While none of the nine provinces reached the 95-95-95 UNAids target last year, KwaZulu-Natal was the best-performing province as it had 76% of clients remaining on antiretroviral therapy (ART).
This is according to the 16th District Health Barometer (DHB) launched last week by non-governmental organisation Health Systems Trust for the 2022/23 period. The barometer presents key findings on the performance of South Africa’s 52 health districts.
Health Systems Trust CEO Dr Themba Moeti said the barometer was a vital statistical and analytical resource that provided an overall view of district health performance on key health systems indicators.
“This 16th edition of the DHB provides information across a wide range of district health services, covers over 30 indicators and continues to provide policy-makers, health workers, planners, researchers, academics and stakeholders a unique overview of the performance of public health services in South Africa,” said Moeti.
According to the findings, the Western Cape was the poorest-performing province, with only 54.4% of clients remaining on ART.
The 95-95-95 strategy, created in 2014, aims to end the Aids epidemic by 2030 by achieving 95% diagnosed among all people living with HIV (PLHIV), 95% on ART among the diagnosed, and 95% virally suppressed among the treated.
“The national ART viral load suppression rate for Quarter 1 of 2023 was 90%. Overall the country is on target to reach the third 95 within the cohort of those on ART by 2026 as per the National Strategic Plan.”
With regard to TB, none of the districts reached the National Strategic Plan target of 90%. The national drug-sensitive tuberculosis (DS-TB) treatment success rate in 2021 was 77.9% and the rate in the provinces varied between 64.9% in Northern Cape and 82.8% in Mpumalanga.
However, 14 sub-districts reached the target of 90% for the DS-TB treatment success rate in 2021.
According to the barometer, none of the districts across South Africa reached the World Health Organization (WHO) cervical screening target of 70% by 2030.
“KwaZulu-Natal was the best-performing province in 2022/23, with all the districts obtaining a cervical cancer screening coverage above the national average of 21.4%.”
The Northern Cape had the lowest coverage; three of its five districts had the lowest coverage in the country.
“The Covid-19 pandemic, coupled with the change in the definition of the cervical cancer screening coverage indicator in 2020, contributed to the decrease in the screening coverage in 2020/21.”
In addition, the barometer shows an estimated 17% emigration rate for skilled health professionals, which is a key risk for the health system.
Medical practitioners, professional nurses and pharmacists show positive growth in number between March 2009 and March 2023, with pharmacists experiencing the highest growth rate at 186%. Professional nurses show the lowest growth rate at 29%.
According to the findings, there is huge inequity between districts within provinces for medical practitioners, professional nurses, pharmacists and allied health professionals per 100 000 of the uninsured population.
The Mercury