Mixed report on South Africa’s health

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Leading public health organisation Health Systems Trust this week launched the 20th edition of the South African Health Review (SAHR) at an event attended by public health workers, academics and policy makers to celebrate two decades of the publication, which is widely recognised as one of the most authoritative sources on the South African health system.

“The 20th edition of the South African Health Review provides a unique analysis of progress and challenges in priority areas related to health policy implementation, health service delivery and access over the past two decades,” said Dr Themba Moeti, CEO of HST, on Monday. “It clearly links current health sector challenges, reform initiatives and their implications for transformation of our health system.”

The key findings and conclusions of the Review include:

  • Significant improvements in key health outcomes: death rates have declined from 2006 peaks partly due to HIV treatment trends, although HIV is still the single biggest cause accounting for 29% of deaths; the average life expectancy in South Africa has increased by nine years to 63 since 2005; institutional maternal mortality ratio has decreased in five provinces with increases noted in two.
  •  Improved access to medicines through the Central Chronic Medicines Dispensing and Distribution Programme: in 2015/16 about 400 000 patients received their medication from 1000 pick-up-points closer to their homes and places of work.
  • Health expenditure in the public sector has increased to R183 billion over the past 20 years with a levelling off of per capita spending at province level.
  • Recognisable progress in the Ideal Clinic Realisation and Maintenance Programme: 322 Ideal Clinics were accredited in 2016, and the number of clinics scoring over 70% increased from 139 to 445 while those scoring below 40% reduced from 213 to 90. However, considering that there are 3477 facilities across the country, the programme still faces numerous challenges including in the area of supply-chain management.
  • The growing burden of non-communicable diseases is increasingly impacting on an already stretched health system. While great strides have been made towards management and control of NCDs, more emphasis should be placed on community-level factors that influence health.
  • Breast and cervical cancer are the most commonly diagnosed cancer among women in South Africa, calling for increased access to treatment and screening services.
  • The need for early identification of DR-TB patients, screening for household contacts and educating household members about DR-TB were identified as important community-level interventions to curb community transmission of DR-TB

Said the Managing Editor of the South African Health Review, Ashnie Padarath: “This year’s Review paints a mixed picture and shows evidence of progress in many of the programmes that are needed to ensure the successful implementation of NHI but also identifies areas where sustained and concerted action is required.”

The Health Systems Trust is a non-profit organisation that works to strengthen health systems in Southern Africa using a primary health care approach. The SAHR has been published since 1995 and is officially accredited as a peer-reviewed journal on prevailing local and international public health issues, and is widely read, used and quoted as an authoritative reference work in the country and abroad.

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