15 North West Province

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Section B: DistrictProfile NorthHealth West Profiles Province

Bojanala Platinum District Municipality (DC37)

Overview of the district The Bojanala Platinum District Municipalitya is a Category C municipality situated in the North West Province. It is bordered by the Waterberg District Municipality to the north, Dr Kenneth Kaunda District Municipality to the south, City of Tshwane Metro to the east, West Rand District Municipality to the south-east, and Ngaka Modiri Molema District Municipality to the west. It is one of four district municipalities in the province and comprises five local municipalities: Kgetlengrivier, Madibeng, Moses Kotane, Moretele and Rustenburg. The seat of Bojanala Platinum District Municipality is Rustenburg. Area: 18 333km² Population (2016)b: 1 655 744 Population density (2016): 90.3 persons per km2 Estimated medical scheme coverage: 14.6% Cities/Towns: Brits, Derby, Hartbeesfontein-A, Hartbeespoort, Koster, Madikwe, Marikana, Mooinooi, Phatsima, Rustenburg, Swartruggens, Tlhabane. Main Economic Sectors: Mining (30–35%), community services (15–20%), finance (10–15%), trade (10–15%), transport (5– 10%), manufacturing (5–10%).

Population distribution, local municipality boundaries and health facility locations

Source: Mid-Year Population Estimates 2016, Stats SA. a The Local Government Handbook South Africa 2017. A complete guide to municipalities in South Africa. Seventh edition. Accessible at: www. municipalities.co.za. b Mid-Year Population Estimates 2016, Stats SA.

576 SectionSection B: Profile B: District North Health West Province Profiles

DistrictBojanala population DM (DC37) pyramid and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 25 422 37 475 35 769 49 933 60-64 years 18 090 17 609 26 690 22 672 55-59 years 23 785 20 338 37 678 28 349 50-54 years 34 091 26 685 44 974 33 744 45-49 years 44 496 32 343 51 963 41 509 40-44 years 50 313 37 568 62 034 49 354 35-39 years 55 695 45 451 74 252 57 430 30-34 years 61 574 51 698 79 466 63 992 25-29 years 65 632 55 406 90 137 73 327 20-24 years 60 693 56 248 73 654 65 034 15-19 years 67 873 64 716 63 259 59 249 10-14 years 62 958 61 367 68 179 66 218 05-09 years 62 125 59 171 84 866 83 095 00-04 years 68 851 67 422 85 278 83 639

500 000 0 500 000 500 000 0 500 000 Population Population

2006 2016

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

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 1.9% 2.8% 2.2% 3.0% 60-64 years 1.6% 55-59 years 1.8% 1.5% 2.3% 1.7% 50-54 years 2.6% 2.0% 2.7% 2.0% 45-49 years 3.3% 2.4% 3.1% 2.5% 40-44 years 3.8% 2.8% 3.7% 3.0% 35-39 years 4.2% 3.4% 4.5% 3.5% 30-34 years 4.6% 3.9% 4.8% 3.9% 25-29 years 4.9% 4.1% 5.4% 4.4% 20-24 years 4.5% 4.2% 4.4% 3.9% 15-19 years 5.1% 4.8% 3.8% 3.6% 10-14 years 4.7% 4.6% 4.1% 4.0% 05-09 years 4.7% 4.4% 5.1% 5.0% 00-04 years 5.2% 5.0% 5.2% 5.1%

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

Gender male female

Source: Mid-Year Population Estimates 2016, Stats SA.

Graph 1: District population pyramid 2006 and 2016 Graph 2: District % population by age-gender group in 2006 and 2016 compared to South Africa Bojanala DM (DC37) Show history

577 Section B: DistrictProfile NorthHealth West Profiles Province

Social determinants of health

Source: Stats SA (Local Government Handbook), 2014 Blue Drop Report.

578 SectionSection B: Profile B: District North Health West Province Profiles

NW, Bojanala: DC37 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NW, Bojanala: DC37 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 79% 9% 8%3% 75% 8% 11% 6% HIV and TB 5-14 38% 20% 16% 26% 32% 22% 21% 26% Comm_mat_peri_nut 15-24 24% 24% 16% 35% 18% 24% 18% 40% 25-64 24% 34% 33% 10% 18% 34% 37% 12% 65+ 13% 5% 80% 3% 11% 5% 81% 2% Total 28% 23% 40% 9% 21% 22% 47% 10%

Rank_.. 2006-2010 2011-2015 Percentages are shown 1 Diarrhoeal diseases (32.1%) Diarrhoeal diseases (24.7%) 2 Lower respiratory infections (23.0%) Lower respiratory infections (17.5%) according to all the 3 Preterm birth complications (8.5%) Preterm birth complications (11.2%) deaths within the 4 HIV/AIDS (7.3%) HIV/AIDS (6.5%) age/period category of 5 Protein-energy malnutrition (4.6%) Birth asphyxia (6.2%) each box, although only 6 Birth asphyxia (4.4%) Protein-energy malnutrition (5.5%) the leading 10 causes are <5 years <5 Sepsis/other newborn infectious (3.6%) 7 Other respiratory (2.5%) displayed. 8 Sepsis/other newborn infectious (2.3%) Other perinatal conditions (3.2%) 9 Tuberculosis (2.0%) Other respiratory (2.1%) 10 Other perinatal conditions (1.3%) Tuberculosis (1.8%) 1 Lower respiratory infections (17.5%) Lower respiratory infections (13.2%) 2 Diarrhoeal diseases (13.3%) HIV/AIDS (11.6%) 3 Tuberculosis (11.1%) Diarrhoeal diseases (11.4%) 4 HIV/AIDS (10.0%) Tuberculosis (11.0%) 5 Road injuries (8.0%) Drowning (8.6%)

5-14 6 Drowning (7.6%) Road injuries (7.5%) 7 Meningitis/encephalitis (3.6%) Accidental threats to breathing (5.7%) 8 Fires, hot substances (3.4%) Meningitis/encephalitis (2.6%) 9 Accidental threats to breathing (3.0%) Other respiratory (2.6%) 10 Other respiratory (2.8%) Endocrine nutritional,blood, immune (2.2%) 1 Lower respiratory infections (12.8%) HIV/AIDS (14.3%) 2 Tuberculosis (12.6%) Accidental threats to breathing (12.1%) 3 HIV/AIDS (12.1%) Interpersonal violence (10.6%) 4 Interpersonal violence (10.5%) Tuberculosis (10.2%) 5 Accidental threats to breathing (8.2%) Lower respiratory infections (9.1%) 6 Road injuries (7.5%) Road injuries (8.3%) 15-24 7 Diarrhoeal diseases (5.7%) Mechanical forces (3.7%) 8 Mechanical forces (5.3%) Diarrhoeal diseases (3.3%) 9 Meningitis/encephalitis (2.0%) Epilepsy (2.6%) 10 Endocrine nutritional,blood, immune (1.6%) Fires, hot substances (2.3%) 1 Tuberculosis (17.1%) HIV/AIDS (18.9%) 2 HIV/AIDS (16.8%) Tuberculosis (14.9%) 3 Lower respiratory infections (13.3%) Lower respiratory infections (10.1%) 4 Diarrhoeal diseases (6.3%) Cerebrovascular disease (4.4%) 5 Cerebrovascular disease (4.0%) Hypertensive heart disease (4.1%) 6 Hypertensive heart disease (4.0%) Ischaemic heart disease (3.5%) 25-64 7 Ischaemic heart disease (3.7%) Diabetes mellitus (3.4%) 8 Road injuries (2.4%) Diarrhoeal diseases (3.2%) 9 Diabetes mellitus (2.3%) Accidental threats to breathing (2.9%) 10 Accidental threats to breathing (2.1%) Road injuries (2.5%) 1 Hypertensive heart disease (17.2%) Cerebrovascular disease (17.7%) 2 Cerebrovascular disease (16.7%) Hypertensive heart disease (16.9%) 3 Ischaemic heart disease (8.3%) Diabetes mellitus (8.7%) 4 Lower respiratory infections (7.7%) Ischaemic heart disease (6.7%) 5 Diabetes mellitus (6.7%) Lower respiratory infections (6.5%)

65+ 6 Cardiomyopathy (4.2%) Tuberculosis (3.9%) 7 Nephritis/nephrosis (3.9%) Nephritis/nephrosis (3.8%) 8 Tuberculosis (3.6%) COPD (3.8%) 9 Diarrhoeal diseases (3.5%) Cardiomyopathy (3.1%) 10 COPD (3.4%) Diarrhoeal diseases (2.7%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (40.0%) n=24 Indirect maternal (28.3%) n=53 2 Hypertension in pregnancy (22.1%) n=13 Hypertension in pregnancy (23.0%) n=43 3 Other maternal (15.9%) n=10 Other maternal (20.8%) n=39 4 Abortion (9.0%) n=5 Abortion (10.4%) n=20 15-49 Female 5 Maternal sepsis (7.0%) n=4 Maternal haemorrhage (10.2%) n=19 6 Maternal haemorrhage (6.0%) n=4 Maternal sepsis (7.4%) n=14

579 Section B: DistrictProfile NorthHealth West Profiles Province

Women and maternal health

Source: DHIS.

Value highlighted in green – performance is ranked among the 10 best in the country Value highlighted in red – performance is ranked among the 10 worst in the country Value highlighted in orange – performance of the local municipality is possibly below the performance of the district.

580 SectionSection B: Profile B: District North Health West Province Profiles

Child and school health

Source: DHIS.

581 Section B: DistrictProfile NorthHealth West Profiles Province

HIV

Source: DHIS.

582 SectionSection B: Profile B: District North Health West Province Profiles

Tuberculosis

Source: DHIS, ETR.Net, EDRWeb.

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

583 Section B: DistrictProfile NorthHealth West Profiles Province

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

584 SectionSection B: Profile B: District North Health West Province Profiles

Vital ideal clinic elements in Primary Health Care facilities score (%)

Bojanala Platinum Bojanala Kgetlengrivier LM Madibeng LM Moretele LM Moses Kotane LM Rustenburg LM

Restore the emergency trolley daily or after every time it was used 29 0 38 27 22 40

Resuscitation room is equipped with functional basic equipment for resuscitation 33 100 38 23 24 50

Cold chain procedure for vaccines is maintained 73 100 92 59 61 90

The temperature of the medicine room/dispensary is recorded daily 82 100 96 95 65 90

The temperature of the medicine room/dispensary is maintained within the safety range 82 100 96 95 65 90 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

585 Section B: DistrictProfile NorthHealth West Profiles Province 1.6% 0.4% 0.4% 29.7% (1.6%) (4.7%) (4.8%) (2.2%) (10.6%) (42.2%) % Overspent (underspent) 75 529 6 3 500 563 526 175 177 Provincial Provincial Expenditure Total 2017/18 01 483 628 847 76 935 125 784 42 387 068 464 82 617 154 318 32 095 616 145 86 3 916 476 3 916 1 168 7631 168 Budget 112 274 3 274 112 128 007128 0 481 687 4 333 769 2 538 072 6 380 998 6 Total 2017/18 0 43 652 796 577 890 41

00 577 89 41 577 41 890 2 023 547 454 2 032 332 966 Transfer to LG to Transfer

17 47 95 84 64 177 2017/18 Provincial Expenditure 675 529 3 500 563 318 154 6 154 318 526 175 145 616 0 616 145 125 935125 7 483 628 8 387 068 4 Provincial

6 LG

0 43 652 796 1 990 755 076

0 43 652 79 Transfer to LG to Transfer 2017/18 Budget

3 916 476 3 916 1 168 7631 168 112 274 332 274 112 128 007128 076 481 687 401 333 769 282 538 072 686 380 998 642 Provincial 1 979 894 658 al Government. *LG – Loc*LG

BAS,

2.5 Other2.5 Community Services 2.2 Community Health Clinics Community2.2 Health Centres Community Health 2.3 Services Community-based 2.4 HIV/AIDS 2.6 Nutrition 2.7 Total Grand 2.9 District Hospitals District 2.9 2.1 District Management 2.1 Local government expenditure Source: District health expenditure and budget, 2017/18

586 SectionSection B: Profile B: District North Health West Province Profiles

Ngaka Modiri Molema District Municipality (DC38)

Overview of the district The Ngaka Modiri Molema District Municipalitya is a Category C municipality and one of four district municipalities in the North West Province. It is situated centrally within the province and shares an international border with Botswana. It is comprised of five local municipalities: Mahikeng, Ratlou, Ramotshere Moiloa, Ditsobotla and Tswaing. The district is home to Mahikeng (previously Mafikeng), the capital of the province. Area: 28 114km² Population (2016)b: 934 859 Population density (2016): 33.3 persons per km2 Estimated medical scheme coverage: 11.0% Cities/Towns: Biesiesvlei, Coligny, Delareyville, Disaneng, Groot Marico, Kraaipan, Lichtenburg, Madibogo, Mahikeng, Mmabatho, Ottosdal, Ottoshoop, Sannieshof, Setlagole, Zeerust. Main Economic Sectors: Agriculture, tourism, mining.

Population distribution, local municipality boundaries and health facility locations

Source: Mid-Year Population Estimates 2016, Stats SA.

a The Local Government Handbook South Africa 2017. A complete guide to municipalities in South Africa. Seventh edition. Accessible at: www. municipalities.co.za. b Mid-Year Population Estimates 2016, Stats SA.

587 Section B: DistrictProfile NorthHealth West Profiles Province

DistrictNM Molema population DM pyramid (DC38) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 14 449 23 097 14 625 29 266 60-64 years 9 561 11 560 9 603 12 895 55-59 years 11 202 12 617 13 707 15 280 50-54 years 14 057 15 855 16 576 17 503 45-49 years 18 454 18 521 20 355 21 112 40-44 years 20 975 21 051 23 834 25 030 35-39 years 24 651 25 439 32 252 31 701 30-34 years 26 455 29 037 39 321 38 758 25-29 years 32 762 34 413 48 780 46 749 20-24 years 38 361 40 468 47 569 46 868 15-19 years 49 278 49 129 45 644 45 176 10-14 years 48 735 48 616 46 257 46 696 05-09 years 45 958 45 393 50 810 51 055 00-04 years 46 833 46 772 49 066 48 371

500 000 0 500 000 500 000 0 500 000 Population Population

2006 2016

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

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 1.8% 2.8% 1.6% 3.1% 60-64 years 1.4% 55-59 years 1.5% 1.5% 1.6% 50-54 years 1.7% 1.9% 1.8% 1.9% 45-49 years 2.2% 2.2% 2.2% 2.3% 40-44 years 2.5% 2.6% 2.5% 2.7% 35-39 years 3.0% 3.1% 3.4% 3.4% 30-34 years 3.2% 3.5% 4.2% 4.1% 25-29 years 4.0% 4.2% 5.2% 5.0% 20-24 years 4.7% 4.9% 5.1% 5.0% 15-19 years 6.0% 6.0% 4.9% 4.8% 10-14 years 5.9% 5.9% 4.9% 5.0% 05-09 years 5.6% 5.5% 5.4% 5.5% 00-04 years 5.7% 5.7% 5.2% 5.2%

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

Gender male female Source: Mid-Year Population Estimates 2016, Stats SA.

Graph 1: District population pyramid 2006 and 2016 Graph 2: District % population by age-gender group in 2006 and 2016 compared to South Africa NM Molema DM (DC38) Show history

588 SectionSection B: Profile B: District North Health West Province Profiles

Social determinants of health

Source: Stats SA (Local Government Handbook), 2014 Blue Drop Report.

589 Section B: DistrictProfile NorthHealth West Profiles Province

NW, NM Molema: DC38 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NW, NM Molema: DC38 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 83% 8% 6%2% 80% 7%10%4% HIV and TB 5-14 39% 21% 17% 23% 30% 20% 22% 27% Comm_mat_peri_nut 15-24 31% 27% 18% 24% 25% 28% 17% 31% 25-64 31% 32% 31% 6% 22% 35% 36% 8% 65+ 15% 5% 78% 2% 12% 5% 80% 2% Total 34% 22% 38% 6% 26% 22% 45% 7%

Rank_.. 2006-2010 2011-2015 Percentages are shown 1 Diarrhoeal diseases (25.1%) Diarrhoeal diseases (21.4%) 2 Lower respiratory infections (24.4%) Lower respiratory infections (17.9%) according to all the 3 Preterm birth complications (12.9%) Preterm birth complications (13.5%) deaths within the 4 Protein-energy malnutrition (6.1%) Birth asphyxia (8.3%) age/period category of 5 Birth asphyxia (5.8%) Protein-energy malnutrition (7.7%) each box, although only 6 Tuberculosis (4.3%) Sepsis/other newborn infectious (4.2%) the leading 10 causes are <5 years <5 7 HIV/AIDS (4.0%) Tuberculosis (3.5%) displayed. 8 Sepsis/other newborn infectious (3.3%) HIV/AIDS (3.2%) 9 Septicaemia (2.4%) Septicaemia (3.1%) 10 Other perinatal conditions (1.8%) Other perinatal conditions (2.7%) 1 Lower respiratory infections (18.6%) Road injuries (14.7%) 2 Tuberculosis (16.8%) Tuberculosis (13.7%) 3 Road injuries (14.2%) Lower respiratory infections (11.7%) 4 Diarrhoeal diseases (11.5%) Diarrhoeal diseases (8.7%) 5 HIV/AIDS (5.0%) HIV/AIDS (7.5%)

5-14 6 Drowning (4.1%) Drowning (7.3%) 7 Meningitis/encephalitis (4.1%) Meningitis/encephalitis (3.6%) 8 Septicaemia (2.6%) Epilepsy (2.6%) 9 Epilepsy (2.3%) Protein-energy malnutrition (2.3%) 10 Other respiratory (2.2%) Endocrine nutritional,blood, immune (2.3%) 1 Lower respiratory infections (20.0%) Tuberculosis (16.0%) 2 Tuberculosis (19.4%) Lower respiratory infections (13.9%) 3 Road injuries (10.7%) HIV/AIDS (12.4%) 4 HIV/AIDS (7.9%) Road injuries (12.1%) 5 Interpersonal violence (5.6%) Interpersonal violence (7.5%) 6 Accidental threats to breathing (4.5%) Accidental threats to breathing (4.5%) 15-24 7 Diarrhoeal diseases (4.4%) Diarrhoeal diseases (3.5%) 8 Meningitis/encephalitis (2.6%) Endocrine nutritional,blood, immune (2.6%) 9 Epilepsy (2.5%) Epilepsy (2.6%) 10 Endocrine nutritional,blood, immune (2.0%) Meningitis/encephalitis (2.5%) 1 Tuberculosis (22.1%) Tuberculosis (17.9%) 2 Lower respiratory infections (19.6%) HIV/AIDS (16.7%) 3 HIV/AIDS (9.5%) Lower respiratory infections (14.4%) 4 Diarrhoeal diseases (6.1%) Cerebrovascular disease (5.3%) 5 Cerebrovascular disease (4.2%) Hypertensive heart disease (3.9%) 6 Road injuries (3.0%) Diarrhoeal diseases (3.4%) 25-64 7 Hypertensive heart disease (2.7%) Road injuries (3.3%) 8 Asthma (2.4%) Diabetes mellitus (3.1%) 9 Diabetes mellitus (2.2%) Ischaemic heart disease (2.9%) 10 Meningitis/encephalitis (2.2%) Nephritis/nephrosis (2.1%) 1 Cerebrovascular disease (18.4%) Cerebrovascular disease (19.3%) 2 Hypertensive heart disease (17.5%) Hypertensive heart disease (17.9%) 3 Lower respiratory infections (9.8%) Lower respiratory infections (7.5%) 4 Ischaemic heart disease (6.2%) Ischaemic heart disease (7.4%) 5 Diabetes mellitus (5.5%) Diabetes mellitus (6.5%)

65+ 6 Tuberculosis (4.8%) Tuberculosis (4.0%) 7 Cardiomyopathy (4.6%) Nephritis/nephrosis (3.6%) 8 COPD (3.5%) Diarrhoeal diseases (2.9%) 9 Asthma (3.3%) Asthma (2.8%) 10 Diarrhoeal diseases (3.1%) COPD (2.7%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (40.9%) n=9 Indirect maternal (31.4%) n=40 2 Other maternal (20.5%) n=4 Hypertension in pregnancy (26.2%) n=33 3 Hypertension in pregnancy (20.4%) n=4 Other maternal (16.7%) n=21 4 Maternal sepsis (18.1%) n=4 Maternal haemorrhage (16.2%) n=21 15-49 Female 5 Abortion (6.4%) n=8 6 Maternal sepsis (3.0%) n=4

590 SectionSection B: Profile B: District North Health West Province Profiles

Women and maternal health

Source: DHIS.

591 Section B: DistrictProfile NorthHealth West Profiles Province

Child and school health

Source: DHIS.

592 SectionSection B: Profile B: District North Health West Province Profiles

HIV

Source: DHIS.

593 Section B: DistrictProfile NorthHealth West Profiles Province

Tuberculosis

Source: DHIS, ETR.Net, EDRWeb.

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

594 SectionSection B: Profile B: District North Health West Province Profiles

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

595 Section B: DistrictProfile NorthHealth West Profiles Province

Vital ideal clinic elements in Primary Health Care facilities score (%)

NM Molema Ditsobotla LM Mahikeng LM Ramotshere LM Moiloa LM Ratlou Tswaing LM

Resuscitation room is equipped with functional basic equipment for resuscitation 34 41 17 30 46 60

Restore the emergency trolley daily or after every time it was used 35 41 21 30 46 60

Cold chain procedure for vaccines is maintained 85 100 76 80 100 80

The temperature of the medicine room/dispensary is recorded daily 90 94 90 90 77 100

There is at least one functional wall mounted room thermometer in the medicine room/dispensary 91 94 83 100 85 100 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

596 SectionSection B: Profile B: District North Health West Province Profiles (2.1%) (1.5%) (6.4%) (4.0%) (0.0%) (2.9%) (4.6%) 557.7% (44.3%) (42.2%) % Overspent (underspent) 81 414 3 2 070 410 Provincial Provincial Expenditure Total 2017/18 19 905 326 017 61 027 103 931 75 305 036 436 82 742 82 511 02 347 072 606 26 068 289 318 659 902659 2 211 303 2 211 Budget 333 8 107 289 413 0 289 413 309 725 1 148 235148 3 106 065 9 361 563 0 Total 2017/18

LG 8 060 428 4 265 836 28 056 900

-3 528 2 -3 528 28 060 428 1 555 247 406 1 483 493 413 Transfer to LG to Transfer 2

31 36 05 68 06 2017/18 Provincial Expenditure 381 414 2 070 410 82 511 74 82 511 326 017 9 326 017 103 027103 9 289 318 0 289 318 347 072 6 305 036 4 Provincial

2 008 184 11 -6 17 918 Transfer to LG to Transfer 2017/18 Budget

659 902659 2 211 303 2 211 333 819 107 289 413 026 289 413 309 725 175 148 235148 382 106 065 961 361 563 002 Provincial 1 550 981 570 -6 172 918 184 008 11 1 455 436 513 al Government. *LG – Loc*LG

BAS,

2.5 Other2.5 Community Services Nutrition 2.7 2.6 HIV/AIDS 2.6 Hospitals District 2.9 2.2 Community Health Clinics Community2.2 Health Centres Community Health 2.3 Services Community-based 2.4 Local government expenditure Total Grand 2.1 District Management 2.1 District health expenditure and budget, 2017/18 Source:

597 Section B: DistrictProfile NorthHealth West Profiles Province

Dr Ruth Segomotsi Mompati District Municipality (DC39)

Overview of the district The Dr Ruth Segomotsi Mompati District Municipalitya (previously Bophirima District Municipality) is a Category C municipality located in the North West Province. It is bordered by Ngaka Modiri Molema and Dr Kenneth Kaunda in the north, and John Taolo Gaetsewe in the south, which is a cross-boundary within the Northern Cape. It is the largest district in the province, making up almost half of its geographical area. The district municipality comprises five local municipalities: Naledi, Greater Taung, Kagisano-Molopo, Mamusa and Lekwa-Teemane. It is one of four districts in the province, with poor rural areas, formerly situated in the former Bophuthatswana homeland. With the population situated in more than 470 villages and towns dispersed in a 250km radius (approximately 50km north to south and 200km east to west), this district presents unique management and organisational challenges. Area: 43 764km² Population (2016)b: 474 804 Population density (2016): 10.8 persons per km2 Estimated medical scheme coverage: 9.9% Cities/Towns: Amalia, Bloemhof, Christiana, Piet Plessis, Pomfret, Pudimoe, Reivilo, Schweizer-Reneke, Stella, Taung, Vryburg. Main Economic Sectors: Community services (33.1%), agriculture (17.1%), finance (16.2%), trade (12.7%), transport (9%), manufacturing (4%), mining (3.2%), construction (3.2%).

Population distribution, local municipality boundaries and health facility locations

Source: Mid-Year Population Estimates 2016, Stats SA.

598 SectionSection B: Profile B: District North Health West Province Profiles

DistrictRS Mompati population DM pyramid (DC39) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 9 161 13 776 8 804 17 330 60-64 years 5 702 7 018 4 943 6 714 55-59 years 6 341 7 283 6 247 7 332 50-54 years 7 670 8 471 7 157 8 284 45-49 years 9 073 9 343 8 388 9 165 40-44 years 9 927 10 650 9 240 10 715 35-39 years 11 313 11 968 11 967 13 673 30-34 years 11 853 13 789 14 879 16 753 25-29 years 14 756 16 772 20 696 21 471 20-24 years 18 999 20 534 23 384 23 177 15-19 years 28 924 28 039 24 724 24 105 10-14 years 29 910 28 452 26 819 27 353 05-09 years 26 835 25 964 30 511 30 577 00-04 years 28 647 28 911 30 241 30 155

500 000 0 500 000 500 000 0 500 000 Population Population

2006 2016

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

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 2.0% 3.1% 1.9% 3.6% 60-64 years 1.6% 1.4% 55-59 years 1.6% 1.5% 50-54 years 1.7% 1.9% 1.5% 1.7% 45-49 years 2.0% 2.1% 1.8% 1.9% 40-44 years 2.2% 2.4% 1.9% 2.3% 35-39 years 2.5% 2.7% 2.5% 2.9% 30-34 years 2.6% 3.1% 3.1% 3.5% 25-29 years 3.3% 3.7% 4.4% 4.5% 20-24 years 4.2% 4.6% 4.9% 4.9% 15-19 years 6.4% 6.2% 5.2% 5.1% 10-14 years 6.6% 6.3% 5.6% 5.8% 05-09 years 6.0% 5.8% 6.4% 6.4% 00-04 years 6.4% 6.4% 6.4% 6.4%

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

Gender male female Source: Mid-Year Population Estimates 2016, Stats SA.

Graph 1: District population pyramid 2006 and 2016 Graph 2: District % population by age-gender group in 2006 and 2016 compared to South Africa RS Mompati DM (DC39) Show history

599 Section B: DistrictProfile NorthHealth West Profiles Province

Social determinants of health

Source: Stats SA (Local Government Handbook), 2014 Blue Drop Report.

600 SectionSection B: Profile B: District North Health West Province Profiles

NW, RS Mompati: DC39 BurdenPercentage of disease of deaths – leading by causes broad ofcauses death inand district single leading causes Show history NW, RS Mompati: DC39 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 85% 7%6%2% 80% 8% 8%4% HIV and TB 5-14 37% 22% 15% 26% 27% 24% 18% 31% Comm_mat_peri_nut 15-24 26% 36% 12% 25% 18% 37% 13% 32% 25-64 27% 40% 27% 6% 18% 46% 30% 7% 65+ 16% 6% 76% 2% 14% 7% 78% 2% Total 33% 26% 35% 5% 24% 28% 41% 6%

Rank_.. 2006-2010 2011-2015 Percentages are shown 1 Diarrhoeal diseases (32.4%) Diarrhoeal diseases (24.2%) 2 Lower respiratory infections (23.6%) Lower respiratory infections (15.9%) according to all the 3 Preterm birth complications (9.8%) Preterm birth complications (15.2%) deaths within the 4 Protein-energy malnutrition (7.1%) Protein-energy malnutrition (10.1%) age/period category of 5 Birth asphyxia (5.5%) Birth asphyxia (7.5%) each box, although only 6 HIV/AIDS (4.8%) HIV/AIDS (6.4%) the leading 10 causes are <5 years <5 7 Other respiratory (2.5%) Tuberculosis (2.7%) displayed. 8 Sepsis/other newborn infectious (2.1%) Sepsis/other newborn infectious (2.5%) 9 Other respiratory (1.7%) Other perinatal conditions (2.3%) 10 Other perinatal conditions (1.4%) Tuberculosis (1.6%) 1 Tuberculosis (15.1%) Drowning (15.3%) 2 Diarrhoeal diseases (14.2%) HIV/AIDS (14.1%) 3 Lower respiratory infections (13.5%) Tuberculosis (13.8%) 4 HIV/AIDS (10.4%) Lower respiratory infections (9.6%) 5 Drowning (8.8%) Diarrhoeal diseases (7.9%)

5-14 6 Accidental threats to breathing (5.8%) Accidental threats to breathing (5.8%) 7 Meningitis/encephalitis (5.4%) Meningitis/encephalitis (4.7%) 8 Epilepsy (3.5%) Fires, hot substances (4.4%) 9 Road injuries (3.5%) Epilepsy (3.9%) 10 Exposure to natural forces (2.8%) Road injuries (3.8%) 1 Tuberculosis (20.4%) HIV/AIDS (23.6%) 2 HIV/AIDS (17.4%) Tuberculosis (15.1%) 3 Lower respiratory infections (13.5%) Interpersonal violence (12.8%) 4 Interpersonal violence (11.3%) Lower respiratory infections (11.1%) 5 Diarrhoeal diseases (6.7%) Accidental threats to breathing (9.7%) 6 Road injuries (4.8%) Fires, hot substances (2.9%) 15-24 7 Accidental threats to breathing (4.0%) Epilepsy (2.7%) 8 Meningitis/encephalitis (1.9%) Mechanical forces (2.6%) 9 Endocrine nutritional,blood, immune (1.9%) Diarrhoeal diseases (2.3%) 10 Epilepsy (1.5%) Endocrine nutritional,blood, immune (2.1%) 1 Tuberculosis (22.6%) HIV/AIDS (28.7%) 2 HIV/AIDS (17.2%) Tuberculosis (16.9%) 3 Lower respiratory infections (16.1%) Lower respiratory infections (11.4%) 4 Diarrhoeal diseases (7.1%) Cerebrovascular disease (4.1%) 5 Cerebrovascular disease (3.6%) Ischaemic heart disease (3.3%) 6 Hypertensive heart disease (2.8%) Hypertensive heart disease (3.2%) 25-64 7 Ischaemic heart disease (2.4%) Diarrhoeal diseases (3.2%) 8 Meningitis/encephalitis (1.9%) Accidental threats to breathing (2.4%) 9 Endocrine nutritional,blood, immune (1.7%) Endocrine nutritional,blood, immune (2.1%) 10 Other respiratory (1.7%) Diabetes mellitus (1.9%) 1 Cerebrovascular disease (18.9%) Cerebrovascular disease (19.2%) 2 Hypertensive heart disease (14.7%) Hypertensive heart disease (15.1%) 3 Lower respiratory infections (9.7%) Ischaemic heart disease (12.3%) 4 Ischaemic heart disease (9.5%) Lower respiratory infections (8.5%) 5 Tuberculosis (5.2%) Diabetes mellitus (4.8%)

65+ 6 Diarrhoeal diseases (4.2%) Tuberculosis (4.5%) 7 Diabetes mellitus (4.0%) Diarrhoeal diseases (3.3%) 8 COPD (3.2%) COPD (2.4%) 9 Other respiratory (2.2%) Nephritis/nephrosis (2.3%) 10 Prostate (2.1%) Asthma (2.3%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (39.8%) n=9 Indirect maternal (30.3%) n=21 2 Other maternal (25.1%) n=6 Maternal haemorrhage (25.1%) n=17 3 Maternal sepsis (20.0%) n=4 Hypertension in pregnancy (18.8%) n=13 4 Hypertension in pregnancy (15.1%) n=3 Other maternal (14.2%) n=10 15-49 Female 5 Abortion (11.6%) n=8 6

601 Section B: DistrictProfile NorthHealth West Profiles Province

Women and maternal health

Source: DHIS.

602 SectionSection B: Profile B: District North Health West Province Profiles

Child and school health

Source: DHIS.

603 Section B: DistrictProfile NorthHealth West Profiles Province

HIV

Source: DHIS.

604 SectionSection B: Profile B: District North Health West Province Profiles

Tuberculosis

Source: DHIS, ETR.Net, EDRWeb.

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

605 Section B: DistrictProfile NorthHealth West Profiles Province

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

606 SectionSection B: Profile B: District North Health West Province Profiles

Vital ideal clinic elements in Primary Health Care facilities score (%)

RS Mompati Greater LM Taung Kagisano-Molopo LM LM Lekwa-Teemane Mamusa LM Naledi LM

Resuscitation room is equipped with functional basic equipment for resuscitation 43 25 50 40 100 75

Restore the emergency trolley daily or after every time it was used 45 25 50 60 100 75

Cold chain procedure for vaccines is maintained 75 61 78 100 100 100

The temperature of the medicine room/dispensary is maintained within the safety range 83 75 89 100 100 75

The temperature of the medicine room/dispensary is recorded daily 85 79 89 80 100 100 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

607 Section B: DistrictProfile NorthHealth West Profiles Province - 6.1% 29.7% (1.6%) (0.8%) (0.9%) (5.8%) (8.3%) (0.2%) (41.8%) % Overspent (underspent) 0 96 851 1 1 029 954 274 480274 345 Provincial Provincial Expenditure Total 2017/18 5 548 101 371 0 1 757 122 41 41 57 160 494 565 57 783 314 177 48 225 354 169 338 357 1 123 0951 123 32 98 195 95 687 46 Budget 178 914 5 914 178 276 755 5 170 288 0 170 228 947 0 Total 2017/18

0 0 984 250 101 982 160 176 LG

0 0 Transfer to LG to Transfer

2 1 71 65 69 83 45 2017/18 Provincial Expenditure 196 85 1 029 954 41 757 12 41 177 314 7 314 177 101 548101 3 274 480274 3 225 354 1 160 494 5 Provincial

0 0 982 160 176 LG

0 0 Transfer to LG to Transfer 2017/18 Budget

338 357 1 123 0951 123 32 981 195 95 687 465 178 914 557 914 178 276 755 541 170 288 057170 228 947 048 984 250 101 Provincial al Government. *LG – Loc*LG

tal BAS,

Local government expenditure 2.4 Community-based Services Community-based 2.4 HIV/AIDS 2.6 To Grand 2.2 Community Health Clinics Community2.2 Health Centres Community Health 2.3 Other2.5 Community Services Nutrition 2.7 Hospitals District 2.9 2.1 District Management 2.1 District health expenditure and budget, 2017/18 Source:

608 SectionSection B: Profile B: District North Health West Province Profiles

Dr Kenneth Kaunda District Municipality (DC40)

Overview of the district The Dr Kenneth Kaunda District Municipalitya is a Category C municipality in the North West Province. It is located 65km south-west of Johannesburg and borders the Gauteng Province on that side. It is the smallest district in the province, making up 14% of its geographical area. The municipality consists of three local municipalities: JB Marks, City of Matlosana and Maquassi Hills. It is a region with a rich and diverse natural and cultural heritage, with the potential for sustained economic growth. The region is home to some of the most prominent gold mines in the world and one of the oldest meteor impact sites in the world. The district is serviced by a number of primary roads, with the N12 Treasure Corridor forming the main development axis in the district and serving as a potential concentration point for future industrial, commercial and tourism development. Area: 14 671km² Population (2016)b: 739 467 Population density (2016): 50.4 persons per km2 Estimated medical scheme coverage: 14.6% Cities/Towns: Hartbeesfontein, Klerksdorp, Leeudoringstad, Makwassie, Orkney, Potchefstroom, Stilfontein, Ventersdorp, Witpoort, Wolmaransstad. Main Economic Sectors: Mining (19.6%), trade (17.3%), finance (16.2%), government (13.8%), transport and communications (9.1%), manufacturing (8.8%), services (8.0%), construction (3.5%), agriculture (2.3%).

Population distribution, local municipality boundaries and health facility locations

609 Section B: DistrictProfile NorthHealth West Profiles Province

DistrictDr K Kaunda population DM pyramid (DC40) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 11 214 15 848 14 009 21 073 60-64 years 8 994 9 335 11 309 11 567 55-59 years 11 937 11 301 15 769 14 408 50-54 years 16 045 14 685 18 680 17 298 45-49 years 21 000 17 634 21 059 20 503 40-44 years 23 591 20 489 22 803 22 990 35-39 years 25 365 23 913 26 308 27 083 30-34 years 25 394 25 497 29 657 30 300 25-29 years 26 919 28 090 34 990 34 303 20-24 years 28 678 30 516 32 504 32 551 15-19 years 31 665 32 224 31 175 31 085 10-14 years 28 965 28 946 34 767 34 543 05-09 years 29 707 29 439 37 013 36 724 00-04 years 34 532 34 253 37 590 37 406

500 000 0 500 000 500 000 0 500 000 Population Population

2006 2016

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

AgeGrp 8% 6% 4% 2% 0% 2% 4% 6% 8% 8% 6% 4% 2% 0% 2% 4% 6% 8% 65+ 1.7% 2.5% 1.9% 2.8% 60-64 years 1.4% 1.5% 1.6% 55-59 years 1.8% 1.7% 2.1% 1.9% 50-54 years 2.5% 2.3% 2.5% 2.3% 45-49 years 3.2% 2.7% 2.8% 2.8% 40-44 years 3.7% 3.2% 3.1% 3.1% 35-39 years 3.9% 3.7% 3.6% 3.7% 30-34 years 3.9% 3.9% 4.0% 4.1% 25-29 years 4.2% 4.3% 4.7% 4.6% 20-24 years 4.4% 4.7% 4.4% 4.4% 15-19 years 4.9% 5.0% 4.2% 4.2% 10-14 years 4.5% 4.5% 4.7% 4.7% 05-09 years 4.6% 4.6% 5.0% 5.0% 00-04 years 5.3% 5.3% 5.1% 5.1%

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

Gender male female

Source: Mid-Year Population Estimates 2016, Stats SA.

Graph 1: District population pyramid 2006 and 2016 Graph 2: District % population by age-gender group in 2006 and 2016 compared to South Africa Dr K Kaunda DM (DC40) Show history

610 SectionSection B: Profile B: District North Health West Province Profiles

Social determinants of health

Source: Stats SA (Local Government Handbook), 2014 Blue Drop Report.

611 Section B: DistrictProfile NorthHealth West Profiles Province

NW, Dr K Kaunda: DC40 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NW, Dr K Kaunda: DC40 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 78% 10% 8%4% 74% 9% 11% 7% HIV and TB 5-14 28% 29% 12% 31% 30% 27% 19% 24% Comm_mat_peri_nut 15-24 19% 34% 12% 35% 10% 33% 16% 42% 25-64 17% 42% 31% 9% 10% 42% 38% 10% 65+ 13% 6% 78% 3% 11% 6% 80% 3% Total 24% 29% 38% 9% 16% 28% 47% 9%

Rank_.. 2006-2010 2011-2015 Percentages are shown 1 Diarrhoeal diseases (26.0%) Diarrhoeal diseases (17.4%) 2 Lower respiratory infections (22.4%) Lower respiratory infections (14.6%) according to all the 3 Preterm birth complications (10.6%) Preterm birth complications (13.0%) deaths within the 4 HIV/AIDS (6.8%) Protein-energy malnutrition (7.5%) age/period category of 5 Protein-energy malnutrition (6.3%) Birth asphyxia (7.1%) each box, although only 6 Birth asphyxia (4.3%) Sepsis/other newborn infectious (6.8%) the leading 10 causes are <5 years <5 Tuberculosis (3.6%) 7 HIV/AIDS (6.1%) displayed. 8 Sepsis/other newborn infectious (3.2%) Tuberculosis (2.6%) 9 Septicaemia (1.7%) Septicaemia (2.6%) 10 Meningitis/encephalitis (1.7%) Other perinatal conditions (2.5%) 1 Tuberculosis (21.6%) HIV/AIDS (17.0%) 2 Lower respiratory infections (11.2%) Tuberculosis (12.4%) 3 HIV/AIDS (10.5%) Lower respiratory infections (11.1%) 4 Drowning (9.8%) Drowning (10.6%) 5 Diarrhoeal diseases (8.5%) Meningitis/encephalitis (6.1%)

5-14 6 Road injuries (7.9%) Diarrhoeal diseases (5.7%) 7 Meningitis/encephalitis (4.9%) Fires, hot substances (5.3%) 8 Fires, hot substances (4.2%) Accidental threats to breathing (5.1%) 9 Accidental threats to breathing (2.8%) Septicaemia (2.7%) 10 Other unintentional injuries (1.8%) Other unintentional injuries (1.9%) 1 Tuberculosis (21.7%) HIV/AIDS (17.4%) 2 Interpersonal violence (18.1%) Tuberculosis (16.4%) 3 HIV/AIDS (13.3%) Interpersonal violence (13.2%) 4 Lower respiratory infections (7.9%) Accidental threats to breathing (13.1%) 5 Accidental threats to breathing (4.9%) Fires, hot substances (5.5%) 6 Diarrhoeal diseases (4.1%) Road injuries (3.3%) 15-24 7 Road injuries (4.1%) Mechanical forces (3.1%) 8 Meningitis/encephalitis (2.6%) Drowning (2.4%) 9 Mechanical forces (2.4%) Lower respiratory infections (2.2%) 10 Fires, hot substances (2.3%) Diarrhoeal diseases (1.8%) 1 Tuberculosis (26.8%) HIV/AIDS (22.4%) 2 HIV/AIDS (15.4%) Tuberculosis (19.6%) 3 Lower respiratory infections (9.1%) Lower respiratory infections (5.4%) 4 Diarrhoeal diseases (3.8%) Cerebrovascular disease (4.4%) 5 Cerebrovascular disease (3.6%) Nephritis/nephrosis (2.8%) 6 Ischaemic heart disease (2.9%) Accidental threats to breathing (2.6%) 25-64 7 Interpersonal violence (2.3%) Ischaemic heart disease (2.5%) 8 Nephritis/nephrosis (2.1%) Diabetes mellitus (2.1%) 9 Road injuries (2.0%) Diarrhoeal diseases (1.9%) 10 Cardiomyopathy (1.7%) COPD (1.8%) 1 Cerebrovascular disease (12.2%) Cerebrovascular disease (13.6%) 2 Ischaemic heart disease (11.8%) Ischaemic heart disease (9.9%) 3 Lower respiratory infections (8.4%) Hypertensive heart disease (6.7%) 4 Hypertensive heart disease (6.5%) Lower respiratory infections (6.5%) 5 COPD (5.4%) COPD (5.2%)

65+ 6 Tuberculosis (4.9%) Nephritis/nephrosis (4.8%) 7 Nephritis/nephrosis (3.8%) Diabetes mellitus (4.6%) 8 Cardiomyopathy (3.6%) Tuberculosis (4.2%) 9 Diabetes mellitus (3.6%) Trachea/bronchi/lung (2.9%) 10 Diarrhoeal diseases (2.4%) Prostate (2.6%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (48.8%) n=24 Indirect maternal (32.7%) n=43 2 Other maternal (29.9%) n=15 Other maternal (26.7%) n=36 3 Hypertension in pregnancy (14.1%) n=7 Hypertension in pregnancy (24.4%) n=33 4 Abortion (7.3%) n=4 Maternal sepsis (7.5%) n=10 15-49 Female 5 Abortion (4.6%) n=6 6 Maternal haemorrhage (4.1%) n=5

612 SectionSection B: Profile B: District North Health West Province Profiles

Women and maternal health

Source: DHIS.

613 Section B: DistrictProfile NorthHealth West Profiles Province

Child and school health

Source: DHIS.

614 SectionSection B: Profile B: District North Health West Province Profiles

HIV

Source: DHIS.

615 Section B: DistrictProfile NorthHealth West Profiles Province

Tuberculosis

Source: DHIS, ETR.Net, EDRWeb.

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

616 SectionSection B: Profile B: District North Health West Province Profiles

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

617 Section B: DistrictProfile NorthHealth West Profiles Province

Vital ideal clinic elements in Primary Health Care facilities score (%)

Dr K Kaunda City of Matlosana LM JB Marks LM LM Maquassi Hills

Resuscitation room is equipped with functional basic equipment for resuscitation 85 81 94 75

Restore the emergency trolley daily or after every time it was used 88 81 88 100

Oxygen cylinder with pressure a gauge available in resuscitation/ emergency room 98 100 100 88

Cold chain procedure for vaccines is maintained 98 94 100 100

90% of the tracer medicines are available 100 100 100 100 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

618 SectionSection B: Profile B: District North Health West Province Profiles (6.1%) (4.4%) 28.0% (0.7%) (0.0%) (2.6%) (6.3%) (1.2%) (42.2%) (56.0%) % Overspent (underspent) 1 696 1 30 1 639 306 76 56376 289 Provincial Provincial Expenditure Total 2017/18 0 68 507 165 3 8 83 349 916 8340 424 565 119 228 835 843 38 261 528 822 521 978 1 749 126 1 749 80 109 10 53 274 8453 274 88 735 76 Budget 119 451 7 451 119 230 347 7 268 555 9 Total 2017/18

LG 6 005 892 930 12 544 5 692 007 6 005 892 855 676 820 845 500 949

5 -313 88 -313 885 -313 Transfer to LG to Transfer

7 9 6 65 22 43 2017/18 Provincial Expenditure 301 696 301 1 639 306 83 349 91 68 50 165 76 56376 28 119 424 5 119 261 528 8 228 835 8 Provincial

6 286 13 200 -355 65 Transfer to LG to Transfer 2017/18 Budget

521 978 1 749 126 1 749 80 109 103 53 274 84053 274 88 735 768 119 451 783 451 119 230 347 740 842 276 746 -355 656 286 13 200 839 808 942 268 555 938 Provincial al Government. *LG – Loc*LG

BAS,

2.4 Community-based Services Community-based 2.4 2.5 Other2.5 Community Services 2.2 Community Health Clinics Community2.2 Health Centres Community Health 2.3 Nutrition 2.7 2.6 HIV/AIDS 2.6 Hospitals District 2.9 Local government expenditure 2.1 District Management 2.1 Grand Total Grand District health expenditure and budget, 2017/18 Source:

619