SectionSection B: Profile B: District Free HealthState Province Profiles 9 Free State Province Xhariep District Municipality (DC16) Overview of the district The Xhariep District Municipalitya is a Category C municipality situated in the southern part of the Free State. It is bordered by the Mangaung Metro to the north, Eastern Cape to the south, Lesotho to the east, and Northern Cape to the west. It is the largest district in the province, making up just more than a third of its geographical area. It is comprised of three local municipalities: Letsemeng, Kopanong and Mohokare, which include 21 towns. Its administrative headquarters are in Trompsburg, which lies 125km south of Bloemfontein. The towns in this district boast abundant natural resources such as water and agricultural land. The largest dam in South Africa is situated at the southern tip of the district. Three national roads (N1 – Gauteng to Cape Town, N6 – Eastern Cape to Bloemfontein and N8 – Bloemfontein to Kimberley) pass through this area. Area: 34 250km² Population (2016)b: 153 612 Population density (2016): 4.5 persons per km2 Estimated medical scheme coverage: 12.7% Cities/Towns: Bethulie, Edenburg, Fauresmith, Gariep Dam, Jacobsdal, Jagersfontein, Koffiefontein, Luckhoff, Oppermansgronde, Petrusburg, Philippolis, Reddersburg, Rouxville, Smithfield, Springfontein, Trompsburg, Waterkloof, Zastron. Main Economic Sectors: Agriculture, construction, mining, transport and communication. 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. 199 Section B: DistrictProfile FreeHealth State Profiles Province DistrictXhariep population DM (DC16) pyramid and comparison with the national pyramid Year AgeGrp 2006 2016 65+ 3 374 5 228 4 335 6 627 60-64 years 2 074 2 398 2 214 2 556 55-59 years 2 551 2 955 2 549 2 881 50-54 years 3 071 3 228 3 121 3 207 45-49 years 3 391 3 593 3 886 3 829 40-44 years 4 036 4 027 4 288 4 297 35-39 years 4 840 4 787 5 211 5 226 30-34 years 4 995 5 093 6 404 6 234 25-29 years 5 625 5 886 7 902 7 626 20-24 years 6 834 6 964 7 585 7 517 15-19 years 8 807 9 022 7 253 7 471 10-14 years 8 368 8 519 6 804 6 987 05-09 years 7 585 7 797 7 081 7 229 00-04 years 7 022 7 107 6 689 6 603 500 000 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+ 2.3% 3.5% 2.8% 4.3% 60-64 years 1.6% 1.7% 55-59 years 1.7% 2.0% 1.7% 1.9% 50-54 years 2.1% 2.2% 2.0% 2.1% 45-49 years 2.3% 2.4% 2.5% 2.5% 40-44 years 2.7% 2.7% 2.8% 2.8% 35-39 years 3.2% 3.2% 3.4% 3.4% 30-34 years 3.3% 3.4% 4.2% 4.1% 25-29 years 3.8% 3.9% 5.1% 5.0% 20-24 years 4.6% 4.7% 4.9% 4.9% 15-19 years 5.9% 6.0% 4.7% 4.9% 10-14 years 5.6% 5.7% 4.4% 4.5% 05-09 years 5.1% 5.2% 4.6% 4.7% 00-04 years 4.7% 4.8% 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 Xhariep DM (DC16) Show history 200 SectionSection B: Profile B: District Free HealthState Province Profiles Social determinants of health Source: Stats SA (Local Government Handbook), 2014 Blue Drop Report. 201 Section B: DistrictProfile FreeHealth State Profiles Province FS, Xhariep: DC16 Burden of disease – leading causes of death in district Percentage of deaths by broad causes and single leading causes Show history FS, Xhariep: DC16 Broadcause Injury AgeGroup.. 2006-2010 2011-2015 NCD <5 years 81% 9% 6%4% 70% 5% 15% 10% HIV and TB 5-14 30% 25% 15% 31% 19% 15% 24% 42% Comm_mat_peri_nut 15-24 26% 28% 13% 32% 10% 29% 15% 46% 25-64 29% 32% 29% 10% 15% 34% 39% 13% 65+ 22% 3% 73% 3% 14% 4% 79% 2% Total 32% 23% 37% 9% 18% 22% 49% 11% Rank_.. 2006-2010 2011-2015 1 Diarrhoeal diseases (31.6%) Diarrhoeal diseases (22.0%) Percentages are shown 2 Lower respiratory infections (26.8%) Lower respiratory infections (18.8%) according to all the 3 Protein-energy malnutrition (8.4%) Preterm birth complications (10.0%) deaths within the 4 Preterm birth complications (7.4%) Protein-energy malnutrition (9.3%) age/period category of 5 HIV/AIDS (7.3%) Birth asphyxia (4.6%) each box, although only 6 Birth asphyxia (3.1%) HIV/AIDS (3.7%) the leading 10 causes are <5 years <5 Sepsis/other newborn infectious (2.3%) Sepsis/other newborn infectious (2.8%) 7 displayed. 8 Tuberculosis (2.2%) Other congenital abnormalities (2.6%) 9 Other congenital abnormalities (1.0%) Accidental threats to breathing (2.6%) 10 Other perinatal conditions (1.0%) Septicaemia (2.5%) 1 Drowning (22.0%) Drowning (19.3%) 2 HIV/AIDS (18.7%) Road injuries (12.7%) 3 Lower respiratory infections (18.7%) Tuberculosis (11.1%) 4 Tuberculosis (15.0%) HIV/AIDS (9.7%) 5 Diarrhoeal diseases (11.6%) Lower respiratory infections (9.3%) 5-14 6 Meningitis/encephalitis (4.4%) Meningitis/encephalitis (5.1%) 7 Road injuries (3.9%) Other malignant neoplasms (4.9%) 8 Interpersonal violence (3.0%) Other unintentional injuries (4.8%) 9 Epilepsy (2.7%) Fires, hot substances (4.8%) 10 Diarrhoeal diseases (4.0%) 1 Interpersonal violence (18.4%) Interpersonal violence (18.8%) 2 Tuberculosis (17.8%) HIV/AIDS (16.4%) 3 Lower respiratory infections (15.8%) Tuberculosis (14.0%) 4 HIV/AIDS (13.5%) Accidental threats to breathing (8.3%) 5 Diarrhoeal diseases (6.6%) Road injuries (7.2%) 6 Accidental threats to breathing (6.2%) Drowning (7.1%) 15-24 7 Mechanical forces (2.9%) Lower respiratory infections (6.0%) 8 Meningitis/encephalitis (2.4%) Mechanical forces (3.0%) 9 Fires, hot substances (2.2%) Fires, hot substances (2.0%) 10 Other infectious diseases (1.8%) Meningitis/encephalitis (1.6%) 1 Tuberculosis (19.5%) HIV/AIDS (17.8%) 2 Lower respiratory infections (17.7%) Tuberculosis (15.9%) 3 HIV/AIDS (13.1%) Lower respiratory infections (8.8%) 4 Diarrhoeal diseases (7.1%) Cerebrovascular disease (5.8%) 5 Cerebrovascular disease (4.6%) Ischaemic heart disease (4.2%) 6 Interpersonal violence (3.4%) Diarrhoeal diseases (3.4%) 25-64 7 Ischaemic heart disease (2.2%) Interpersonal violence (3.1%) 8 Hypertensive heart disease (1.9%) Hypertensive heart disease (2.7%) 9 COPD (1.7%) Road injuries (2.6%) 10 Meningitis/encephalitis (1.4%) Nephritis/nephrosis (2.1%) 1 Cerebrovascular disease (17.1%) Cerebrovascular disease (17.3%) 2 Lower respiratory infections (14.2%) Ischaemic heart disease (13.3%) 3 Ischaemic heart disease (11.4%) Lower respiratory infections (9.5%) 4 Hypertensive heart disease (7.6%) Hypertensive heart disease (9.2%) 5 Diarrhoeal diseases (5.1%) COPD (4.7%) 65+ 6 COPD (4.7%) Diabetes mellitus (3.9%) 7 Diabetes mellitus (3.5%) Tuberculosis (3.2%) 8 Nephritis/nephrosis (3.3%) Diarrhoeal diseases (2.8%) 9 Tuberculosis (2.5%) Nephritis/nephrosis (2.4%) 10 Prostate (2.0%) Asthma (2.2%) Maternal conditions Rank.. 2006-2010 2011-2015 1 Indirect maternal (100.0%) n=6 Indirect maternal (58.8%) n=5 2 Hypertension in pregnancy (41.2%) n=4 3 4 15-49 Female 5 6 202 SectionSection B: Profile B: District Free HealthState 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. 203 Section B: DistrictProfile FreeHealth State Profiles Province Child and school 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. 204 SectionSection B: Profile B: District Free HealthState Province Profiles HIV 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. 205 Section B: DistrictProfile FreeHealth State 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. 206 SectionSection B: Profile B: District Free HealthState Province Profiles Non-communicable diseases Source: DHIS.