GERT SIBANDE DISTRICT MUNICIPALITY Table of Contents 1. Demographic Information ......................................................................................................................................... 3 2. Social Determinants of Health .................................................................................................................................. 5 3. Service Delivery Platform .......................................................................................................................................... 9 3.1. Public Health Facility Types Sub-Districts ......................................................................................................... 9 3.2. Private Medical Practices and Hospitals ......................................................................................................... 10 3.3. Maps ................................................................................................................................................................ 11 3.4. District Hospital Performance ......................................................................................................................... 14 3.5. Trend of Public Health Expenditure ................................................................................................................ 16 3.6. Trend of Health Services Delivery ................................................................................................................... 17 3.1. Burden of Disease ........................................................................................................................................... 18 3.1.1. Poverty and Hunger ................................................................................................................................ 18 3.1.2. Child Health ............................................................................................................................................. 19 3.1.3. Maternal and Woman’s Health ............................................................................................................... 20 3.1.4. HIV/TB ..................................................................................................................................................... 21 4. Performance on Priority Indicators 2012/13 .......................................................................................................... 23 5. Glossary ................................................................................................................................................................... 28 6. Indicator Definitions................................................................................................................................................ 29 2 1. Demographic Information Gert Sibande is one of the 3 districts of Mpumalanga province of South Africa. The seat of Gert Sibande is Ermelo. The district code is DC30. The district is named after the ANC activist Gert Sibande. Gert Sibande District has the following neighbours: Nkangala to the north (DC31) Ehlanzeni to the north-east (DC32) The kingdom of Swaziland to the east Zululand to the south-east (DC26) Amajuba to the south (DC25) Thabo Mofutsanyane to the south-west (DC19) Fezile Dabi to the south-westDC20) Sedibeng to the west (DC42) The district contains the local municipalities of Govan Mbeki , Albert Luthuli , Mkhondo, Msukaligwa, Lekwa ,Pixley Ka Seme and Dipaleseng . The District has a total population of 1,043,193, with a population density of 32.7/Km2. Demographic Data Geographical area 31,841 Km2 Total population (Census 2011) 1,043,193 Population density (Census 2011) 32.7/Km2 Percentage of population with medical insurance (General Household Survey 2007) 14. % 3 Age Group Female Male Number % Of total population Number % Of total population 0-4 Years 59,063.00 6% 59,731.00 6% 5-9 Years 53,751.00 5% 53,899.00 5% 10-14 Years 50,997.00 5% 51,984.00 5% 15-19 Years 54,201.00 5% 54,324.00 5% 20-24 Years 52,533.00 5% 55,195.00 5% 25-29 Years 48,103.00 5% 51,613.00 5% 30-34 Years 35,718.00 3% 38,747.00 4% 35-39 Years 32,140.00 3% 31,878.00 3% 40-44 Years 29,144.00 3% 26,867.00 3% 45-49 Years 28,031.00 3% 23,462.00 2% 50-54 Years 23,532.00 2% 20,863.00 2% 55-59 Years 18,729.00 2% 16,586.00 2% 60-64 Years 13,696.00 1% 11,331.00 1% 65-69 Years 9,613.00 1% 7,183.00 1% 70-74 Years 8,152.00 1% 4,870.00 0.5% 75-79 Years 5,002.00 0.5% 2,738.00 0.3% 80+ Years 6,383.00 1% 3,134.00 0.3% Total 528,788.00 51% 514,405.00 49% The majority of household heads are males and black Africans and 1.6% of households have teenage household heads (less than 19 years). Age Household Head 19 Years and 20-35 Years 36-65 Years 66-84 Years 85 Years and older younger 1.6% 31.7% 56.2% 9.6% 1% Race Household Head Gender Household Head Black Coloured Indian or Asian White Female Male 89.5% 0.7% 0.9% 8.5% 38.8% 61.2% 4 The main language spoken in Gert Sibande is IsiZulu (60%), followed by Siswati (13%), and Afrikaans (9%). 2. Social Determinants of Health According to the 2007 DHB, the deprivation index for the district is 2.5. In terms of services to communities, 9% of households do not have access to piped water, 19.8% have no access to improved sanitation (bucket system, pit latrines without ventilation or no toilet) and 35.4% have no access to refuse removal by local authority or private company. In terms of housing, 10.8% of households live in informal dwellings or squatter settlements. Household Access to Basic Services Census 2011 Percentage traditional and informal dwelling, shacks and squatter settlement 10.8% Percentage households without access to improved sanitation 19.8% Percentage households without Access to Piped Water 9.0% Percentage households without access to electricity for lighting 16.6% Percentage households without refuse removal by local authority/private company 35.4% 5 According to Census 2011, 11.7% of household heads are unemployed and 19.2% of households live with an annual income below R4, 800 or less than R400 per month. In terms of the education level, 9.1% of the population have no schooling. The majority of the households have 5 or less people per household and only 2.8% of households have 10 or more people per household. 6 The proportion of enumeration area types gives an indication of infrastructure development, rural/urban settings and population distribution in the district. 69.9% of enumeration areas are formal residential areas, 11.1% traditional residential areas, 11.8% farming areas or smallholdings and 5.1% informal residential areas. The map below displays the geographical space that the different enumeration area types occupy in the district. Gert Sibande district has vast farming areas. Traditional residential areas occupy a large area of the district. There are big industrial areas around Secunda and relatively big vacant areas in Albert Luthuli sub-district. 7 8 3. Service Delivery Platform Community District Regional Satellite Specialised TB Grand Sub District Clinic Mobile Health Centre Hospital Hospital Clinic Hospital Total Albert Luthuli 17 4 2 4 27 Dipaleseng 4 2 1 7 Govan Mbeki 9 3 2 5 19 Lekwa 6 1 1 3 1 12 Mkhondo 7 4 1 8 4 24 Msukaligwa 9 2 4 1 1 17 (Functioning as Clinics) Pixley Ka Seme 5 2 2 3 12 Total 57 18 8 28 1 4 2 118 Public Health Facility Types Sub-Districts Health services are delivered by 8 district hospitals, 1 regional hospital, 18 community health centers, 57 clinics, 4 satellite clinics and 28 mobile clinics. 9 3.1. Private Medical Practices Sub-District Number Albert Luthuli Local Municipality 12 Dipaleseng Local Municipality 4 Govan Mbeki Local Municipality 67 Lekwa Local Municipality 15 Mkhondo Local Municipality 8 Msukaligwa Local Municipality 30 Pixley Ka Seme Local Municipality 12 Grand Total 148 10 3.2. Maps 11 Quintile 1 and Quintile 2 Schools in Relation to Public Health Facilities. Badplaas Carolina Albert Luthuli LMEersthoek Lochiel Chrissiesmeer Breyton Leandra Lothair Kinross Bethal Govan Mbeki LMLeslie Trichardt Ermelo Msukaligwa LM Secunda Amsterdam Balfour Greylingstad Panbult Lekwa LM Bettiesdam Holmerdene Iswepe Dipaleseng LM Standerton Meyerville Amersfoort Mkhondo LM Piet Retief Wittenberg District Berbice Pixley Ka Seme LM Sub-Districts Braunschweig Commondale Towns Volksrust Wakkerstroom Clinics_Satellites CHC District Hospitals Q2Schools Q1Schools 12 13 3.3. Hospital Performance 3.3.1. District Hospitals District hospital performance on 4 key indicators is displayed in the table below. Usable bed utilisation measures the occupancy of district hospital beds, namely the proportion of usable beds occupied over the year, and therefore measures how efficiently a hospital is using its available capacity. BUR should be read in conjunction with the average length of stay (ALOS). If a low ALOS occurs in conjunction with a high bed utilisation rate (>90%), this suggests that the hospital has a high demand for beds. A very high bed utilisation rate (BUR) suggests that the quality of care provided to the patients may be compromised due to insufficient staff to provide optimal care to patients or patients might get discharged before optimal recovery due to the high demand for beds. A very low BUR may suggest that the hospital is under-utilised either because there is no need for the service in the area, or because patients choose not to use the hospital. The BUR rate in Gert Sibande district was low for Amajuba hospital throughout the reporting period. The average length of stay