coverage (%) coverage School Grade 0 Output 949 81.0 93.5 83.0 82.9 96.2 20 123.1 3 147 5 924 102.5 1 604 2 443 Inpatient early 11 624 14 061 18 771 30 669

149 256 neonatal death dose

nd rate 10 Measles Measles 2

coverage (%) coverage 0

150 rd 513 780 659 47.6 41.6 40.1 40.1 84.5 45.3 45.5 2 716 1 279 4 750 5 704 85 755 2 285 Immunisation 10 479 coverage under 100

Infant Infant 1 year DTaP-IPV- exclusively exclusively Hib-HBV 3 breastfed at dose rate (%) 50

Infant

676 80 74.4 74.8 73.7 59.9 86.7 72.3 82.3 exclusively 9 159 30 516 17 286 13 536 86 331 breastfed at 60 147 669

(%) DTaP-IPV-Hib- HBV 3rd dose 40 coverage

under 1 year rate Immunisation Immunisation 20 3 7 2 206 1 293 4 1 078 18 5 199 32 3_Output 1.4 1.6 1.5 1.3 1.3 1.5 1.5 150 207 440 304 2 131 1 180 Measles 2nd

(%) dose coverage 100 Outcome around 10 Infant PCR weeks rate test positive positive test 50 3 10 40 90 100 7.8 4.8 143 11.9 12.1 12.4 12.0 16.2 School Grade 1 screening 50 cover age (per1K) neonatal neonatal Inpatient Inpatient death rate 0 3 9 2009 2010 2011 2012 2013 2014 2015 2016 73 32 7.0 9.7 9.8 9.9 4.8 117 624 624 10.0 13.0 Year 1 281 1 281 2 467 2 467 7 535 7 535

11 907 11 907 Measure Names IndValue (per1K) Inpatient Inpatient death rate P rov_av early neonatal neonatal early ZA_av 7 19 48 4.1 3.1 4.4 4.3 6.6 6.3 5.2 212 162 138 608 1 184 2 100 4 054 Inpatient Inpatient year rate (%) death under 5 6 13 84 44 7.1 7.0 7.9 4.7 6.3 3.8 124 187 278 10.6 1 170 1 144 2 676 Impact Inpatient Inpatient year rate (%) death under 1 1 9 1 19 81 20 72 30 9.4 1.2 5.0 8.0 147 10.6 12.9 12.5 5 years rate (%) Child under case fatality fatality case malnutrition malnutrition severe acute 1 4 1 1 7 38 54 7.4 1.2 0.6 2.6 2.0 0.3 2.5 178 325 595 320 5 years rate (%) pneumonia pneumonia Child under case fatality fatality case 3 2 3 8 - - 24 81 46 1.2 2.0 4.3 2.0 3.2 245 396 12.5 5 years 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 rate (%) diarrhoea diarrhoea Child under case fatality fatality case Indicator Denominator Numerator Indicator Indicator Indicator Numerator Denominator Indicator Indicator Numerator Denominator Denominator Numerator Numerator Denominator Indicator D

Dr K Kaunda Ventersdorp SD Ventersdorp Tlokwe SD Tlokwe Matlosana SD Matlosana North West South Africa South Maquassi Hills SD Hills Maquassi Source: HIS.

743 Section B: NationalProfile North and WestDistrict Province Profiles

HIV Annual trends NW, DC40, Dr Kenneth Kaunda District Municipality, SEQ 4 (well off)

60 Measure Names 610

344 IndValue 19.0 14.5 19.3 32.7 18.2 34.8 36.8 4_HIV 6 361 9 770 2 455 HIV testing 40 Prov_av 847 188 847 379 860 285 333 285 coverage (including ANC) ZA_av 20 (per1K) 2016/17 Medical male male Medical

circumcision rate rate circumcision 200

Male condom

47.5 distribution 37.8 50.0 82.6 36.6 44.8 44.2 100 coverage 760 518 331 005 331 4_Process_input 2 841 7802 841 1 686 000 1 380 000 11 694 167 11

2016/17 80 distribution distribution

Male condom condom Male 60 coverage (No) Medical male circumcision 40 rate 20 41.8 31.7 29.1 31.9 35.1 32.6 35.9 32 210

17 649 0 67 756 5 786 387 10 544 128 159 507 168 360 246 244 794

4 843 821 056 3 172 3 584 793 2009 2010 2011 2012 2013 2014 2015 2016 (%)

90-90-90 Year 2016/17 st coverage HIV testing 1 Measure Names Process & input (including ANC) IndValue P rov_av - - - - - 2 789 451 1 835 739 2 072 412 ------956 1 186 - 7.4 7.8 8.2 ZA_av 10 642 137 028 (%) 2016/17 and older rate client years 15 (including ANC) HIV test positive ------55.0 46.6 46.9 95 770 44 608 2016/17 on ART rate (%) Clients remaining - 18 19 24 76 37 42 89 34 187 152 81.0 81.3 94.7 85.4 79.2 64.9 2015 90-90-90 Output nd months (%) 2 on ART after 12 Child percentage ------759 67.2 69.4 72.4 75.9 75.5 68.8 1 174 9 129 5 193 2 003 2015 months (%) on ART after 12 Adult percentageAdult 9 5 9 9 - 11 15 15 28 63 38 81.8 59.3 55.6 60.0 53.6 60.3 (%) 2015 rate months 12 Child with viral load suppressed suppressed load ------525 329 394 77.7 81.0 74.2 80.4 83.4 83.9 2 601 1 353 (%) 2015 90-90-90 Outcome rd 3 rate months 12 Adult with viral load suppressed suppressed load 9 - 11 17 14 15 28 98 22 63 45 64.7 65.7 64.3 64.3 62.2 68.2 (%) 2015 Child with viral load completion completion load rate at months 12 ------911 618 541 61.1 57.6 61.8 69.9 60.8 63.8 2 190 4 260 (%) 2015 Adult with viral load completion completion load rate at months 12 Numerator Indicator Denominator Numerator Numerator Denominator Indicator Denominator Denominator Indicator Indicator Numerator Denominator Indicator Indicator Indicator Numerator

Tlokwe SD Tlokwe Matlosana SD Matlosana North West Maquassi Hills SD Hills Maquassi Ventersdorp SD Ventersdorp Dr K Kaunda Africa South Source: HIS.

744 SectionSection B: B: National Profile North and District West Province Profiles

TB Annual trends NW, DC40, Dr Kenneth Kaunda District Municipality, SEQ 4 (well off)

Measure Names 15 51.6 67.0 74.3 IndValue 42.4 5_TB 94.3 93.6 69.2

98 680 98 TB death rate Prov_av 563 213 161 206 162 778 153 535 153 105 403 790 729 10 (ETR.net) ZA_av

2016/17 5 screened in TB symptom 5 facility rate (%) rate facility years and older Process & input 60 1_Impact ------377 308 - - - 232 905 - - - TB DR client 40 738 47.4 18.7 72.8

3 944 1 064 299 death rate (EDRWeb) 20 2016 Output rate (%) 0

on treatment treatment on 15 TB client initiated TB client lost to 10 91 82 83 follow up rate 110 618 215 196 278 257 694 90.1 91.2 89.0 92.4 75.5 82.9 88.3 (ETR.Net) 5

0 2016 Net) (%) Net)

TB/HIV co- 80

ART rate (ETR. TB client infected client on treatment 60 -

- success rate ------(ETR.net) 239 309 80.6 68.0

129.3 40

40 2016

treatment treatment TB DR client TB Rifampicin Rifampicin TB

resistant clients clients resistant loss to follow up initiation rate (%) rate initiation 20 rate (EDRWeb) ------5.1 6.1 6.2 239 0 3 944

60 2_Outcome TB DR 2016

rate (%) treatment 40 resistance resistance success rate TB Rifampicin Rifampicin TB

confirmed client confirmed client (EDRWeb) 20 ------0 580 334 57.6 58.4 50.5

TB Rifampicin 20 resistance 2014 confirmed client

Outcome 10 rate success rate rate success (EDRWeb) (%) TB DR treatment treatment DR TB 0 100 ------66 580 17.9 11.4 10.9 TB/HIV co-infected client on ART 50

2014 rate (ETR.Net)

(EDRWeb) (%) 0 to follow up rate TB DR client loss 100 TB symptom 5 815 616 291 820 232 208 367 339 41.6 75.1 81.0 71.5 69.0 60.8 63.2 years and older 2 293 1 395 screened in 50 facility rate 2015 4_Process_input 0 TB client client TB treatment treatment success rate rate success (ETR.net) (%) 2009 2010 2011 2012 2013 2014 2015 2016 Year

4 Measure Names 26 83 54 7.1 7.3 1.4 6.4 6.6 6.3 815 167 291 820 367 10.1 IndValue 2 293 P rov_av ZA_av 2015 TB client loss (ETR.Net) (%) (ETR.Net) to follow up rate ------147 580 23.0 25.3 25.3 2014 death rate TB DR client (EDRWeb) (%) 74 Impact 97 52 48 9.1 9.0 6.6 815 271 291 820 367 17.9 11.8 11.8 13.1 2 293 2015 TB death rate (ETR.net) (%) Indicator Numerator Indicator Denominator Numerator Denominator Indicator Indicator Numerator Denominator Indicator Numerator Denominator Indicator Numerator Denominator Indicator D

Maquassi Hills SD Hills Maquassi South Africa South North West Matlosana SD Matlosana Tlokwe SD Tlokwe Ventersdorp SD Ventersdorp Dr K Kaunda Source: HIS.

745 Section B: NationalProfile North and WestDistrict Province Profiles

Non-communicable diseases

Outcome Diabetes Hypertension incidence incidence (per1K) (per1K) 2016/17 2016/17 Maquassi Hills SD Indicator 5.3 31.6 Numerator 433 737 Denominator 983 280 279 882 Matlosana SD Indicator 1.1 15.5 Numerator 465 2 081 Denominator 5 076 324 1 613 187 Tlokwe SD Indicator 1.5 13.7 Numerator 261 752 Denominator 2 069 766 660 318 Ventersdorp SD Indicator 2.4 15.4 Numerator 145 263 Denominator 715 851 204 846 Dr K Kaunda Indicator 1.8 16.7 Numerator 1 304 3 833 Denominator 8 845 221 2 758 233 North West Indicator 1.4 16.0 South Africa Indicator 2.5 18.9 Source: DHIS.

AnnualNW, DC40, trends Dr Kenneth Kaunda District Municipality, SEQ 4 (well off)

Measure Names IndValue Prov_av 6_NCDs Diabetes 5 incidence ZA_av

2_Outcome 40 Hypertension incidence 20

2010 2011 2012 2013 2014 2015 2016 2017 Year

746