14 Northern Cape Province

Home , Barkly West, Cape Province, Delportshoop, De Aar, Dibeng, Garies

Section B:Section Profile B:Northern District HealthCape Province Profiles

John Taolo Gaetsewe District Municipality (DC45)

Overview of the district The John Taolo Gaetsewe District Municipalitya (previously Kgalagadi) is a Category C municipality located in the north of the Northern Cape Province, bordering Botswana in the west. It comprises the three local municipalities of Gamagara, Ga- Segonyana and Joe Morolong, and 186 towns and settlements, of which the majority (80%) are villages. The boundaries of this district were demarcated in 2006 to include the once north-western part of Joe Morolong and Olifantshoek, along with its surrounds, into the Gamagara Local Municipality. It has an established rail network from Sishen South and between Black Rock and Dibeng. It is characterised by a mixture of land uses, of which agriculture and mining are dominant. The district holds potential as a viable tourist destination and has numerous growth opportunities in the industrial sector. Area: 27 322km² Population (2016)b: 238 306 Population density (2016): 8.7 persons per km2 Estimated medical scheme coverage: 14.5% Cities/Towns: Bankhara-Bodulong, Deben, Hotazel, Kathu, Kuruman, Mothibistad, Olifantshoek, Santoy, Van Zylsrus. Main Economic Sectors: Agriculture, mining, retail.

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.

521521 Section B: DistrictProfile NorthernHealth Profiles Cape Province

DistrictJT Gaetsewe population DM pyramid (DC45) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 2 990 5 216 3 496 6 382 60-64 years 2 155 2 601 2 401 3 067 55-59 years 2 606 3 146 3 326 3 800 50-54 years 3 484 3 961 3 646 4 223 45-49 years 4 345 4 699 4 493 4 827 40-44 years 4 430 5 152 5 639 5 775 35-39 years 5 251 5 896 8 069 7 766 30-34 years 5 961 6 864 10 075 9 650 25-29 years 7 692 8 541 12 607 12 215 20-24 years 9 308 9 980 12 072 12 217 15-19 years 13 151 13 238 12 024 12 352 10-14 years 13 389 13 271 12 885 13 282 05-09 years 12 409 12 523 13 417 13 465 00-04 years 13 246 13 250 12 715 12 420

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+ 2.5% 1.5% 2.7% 60-64 years 55-59 years 1.5% 1.6% 50-54 years 1.7% 1.9% 1.5% 1.8% 45-49 years 2.1% 2.3% 1.9% 2.0% 40-44 years 2.1% 2.5% 2.4% 2.4% 35-39 years 2.5% 2.8% 3.4% 3.3% 30-34 years 2.9% 3.3% 4.2% 4.0% 25-29 years 3.7% 4.1% 5.3% 5.1% 20-24 years 4.5% 4.8% 5.1% 5.1% 15-19 years 6.3% 6.3% 5.0% 5.2% 10-14 years 6.4% 6.4% 5.4% 5.6% 05-09 years 5.9% 6.0% 5.6% 5.7% 00-04 years 6.3% 6.3% 5.3% 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 JT Gaetsewe DM (DC45) Show history

522 Section B:Section Profile B:Northern District HealthCape Province Profiles

Social determinants of health

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

523523 Section B: DistrictProfile NorthernHealth Profiles Cape Province

NC, JT Gaetsewe: DC45 BurdenPercentage of disease of deaths – leading by causes broad ofcauses death inand district single leading causes Show history NC, JT Gaetsewe: DC45 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 86% 4%8%2% 79% 12% 6%3% HIV and TB 5-14 35% 18% 25% 22% 35% 24% 17% 24% Comm_mat_peri_nut 15-24 35% 19% 19% 26% 18% 28% 13% 40% 25-64 37% 25% 32% 6% 20% 42% 28% 10% 65+ 22% 4% 72% 2% 19% 6% 73% 2% Total 41% 17% 36% 5% 28% 28% 36% 9%

Rank_.. 2006-2010 2011-2015 1 Diarrhoeal diseases (37.2%) Diarrhoeal diseases (25.7%) Percentages are shown 2 Lower respiratory infections (19.6%) Lower respiratory infections (17.4%) according to all the 3 Preterm birth complications (11.8%) Preterm birth complications (14.6%) deaths within the 4 Birth asphyxia (8.0%) HIV/AIDS (10.0%) age/period category of 5 Protein-energy malnutrition (6.6%) Birth asphyxia (9.0%) each box, although only 6 Other respiratory (5.2%) Protein-energy malnutrition (5.6%) the leading 10 causes are <5 years <5 7 HIV/AIDS (2.2%) Sepsis/other newborn infectious (3.2%) displayed. 8 Tuberculosis (1.6%) Other perinatal conditions (3.0%) 9 Other perinatal conditions (1.5%) Tuberculosis (1.8%) 10 Sepsis/other newborn infectious (1.5%) Drowning (1.3%) 1 Tuberculosis (18.9%) HIV/AIDS (20.4%) 2 Lower respiratory infections (16.6%) Lower respiratory infections (15.1%) 3 Diarrhoeal diseases (15.3%) Diarrhoeal diseases (13.3%) 4 Road injuries (12.3%) Tuberculosis (12.6%) 5 Drowning (7.6%) Drowning (11.5%)

5-14 6 Other respiratory (6.2%) Road injuries (8.1%) 7 Meningitis/encephalitis (5.4%) Meningitis/encephalitis (6.5%) 8 HIV/AIDS (4.8%) Epilepsy (4.1%) 9 Nephritis/nephrosis (3.8%) Other transport accidents (3.0%) 10 Accidental threats to breathing (3.3%) Protein-energy malnutrition (2.9%) 1 Lower respiratory infections (19.8%) HIV/AIDS (19.0%) 2 Tuberculosis (11.3%) Road injuries (15.4%) 3 Interpersonal violence (10.0%) Interpersonal violence (14.8%) 4 Diarrhoeal diseases (9.8%) Tuberculosis (11.3%) 5 HIV/AIDS (9.0%) Lower respiratory infections (10.0%) 6 Accidental threats to breathing (7.0%) Accidental threats to breathing (5.1%) 15-24 7 Road injuries (6.9%) Self-inﬂicted injuries (4.4%) 8 Other respiratory (5.2%) Meningitis/encephalitis (4.1%) 9 Endocrine nutritional,blood, immune (5.1%) Diarrhoeal diseases (2.7%) 10 Meningitis/encephalitis (2.7%) Epilepsy (1.9%) 1 Lower respiratory infections (24.1%) HIV/AIDS (28.9%) 2 Tuberculosis (15.5%) Lower respiratory infections (13.6%) 3 HIV/AIDS (10.1%) Tuberculosis (13.6%) 4 Diarrhoeal diseases (8.6%) Road injuries (4.1%) 5 Other respiratory (5.9%) Diarrhoeal diseases (3.8%) 6 Cerebrovascular disease (3.1%) Cerebrovascular disease (3.7%) 25-64 7 Meningitis/encephalitis (2.4%) Ischaemic heart disease (3.2%) 8 Ischaemic heart disease (2.1%) Diabetes mellitus (2.6%) 9 Road injuries (2.0%) Hypertensive heart disease (2.4%) 10 Endocrine nutritional,blood, immune (2.0%) Interpersonal violence (2.2%) 1 Cerebrovascular disease (17.9%) Cerebrovascular disease (17.5%) 2 Lower respiratory infections (14.1%) Lower respiratory infections (13.2%) 3 Ischaemic heart disease (10.7%) Hypertensive heart disease (11.2%) 4 Diarrhoeal diseases (6.4%) Ischaemic heart disease (10.4%) 5 Hypertensive heart disease (5.6%) Diabetes mellitus (5.4%)

65+ 6 Other respiratory (5.5%) Diarrhoeal diseases (4.5%) 7 Cardiomyopathy (5.2%) Tuberculosis (3.7%) 8 Diabetes mellitus (4.4%) COPD (2.9%) 9 Tuberculosis (3.6%) Cardiomyopathy (2.5%) 10 COPD (2.3%) Nephritis/nephrosis (2.5%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Maternal haemorrhage (50.4%) n=3 Maternal haemorrhage (34.8%) n=5 2 Indirect maternal (49.6%) n=3 Hypertension in pregnancy (34.5%) n=5 3 Indirect maternal (30.7%) n=4 4 15-49 Female 5 6

524 Section B:Section Profile B:Northern District HealthCape Province Profiles

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.

525525 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Child and school health

Source: DHIS.

526 Section B:Section Profile B:Northern District HealthCape Province Profiles

HIV

Source: DHIS.

527527 Section B: DistrictProfile NorthernHealth Profiles Cape 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.

528 Section B:Section Profile B:Northern District HealthCape Province Profiles

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

529529 Section B: DistrictProfile NorthernHealth Profiles Cape Province

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

J T Gaetsewe Ga-Segonyana LM LM Gamagara LM Morolong Joe

Restore the emergency trolley daily or after every time it was used 23 0 14 29

Resuscitation room is equipped with functional basic equipment for resuscitation 40 20 14 50

90% of the tracer medicines are available 78 40 86 82

The temperature of the medicine room/dispensary is maintained within the safety range 80 100 57 82

Cold chain procedure for vaccines is maintained 85 80 71 89 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

530 Section B:Section Profile B:Northern District HealthCape Province Profiles 2.4% 27.0% 26.4% 20.7% 39.5% (2.6%) (87.9%) (18.6%) (83.2%) % Overspent (underspent) 267 148 5 591 117 44 111 689 Provincial Provincial Expenditure Total 2017/18 0 00 40 396 198 98 538 833 02 83 042 896 00 895 146 592 883 000 883 4 402 000 31 62631 00 77 931 00 33 303 00 Budget 150 813 0 813 150 102 008102 8 Total 2017/18

LG 1 118 2541 118 8 892 188 1 077 360

-40 894 Transfer to LG to Transfer

6 6 9 3 92 2017/18 Provincial Expenditure 148 267 5 591 117 44 111 68 40 39 198 83 042 89 98 538 83 146 895146 5 Provincial

LG 8 914 888 8 914

-22 700 Transfer to LG to Transfer 2017/18 Budget

883 000 883 4 402 000 31 62631 000 77 931 000 33 303 000 150 813 000 813 150 102 008102 802 400 966 802 -22 700 888 8 914 526 418 789 -40 894 254 1 118 409 858 990 604 419 149 Provincial al Government. *LG – Loc*LG

BAS,

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

531531 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Namakwa District Municipality (DC6)

Overview of the district The Namakwa District Municipalitya is a Category C municipality located in the Northern Cape Province. It is bordered by the republic of Namibia in the north, ZF Mgcawu Local Municipality in the north-east, Cape Winelands District Municipality in the south, West Coast District Municipality in the south-west, Pixley Ka Seme District Municipality in the east, Central Karoo District Municipality in the south-east, and the Atlantic Ocean in the west. It is the largest district in the province, making up over a third of its geographical area. It is comprised of six local municipalities: Nama Khoi, Hantam, Khai-Ma, Kamiesberg, Karoo Hoogland and Richtersveld. The seat of the Namakwa District Municipality is Springbok. Area: 126 836km² Population (2016)b: 113 750 Population density (2016): 0.9 persons per km2 Estimated medical scheme coverage: 18.7% Cities/Towns: Aggeneys, Alexander Bay, Brandvlei, Bulletrap, Calvinia, Carolusberg, Concordia, Eksteensfontein, Frasersburg, Garies, Hondeklip Bay, Kamieskroon, Kleinzee, Koingnaas, Komaggas, Kuboes, Leliefontein/Kamiesberg, Loeriesfontein, Middelpos, Nababeep, Nieuwoudtville, O’Kiep, Onderste Doorns, Pella, Pofadder, Port Nolloth, Richtersveld, Sanddrift, Springbok, Steinkopf, Sutherland, Williston. Main Economic Sectors: Agriculture, tourism.

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.

532 Section B:Section Profile B:Northern District HealthCape Province Profiles

DistrictNamakwa population DM (DC6) pyramid and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 2 813 3 667 3 553 4 778 60-64 years 2 067 2 304 2 386 2 551 55-59 years 2 497 2 518 2 640 2 794 50-54 years 3 130 3 141 3 109 3 158 45-49 years 3 259 3 302 3 581 3 698 40-44 years 3 797 3 721 3 573 3 526 35-39 years 4 344 4 306 3 691 3 647 30-34 years 4 176 3 972 3 976 4 010 25-29 years 4 009 3 874 5 045 4 672 20-24 years 4 388 4 297 5 170 4 734 15-19 years 6 160 5 606 5 388 4 912 10-14 years 6 312 5 793 5 070 4 982 05-09 years 6 152 5 487 5 054 4 915 00-04 years 5 357 5 226 4 596 4 541

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+ 2.4% 3.2% 3.1% 4.2% 60-64 years 1.8% 2.0% 2.1% 2.2% 55-59 years 2.2% 2.2% 2.3% 2.5% 50-54 years 2.7% 2.7% 2.7% 2.8% 45-49 years 2.8% 2.9% 3.1% 3.3% 40-44 years 3.3% 3.2% 3.1% 3.1% 35-39 years 3.8% 3.7% 3.2% 3.2% 30-34 years 3.6% 3.4% 3.5% 3.5% 25-29 years 3.5% 3.3% 4.4% 4.1% 20-24 years 3.8% 3.7% 4.5% 4.2% 15-19 years 5.3% 4.8% 4.7% 4.3% 10-14 years 5.5% 5.0% 4.5% 4.4% 05-09 years 5.3% 4.7% 4.4% 4.3% 00-04 years 4.6% 4.5% 4.0% 4.0%

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 Namakwa DM (DC6) Show history

533533 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Social determinants of health

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

534 Section B:Section Profile B:Northern District HealthCape Province Profiles

NC, Namakwa: DC6 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NC, Namakwa: DC6 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 72% 6% 13% 9% 71% 5% 14% 10% HIV and TB 5-14 8% 18% 19% 56% 11%6% 32% 51% Comm_mat_peri_nut 15-24 7% 20% 14% 60% 7% 16% 16% 61% 25-64 8% 23% 54% 15% 5% 22% 56% 16% 65+ 6%3% 89% 3% 5%3% 88% 3% Total 11% 13% 64% 12% 8% 13% 67% 12%

Rank_.. 2006-2010 2011-2015 1 Preterm birth complications (36.8%) Preterm birth complications (27.1%) Percentages are shown 2 Diarrhoeal diseases (16.7%) Lower respiratory infections (14.5%) according to all the 3 Lower respiratory infections (11.0%) Birth asphyxia (13.1%) deaths within the 4 Birth asphyxia (6.4%) Diarrhoeal diseases (8.5%) age/period category of 5 Accidental threats to breathing (5.7%) Congenital heart anomalies (4.7%) each box, although only 6 Protein-energy malnutrition (5.2%) Accidental threats to breathing (4.6%) the leading 10 causes are <5 years <5 Other perinatal conditions (4.3%) 7 HIV/AIDS (4.0%) displayed. 8 Other respiratory (3.5%) HIV/AIDS (3.8%) 9 Tuberculosis (2.6%) Protein-energy malnutrition (3.7%) 10 Road injuries (1.6%) Septicaemia (3.6%) 1 Road injuries (35.0%) Drowning (36.6%) 2 Tuberculosis (25.9%) Accidental threats to breathing (25.0%) 3 Drowning (19.5%) Road injuries (20.7%) 4 Accidental threats to breathing (19.5%) Epilepsy (17.7%) 5

5-14 6 7 8 9 10 1 Accidental threats to breathing (20.0%) Accidental threats to breathing (22.6%) 2 Interpersonal violence (17.6%) Road injuries (16.7%) 3 Road injuries (16.9%) Tuberculosis (13.7%) 4 Tuberculosis (14.8%) Drowning (13.7%) 5 HIV/AIDS (9.8%) Interpersonal violence (13.0%) 6 Drowning (5.7%) HIV/AIDS (6.6%) 15-24 7 Self-inﬂicted injuries (4.9%) Self-inﬂicted injuries (5.0%) 8 Cerebrovascular disease (3.8%) Lower respiratory infections (4.0%) 9 Meningitis/encephalitis (2.3%) Nephritis/nephrosis (2.5%) 10 Mechanical forces (2.3%) Fires, hot substances (2.3%) 1 Tuberculosis (15.1%) Tuberculosis (12.2%) 2 Ischaemic heart disease (9.7%) HIV/AIDS (10.5%) 3 HIV/AIDS (8.3%) Ischaemic heart disease (9.4%) 4 COPD (5.6%) COPD (6.9%) 5 Interpersonal violence (4.5%) Road injuries (4.8%) 6 Cerebrovascular disease (4.3%) Cerebrovascular disease (4.6%) 25-64 7 Road injuries (4.1%) Trachea/bronchi/lung (4.6%) 8 Lower respiratory infections (3.9%) Interpersonal violence (3.9%) 9 Other respiratory (3.7%) Lower respiratory infections (2.8%) 10 Trachea/bronchi/lung (3.2%) Accidental threats to breathing (2.7%) 1 Ischaemic heart disease (18.3%) Ischaemic heart disease (17.6%) 2 Cerebrovascular disease (13.2%) Cerebrovascular disease (11.6%) 3 COPD (7.8%) COPD (11.2%) 4 Hypertensive heart disease (7.0%) Hypertensive heart disease (5.7%) 5 Trachea/bronchi/lung (5.5%) Trachea/bronchi/lung (4.9%)

65+ 6 Diabetes mellitus (4.1%) Diabetes mellitus (4.8%) 7 Prostate (3.9%) Prostate (4.3%) 8 Other respiratory (3.2%) Tuberculosis (3.2%) 9 Lower respiratory infections (2.9%) Lower respiratory infections (3.1%) 10 Nephritis/nephrosis (2.3%) Alzheimer’s and other dementias (2.7%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (65.2%) n=13 Other maternal (34.6%) n=17 2 Maternal sepsis (34.8%) n=7 Indirect maternal (24.2%) n=12 3 Maternal sepsis (17.1%) n=8 4 Maternal haemorrhage (12.1%) n=6 15-49 Female 5 Abortion (12.0%) n=6 6

535535 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Women and maternal health

Source: DHIS.

536 Section B:Section Profile B:Northern District HealthCape Province Profiles

Child and school health

Source: DHIS.

537537 Section B: DistrictProfile NorthernHealth Profiles Cape Province

HIV

Source: DHIS.

538 Section B:Section Profile B:Northern District HealthCape 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.

539539 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

540 Section B:Section Profile B:Northern District HealthCape Province Profiles

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

Namakwa Hantam LM Kamiesberg LM Hoogland Karoo LM Khâi-Ma LM Nama Khoi LM Richtersveld LM

Restore the emergency trolley daily or after every time it was used 37 20 0 33 80 30 67

Resuscitation room is equipped with functional basic equipment for resuscitation 46 0 33 67 60 70 33

90% of the tracer medicines are available 80 80 100 67 80 70 83

There is at least one functional wall mounted room thermometer in the medicine room/dispensary 83 80 83 100 80 80 83

The temperature of the medicine room/dispensary is recorded daily 83 80 83 100 80 80 83 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

541541 Section B: DistrictProfile NorthernHealth Profiles Cape Province 17.3% 23.2% (6.9%) (8.4%) (12.5%) (16.3%) (20.4%) (33.7%) (26.8%) % Overspent (underspent) 2 823 54 88 665 604 665 88 301 621 630 621 301 Provincial Provincial Expenditure Total 2017/18 0 477 177 24 4 45 242 755 00 65 204 768 0 64 737 988 987 638 10 00 682 000 682 13 122 00 122 13 20 614 00 20 614 69 00 571 68 270 85 52 923 00 Budget 101 275 0 101 Total 2017/18

0 4 490 578 759 2 818 2 062 578 -2 428 00 Transfer to LG to Transfer 7 5 8 8 8

2017/18 Provincial Expenditure 542 823 24 177 47 177 24 45 242 75 10 987 6310 64 737 98 65 204 76 88 665 604 665 88 Provincial

6 5 243 025 -2 424 26 Transfer to LG to Transfer 2017/18 Budget

682 000 682 13 122 000 122 13 20 614 00020 614 69 000 571 68 270 854 52 923 000 101 275 000101 326 457 854 -2 424 266 5 243 025 299 559 052 -2 428 000 4 490 578 329 276 613 Provincial al Government. *LG – Loc*LG

BAS,

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

542 Section B:Section Profile B:Northern District HealthCape Province Profiles

Pixley Ka Seme District Municipality (DC7)

Overview of the district The Pixley Ka Seme District Municipalitya is a Category C municipality situated in the south-east of the Northern Cape Province. It shares its borders with three other provinces, namely the Free State to the east, the Eastern Cape to the south-east, and the Western Cape to the south-west. It is the second-largest district of the five in the province, but makes up almost a third of its geographical area. The district is comprised of eight local municipalities: Ubuntu, Umsobomvu, Emthanjeni, Kareeberg, Renosterberg, Thembelihle, Siyathemba and Siyancuma. Its main town is De Aar. Traffic flows through the region, linking the major industrial areas of the country. Although the area has a low rainfall, the longest river in South Africa, the Orange River, flows through it. Two of the major dams in South Africa, the Vanderkloof and Gariep Dams, are situated on the borders of the district municipality. Area: 103 411km² Population (2016)b: 205 538 Population density (2016): 2.0 persons per km2 Estimated medical scheme coverage: 14.3% Cities/Towns: Britstown, Burgerville, Campbell, Carnarvon, Colesberg, Copperton, De Aar, Douglas, Griekwastad, Griesenkraal, Hanover, Hopetown, Hutchinson, Loxton, Marydale, Niekerkshoop, Norvalspont, Noupoort, Petrusville, Philipstown, Prieska, Richmond, Riet River, Schmidtsdrif, Strydenburg, Van der Kloof, Vanwyksvlei, Victoria West, Vosburg. Main Economic Sectors: Finance and business services (22.5%), manufacturing (17.4%), trade and accommodation (15.4%), government services (12.9%), transport and communication (11.3%), mining (6.8%), community and social services (5.6%), construction (3.3%), agriculture (2.7%).

Population distribution, local municipality boundaries and health facility locations

543543 Section B: DistrictProfile NorthernHealth Profiles Cape Province

DistrictPixley population ka Seme pyramidDM (DC7) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 3 923 5 807 5 453 8 089 60-64 years 2 602 3 063 3 121 3 453 55-59 years 3 317 3 574 3 536 3 800 50-54 years 4 070 4 272 4 326 4 426 45-49 years 4 371 4 585 5 295 5 289 40-44 years 5 143 5 174 5 763 5 436 35-39 years 5 987 5 929 6 796 6 454 30-34 years 6 109 5 785 8 656 8 267 25-29 years 6 642 6 549 10 449 10 210 20-24 years 8 260 8 185 9 939 10 084 15-19 years 10 399 10 347 9 959 10 021 10-14 years 10 169 10 237 9 757 9 937 05-09 years 10 053 9 805 9 613 9 596 00-04 years 9 701 9 611 8 948 8 865

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+ 2.1% 3.2% 2.7% 3.9% 60-64 years 1.7% 1.5% 1.7% 55-59 years 1.8% 1.9% 1.7% 1.8% 50-54 years 2.2% 2.3% 2.1% 2.2% 45-49 years 2.4% 2.5% 2.6% 2.6% 40-44 years 2.8% 2.8% 2.8% 2.6% 35-39 years 3.3% 3.2% 3.3% 3.1% 30-34 years 3.3% 3.1% 4.2% 4.0% 25-29 years 3.6% 3.6% 5.1% 5.0% 20-24 years 4.5% 4.5% 4.8% 4.9% 15-19 years 5.7% 5.6% 4.8% 4.9% 10-14 years 5.5% 5.6% 4.7% 4.8% 05-09 years 5.5% 5.3% 4.7% 4.7% 00-04 years 5.3% 5.2% 4.4% 4.3%

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 Pixley ka Seme DM (DC7) Show history

544 Section B:Section Profile B:Northern District HealthCape Province Profiles

Social determinants of health

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

545545 Section B: DistrictProfile NorthernHealth Profiles Cape Province

NC, Pixley ka Seme: DC7 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NC, Pixley ka Seme: DC7 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 77% 9% 7%6% 72% 8% 12% 8% HIV and TB 5-14 17% 20% 17% 46% 18% 19% 21% 42% Comm_mat_peri_nut 15-24 15% 30% 11% 44% 8% 30% 14% 48% 25-64 14% 34% 42% 10% 10% 34% 45% 11% 65+ 10%4% 83% 3% 10%5% 83% 3% Total 19% 23% 48% 10% 14% 23% 52% 10%

Rank_.. 2006-2010 2011-2015 1 Diarrhoeal diseases (27.0%) Diarrhoeal diseases (17.7%) Percentages are shown 2 Preterm birth complications (17.8%) Preterm birth complications (16.5%) according to all the 3 Lower respiratory infections (15.9%) Lower respiratory infections (13.8%) deaths within the 4 Protein-energy malnutrition (6.5%) Protein-energy malnutrition (9.0%) age/period category of 5 HIV/AIDS (6.5%) HIV/AIDS (7.0%) each box, although only 6 Birth asphyxia (5.1%) Birth asphyxia (5.6%) the leading 10 causes are <5 years <5 7 Tuberculosis (3.1%) Other perinatal conditions (3.0%) displayed. 8 Accidental threats to breathing (2.6%) Accidental threats to breathing (3.0%) 9 Meningitis/encephalitis (1.9%) Sepsis/other newborn infectious (2.5%) 10 Other respiratory (1.7%) Meningitis/encephalitis (2.2%) 1 Drowning (26.0%) Road injuries (18.4%) 2 HIV/AIDS (15.4%) Drowning (18.0%) 3 Road injuries (11.8%) Tuberculosis (12.5%) 4 Tuberculosis (11.1%) HIV/AIDS (11.2%) 5 Fires, hot substances (9.8%) Endocrine nutritional,blood, immune (5.5%)

5-14 6 Epilepsy (5.2%) Lower respiratory infections (4.3%) 7 Interpersonal violence (5.0%) Fires, hot substances (3.5%) 8 Diarrhoeal diseases (4.8%) Meningitis/encephalitis (3.5%) 9 Meningitis/encephalitis (4.1%) Mechanical forces (3.5%) 10 Lower respiratory infections (4.0%) Epilepsy (3.3%) 1 Interpersonal violence (19.1%) Interpersonal violence (24.0%) 2 HIV/AIDS (16.5%) HIV/AIDS (18.6%) 3 Tuberculosis (15.9%) Tuberculosis (13.4%) 4 Road injuries (9.5%) Road injuries (11.4%) 5 Lower respiratory infections (7.0%) Accidental threats to breathing (4.9%) 6 Accidental threats to breathing (5.1%) Drowning (3.8%) 15-24 7 Mechanical forces (3.9%) Lower respiratory infections (2.4%) 8 Diarrhoeal diseases (3.6%) Self-inﬂicted injuries (2.2%) 9 Drowning (2.8%) Fires, hot substances (2.2%) 10 Endocrine nutritional,blood, immune (1.8%) Endocrine nutritional,blood, immune (1.7%) 1 Tuberculosis (19.0%) HIV/AIDS (18.7%) 2 HIV/AIDS (15.2%) Tuberculosis (15.6%) 3 Lower respiratory infections (7.4%) Cerebrovascular disease (6.1%) 4 Ischaemic heart disease (5.6%) Lower respiratory infections (5.6%) 5 Cerebrovascular disease (5.1%) Ischaemic heart disease (5.0%) 6 COPD (4.5%) COPD (4.6%) 25-64 7 Interpersonal violence (3.2%) Interpersonal violence (3.7%) 8 Diarrhoeal diseases (2.8%) Road injuries (2.8%) 9 Road injuries (2.3%) Cirrhosis of liver (2.4%) 10 Cirrhosis of liver (2.0%) Trachea/bronchi/lung (2.1%) 1 Cerebrovascular disease (17.5%) Cerebrovascular disease (16.6%) 2 Ischaemic heart disease (14.1%) Ischaemic heart disease (13.8%) 3 COPD (8.2%) COPD (7.1%) 4 Hypertensive heart disease (7.1%) Hypertensive heart disease (6.4%) 5 Lower respiratory infections (6.5%) Lower respiratory infections (5.6%)

65+ 6 Diabetes mellitus (4.2%) Diabetes mellitus (4.3%) 7 Tuberculosis (3.3%) Tuberculosis (3.5%) 8 Trachea/bronchi/lung (2.6%) Trachea/bronchi/lung (2.7%) 9 Other circulatory diseases (2.6%) Prostate (2.6%) 10 Nephritis/nephrosis (2.4%) Nephritis/nephrosis (2.4%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (47.3%) n=11 2 Other maternal (24.1%) n=6 3 Hypertension in pregnancy (14.5%) n=3 4 Abortion (14.1%) n=3 15-49 Female 5 6

546 Section B:Section Profile B:Northern District HealthCape Province Profiles

Women and maternal health

Source: DHIS.

547547 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Child and school health

Source: DHIS.

548 Section B:Section Profile B:Northern District HealthCape Province Profiles

HIV

Source: DHIS.

549549 Section B: DistrictProfile NorthernHealth Profiles Cape 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.

550 Section B:Section Profile B:Northern District HealthCape Province Profiles

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

551551 Section B: DistrictProfile NorthernHealth Profiles Cape Province

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

Pixley Ka Seme Emthanjeni LM Kareeberg LM Renosterberg LM LMSiyancuma LM Siyathemba Thembelihle LM Ubuntu LM LM Umsobomvu

Resuscitation room is equipped with functional basic equipment for resuscitation 97 100 100 100 100 75 100 100 100

Sharps containers are disposed of when they reach the limit mark 100 100 100 100 100 100 100 100 100 There is at least one functional wall mounted room thermometer in the medicine room/ 100 100 100 100 100 100 100 100 100 dispensary

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

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

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

552 Section B:Section Profile B:Northern District HealthCape Province Profiles 7.1% 1.5% 6.0% 5.8% 18.1% (1.2%) (10.8%) (24.3%) (80.6%) % Overspent (underspent) 065 140 66 764 675 134 996 340 996 134 Provincial Provincial Expenditure Total 2017/18 00 65 449 156 907 270 15 00 278 28 816 94 530 472 3 00 723 000 723 93 112 00 93 112 15 010 00 010 15 88 170 2288 170 73 047 00 27 229 00 Budget 114 301 0 114 Total 2017/18

5 121 4 203 393 4 503 719 LG 4 50 4 505 121 795 415 616 268 815 410

-1 402 -1 402 Transfer to LG to Transfer 2 9 8 0

0 75 2017/18 Provincial Expenditure 140 065 28 816 27 28 816 15 907 2715 94 530 47 65 44 156 66 764 6 134 996 34 996 134 Provincial

0 4 203 393 406 549 311 0 4 203 393

Transfer to LG to Transfer 2017/18 Budget

723 000 723 93 112 000 93 112 15 010 000 010 15 88 170 22388 170 73 047 000 27 229 000 114 301 000 114 411 592 223411 Provincial al Government. *LG – Loc*LG

BAS,

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

553553 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Zwelentlanga Fatman Mgcawu District Municipality (DC8)

Overview of the district The Zwelentlanga Fatman Mgcawu District Municipalitya (previously Siyanda District Municipality) is a Category C municipality forming the mid-northern section of the Northern Cape Province, bordering with Botswana in the north and Namibia in the west. It makes up just under a third of the province’s geographical area, of which 65 000km² comprise the vast Kalahari Desert, Kgalagadi Transfrontier Park and the former Bushmanland. This district comprises five local municipalities: Dawid Kruiper, Kai !Garib, Tsantsabane, !Kheis and Kgatelopele. Upington is the district municipal capital, where the municipal government is located. Area: 102 484km² Population (2016)b: 256 929 Population density (2016): 2.5 persons per km2 Estimated medical scheme coverage: 15.6% Cities/Towns: Beeshoek, Brandboom, Danielskuil, Eksteenskuil, Groblershoop, Kakamas, Keimoes, Kenhardt, Lime Acres, Mier, Postmasburg, Rietfontein, Upington. Main Economic Sectors: Agriculture, mining, tourism.

Population distribution, local municipality boundaries and health facility locations

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

554 Section B:Section Profile B:Northern District HealthCape Province Profiles

DistrictZF Mgcawu population DM pyramid (DC8) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 4 771 6 013 6 958 9 294 60-64 years 2 889 3 329 3 791 4 071 55-59 years 3 731 4 108 4 726 4 883 50-54 years 4 782 4 929 5 705 5 637 45-49 years 5 710 5 755 7 145 6 808 40-44 years 6 673 6 489 8 214 7 757 35-39 years 8 015 7 679 10 087 9 268 30-34 years 8 748 8 387 12 066 10 810 25-29 years 9 812 9 490 14 442 12 327 20-24 years 10 718 10 402 13 320 12 023 15-19 years 11 765 11 127 12 123 11 495 10-14 years 11 598 11 208 10 710 10 898 05-09 years 12 087 11 409 10 874 11 018 00-04 years 10 848 10 889 10 259 10 220

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+ 2.1% 2.7% 2.7% 3.6% 60-64 years 1.5% 1.5% 1.6% 55-59 years 1.7% 1.8% 1.8% 1.9% 50-54 years 2.1% 2.2% 2.2% 2.2% 45-49 years 2.6% 2.6% 2.8% 2.6% 40-44 years 3.0% 2.9% 3.2% 3.0% 35-39 years 3.6% 3.4% 3.9% 3.6% 30-34 years 3.9% 3.8% 4.7% 4.2% 25-29 years 4.4% 4.2% 5.6% 4.8% 20-24 years 4.8% 4.7% 5.2% 4.7% 15-19 years 5.3% 5.0% 4.7% 4.5% 10-14 years 5.2% 5.0% 4.2% 4.2% 05-09 years 5.4% 5.1% 4.2% 4.3% 00-04 years 4.9% 4.9% 4.0% 4.0%

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 ZF Mgcawu DM (DC8) Show history

555555 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Social determinants of health

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

556 Section B:Section Profile B:Northern District HealthCape Province Profiles

NC, ZF Mgcawu: DC8 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NC, ZF Mgcawu: DC8 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 76% 11% 7%6% 71% 9% 11% 10% HIV and TB 5-14 20% 17% 23% 41% 16% 15% 18% 51% Comm_mat_peri_nut 15-24 13% 29% 9% 48% 7% 28% 10% 55% 25-64 15% 37% 37% 12% 9% 36% 41% 14% 65+ 10%6% 81% 3% 10%5% 82% 3% Total 19% 26% 44% 11% 14% 25% 48% 12%

Rank_.. 2006-2010 2011-2015 Percentages are shown 1 Diarrhoeal diseases (24.4%) Diarrhoeal diseases (18.1%) 2 Lower respiratory infections (18.6%) Lower respiratory infections (16.8%) according to all the 3 Preterm birth complications (15.0%) Preterm birth complications (14.3%) deaths within the 4 HIV/AIDS (7.2%) Protein-energy malnutrition (8.5%) age/period category of 5 Protein-energy malnutrition (6.8%) Birth asphyxia (6.9%) each box, although only 6 Birth asphyxia (4.1%) HIV/AIDS (5.9%) the leading 10 causes are <5 years <5 7 Tuberculosis (3.7%) Accidental threats to breathing (3.7%) displayed. 8 Sepsis/other newborn infectious (3.3%) Sepsis/other newborn infectious (3.0%) 9 Accidental threats to breathing (2.0%) Tuberculosis (2.9%) 10 Other perinatal conditions (1.9%) Other perinatal conditions (2.4%) 1 Drowning (20.5%) Road injuries (24.3%) 2 Road injuries (19.6%) Drowning (24.0%) 3 Tuberculosis (12.4%) HIV/AIDS (15.0%) 4 Lower respiratory infections (8.4%) Fires, hot substances (7.7%) 5 HIV/AIDS (8.0%) Lower respiratory infections (5.1%)

5-14 6 Meningitis/encephalitis (5.6%) Epilepsy (5.0%) 7 Interpersonal violence (3.5%) Meningitis/encephalitis (4.9%) 8 Other infectious diseases (3.1%) Tuberculosis (4.8%) 9 Epilepsy (2.7%) Self-inflicted injuries (3.3%) 10 Diarrhoeal diseases (2.7%) Other malignant neoplasms (3.2%) 1 Interpersonal violence (20.9%) Interpersonal violence (19.8%) 2 Tuberculosis (18.5%) HIV/AIDS (17.9%) 3 Road injuries (15.8%) Road injuries (14.3%) 4 HIV/AIDS (12.6%) Tuberculosis (11.7%) 5 Self-inflicted injuries (7.7%) Self-inflicted injuries (9.1%) 6 Lower respiratory infections (5.5%) Drowning (7.3%) 15-24 7 Diarrhoeal diseases (3.0%) Accidental threats to breathing (3.7%) 8 Drowning (2.7%) Lower respiratory infections (2.5%) 9 Meningitis/encephalitis (2.4%) Epilepsy (2.1%) 10 Fires, hot substances (1.5%) Diabetes mellitus (1.2%) 1 Tuberculosis (19.4%) HIV/AIDS (20.8%) 2 HIV/AIDS (17.9%) Tuberculosis (15.8%) 3 Lower respiratory infections (8.2%) Lower respiratory infections (5.1%) 4 Cerebrovascular disease (4.5%) Cerebrovascular disease (4.9%) 5 COPD (4.5%) COPD (4.5%) 6 Interpersonal violence (4.4%) Interpersonal violence (4.3%) 25-64 7 Ischaemic heart disease (4.1%) Ischaemic heart disease (4.3%) 8 Road injuries (3.5%) Road injuries (4.0%) 9 Diarrhoeal diseases (3.4%) Diabetes mellitus (2.6%) 10 Diabetes mellitus (1.9%) Trachea/bronchi/lung (2.5%) 1 Cerebrovascular disease (14.5%) Cerebrovascular disease (14.4%) 2 Ischaemic heart disease (13.8%) Ischaemic heart disease (14.2%) 3 COPD (8.6%) COPD (7.7%) 4 Lower respiratory infections (6.2%) Hypertensive heart disease (7.6%) 5 Hypertensive heart disease (5.9%) Diabetes mellitus (5.4%)

65+ 6 Tuberculosis (5.1%) Lower respiratory infections (5.0%) 7 Diabetes mellitus (4.2%) Tuberculosis (4.0%) 8 Trachea/bronchi/lung (3.2%) Trachea/bronchi/lung (3.5%) 9 Nephritis/nephrosis (2.9%) Diarrhoeal diseases (3.1%) 10 Diarrhoeal diseases (2.6%) Nephritis/nephrosis (2.7%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (52.7%) n=10 2 Hypertension in pregnancy (47.3%) n=9 3 4 15-49 Female 5 6

557557 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Women and maternal health

Source: DHIS.

558 Section B:Section Profile B:Northern District HealthCape Province Profiles

Child and school health

Source: DHIS.

559559 Section B: DistrictProfile NorthernHealth Profiles Cape Province

HIV

Source: DHIS.

560 Section B:Section Profile B:Northern District HealthCape 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.

561561 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

562 Section B:Section Profile B:Northern District HealthCape Province Profiles

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

ZF Mgcawu !Kheis LM Dawid Kruiper LM LM Kai!Garib Kgatelopele LM Tsantsabane LM

Restore the emergency trolley daily or after every time it was used 62 50 89 0 100 100

Resuscitation room is equipped with functional basic equipment for resuscitation 81 50 89 67 100 100

90% of the tracer medicines are available 86 100 89 83 100 67

The temperature of the medicine room/dispensary is recorded daily 86 50 89 83 100 100

The temperature of the medicine room/dispensary is maintained within the safety range 86 50 89 83 100 100 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

563563 Section B: DistrictProfile NorthernHealth Profiles Cape Province 8.1% 3.3% 21.0% (0.3%) (61.2%) (28.6%) (28.9%) (16.4%) (36.8%) % Overspent (underspent) 2 745 2 45 Provincial Provincial Expenditure Total 2017/18 00 780 34 310 426 303 12 0 72 477 627 00 29 894 272 69 859 117 32 65 435 080 5 655 218 5 842 838 1 168 0001 168 17 482 0017 97 879 00 59 907 00 34 407 00 27 658 00 Budget 103 531103 8 Total 2017/18

0 5 842 838 0 5 842 838 347 688 050 290 698 762 Transfer to LG to Transfer

2 0 0 7 7 3 2017/18 Provincial Expenditure 452 745 452 69 859 11 34 310 78 34 310 12 426 3012 72 477 62 29 894 27 65 435 08 Provincial

0 5 655 218 0 5 655 218 284 855 924 Transfer to LG to Transfer 2017/18 Budget

1 168 0001 168 17 482 00017 97 879 000 59 907 000 34 407 000 27 658 000 103 531103 832 342 032 832 Provincial al Government. *LG – Loc*LG

BAS,

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

564 Section B:Section Profile B:Northern District HealthCape Province Profiles

Frances Baard District Municipality (DC9)

Overview of the district The Frances Baard District Municipalitya is a Category C municipality located in the far eastern portion of the Northern Cape Province. It shares its northern borders with the North West Province and its eastern border with the Free State Province. The municipality is the smallest district in the Northern Cape, making up only 3% of its geographical area. However, it accommodates the largest proportion of the province’s population. It comprises the four local municipalities of Dikgatlong, Magareng, Phokwane and Sol Plaatje. Kimberley, which is where the district municipality is located, is less than 500km away from Johannesburg in the north, less than 1 000km away from Cape Town in the south, and less than 800km away from the Port of Durban in the east. Area: 12 836km² Population (2016)b: 379 391 Population density (2016): 29.6 persons per km2 Estimated medical scheme coverage: 16.1% Cities/Towns: Barkly West, Delportshoop, Hartswater, Jan Kempdorp, Kimberley, Pampierstat, Ritchie, Warrenton, Windsorton. Main Economic Sectors: Community services (28%), finance (22%), trade (15%), transport (12%), mining (10%), agriculture (4%), manufacturing (4%), construction (3%), electricity (2%).

Population distribution, local municipality boundaries and health facility locations

2017 Total Population per LM 9 155 - 243 051 243 052 - 543 806

565565 Section B: DistrictProfile NorthernHealth Profiles Cape Province

DistrictFrances population Baard DMpyramid (DC9) and comparison with the national pyramid

Year AgeGrp 2006 2016 65+ 7 707 12 439 12 040 18 741 60-64 years 5 215 6 800 6 429 7 800 55-59 years 6 638 7 860 7 826 8 725 50-54 years 8 144 9 623 8 853 9 507 45-49 years 9 561 10 710 10 449 10 918 40-44 years 10 497 11 696 11 528 11 665 35-39 years 11 986 13 464 13 344 12 696 30-34 years 12 471 14 175 15 187 13 511 25-29 years 13 576 15 162 17 247 15 206 20-24 years 15 183 16 253 16 332 15 034 15-19 years 18 248 19 599 16 344 16 082 10-14 years 18 032 19 144 18 194 16 385 05-09 years 17 471 18 758 18 652 17 136 00-04 years 19 372 18 402 17 277 16 283

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+ 2.1% 3.4% 3.2% 4.9% 60-64 years 1.8% 1.7% 2.1% 55-59 years 1.8% 2.1% 2.1% 2.3% 50-54 years 2.2% 2.6% 2.3% 2.5% 45-49 years 2.6% 2.9% 2.8% 2.9% 40-44 years 2.9% 3.2% 3.0% 3.1% 35-39 years 3.3% 3.7% 3.5% 3.3% 30-34 years 3.4% 3.8% 4.0% 3.6% 25-29 years 3.7% 4.1% 4.5% 4.0% 20-24 years 4.1% 4.4% 4.3% 4.0% 15-19 years 5.0% 5.3% 4.3% 4.2% 10-14 years 4.9% 5.2% 4.8% 4.3% 05-09 years 4.7% 5.1% 4.9% 4.5% 00-04 years 5.3% 5.0% 4.6% 4.3%

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 Frances Baard DM (DC9) Show history

566 Section B:Section Profile B:Northern District HealthCape Province Profiles

Social determinants of health

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

567567 Section B: DistrictProfile NorthernHealth Profiles Cape Province

NC, Frances Baard: DC9 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history NC, Frances Baard: DC9 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 68% 17% 10%5% 66% 11% 15% 8% HIV and TB 5-14 22% 25% 16% 37% 14% 20% 25% 40% Comm_mat_peri_nut 15-24 15% 32% 13% 40% 11% 32% 15% 43% 25-64 16% 39% 36% 9% 11% 37% 41% 11% 65+ 12% 5% 81% 3% 11%5% 81% 3% Total 20% 28% 44% 9% 15% 25% 50% 10%

Rank_.. 2006-2010 2011-2015 1 Diarrhoeal diseases (21.9%) Diarrhoeal diseases (17.3%) Percentages are shown 2 Lower respiratory infections (15.7%) Lower respiratory infections (13.3%) according to all the 3 HIV/AIDS (13.6%) Preterm birth complications (12.2%) deaths within the 4 Preterm birth complications (10.3%) HIV/AIDS (8.8%) age/period category of 5 Protein-energy malnutrition (6.7%) Protein-energy malnutrition (8.7%) each box, although only 6 Tuberculosis (3.9%) Birth asphyxia (5.1%) the leading 10 causes are <5 years <5 Birth asphyxia (3.5%) Sepsis/other newborn infectious (3.0%) 7 displayed. 8 Sepsis/other newborn infectious (3.5%) Septicaemia (2.7%) 9 Septicaemia (3.0%) Other perinatal conditions (2.6%) 10 Meningitis/encephalitis (2.7%) Tuberculosis (2.2%) 1 Drowning (20.8%) Road injuries (16.6%) 2 Tuberculosis (15.6%) Drowning (15.4%) 3 HIV/AIDS (14.0%) HIV/AIDS (12.9%) 4 Road injuries (11.0%) Tuberculosis (12.3%) 5 Meningitis/encephalitis (6.5%) Fires, hot substances (4.6%)

5-14 6 Lower respiratory infections (5.8%) Epilepsy (4.3%) 7 Diarrhoeal diseases (5.0%) Endocrine nutritional,blood, immune (3.9%) 8 Interpersonal violence (4.8%) Interpersonal violence (3.9%) 9 Septicaemia (2.4%) Accidental threats to breathing (3.8%) 10 Accidental threats to breathing (2.3%) Meningitis/encephalitis (3.2%) 1 Interpersonal violence (21.6%) HIV/AIDS (18.9%) 2 Tuberculosis (18.7%) Interpersonal violence (18.7%) 3 HIV/AIDS (15.6%) Tuberculosis (15.7%) 4 Road injuries (6.3%) Road injuries (8.9%) 5 Lower respiratory infections (5.9%) Accidental threats to breathing (6.5%) 6 Accidental threats to breathing (5.8%) Lower respiratory infections (4.4%) 15-24 7 Meningitis/encephalitis (2.9%) Fires, hot substances (2.9%) 8 Diarrhoeal diseases (2.7%) Drowning (2.8%) 9 Fires, hot substances (2.5%) Self-inﬂicted injuries (2.5%) 10 Mechanical forces (1.8%) Mechanical forces (1.9%) 1 Tuberculosis (22.1%) HIV/AIDS (23.1%) 2 HIV/AIDS (16.5%) Tuberculosis (14.4%) 3 Lower respiratory infections (8.7%) Lower respiratory infections (6.2%) 4 Cerebrovascular disease (4.2%) Cerebrovascular disease (5.1%) 5 Diarrhoeal diseases (3.8%) Ischaemic heart disease (3.5%) 6 Ischaemic heart disease (3.5%) COPD (2.5%) 25-64 7 Interpersonal violence (3.0%) Road injuries (2.5%) 8 Cirrhosis of liver (2.1%) Interpersonal violence (2.3%) 9 COPD (2.0%) Diabetes mellitus (2.3%) 10 Road injuries (1.9%) Trachea/bronchi/lung (2.2%) 1 Cerebrovascular disease (15.4%) Cerebrovascular disease (14.6%) 2 Ischaemic heart disease (12.0%) Ischaemic heart disease (11.2%) 3 Hypertensive heart disease (7.9%) Hypertensive heart disease (7.3%) 4 Lower respiratory infections (7.2%) Lower respiratory infections (6.7%) 5 COPD (5.2%) Diabetes mellitus (5.1%)

65+ 6 Diabetes mellitus (4.3%) COPD (4.9%) 7 Tuberculosis (3.8%) Nephritis/nephrosis (3.3%) 8 Trachea/bronchi/lung (2.7%) Tuberculosis (3.3%) 9 Nephritis/nephrosis (2.6%) Trachea/bronchi/lung (3.1%) 10 Prostate (2.4%) Prostate (2.9%)

Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (100.0%) n=9 Other maternal (30.1%) n=10 2 Indirect maternal (30.0%) n=10 3 Hypertension in pregnancy (29.7%) n=10 4 Maternal haemorrhage (10.2%) n=3 15-49 Female 5 6

568 Section B:Section Profile B:Northern District HealthCape Province Profiles

Women and maternal health

Source: DHIS.

569569 Section B: DistrictProfile NorthernHealth Profiles Cape Province

Child and school health

Source: DHIS.

570 Section B:Section Profile B:Northern District HealthCape Province Profiles

HIV

Source: DHIS.

571571 Section B: DistrictProfile NorthernHealth Profiles Cape 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.

572 Section B:Section Profile B:Northern District HealthCape Province Profiles

Non-communicable diseases

Source: DHIS.

Numbers of deaths in facilities

Source: DHIS.

Percentage ideal clinics

Source: Ideal Clinic database.

573573 Section B: DistrictProfile NorthernHealth Profiles Cape Province

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

Frances Baard LM Dikgatlong Magareng LM Phokwane LM Sol Plaatje LM

Restore the emergency trolley daily or after every time it was used 48 80 50 100 8

Resuscitation room is equipped with functional basic equipment for resuscitation 52 20 50 100 38

The temperature of the medicine room/dispensary is recorded daily 90 100 75 100 85

The temperature of the medicine room/dispensary is maintained within the safety range 93 100 75 100 92

Cold chain procedure for vaccines is maintained 97 100 75 100 100 Source: Ideal Clinic database.

Number of facilities by level, 2017/18

Source: DHIS.

Human resources – filled posts

Source: Persal, Ward-based outreach team database.

574 Section B:Section Profile B:Northern District HealthCape Province Profiles 1.7% 2.7% 8.8% 11.3% 35.1% 12.1% 14.0% 13.2% (19.1%) % Overspent (underspent) 1 005 807 117 764 760 117 597 646 026 Provincial Provincial Expenditure Total 2017/18 00 80 526 443 23 501 933 0 48 542 048 90 848 192 408 00 052 352 116 00 1 244 000 71 124 00 124 71 35 918 0035 918 23 106 00 Budget 177 247 2 247 177 101 839101 0 105 832105 0 533 255 836 255 533 Total 2017/18

LG 17 461 83117 945 16 546 404 17 275

-57 556 Transfer to LG to Transfer 8 3 3

52 08 760 2017/18 Provincial Expenditure 1 005 807 23 501 93 80 526 44 48 542 04 117 764 117 116 052 3 116 192 848192 4 Provincial

75 54675 LG 16 9 16 16 97516 546 580 241 751 -57 556 461 17 831

-30 000 -30 -30 000 -30 Transfer to LG to Transfer 2017/18 Budget

1 244 000 71 124 000 124 71 35 918 00035 918 23 106 000 177 247 290 247 177 516 310 290 101 839101 000 105 832105 000 Provincial al Government. *LG – Loc*LG

BAS,

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

575575