In South Africa – “the quality of health care, including access to HIV prevention and testing services,” largely depends on which of the country’s 52 districts a resident lives in – according to findings in the latest District Health Barometer (DHB), an annual report by Health Systems Trust, IRIN reports. “Some of the inequities highlighted by the [report] can be traced to differences in health spending,” IRIN writes. Districts in Western Cape Province spend the most on primary health care, while districts in Free State Province spend the least. In addition, the “uneven distribution of HIV infection in South Africa” influenced the ratings, the news service reports (7/7).  

“[O]verall there have been impressive improvements in HIV test uptake among pregnant women across the country,” and the report also found that the prevention of mother to child HIV transmission (PMTCT) program “is not being monitored properly,” according to Tanya Doherty of the Medical Research Council, Health-e reports. In the DHB, Doherty attributes the lack of improvement in child mortality in South Africa since 1990 to mother to child transmission of HIV (Thom, 7/7).

Other health indicators examined in the report include condom distribution, tuberculosis cure rates and the number patients seen per day by nurses. According to IRIN, the DHB also addresses “South Africa’s progress towards achieving the UN Millennium Development Goals and the targets set in the National Strategic Plan for HIV and AIDS” (7/7).

Health Systems Trust CEO Thobile Mbengashe said, “This report shows that whilst some progress in improving primary healthcare data and services has been made in certain areas, many areas still have a very long way to go.” The DHB calls for the establishment of a formal system to monitor nurses’ clinical workload because their “work at district level is perhaps the most important factor in the delivery of primary healthcare,” BusinessDay reports (Musgrave, 7/7).