18 KwaZulu-Natal Province - Health Systems Trust Health Barometers/18... · Section B: National and District ProfilesSection B: Profile KwaZulu-Natal Province 18 KwaZulu-Natal Province

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Section B: National and District Profiles

420

Section B: Profile KwaZulu-Natal Province

18 KwaZulu-Natal Province

Ugu District Municipality (DC21) Naomi Massyn and Noluthando Ndlovu

Ugu District is situated in KwaZulu-Natal Province and has a population of 741 541, with a population density of 146.9 persons per km2. The district comprises six sub-districts, namely Vulamehlo, Umdoni, uMzumbe, Hibiscus Coast, Ezinqoleni and uMuziwabantu, and falls in socio-economic Quintile 2.

Population distribution, sub-district boundaries and health facility locations: Ugu (DC21)

Broad age.. Female Male

<5 years

5-14

15-24

25-64

65+

Total 43.9%30.9%21.0%

16.2%

10.4%

19.7%

11.7%

29.7%

80.4%

13.5%

28.3%

53.7%

47.2%

72.4%

35.7%

24.2%

19.4%

11.3%

12.8%33.1%33.1%21.1%

20.5%

51.7%

12.7%

18.8%

11.9%

25.2%

74.4%

13.2%

28.1%

24.2%

44.4%

72.1%

32.6%

12.2%

17.8%

12.0% 9.9%

KZN, Ugu: DC21

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

18.1%

27.3%

16.7%

25.2%

79.4%

13.7%

29.0%

39.9%

45.2%

73.7%

36.1%

22.0%

21.7%

18.9%

31.7%

21.8%

13.1%

29.9%

76.8%

12.6%

27.4%

40.9%

46.1%

69.9%

32.0%

14.3%

14.2%

12.1%

9.8%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Poisonings (including herbal) (2.1%)

Sepsis/other newborn infectious (4.1%)

Protein-energy malnutrition (5.7%)Birth asphyxia (6.9%)

Preterm birth complications (9.3%)

Septicaemia (2.3%)

Diarrhoeal diseases (28.1%)Lower respiratory infections (14.2%)

HIV/AIDS (9.0%)

Tuberculosis (4.9%)

Other perinatal conditions (2.5%)Sepsis/other newborn infectious (3.1%)



Septicaemia (2.4%)


HIV/AIDS (8.4%)

Tuberculosis (4.5%)

Drowning (5.9%)

Epilepsy (2.1%)

Asthma (3.9%)Accidental threats to breathing (2.7%)

Meningitis/encephalitis (5.0%)Road injuries (5.1%)

Diarrhoeal diseases (18.6%)

Lower respiratory infections (10.5%)HIV/AIDS (12.1%)

Tuberculosis (18.3%)

Drowning (5.5%)

Epilepsy (2.9%)

Asthma (4.8%)

Accidental threats to breathing (3.4%)Meningitis/encephalitis (3.6%)Road injuries (4.1%)




Drowning (2.0%)

Interpersonal violence (5.8%)Mechanical forces (5.6%)

Accidental threats to breathing (7.6%)





Epilepsy (2.8%)

Interpersonal violence (9.3%)

Mechanical forces (3.0%)


Meningitis/encephalitis (2.9%)

Road injuries (3.1%)Diarrhoeal diseases (4.0%)Lower respiratory infections (5.4%)

HIV/AIDS (19.2%)Tuberculosis (23.1%)

Asthma (2.1%)Meningitis/encephalitis (2.1%)Diabetes mellitus (2.5%)Hypertensive heart disease (2.9%)

Ischaemic heart disease (2.1%)

Diarrhoeal diseases (7.7%)Cerebrovascular disease (4.4%)



Asthma (2.0%)Interpersonal violence (2.1%)

Diabetes mellitus (3.0%)Hypertensive heart disease (2.4%)Ischaemic heart disease (2.4%)

Diarrhoeal diseases (4.5%)Cerebrovascular disease (5.4%)Lower respiratory infections (6.6%)


Asthma (3.9%)

COPD (3.3%)Nephritis/nephrosis (3.6%)

Diabetes mellitus (7.7%)

Hypertensive heart disease (11.3%)Ischaemic heart disease (8.2%)


Cerebrovascular disease (23.3%)

Lower respiratory infections (5.9%)Tuberculosis (5.7%)

Asthma (2.9%)







Prov, DistrictKZN, Ugu: DC21

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut

Percentage ofdeaths by broadcause and leadingcauses, 2008-2013


421


421

Burden of disease profile

Percentage of deaths by broad cause and leading causes, 2008–2013: Ugu (DC21)

422


422


Broad cause groups by age and gender

In the under-5-year age group, communicable diseases and maternal, perinatal and nutritional conditions accounted for 72% of deaths. HIV and TB accounted for 13% of deaths in this age group.

In the 5–14-year age group, deaths due to communicable diseases and maternal, perinatal and nutritional conditions occurred slightly more often among females than males (35.7% versus 32.6%). HIV and TB and non-communicable disease mortality were very similar among males and females, at about 28% and 19% respectively. There were more injury-related deaths among males than females in this age group (20.5% versus 16.2%).

In the 15–24-year age group, HIV and TB accounted for 53.7% of deaths among females versus 24.2% among males, while injury-related deaths were predominant among males (51.7% versus only 10.4% among females). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for almost twice the percentage of deaths among females than males (24.2% versus 12.2%), while deaths due to non-communicable diseases were around 12% for both males and females.

In the 25–64-year age group, HIV and TB accounted for the majority of deaths among both males and females (44.4% versus 47.2%), followed by non-communicable diseases (25.2% versus 29.7%) and communicable diseases together with maternal, perinatal and nutritional conditions (17.8% versus 19.4%). Injuries accounted for a smaller proportion of deaths in this age group for both males and females; however, the proportion of deaths was about 3.5 times higher among males than females (12.7% versus 3.7%).

In the 65-years-and-older age group, non-communicable diseases accounted for the highest proportion of deaths (74.4% among males and 80.4% among females), followed by communicable diseases together with maternal, perinatal and nutritional conditions.

Trends in broad cause groups by age

In the under-5-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased from 73.7% to 69.9% between 2008–2010 and 2011–2013, and HIV and TB mortality decreased. However, there was a slight increase in deaths due to non-communicable diseases and injuries across both periods. A similar trend was observed in the 5–14-year age group: deaths due to communicable diseases together with maternal, perinatal and nutritional conditions and HIV and TB deaths decreased, while non-communicable disease mortality and injury-related deaths decreased. In the 15–24-year age group there was a decline only in deaths due to communicable diseases together with maternal, perinatal and nutritional conditions from 22.0% to 14.3%. All the other broad causes increased. Both non-communicable disease mortality and injury-related deaths increased by less than five percentage points. In the 25–64-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions also decreased (from 21.7% to 14.2%). All the other broad causes increased over the period. In the 65-years-and-older age group there was not much change in the broad cause groups over the period, other than a drop in non-communicable disease mortality from 79.4% to 76.8%.

Trends in leading causes of death by age

Under 5 years

Diarrhoeal diseases and lower respiratory infections were the leading causes of death in 2008– 2010 and 2011– 2013, followed by preterm birth complications and HIV and AIDS. All the others causes of death remained the same over the two periods, aside from the inclusion of other perinatal conditions and the exclusion of poisonings (including herbal) in 2011–2013. Tuberculosis remains the seventh leading cause of death in this age group.

5–14 years

Tuberculosis replaced diarrhoeal diseases as the leading cause of death, with the latter dropping to second place followed by HIV and AIDS. Lower respiratory infections and drowning remain in the top five leading causes of death, with asthma moving up the ranks from eighth to sixth place, replacing road injuries. Meningitis/encephalitis moved down to eighth position, while accidental threats to breathing and epilepsy remained the same.

15–24 years

Tuberculosis and HIV and AIDS remained the leading causes of death in this age group. Accidental threats to breathing replaced lower respiratory infections as the third leading cause of death, followed by interpersonal violence. Diarrhoeal diseases and road injuries both moved down one position, while mechanical forces moved up. Meningitis/encephalitis remained the same, and epilepsy replaced drowning in 10th position.


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25–64 years

Tuberculosis, HIV and AIDS accounted for over 45% of deaths in this age group, followed by lower respiratory infections, cerebrovascular disease and diarrhoeal diseases. Diabetes mellitus, hypertensive heart disease and asthma still featured in the top 10 causes of death, while meningitis/encephalitis dropped out and interpersonal violence moved in.

65 years and older

Cerebrovascular disease, hypertensive heart disease, ischaemic heart disease, diabetes mellitus, lower respiratory infec-tions and TB remained the leading causes of death. Asthma dropped from seventh to 10th position, while nephritis/nephrosis, chronic obstructive pulmonary disease and diarrhoeal diseases all moved up.

Indicator performance: Ugu (DC21)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16Management PHC

PHC supervisor visit rate (fixed clinic/CHC/CDC) [Percentage]

62.1 65.9 64.9 38 60.5 66.4 73.5

Management Inpatients

Average length of stay (district hospitals) [Days]

6.2 5.9 5.7 32 5.8 5.5 4.6

Expenditure per patient day equivalent (district hospitals) [Rand (real 2014/15 prices)]

1 716.5 1 803.3 1 845.6 31 2 004.3 2 136.4

Inpatient bed utilisation rate (district hospitals) [Percentage]

74.6 72.0 69.4 19 62.8 62.7 65.8

OPD new client not referred rate (district hospitals) [Percentage]

21.0 15.4 27.0 6 53.0 60.7

Mortality Inpatients

Child under 5 years diarrhoea case fatality rate [Percentage]

4.5 4.3 2.5 19 3.0 3.6 3.2 3.3 3.5 3.0

Child under 5 years pneumonia case fatality rate [Percentage]

1.7 3.1 2.2 19 2.7 2.9 2.4 2.9

Child under 5 years severe acute malnutrition case fatality rate [Percentage]

11.3 12.5 9.1 16 10.4 10.2 8.0 11.6 8.0 7.0

Inpatient crude death rate [Percentage]

6.6 6.0 5.9 33 5.1 5.2

Delivery Delivery by Caesarean section rate (district hospitals) [Percentage]

37.1 36.3 37.5 27.8 22.7

Delivery in facility under 18 years rate [Percentage]

10.5 10.6 10.0 42 8.9 9.0 7.4

Inpatient early neonatal death rate [per 1 000 live births]

8.3 10.1 9.6 23 10.3 9.7 10.1 0

Maternal mortality in facility ratio [per 100 000 live births]

155.9 161.0 111.7 21 124.9 133.0 119.5 132.5 100 80.0

Mother postnatal visit within 6 days rate [Percentage]

76.6 60.1 60.3 37 66.4 74.4 74.3 80.0 85.0

Stillbirth in facility rate [per 1 000 births]

23.5 24.0 21.4 28 21.1 20.7

PMTCT Antenatal 1st visit before 20 weeks rate [Percentage]

49.1 58.4 61.6 10 57.3 60.0 60.0 53.9 65.0 70.0

Antenatal client initiated on ART rate [Percentage]

74.6 91.3 98.0 7 95.2 95.0 91.2 93.0 96.0

Infant 1st PCR test around 6 weeks uptake rate [Percentage]

114.6 108.3 102.1 21 107.9 100.6

Infant 1st PCR test positive around 6 weeks rate [Percentage]

2.6 2.1 1.6 27 1.3 1.0 1.5 1.8 2.0

Child Health School Grade 1 screening coverage [Percentage]

7.2 20.4 30 20.7 55.0 23.2 30.0 35.0

Vitamin A dose 12-59 months coverage [Percentage]

38.1 41.9 49.1 35 54.5 55.0 60.0 52.2 55.0

Immunisation Immunisation coverage under 1 year [Percentage]

72.7 73.8 78.3 41 89.9 96.0 90.0 89.8 95.0 91.0

Measles 2nd dose coverage [Percentage]

70.0 69.6 72.9 42 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health

Cervical cancer screening coverage ([Percentage]

93.1 87.8 80.1 3 70.3 79.7 75.0 54.5 60.0 64.0

Couple year protection rate [Percentage]

31.8 41.9 47.0 23 57.8 45.0 46.8 55.0

TB case finding TB Rifampicin resistance confirmed client rate [Percentage]

10.8 8.3 8.0 44 8.3 6.4

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District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16HIV HIV testing coverage

(including ANC)48.5 46.4 6 39.0 32.1

Male condom distribution coverage

20.3 34.3 38.1 24 58.9 62.9 38.4

Non-communicable diseases

Hypertension incidence [per 1 000]

25.7 30.1 22.4 19.1 22.8 13.9

Mental health admission rate [Percentage]

2.4 2.5 1.0 1.1 1.2

Human Resources

PHC doctor clinical workload [Clients per doctor per day]

24.4 32.0 25.8 3 29.0 26.9

PHC professional nurse clinical workload [Clients per nurse per day]

31.3 31.2 38.6 44 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2011 2012 2013 2014 2013 2013 2013 2014 2013 2013 2014TB case finding

Incidence (diagnosed cases) of TB - all types [Cases per 100 000 population]

1 343.6 1 042.2 1 043.6 50 864.4 592.5

TB treatment outcomes

TB cure rate (new smear positive) [Percentage]

70.4 73.7 80.1 17 82.8 76.8

TB death rate (all TB) [Percentage] 7.5 8.0 7.3 20 6.4 7.4 6.0 5.0

TB defaulter rate (new smear positive) [Percentage]

4.5 4.7 4.2 13 4.1 4.5 5.8 6.0 5.5

TB treatment success rate (all TB) [Percentage]

72.9 74.7 77.8 26 81.8 85.0 77.9 82.0 83.0

HIV Percentage of TB cases with known HIV status (ETR.Net) [Percentage]

82.5 84.8 91.7 36 92.5 92.8

TB/HIV co-infected client on ART rate (ETR.Net) [Percentage]

39.1 60.8 79.0 29 74.8 78.9

NCDs Hypertension prevalence rate (crude) [Percentage]

36.8 36 31.1 31.8

Burden of disease

Percentage of deaths garbage codes [Percentage]

12.6 13.5 13.9 31 14.8 14.5

Percentage of deaths ill-defined [Percentage]

10.7 11.6 9.7 22 11.4 14.0

Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes [Percentage]

22.2 20.3 18.8 19 20.8 22.1

Percentage of YLLs due to HIV and TB [Percentage]

39.8 37.5 35.8 45 34.2 27.9

Percentage of YLLs due to injuries [Percentage]

9.7 10.9 14.1 40 12.6 13.1

Percentage of YLLs due to non-communicable diseases [Percentage]

28.3 31.3 31.3 14 32.4 36.9

Value in red – improvement strategies are urgently needed

Value highlighted in yellow – performance is ranked among the 10 best in the country

Value highlighted in red – performance is ranked among the 10 worst in the country

The district performed very well with regard to some indicators, which ranked among the 10 best in the country in the last reporting period. These indicators were:

✦ OPD new client not referred rate for district hospitals

✦ Antenatal 1st visit before 20 weeks rate (although below the national target of 65%)

✦ Antenatal client initiated on ART rate

✦ Cervical cancer screening coverage (third highest in the country)

✦ HIV testing coverage including ANC

✦ PHC doctor clinical workload

However, the performance of some indicators ranked among the 10 worst in the country. These indicators included the following:

✦ TB Rifampicin resistance confirmed client rate

✦ PHC professional nurse clinical workload

✦ Incidence (diagnosed cases) of TB (all types)

✦ Percentage of years of life lost (YLLs) due to HIV and TB


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425

Although the district recorded an improvement in the performance of several indicators over the past three years, improvement strategies are needed urgently for the following indicators, especially when compared with the district ranking, 2014/15 provincial and national averages, and the 2014/15 and 2015/16 provincial and national targets. These indicators are:

✦ PHC supervisor visit rate (fixed clinic/CHC/CDC)

✦ Average length of stay (district hospitals)

✦ Child under 5 years severe acute malnutrition case fatality rate

✦ Inpatient crude death rate

✦ Delivery by Caesarean section rate (district hospitals)

✦ Delivery in facility under 18 years rate

✦ Maternal mortality in facility ratio

✦ Mother postnatal visit within 6 days rate

✦ Stillbirth in facility rate

✦ Antenatal 1st visit before 20 weeks rate

✦ Infant 1st PCR test positive around 6 weeks rate

✦ School Grade 1 screening coverage

✦ Vitamin A dose 12–59 months coverage

✦ Immunisation coverage under 1 year

✦ Measles 2nd dose coverage

✦ Couple year protection rate


✦ Male condom distribution coverage

✦ Hypertension incidence

✦ Mental health admission rate



✦ TB death rate (all TB)

✦ TB treatment success rate (all TB)

✦ Hypertension prevalence

✦ Percentage of YLLs due to HIV and TB

✦ Percentage of YLLs due to injuries

Annual indicators for district: Ugu: DC21

Valu

e

30

40

50

60

70

80

2006 2008 2010 2012 2014

02_Fixed PHC super vis rate

4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014

03_Avg length of stay (DH)

4

6

8

2006 2008 2010 2012 2014

03_Child <5 diar fat rate

2

3

4

5

6

2008 2010 2012 2014 2016

03_Child <5 pneumo death

10

15

20

25

30

2008 2010 2012 2014 2016

03_Child <5 sev mal fata

5.0

5.5

6.0

6.5

7.0

2008 2010 2012 2014 2016

03_Crude death rate

1000

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014

03_Expenditure per PDE

20

30

40

50

60

2008 2010 2012 2014 2016

03_OPD new not ref rate (DH)

65

70

75

2006 2008 2010 2012 2014

03_Usable bed util (DH)

15

20

25

30

35

2006 2008 2010 2012 2014

04_Caesarean sect (DH)

8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

4

6

8

10

2006 2008 2010 2012 2014

04_IP early neo death rate

100

150

200

250

2006 2008 2010 2012 2014

04_Maternal Mort ratio yy

20

40

60

2008 2010 2012 2014 2016

04_Posnatal mother <6d

20

25

30

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014

05_ANC 1st visit <20 w rate

100

150

200

2008 2010 2012 2014 2016

05_ANC initiate ART rate

40

60

80

100

120

2006 2008 2010 2012 2014

05_Infant PCR 6w uptake rate

5

10

2006 2008 2010 2012 2014

05_Infant PCR pos 6w rate

10

15

20

2010 2012 2014 2016 2018

06_School G1 screen cov yy

District value Provincial average ZA (national) average

426


426


Annual indicators for district: Ugu (DC21)

Annual indicators for district: Ugu: DC21Va

lue

20

30

40

50

2006 2008 2010 2012 2014

06_VitA 12−59 mm cov yy

65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2006 2008 2010 2012 2014

07_Measles 2nd cov yy

20

40

60

80

100

2006 2008 2010 2012 2014

08_Cerv cancer screen cov yy

30

40

50

2006 2008 2010 2012 2014

08_Couple Year Prot Rate yy

4

5

6

7

2008 2010 2012 2014

09_New pulmonary TB LTF rate

4

6

8

10

2008 2010 2012 2014 2016

09_RIF resistance rate

0

20

40

60

80

2006 2008 2010 2012 2014

09_TB cure rate new sm+

6.5

7.0

7.5

8.0

8.5

2008 2010 2012 2014 2016

09_TB deaths all TB

0

500

1000

1500

2006 2008 2010 2012 2014

09_TB inc all TB

50

60

70

80

2006 2008 2010 2012 2014

09_TB success all TB

30

35

40

45

2010 2012 2014 2016 2018

10_HIV test cov inc ANC

10

20

30

40

50

60

2006 2008 2010 2012 2014

10_Male cond dist cov yy

40

50

60

70

80

90

2008 2010 2012 2014

10_TB known HIV status

20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

30

32

34

36

2006 2008 2010 2012 2014

11_Hypertension prevalence

1.0

1.5

2.0

2.5

2010 2012 2014 2016 2018

11_Mental hlth adm rate

24

26

28

30

32

2010 2012 2014 2016

12_PHC dr clinical work load

30

32

34

36

38

2010 2012 2014 2016

12_PHC PN clin workload

13

14

15

2006 2008 2010 2012 2014

13_Garbage codes



427


427

Annual indicators for district: Ugu (DC21)

428


428


uMgungundlovu District Municipality (DC22) Naomi Massyn and Noluthando Ndlovu

uMgungundlovu District, one of 11 National Health Insurance (NHI) pilot districts, is situated in the midlands of KwaZulu- Natal Province and comprises seven sub-districts, namely Impendle, Mkhambathini, Mooi Mpofana, Msunduzi, Richmond, uMngeni, and uMshwathi. The district has a population of 1 069 657, with a population density of 110.7 persons per km2, and falls in socio-economic Quintile 3.

Population distribution, sub-district boundaries and health facility locations: uMgungundlovu (DC22)


<5 years

5-14

15-24

25-64

65+

Total 50.4%25.4%19.6%

17.4%

12.5%

13.6%

19.5%

15.7%

38.1%

83.2%

14.5%

28.1%

47.7%

38.0%

66.1%

35.0%

24.2%

19.8%

13.9%39.5%28.6%17.9%

25.9%

56.0%

13.7%

12.8%

20.7%

13.4%

31.9%

79.9%

11.4%

25.7%

19.7%

38.1%

69.1%

27.8%

16.3%

KZN, uMgungundlovu: DC22

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

19.9%

30.9%

19.7%

13.9%

31.4%

80.7%

13.5%

28.8%

35.0%

38.7%

69.9%

31.6%

20.2%

21.0%

12.3%

8.9%

25.0%

37.3%

16.5%

20.8%

15.5%

38.9%

83.2%

12.1%

23.9%

32.9%

37.1%

64.7%

30.3%

14.2%

13.5%

9.4%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Sepsis/other newborn infectious (3.5%)Protein-energy malnutrition (3.2%)

Birth asphyxia (4.0%)

Fires, hot substances (2.0%)


Septicaemia (2.2%)




Protein-energy malnutrition (2.6%)



Septicaemia (3.2%)


HIV/AIDS (8.4%)

Tuberculosis (3.9%)

Drowning (9.2%)

Epilepsy (2.8%)Fires, hot substances (2.2%)Asthma (1.9%)

Accidental threats to breathing (5.0%)Meningitis/encephalitis (4.5%)

Diarrhoeal diseases (12.2%)Lower respiratory infections (13.4%)HIV/AIDS (15.3%)Tuberculosis (15.3%)

Drowning (7.3%)

Epilepsy (3.0%)

Fires, hot substances (5.0%)Accidental threats to breathing (6.8%)



Lower respiratory infections (8.5%)

HIV/AIDS (15.4%)


Drowning (1.8%)Fires, hot substances (1.9%)




Meningitis/encephalitis (3.0%)Diarrhoeal diseases (6.3%)







Road injuries (2.1%)




Mechanical forces (2.2%)Meningitis/encephalitis (2.3%)

Diabetes mellitus (2.6%)Ischaemic heart disease (3.7%)




Interpersonal violence (2.6%)Nephritis/nephrosis (2.7%)





Asthma (1.8%)COPD (2.5%)

Nephritis/nephrosis (4.1%)

Diabetes mellitus (7.7%)Hypertensive heart disease (8.6%)





Tuberculosis (3.5%)

Trachea/bronchi/lung (2.0%)

COPD (2.6%)






Tuberculosis (2.9%)

Prov, DistrictKZN, uMgungundlovu: DC22

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut



429


429


Percentage of deaths by broad cause and leading causes, 2008–2013: uMgungundlovu (DC22)

430


430



In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for most deaths among both males and females (69.1% and 66.1% respectively). HIV and TB accounted for more deaths among females than males (14.5% versus 11.4%); this was also the case for non-communicable diseases (13.6% and 12.8%). There were slightly more injury-related deaths among males than females.

In the 5–14-year age group, the majority of deaths were due to communicable diseases and maternal, perinatal and nutritional conditions (27.8% among males and 35% among females), and HIV and TB (25.7% among males and 28.1% among females). Non-communicable disease mortality and injury-related deaths were higher among males.

In the 15–24-year age group, HIV and TB deaths were significantly higher among females than males (47.7% versus 19.7%). The opposite pattern was observed for injury-related deaths, which were much higher among males than females (56.0% versus only 12.5%). Deaths due to communicable diseases and maternal, perinatal and nutritional conditions were more than twice as high in females (24.2% among females versus 10.9% among males).

In the 25–64-year age group, HIV and TB mortality were the same in both genders at about 38%. Deaths due to non-communicable diseases were more common among females than males (38.1% versus 31.9%). Deaths due to communicable diseases and maternal, perinatal and nutritional conditions were also higher among females, while injury-related deaths were more than three times higher among males than females (13.7% versus 4.1%).

In the 65-years-and-older age group, non-communicable diseases were the predominant broad cause of death for both males and females at 79.9% and 83.2% respectively. Deaths due to HIV and TB and injuries were higher among males than females, while communicable diseases and maternal, perinatal and nutritional conditions were higher among females.


Communicable diseases together with maternal, perinatal and nutritional conditions were the leading broad cause of death in the under-5-year age group, but declined from 69.9% in 2008–2010 to 64.7% in 2011–2013. Deaths due to HIV and TB also declined, while non-communicable disease mortality and injury-related deaths increased over the two time periods. In the 5–14-year age group, communicable diseases together with maternal, perinatal and nutritional conditions decreased slightly, while HIV and TB mortality decreased the most, from 28.8% to 23.9%. Non-communicable disease deaths and injury-related deaths increased. In the 15–24-year age group, HIV and TB mortality decreased from 35% in 2008–2010 to 32.9% in 2011–2013, to be replaced by injury as the leading cause of death (30.9% in 2008–2010 to 37.3% in 2011–2013). Deaths due to communicable diseases and maternal, perinatal and nutritional conditions declined from 20.2% to 14.2%, while non-communicable disease mortality increased. In the 25–64-year age group, HIV and TB, communicable diseases together with maternal, perinatal and nutritional conditions, and non-communicable diseases all declined over the two periods, while injury-related deaths increased slightly. In the 65-years-and-older age group, non-communicable diseases were the major broad cause of death and increased from 80.7% to 83.2%. Communicable diseases and maternal, perinatal and nutritional conditions declined by more than three percentage points from 12.3% to 9.4%, while there was not much change in HIV and TB mortality and injury-related deaths.


Under 5 years

Diarrhoeal diseases, lower respiratory infections, preterm birth complications and HIV and AIDS remained the four leading causes of death between 2008–2010 and 2011–2013. Tuberculosis dropped from fifth to eighth position, while birth asphyxia, sepsis/other newborn infectious diseases and protein-energy malnutrition all moved up in the rankings. Other perinatal conditions appeared in the top 10 causes of death for the first time in 2011–2013, in seventh position.

5–14 years

HIV and AIDS replaced TB as the leading cause of death; diarrhoeal diseases were in second place and TB moved down to third position. Lower respiratory infections and drowning remained in the top five leading causes of death, followed by accidental threats to breathing. Asthma no longer featured in the top 10 in 2011–2013, while road injuries, fires and hot substances were included in the leading causes.

15–24 years

HIV and AIDS and TB remained the leading causes of death, with accidental threats to breathing and interpersonal violence making up the top four leading causes. There were more deaths due to mechanical forces than deaths due to lower respiratory infections in 2011–2013; diarrhoeal diseases, meningitis/encephalitis, and fire and hot substances were part of the ranking, and road injuries replaced drowning to complete the top 10 causes of death in this age group.


431


431

25–64 years

HIV and AIDS, TB, lower respiratory infections, cerebrovascular disease and diarrhoeal diseases accounted for over 50% of deaths in this age group. Other leading causes of death included diabetes mellitus, ischaemic heart disease and interpersonal violence. Hypertensive heart diseases first appeared in the top 10 causes of death in 2011–2013, and nephritis/nephrosis replaced meningitis/encephalitis and mechanical forces.

65 years and older

Cerebrovascular disease, ischaemic heart disease, hypertensive heart disease, diabetes mellitus, lower respiratory infections and nephritis/nephrosis remained the leading causes of death (in that order) for this age group. Diarrhoeal diseases dropped to ninth place, while both TB and chronic obstructive pulmonary disease moved up in the ranking over this period. Asthma dropped out of the top 10 and was replaced by tracheal/bronchial/lung cancer as a leading cause of death.

432


432


Indicator performance: uMgungundlovu (DC22)District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



37.9 36.0 43.2 49 60.5 66.4 73.5



5.0 5.2 5.6 28 5.8 5.5 4.6


2 065.5 1 927.8 1 835.3 35 2 004.3 2 136.4


73.5 74.6 79.6 6 62.8 62.7 65.8


26.1 29.7 44.1 15 53.0 60.7



2.6 3.4 2.5 22 3.0 3.6 3.2 3.3 3.5 3.0


3.3 1.6 2.1 18 2.7 2.9 2.4 2.9


9.0 6.8 7.0 11 10.4 10.2 8.0 11.6 8.0 7.0


5.8 5.1 5.5 26 5.1 5.2


26.3 31.1 31.7 27.8 22.7


9.8 9.1 8.6 30 8.9 9.0 7.4


9.1 13.2 9.1 18 10.3 9.7 10.1 0


279.4 208.3 185.9 39 124.9 133.0 119.5 132.5 100 80.0


82.9 63.5 66.8 30 66.4 74.4 74.3 80.0 85.0


27.6 32.4 27.9 50 21.1 20.7


46.5 58.8 59.9 16 57.3 60.0 60.0 53.9 65.0 70.0


80.1 102.9 98.7 2 95.2 95.0 91.2 93.0 96.0


106.6 107.0 100.7 24 107.9 100.6


2.5 1.4 0.8 1 1.3 1.0 1.5 1.8 2.0


6.2 18.6 31 20.7 55.0 23.2 30.0 35.0


30.6 36.9 58.5 12 54.5 55.0 60.0 52.2 55.0


78.4 96.3 91.2 15 89.9 96.0 90.0 89.8 95.0 91.0


68.2 65.1 75.2 33 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


87.5 78.9 73.3 9 70.3 79.7 75.0 54.5 60.0 64.0


53.8 110.7 152.9 1 57.8 45.0 46.8 55.0


8.0 6.1 6.4 38 8.3 6.4

HIV HIV testing coverage (including ANC)

28.2 37.1 16 39.0 32.1


58.0 153.4 216.8 1 58.9 62.9 38.4



22.0 19.4 26.3 19.1 22.8 13.9


0.5 1.6 1.0 1.1 1.2

Human Resources


19.7 28.7 25.7 4 29.0 26.9


29.2 26.0 25.9 21 33.3 29.4


433


433

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



1 008.6 853.4 1 096.9 51 864.4 592.5



80.7 83.4 83.4 10 82.8 76.8



5.3 5.2 4.7 21 4.1 4.5 5.8 6.0 5.5


78.5 81.0 82.9 8 81.8 85.0 77.9 82.0 83.0


93.2 96.1 96.2 9 92.5 92.8


57.9 77.9 79.0 30 74.8 78.9


32.4 24 31.1 31.8

Burden of disease


14.4 14.1 14.2 36 14.8 14.5


11.5 13.0 11.8 28 11.4 14.0


19.2 17.1 17.3 14 20.8 22.1


33.3 31.6 29.2 29 34.2 27.9


11.3 12.8 12.8 26 12.6 13.1


36.2 38.6 40.7 37 32.4 36.9





✦ Inpatient bed utilisation rate (district hospitals)

✦ Antenatal client initiated on ART rate (second highest in the country)

✦ Infant 1st PCR test positive around 6 weeks rate (lowest in the country)

✦ Cervical cancer screening coverage

✦ Couple year protection rate (highest in the country, however, coverage appears unrealistic at 152.9%)

✦ Male condom distribution coverage (highest in the country, however, the coverage of 216.7 condoms per male 15 years and older appears unrealistic and it contributed to the high couple year protection rate)


✦ TB cure rate (new smear positive)


✦ Percentage of TB cases with known HIV status

The performance of some indicators ranked among the 10 worst in the country. These indicators included the following:


✦ Stillbirth in facility rate (third highest)

✦ Incidence (diagnosed cases) of TB (all types) (second highest)





434


434














✦ Hypertension prevalence rate (crude)

✦ Percentage of years of life lost due to non-communicable diseases

Annual indicators for district: uMgungundlovu: DC22Va

lue

20

40

60

2006 2008 2010 2012 2014


4.0

4.5

5.0

5.5

2006 2008 2010 2012 2014


0

50

100

150

2006 2008 2010 2012 2014


2

3

4

5

6

2008 2010 2012 2014 2016


10

15

2008 2010 2012 2014 2016


5.2

5.4

5.6

5.8

2008 2010 2012 2014 2016

03_Crude death rate

1000

1500

2000

2500

3000

2006 2008 2010 2012 2014


30

40

50

60

2008 2010 2012 2014 2016


65

70

75

80

2006 2008 2010 2012 2014


15

20

25

30

2006 2008 2010 2012 2014


8

10

12

2006 2008 2010 2012 2014

04_Deliv in fac <18

0

5

10

2006 2008 2010 2012 2014


100

150

200

250

2006 2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016


22

24

26

28

30

32

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014


100

150

200

2008 2010 2012 2014 2016


20

40

60

80

100

2006 2008 2010 2012 2014


5

10

15

2006 2008 2010 2012 2014


10

15

20

2010 2012 2014 2016 2018




435


435

Annual indicators for district: uMgungundlovu (DC22)

Annual indicators for district: uMgungundlovu: DC22

Valu

e

20

30

40

50

60

2006 2008 2010 2012 2014


20

40

60

80

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

65

70

75

80

85

90

2006 2008 2010 2012 2014


20

40

60

80

2006 2008 2010 2012 2014


50

100

150

2006 2008 2010 2012 2014


4

5

6

7

2008 2010 2012 2014


6

8

10

12

14

16

18

2008 2010 2012 2014 2016


50

60

70

80

2006 2008 2010 2012 2014


6.5

7.0

7.5

8.0

8.5

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014


30

35

2010 2012 2014 2016 2018


0

50

100

150

200

2006 2008 2010 2012 2014


40

60

80

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

26

28

30

32

2006 2008 2010 2012 2014


0.6

0.8

1.0

1.2

1.4

1.6

2010 2012 2014 2016 2018


20

22

24

26

28

2010 2012 2014 2016


26

28

30

32

34

2010 2012 2014 2016


13.5

14.0

14.5

15.0

15.5

2006 2008 2010 2012 2014

13_Garbage codes


436


436


Annual indicators for district: uMgungundlovu (DC22)


437


437

uThukela District Municipality (DC23) Naomi Massyn and Noluthando Ndlovu

uThukela District is located on the western boundary of Kwazulu-Natal Province. It consists of five sub-districts: Indaka, Emnambithi/Ladysmith, uMtshezi, Okhahlamba and Imbabazane. The district has a population of 689 122, with a population density of 60.8 persons per km2 and falls in socio-economic Quintile 1, among the poorest districts.

Population distribution, sub-district boundaries and health facility locations: uThukela (DC23)


<5 years

5-14

15-24

25-64

65+

Total 40.8%26.6%28.4%

18.9%

12.2%

16.4%

14.5%

29.0%

78.8%

24.2%

43.8%

40.5%

78.1%

40.6%

29.5%

26.7%

15.0%

13.5%30.9%29.6%26.0%

27.4%

55.0%

13.4%

18.6%

12.6%

25.7%

71.9%

19.9%

19.7%

40.0%

81.4%

34.1%

12.7%

20.9%

15.6%

KZN, uThukela: DC23

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

24.2%

31.6%

15.7%

13.3%

25.4%

75.0%

22.9%

30.7%

39.0%

82.0%

37.2%

24.4%

27.1%

16.4%

22.4%

33.1%

19.3%

14.0%

29.7%

77.5%

21.1%

35.0%

42.0%

76.6%

37.2%

17.9%

18.6%

14.1%

9.8%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (1.4%)



Birth asphyxia (5.2%)Preterm birth complications (12.3%)



HIV/AIDS (4.6%)

Tuberculosis (3.4%)







HIV/AIDS (5.9%)

Tuberculosis (3.3%)

Poisonings (including herbal) (4.3%)

Septicaemia (2.1%)Mechanical forces (2.3%)







Drowning (4.1%)

Epilepsy (2.7%)Endocrine nutritional,blood, immune (2.4%)













Epilepsy (2.3%)
















Meningitis/encephalitis (2.5%)Nephritis/nephrosis (2.1%)





Asthma (2.0%)Endocrine nutritional,blood, immune (1.5%)







Tuberculosis (5.0%)

Cardiomyopathy (2.1%)Asthma (1.9%)






Tuberculosis (4.3%)

Prov, DistrictKZN, uThukela: DC23

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


438


438



Percentage of deaths by broad cause and leading causes, 2008–2013: uThukela (DC23)


439


439


In the under-5-year age group, communicable diseases and maternal, perinatal and nutritional conditions accounted for more deaths among males than females (81.4% versus 78.1%). The other broad causes of death were relatively the same in both genders.

Conversely, in the 5–14-year age group communicable diseases and maternal, perinatal and nutritional conditions accounted for more deaths among females than males (40.6% versus 34.1%). HIV and TB mortality was also higher among females than males, while injury-related deaths were significantly higher among males (27.4% versus 18.9% among females).

In the 15–24-year age group the majority of females died from HIV and TB (43.8% versus only 19.7% among males), while the majority of males died from injuries (55.0% versus only 12.2% among females). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for almost 30% of deaths among females, compared with only 12.7% of deaths among males.

In the 25–64-year age group, HIV and TB accounted for about 40% of deaths among both males and females. Deaths due to non-communicable diseases were higher among females than males, while mortality for communicable diseases and maternal, perinatal and nutritional conditions was about six percentage points higher among females than males. Injuries accounted for more deaths among males than females.

In the 65-years-and-older age group, non-communicable diseases accounted for the majority of deaths among both males and females; however, more females died from non-communicable diseases than males (78.8% versus 71.9%). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for about 15% of deaths among both males and females, while slightly more males than females died from injuries.


Most children under 5 years died from communicable diseases together with maternal, perinatal and nutritional conditions across the two periods; however there was a decline from 82.0% to 76.6%. In the 5–14-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions remained exactly the same, while there was a slight decrease in HIV and TB mortality and injury-related deaths. Non-communicable disease mortality increased the most in this age group. In the 15–24-year age group, HIV and TB mortality increased by almost five percentage points from 30.7% to 35%, while deaths due to communicable diseases and maternal, perinatal and nutritional conditions decreased moderately from 24.4% to 17.9%. In the 25–64-year age group, there was a three percentage point increase in deaths attributable to HIV and TB, from 39.0% to 42.0%, and a substantial decline in deaths due to communicable diseases together with maternal, perinatal and nutritional conditions from 27.1% to 18.6%. Non-communicable disease mortality and injury-related deaths increased slightly. In the 65-years-and-older age group, non-communicable disease mortality increased from 75.0% to 77.5%, while deaths attributable to communicable diseases and maternal, perinatal and nutritional conditions decreased from 16.4% to 14.1%.


Under 5 years

Most of the leading causes of death remained unchanged. Diarrhoeal diseases remained as the leading cause, followed by lower respiratory infections, preterm birth complications, birth asphyxia, HIV and AIDS, protein-energy malnutrition, TB and sepsis/other newborn infectious diseases. However, fires and hot substances replaced meningitis/encephalitis in the top 10, and other perinatal conditions moved up the ranks.

5–14 years

Diarrhoeal diseases remained the number one leading cause of death. Tuberculosis moved down the ranks and was replaced by lower respiratory infections, and accidental threats to breathing also moved down. HIV and AIDS and meningitis/encephalitis remained the same in fourth and sixth places respectively. Drowning, endocrine, nutritional, blood and immune diseases and epilepsy featured for the first time in the top 10, replacing poisonings (herbal), mechanical forces and septicaemia. Road injuries remained in eighth place.

15–24 years

HIV and AIDS moved up the ranks to become the number one leading cause of death, ahead of TB and accidental threats to breathing. Interpersonal violence and diarrhoeal diseases moved up, while lower respiratory infections moved down from fourth to seventh place. Mechanical forces and meningitis/encephalitis remained the same, and epilepsy replaced cerebrovascular disease. Road injuries moved up one place in the top 10 causes of death.

440


440


25–64 years

HIV and AIDS, TB, lower respiratory infections, diarrhoeal diseases and cerebrovascular disease remained the top five leading causes of death. Meningitis/encephalitis moved down the rankings, while diabetes mellitus and ischaemic heart disease moved up. Nephritis/nephrosis and mechanical forces replaced hypertensive heart disease and accidental threats to breathing in the top 10.

65 years and older

Cerebrovascular and heart diseases remained the leading causes of death, followed by diabetes mellitus and lower respiratory infections. Diarrhoeal diseases, asthma and TB remained in the top 10, and cardiomyopathy replaced endocrine nutritional, blood and immune diseases among the leading causes.

Indicator performance: uThukela (DC23)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



45.6 47.9 46.5 46 60.5 66.4 73.5



5.1 5.3 5.4 24 5.8 5.5 4.6


2 059.3 2 071.4 2 020.9 15 2 004.3 2 136.4


56.4 63.4 63.7 32 62.8 62.7 65.8


49.3 42.9 52.8 21 53.0 60.7



4.1 3.3 2.8 24 3.0 3.6 3.2 3.3 3.5 3.0


2.9 2.6 3.4 34 2.7 2.9 2.4 2.9


14.1 19.9 14.9 39 10.4 10.2 8.0 11.6 8.0 7.0


6.9 6.4 6.1 37 5.1 5.2


22.5 23.0 21.5 27.8 22.7


9.1 9.3 8.8 32 8.9 9.0 7.4


6.6 9.0 8.2 13 10.3 9.7 10.1 0


221.9 123.0 175.8 38 124.9 133.0 119.5 132.5 100 80.0


63.8 67.1 75.8 14 66.4 74.4 74.3 80.0 85.0


24.4 23.7 26.8 48 21.1 20.7


39.5 54.4 57.0 26 57.3 60.0 60.0 53.9 65.0 70.0


71.0 98.9 95.9 15 95.2 95.0 91.2 93.0 96.0


135.1 127.2 113.4 10 107.9 100.6


2.2 1.6 1.2 10 1.3 1.0 1.5 1.8 2.0


11.8 15.5 34 20.7 55.0 23.2 30.0 35.0


32.0 33.9 52.4 25 54.5 55.0 60.0 52.2 55.0


80.7 76.5 86.0 23 89.9 96.0 90.0 89.8 95.0 91.0


74.1 70.2 84.7 17 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


58.6 63.8 61.8 21 70.3 79.7 75.0 54.5 60.0 64.0


60.4 53.1 57.7 8 57.8 45.0 46.8 55.0


441


441

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16TB case finding TB Rifampicin resistance

confirmed client rate [Percentage]

7.4 8.6 7.8 42 8.3 6.4


35.7 33.0 25 39.0 32.1


80.5 60.5 70.5 3 58.9 62.9 38.4



14.6 15.6 15.4 19.1 22.8 13.9


0.2 0.5 1.0 1.1 1.2

Human Resources


17.8 17.0 18.7 30 29.0 26.9


29.7 34.4 34.2 26 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



751.7 711.0 645.6 23 864.4 592.5



73.1 76.9 84.9 6 82.8 76.8



4.9 3.4 1.1 2 4.1 4.5 5.8 6.0 5.5


80.1 74.1 84.5 4 81.8 85.0 77.9 82.0 83.0


90.0 93.0 94.9 15 92.5 92.8


65.7 87.7 89.2 10 74.8 78.9


29.0 15 31.1 31.8

Burden of disease


18.7 15.8 15.7 42 14.8 14.5


6.9 10.7 6.3 4 11.4 14.0


29.0 27.7 23.4 30 20.8 22.1


32.0 34.1 34.0 42 34.2 27.9


10.8 9.9 12.9 29 12.6 13.1


28.2 28.4 29.7 12 32.4 36.9





✦ Infant 1st PCR test around 6 weeks uptake rate



✦ Male condom distribution coverage (third highest in the country)


✦ TB defaulter rate (new smear positive) (second lowest in the country)


✦ TB/HIV co-infected client on ART rate

✦ Percentage of deaths ill-defined

442


442







✦ Child under 5 years pneumonia case fatality rate














✦ PHC doctor and professional nurse clinical workloads

✦ Percentage of deaths garbage codes

✦ Percentage of years of life lost (YLLs) due to communicable, maternal, perinatal, nutrition causes


Annual indicators for district: uThukela: DC23Va

lue

30

40

50

60

70

2006 2008 2010 2012 2014


4.5

5.0

5.5

2006 2008 2010 2012 2014


3

4

5

6

7

8

9

2006 2008 2010 2012 2014


3

4

5

6

2008 2010 2012 2014 2016


10

15

20

2008 2010 2012 2014 2016


5.0

5.5

6.0

6.5

2008 2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

2006 2008 2010 2012 2014


20

30

40

50

60

2008 2010 2012 2014 2016


55

60

65

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014


100

150

200

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


22

24

26

28

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


40

60

80

100

120

140

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

2010 2012 2014 2016 2018




443


443

Annual indicators for district: uThukela (DC23)

Annual indicators for district: uThukela: DC23

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


70

75

80

85

90

95

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

65

70

75

80

85

90

2006 2008 2010 2012 2014


20

30

40

50

60

70

80

2006 2008 2010 2012 2014


30

40

50

60

2006 2008 2010 2012 2014


2

4

6

2008 2010 2012 2014


8

10

12

2008 2010 2012 2014 2016


65

70

75

80

85

2008 2010 2012 2014


7

8

9

10

2008 2010 2012 2014 2016

09_TB deaths all TB

0

200

400

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

70

75

80

85

2008 2010 2012 2014


30

35

2010 2012 2014 2016 2018


20

40

60

80

2006 2008 2010 2012 2014


60

70

80

90

2008 2010 2012 2014 2016


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

29.0

29.5

30.0

30.5

31.0

31.5

2006 2008 2010 2012 2014


0.2

0.4

0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


18

20

22

24

26

28

2010 2012 2014 2016


30

31

32

33

34

2010 2012 2014 2016


14

15

16

17

18

2006 2008 2010 2012 2014

13_Garbage codes


444


444


Annual indicators for district: uThukela (DC23)


445


445

uMzinyathi District Municipality (DC24) Naomi Massyn and Noluthando Ndlovu

uMzinyathi District is situated in the north-central region of KwaZulu-Natal Province and includes four sub-districts, namely Endumeni, Nquthu, Msinga and uMvoti. The district has a total population of 518 409, with a population density of 60.4 persons per km2 and falls into socio-economic Quintile 1, among the poorest districts. uMzinyathi is one of the 11 National Health Insurance (NHI) pilot districts.

Population distribution, sub-district boundaries and health facility locations: uMzinyathi (DC24)


<5 years

5-14

15-24

25-64

65+

Total 38.7%30.4%26.3%

18.5%

12.7%

17.0%

25.8%

74.1%

25.0%

54.0%

47.3%

77.1%

39.5%

23.7%

22.6%

16.6%

9.5%

12.8%27.7%33.0%26.5%

26.0%

56.5%

12.3%

14.0%

22.9%

65.6%

23.8%

21.5%

44.2%

12.5%

76.1%

36.2%

13.2%

20.6%

18.6%

8.8%

KZN, uMzinyathi: DC24

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

25.4%

30.7%

17.3%

22.2%

72.3%

22.3%

39.8%

45.2%

78.4%

35.0%

20.9%

24.5%

16.1% 9.0%

19.6%

37.2%

13.7%

27.2%

70.0%

26.3%

36.9%

46.2%

74.1%

40.4%

15.9%

17.2%

18.6%

9.5%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910









HIV/AIDS (8.0%)

Tuberculosis (3.3%)Other perinatal conditions (1.8%)

Drowning (1.7%)



Septicaemia (1.7%)




Exposure to natural forces (3.2%)

Drowning (7.1%)


Asthma (3.5%)Meningitis/encephalitis (5.2%)



HIV/AIDS (7.2%)


Exposure to natural forces (1.8%)Other neurological conditions (2.1%)

Drowning (6.8%)

Epilepsy (4.3%)Meningitis/encephalitis (5.5%)


Diarrhoeal diseases (13.4%)Lower respiratory infections (16.1%)HIV/AIDS (17.2%)


Self-inflicted injuries (3.4%)
















Asthma (1.5%)

Mechanical forces (2.9%)Meningitis/encephalitis (2.6%)





Mechanical forces (2.4%)Road injuries (2.4%)


Hypertensive heart disease (2.2%)





Asthma (2.6%)Septicaemia (2.3%)Nephritis/nephrosis (1.9%)






Septicaemia (2.2%)







Tuberculosis (6.8%)

Prov, DistrictKZN, uMzinyathi: DC24

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


446


446



Percentage of deaths by broad cause and leading causes, 2008–2013: uMzinyathi (DC24)


447


447


In the under-5-year age group, communicable diseases and maternal, perinatal and nutritional conditions accounted for approximately the same proportion of deaths among females and males (77.1% and 76.1% respectively). The other broad causes of death were relatively the same in both genders.

In the 5–14-year age group, deaths due to communicable diseases and maternal, perinatal and nutritional conditions were higher among females than males. There were more injury-related deaths among males than females (26.0% versus 18.5%), while more females died from non-communicable diseases than males. HIV and TB mortality was slightly higher among females than males (25.0% versus 23.8%).

In the 15–24-year age group, HIV and TB accounted for the majority of deaths among females (54.0% compared with 21.5% among males), while injury accounted for the majority of deaths among males (56.5% compared with only 12.7% among females). Communicable diseases and maternal, perinatal and nutritional conditions accounted for significantly more deaths among females than males (23.7% versus only 13.2%).

In the 25–64-year age group, HIV and TB accounted for 47.3% of deaths among females compared with 44.2% among males. Deaths due to communicable diseases and maternal, perinatal and nutritional conditions were also higher among females than males (22.6% versus 20.6%), and similarly with non-communicable disease mortality (25.8% among females versus 22.9% among males). However, there were more injury-related deaths among males (12.3%).

In the 65-years-and-older age group, approximately 74% of females died from non-communicable diseases compared with 65.6% of males. However, more males than females died from communicable diseases and maternal, perinatal and nutritional conditions. HIV and TB mortality and injury-related deaths were also higher among males than females.


In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions were the leading broad causes of death, but they declined from 78.4% to 74.1% between 2008–2010 and 2011–2013. The other broad causes of death all increased slightly. In the 5–14-year age group, deaths due to communicable diseases and maternal, perinatal and nutritional and HIV and TB mortality increased. Non-communicable disease mortality and injury-related deaths declined. In the 15–24-year age group, HIV and TB mortality declined. Injury-related deaths increased from 30.7% to 37.2%, while deaths due to communicable diseases and maternal, perinatal and nutritional conditions decreased from 20.9% to 15.9%. In the 25–64-year age group, HIV and TB mortality increased, while deaths due to communicable diseases and maternal, perinatal and nutritional conditions decreased. Both non-communicable disease mortality and injury-related deaths increased. In the 65-years-and-older age group, non-communicable disease mortality decreased, while deaths due to communicable diseases and maternal, perinatal and nutritional conditions increased slightly.


Under 5 years

Diarrhoeal diseases, preterm birth complications, lower respiratory infections and birth asphyxia remained the leading cause of death over the two periods. HIV and AIDS moved down the ranks, and protein-energy malnutrition moved into the top five. Tuberculosis and other perinatal conditions remained in the top 10 causes, while septicaemia and drowning replaced meningitis/encephalitis and sepsis/other newborn infectious diseases.

5–14 years

Most notably, HIV and AIDS moved from fifth to first place in the ranking, replacing TB, which dropped to fourth position. Lower respiratory infections and diarrhoeal diseases still ranked high in the top 10 leading causes of death, as did road injuries and drowning. Meningitis/encephalitis maintained the same position, while exposure to natural forces dropped down. Epilepsy and other neurological conditions replaced asthma and deaths due to fires and hot substances among the leading causes of death.

15–24 years

HIV and AIDS and TB remained the leading causes of death. Most notably, road injuries moved from eighth to third place over the two periods. Lower respiratory infections and accidental threats to breathing moved down the ranks, while mechanical forces and diarrhoeal diseases moved up. Interpersonal violence remained the fifth leading cause of death, while self-inflicted injuries remained in ninth position and meningitis/encephalitis remained in 10th place.

25–64 years

HIV and AIDS, TB, lower respiratory infections, diarrhoeal diseases and cerebrovascular disease remained the five leading causes of death. Diabetes mellitus moved up the most in the rankings, from ninth to sixth position. Ischaemic heart disease

448


448


and mechanical forces remained in the top 10 causes, while road injuries and hypertensive disorder replaced meningitis/encephalitis and asthma.

65 years and older

Cerebrovascular disease remained the leading cause of death in this age group over the two periods. Hypertensive heart disease moved down the rankings and was replaced by ischaemic heart disease in second place, followed by lower respiratory infections in third place. Tuberculosis moved down two positions, while diabetes mellitus moved up one to become the fifth leading cause of death. Chronic obstructive pulmonary disease replaced asthma in the top 10, while nephritis/nephrosis moved from 10th to ninth position.

Indicator performance: uMzinyathi (DC24)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



59.2 47.8 42.7 50 60.5 66.4 73.5



6.0 6.1 6.1 41 5.8 5.5 4.6


2 086.6 2 169.3 2 210.7 10 2 004.3 2 136.4


57.7 63.6 53.6 46 62.8 62.7 65.8


73.9 70.4 61.7 29 53.0 60.7



4.3 5.6 3.8 35 3.0 3.6 3.2 3.3 3.5 3.0


4.1 6.1 2.4 22 2.7 2.9 2.4 2.9


30.5 12.7 12.4 31 10.4 10.2 8.0 11.6 8.0 7.0


6.7 6.6 6.2 38 5.1 5.2


23.1 20.6 23.2 27.8 22.7


9.7 10.0 9.8 39 8.9 9.0 7.4


7.5 11.4 9.4 21 10.3 9.7 10.1 0


34.7 71.6 79.6 15 124.9 133.0 119.5 132.5 100 80.0


36.9 66.9 72.1 18 66.4 74.4 74.3 80.0 85.0


18.0 18.4 17.6 14 21.1 20.7


49.8 59.6 60.9 13 57.3 60.0 60.0 53.9 65.0 70.0


83.5 93.5 98.3 4 95.2 95.0 91.2 93.0 96.0


131.5 132.8 124.3 4 107.9 100.6


1.5 1.3 1.2 9 1.3 1.0 1.5 1.8 2.0


7.2 14.2 37 20.7 55.0 23.2 30.0 35.0


42.9 51.4 60.3 9 54.5 55.0 60.0 52.2 55.0


79.9 77.2 81.5 30 89.9 96.0 90.0 89.8 95.0 91.0


79.2 80.1 85.0 16 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


113.1 102.2 71.6 10 70.3 79.7 75.0 54.5 60.0 64.0


43.3 59.9 76.7 2 57.8 45.0 46.8 55.0


10.7 10.2 8.4 46 8.3 6.4


449


449

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target


(including ANC)60.6 62.5 1 39.0 32.1


51.1 85.3 113.4 2 58.9 62.9 38.4



23.6 20.0 20.0 19.1 22.8 13.9


1.5 1.9 1.0 1.1 1.2

Human Resources


14.7 15.9 13.6 46 29.0 26.9


26.3 26.0 27.8 11 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



828.3 682.6 634.1 21 864.4 592.5



80.7 79.6 88.1 4 82.8 76.8

TB death rate (all TB) [Percentage]

11.0 11.1 11.5 41 6.4 7.4 6.0 5.0


1.1 1.9 1.4 4 4.1 4.5 5.8 6.0 5.5


77.1 77.0 82.9 9 81.8 85.0 77.9 82.0 83.0


92.4 96.6 94.5 17 92.5 92.8


71.0 89.1 87.5 12 74.8 78.9


31.4 19 31.1 31.8

Burden of disease


12.9 12.2 13.2 20 14.8 14.5


14.2 14.6 13.3 33 11.4 14.0


27.5 26.8 27.4 42 20.8 22.1


37.2 37.1 32.2 37 34.2 27.9


10.8 10.6 12.9 28 12.6 13.1


24.5 25.5 27.5 5 32.4 36.9




The district performed very well with regard to some indicators, which ranked among the 10 best in the country in the last reporting period. These 13 indicators were:

✦ Expenditure per patient day equivalent for district hospitals






✦ Couple year protection rate (second best in the country)

✦ HIV testing coverage (including ANC) (best in the country)

✦ Male condom distribution coverage (second best in the country)


450


450


✦ TB defaulter rate (new smear positive)


✦ Percentage of years of life lost (YLLs) due to non-communicable diseases


✦ PHC supervisor visit rate (fixed clinic/CHC/CDC) (third lowest in the country)








✦ OPD new client not referred rate (district hospitals)

✦ Child under 5 years diarrhoea case fatality rate

✦ Child under 5 years severe acute malnutrition case fatality rates













✦ Percentage of YLLs due to communicable, maternal, perinatal and nutritional causes

Annual indicators for district: uMzinyathi: DC24Va

lue

30

40

50

60

70

2006 2008 2010 2012 2014


4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014


3

4

5

6

7

8

9

2006 2008 2010 2012 2014


3

4

5

6

7

2008 2010 2012 2014 2016


10

15

20

25

30

35

2008 2010 2012 2014 2016


5.0

5.5

6.0

6.5

7.0

2008 2010 2012 2014 2016

03_Crude death rate

1000

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014


50

55

60

65

70

75

2008 2010 2012 2014 2016


55

60

65

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


7.5

8.0

8.5

9.0

9.5

10.0

2006 2008 2010 2012 2014

04_Deliv in fac <18

2

4

6

8

10

2006 2008 2010 2012 2014


50

100

150

200

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


15

20

25

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014


100

150

200

2008 2010 2012 2014 2016


40

60

80

100

120

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

2010 2012 2014 2016 2018




451


451

Annual indicators for district: uMzinyathi (DC24)

Annual indicators for district: uMzinyathi: DC24

Valu

e

20

30

40

50

60

2006 2008 2010 2012 2014


75

80

85

90

95

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2006 2008 2010 2012 2014


20

40

60

80

100

120

2006 2008 2010 2012 2014


20

30

40

50

60

70

2006 2008 2010 2012 2014


2

4

6

2008 2010 2012 2014


7

8

9

10

2008 2010 2012 2014 2016


50

60

70

80

2006 2008 2010 2012 2014


7

8

9

10

11

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014


30

40

50

60

2010 2012 2014 2016 2018


20

40

60

80

100

2006 2008 2010 2012 2014


20

40

60

80

100

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

30

32

34

36

38

2006 2008 2010 2012 2014


1.0

1.5

2010 2012 2014 2016 2018


15

20

25

2010 2012 2014 2016


26

28

30

32

34

2010 2012 2014 2016


10

11

12

13

14

15

2006 2008 2010 2012 2014

13_Garbage codes


452


452


Annual indicators for district: uMzinyathi (DC24)


453


453

Amajuba District Municipality (DC25) Naomi Massyn and Noluthando Ndlovu

Amajuba District is located in the north-western corner of KwaZulu-Natal Province and comprises three sub-districts, namely Dannhauser, Emadlangeni and Newcastle. The district has a population of 514 977, with a population density of 74.5 persons per km2 and falls into socio-economic Quintile 3.

Population distribution, sub-district boundaries and health facility locations: Amajuba (DC25


<5 years

5-14

15-24

25-64

65+

Total 41.0%24.0%31.4%

20.5%

11.3%

21.1%

15.1%

30.5%

79.6%

22.5%

38.7%

34.5%

76.3%

36.0%

37.1%

31.9%

14.8%

9.1%

33.1%25.9%30.1%

24.2%

51.5%

19.5%

13.9%

27.6%

70.7%

19.8%

17.3%

34.5%

76.1%

36.6%

17.4%

27.7%

19.3%

KZN, Amajuba: DC25

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

25.7%

24.2%

18.7%

13.7%

27.1%

76.0%

23.3%

29.5%

32.8%

75.9%

32.3%

32.6%

34.1%

16.7%

18.4%

32.5%

11.3%

22.1%

15.9%

31.4%

76.0%

18.2%

29.4%

36.8%

76.5%

41.3%

22.3%

23.7%

16.5%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910




Other respiratory (3.7%)



HIV/AIDS (5.2%)

Tuberculosis (3.3%)

Congenital heart anomalies (2.3%)



Preterm birth complications (16.4%)Diarrhoeal diseases (20.8%)Lower respiratory infections (22.7%)

HIV/AIDS (2.5%)

Tuberculosis (3.1%)

Drowning (9.5%)







HIV/AIDS (8.9%)


Drowning (6.0%)

Epilepsy (4.0%)















Drowning (2.8%)

Interpersonal violence (8.6%)Accidental threats to breathing (8.3%)







Other respiratory (3.5%)Meningitis/encephalitis (2.9%)Diabetes mellitus (2.4%)






Nephritis/nephrosis (2.7%)Diabetes mellitus (2.7%)






Other respiratory (2.1%)Cardiomyopathy (1.9%)




Ischaemic heart disease (6.7%)Diarrhoeal diseases (4.3%)



Tuberculosis (4.3%)

Cardiomyopathy (2.0%)COPD (2.3%)








Tuberculosis (4.2%)

Prov, DistrictKZN, Amajuba: DC25

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


454


454



Percentage of deaths by broad cause and leading causes, 2008–2013: Amajuba (DC25)


455


455


In the under-5-year age group, communicable diseases and maternal, perinatal and nutritional conditions accounted for approximately 76% of deaths. Non-communicable disease mortality and injury-related deaths were slightly higher among females than males, while HIV and TB mortality were slightly the same in both genders.

In the 5–14-age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for about 36% of deaths among both males and females. Slightly more females died due to HIV and TB (22.5% versus 19.8% among males), while there were more injury-related deaths among males than females. Non-communicable disease mortality was higher among females than males.

Strikingly, in the 15–24-year age group, injuries accounted for 51.5% of deaths among males compared with only 9.1% of deaths among females. Deaths among females were distributed almost evenly between communicable diseases together with maternal, perinatal and nutritional conditions (37.1%), and HIV and TB (38.7%), while among males both these conditions accounted for roughly 17% of deaths. Non-communicable disease mortality was slightly higher among females than males.

In the 25–64-year age group, the majority of deaths were due to HIV and TB (34.5% for both genders). More females died from communicable diseases together with maternal, perinatal and nutritional conditions than males, while there were more injury-related deaths among males than females. Non-communicable diseases accounted for 30.5% of deaths among females compared with 27.6% among males.

In the 65-years-and-older age group, non-communicable diseases accounted for over 70% of deaths, followed by communicable diseases together with maternal, perinatal and nutritional conditions at 19.3% for males and 14.8% for females. There were slightly more injury-related deaths among males than females.


In children under 5 years, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions and non-communicable disease mortality increased slightly between 2008–2010 and 2011–2013, while HIV and TB mortality decreased slightly. In the 5–14-year age group, there was a considerable increase in deaths due to communicable diseases together with maternal, perinatal and nutritional conditions from 32.3% to 41.3%. Injury-related deaths dropped from 25.7% to 18.4%, while HIV and TB mortality also declined from 23.3% to 18.2%. Deaths due to non-communicable diseases increased from 18.7% to 22.1%. In the 15–24-year age group, HIV and TB mortality remained constant at around 29%. Deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined by almost ten percentage points, while injury-related deaths increased from 24.2% to 32.5%. Non-communicable disease mortality increased slightly over the two periods, and communicable diseases together with maternal, perinatal and nutritional conditions decreased slightly. In the 25–64-year age group, HIV and TB mortality and non-communicable diseases increased. Only deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased in this age group. In the 65-years-and-older age group all the broad causes remained relatively constant.


Under 5 years

Diarrhoeal diseases, lower respiratory infections and preterm birth complications accounted for over 50% of the leading causes of death, followed by birth asphyxia. Protein-energy malnutrition replaced HIV and AIDS as the fifth leading cause of death, while HIV and AIDS shifted down to ninth position. Tuberculosis and sepsis/other newborn infectious diseases were still part of the top 10 causes. Perinatal conditions and congenital heart anomalies replaced other respiratory conditions and deaths due to fires and hot substances in the ranking.

5–14 years

Lower respiratory infections and diarrhoeal diseases moved ahead of TB as the leading causes of death, while drowning dropped to sixth position. HIV and AIDS moved up the ranking from fifth to fourth place, and road injuries moved into fifth place. Meningitis/encephalitis moved from 10th to seventh position, while asthma replaced cerebrovascular disease and epilepsy replaced fires and hot substances in the ranking. Accidental threats to breathing maintained the same position.

15–24 years

While TB, lower respiratory infections and HIV and AIDS still constituted the top three leading causes of death, they no longer accounted for over 50% of deaths in this age group. Most notable was the increase in road injuries from 3.0% to 9.6%, moving this cause from ninth place to fourth. Other leading causes of death included interpersonal violence, accidental threats to breathing, diarrhoeal diseases and meningitis/encephalitis. Drowning and nephritis/nephrosis replaced mechanical forces and other respiratory conditions in the ranking.

456


456


25–64 years

The leading causes of death remained TB, HIV and AIDS, lower respiratory infections, diarrhoeal diseases and cerebrovascular disease. Road injuries appeared in the top 10 for the first time, in sixth position, along with nephritis/nephrosis, which moved up to eighth position, replacing other respiratory conditions and meningitis/encephalitis. Hypertensive heart disease, diabetes mellitus and ischaemic heart disease also ranked among the top 10 causes.

65 years and older

Cerebrovascular disease, hypertensive heart disease, lower respiratory infections, diabetes mellitus and ischaemic heart disease remained among the leading causes of death, with nephritis/nephrosis moving up in the ranking and diarrhoeal diseases dropping down. Chronic obstructive pulmonary disease replaced other respiratory conditions, while cardiomyopathy remained in 10th position.

Indicator performance: Amajuba (DC25

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



50.3 53.0 55.4 43 60.5 66.4 73.5



3.0 3.7 4.8 5 5.8 5.5 4.6


1 583.7 1 893.7 1 949.5 23 2 004.3 2 136.4


53.5 44.3 62.6 36 62.8 62.7 65.8


46.3 40.0 43.8 14 53.0 60.7



1.0 0.9 3.0 26 3.0 3.6 3.2 3.3 3.5 3.0


1.9 0.8 0.9 8 2.7 2.9 2.4 2.9


9.7 10.3 11.0 26 10.4 10.2 8.0 11.6 8.0 7.0


5.9 6.3 6.0 34 5.1 5.2


23.3 22.9 28.9 27.8 22.7


9.9 9.8 8.9 34 8.9 9.0 7.4


2.9 9.2 7.8 11 10.3 9.7 10.1 0


124.6 109.8 143.2 31 124.9 133.0 119.5 132.5 100 80.0


79.4 79.1 50.1 46 66.4 74.4 74.3 80.0 85.0


25.9 27.9 14.6 5 21.1 20.7


41.3 59.5 52.8 39 57.3 60.0 60.0 53.9 65.0 70.0


81.8 92.4 94.2 20 95.2 95.0 91.2 93.0 96.0


108.3 99.8 95.9 31 107.9 100.6


1.5 1.4 1.0 5 1.3 1.0 1.5 1.8 2.0


14.6 25.2 20 20.7 55.0 23.2 30.0 35.0


31.4 34.7 50.2 29 54.5 55.0 60.0 52.2 55.0


72.2 70.3 79.2 37 89.9 96.0 90.0 89.8 95.0 91.0


64.0 59.2 98.8 4 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


60.8 53.0 62.8 20 70.3 79.7 75.0 54.5 60.0 64.0


62.6 34.9 51.9 14 57.8 45.0 46.8 55.0


457


457

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



0.0 9.4 8.5 48 8.3 6.4


46.2 48.4 4 39.0 32.1


76.5 22.0 52.9 8 58.9 62.9 38.4



20.2 13.7 14.8 19.1 22.8 13.9


0.1 1.0 1.1 1.2

Human Resources


13.0 10.8 12.0 50 29.0 26.9


25.6 29.5 29.8 2 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



682.0 510.4 540.8 17 864.4 592.5



69.4 71.0 76.1 25 82.8 76.8

TB death rate (all TB) [Percentage] 10.9 11.4 11.2 39 6.4 7.4 6.0 5.0TB defaulter rate (new smear positive) [Percentage]

5.5 4.3 5.1 24 4.1 4.5 5.8 6.0 5.5


74.6 76.2 79.1 23 81.8 85.0 77.9 82.0 83.0


95.1 96.9 97.7 2 92.5 92.8


58.6 62.8 70.2 39 74.8 78.9


26.8 11 31.1 31.8

Burden of disease


19.8 17.3 13.9 29 14.8 14.5


6.7 7.5 5.4 3 11.4 14.0


33.3 31.0 24.3 34 20.8 22.1


28.5 28.1 33.5 41 34.2 27.9


8.1 10.5 10.4 6 12.6 13.1


30.1 30.3 31.9 16 32.4 36.9




The district performed very well with regard to 11 indicators, which ranked among the 10 best in the country in the last reporting period. These indicators were:






✦ HIV testing coverage (including ANC)



458


458


✦ Percentage of TB cases with known HIV status (second highest in the country)

✦ Percentage of deaths ill-defined (third lowest in the country)

✦ Percentage of years of life lost (YLLs) due to injuries




























✦ Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes



Annual indicators for district: Amajuba: DC25Va

lue

40

60

80

2006 2008 2010 2012 2014


3.0

3.5

4.0

4.5

5.0

5.5

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


1

2

3

4

5

6

2008 2010 2012 2014 2016


10

12

14

16

18

20

2008 2010 2012 2014 2016


5.0

5.5

6.0

2008 2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014


40

45

50

55

60

65

2008 2010 2012 2014 2016


40

45

50

55

60

65

2006 2008 2010 2012 2014


0

5

10

15

20

25

30

2006 2008 2010 2012 2014


7.5

8.0

8.5

9.0

9.5

10.0

2006 2008 2010 2012 2014

04_Deliv in fac <18

0

2

4

6

8

10

2006 2008 2010 2012 2014


100

150

200

2006 2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016


20

30

40

50

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


40

60

80

100

120

140

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

25

2010 2012 2014 2016 2018




459


459

Annual indicators for district: Amajuba (DC25)

Annual indicators for district: Amajuba: DC25

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

100

2006 2008 2010 2012 2014


20

30

40

50

60

70

80

2006 2008 2010 2012 2014


20

30

40

50

60

2006 2008 2010 2012 2014


3

4

5

6

7

2008 2010 2012 2014


0

2

4

6

8

2008 2010 2012 2014 2016


50

60

70

80

2006 2008 2010 2012 2014


7

8

9

10

11

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014


30

35

40

45

2010 2012 2014 2016 2018


20

40

60

2006 2008 2010 2012 2014


40

50

60

70

80

90

100

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

28

30

32

34

36

2006 2008 2010 2012 2014


0.2

0.4

0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


10

15

20

25

2010 2012 2014 2016


26

28

30

32

34

2010 2012 2014 2016


14

16

18

20

2006 2008 2010 2012 2014

13_Garbage codes


460


460


Annual indicators for district: Amajuba (DC25)


461


461

Zululand District Municipality (DC26) Naomi Massyn and Noluthando Ndlovu

Zululand District is situated in the north-eastern part of KwaZulu-Natal Province. It is primarily a rural district and comprises five sub-districts, namely Nongoma, Ulundi, eDumbe, uPhongolo and Abaqulusi. The district has a population of 834 251, with a population density of 56.4 persons per km2, and falls into socio-economic Quintile 1, among the poorest districts.

Population distribution, sub-district boundaries and health facility locations: Zululand (DC26)


<5 years

5-14

15-24

25-64

65+

Total 34.0%33.4%28.2%

14.9%17.8%

11.6%

24.6%

71.6%

13.0%

33.3%

53.2%

47.6%

72.3%

34.0%

25.4%

24.5%

17.6%

9.9%

11.3%25.7%36.9%26.1%

23.4%

48.7%

17.6%

11.7%

20.9%

62.7%

11.5%

26.8%

25.6%

48.5%

16.6%

72.7%

32.2%

14.0%

20.4%

17.1%

KZN, Zululand: DC26

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

19.6%

21.6%

15.5%

11.3%

21.0%

69.1%

12.5%

31.6%

42.1%

46.3%

72.9%

33.3%

25.0%

26.4%

17.5%

19.3%

30.5%

19.6%

11.9%

24.8%

67.4%

11.8%

28.2%

42.0%

50.4%

12.4%

72.0%

32.8%

15.6%

16.6%

17.3%

8.2%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Other perinatal conditions (2.0%)Poisonings (including herbal) (3.8%)Protein-energy malnutrition (4.8%)





HIV/AIDS (5.3%)

Tuberculosis (7.3%)

Other perinatal conditions (2.4%)Poisonings (including herbal) (4.0%)





HIV/AIDS (7.3%)

Tuberculosis (4.7%)


Drowning (6.4%)

Epilepsy (1.7%)







Drowning (5.5%)Epilepsy (5.2%)






Endocrine nutritional,blood, immune (2.2%)



Road injuries (5.2%)Diarrhoeal diseases (7.7%)Lower respiratory infections (9.2%)


Epilepsy (2.4%)


























Endocrine nutritional,blood, immune (1.9%)Nephritis/nephrosis (2.5%)






HIV/AIDS (1.8%)

Tuberculosis (8.9%)

Cardiomyopathy (2.1%)Endocrine nutritional,blood, immune (2.0%)







Prov, DistrictKZN, Zululand: DC26

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


462


462



Percentage of deaths by broad cause and leading causes, 2008–2013: Zululand (DC26)


463


463


In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for more than 72% of deaths. HIV and TB mortality was slightly higher among females than males, while non-communicable disease mortality was higher among males.

In the 5–14-year age group there were considerable differences between males and females for HIV and TB mortality and injury-related deaths. HIV and TB accounted for 33.3% of deaths among females versus 26.8% among males, while injuries accounted for 23.4% of deaths among males versus 14.9% among females.

In the 15–24-year age group, HIV and TB accounted for the highest proportion of deaths among females at 53.2%, while injury-related deaths were highest among males at 48.7%. Communicable diseases together with maternal, perinatal and nutritional conditions accounted for 25.4% of deaths among females compared with only 14.0% of deaths among males.

In the 25–64-year age group, HIV and TB accounted for a similar proportion of deaths in males and females at around 48%. Deaths due to communicable diseases together with maternal, perinatal and nutritional conditions were higher among females than males. More females also died from non-communicable diseases, while more males died from injuries than females.

In the 65-years-and-older age group, non-communicable disease mortality was almost 10 percentage points higher among females (71.6%) than males (62.7%). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for about 17% of deaths for both genders, while more males died from HIV and TB and injuries in this age group.


In children under 5 years, deaths due to communicable diseases and maternal, perinatal and nutritional conditions continued to be the leading broad cause of death between 2008–2010 and 2011– 2013. HIV and TB deaths decreased, while non-communicable disease mortality increased slightly and injury-related deaths remained the same. In the 5–14-year age group, HIV and TB mortality and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined. Non-communicable disease mortality increased, while injury-related deaths remained the same. In the 15–24-year age group, deaths due to HIV and TB essentially remained the same over the two periods at 42%. Deaths due to communicable diseases together with maternal, perinatal and nutritional conditions increased considerably by almost 10 percentage points (25.0% to 15.6%), as did injury-related deaths. In the 25–64-year age group, HIV and TB deaths increased, while deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined by 10 percentage points (26.4% to 16.6%). In the 65-years-and-older age group, non-communicable disease mortality decreased slightly, while HIV and TB mortality increased.


Under 5 years

Diarrhoeal diseases, lower respiratory infections and preterm birth complications accounted for over 50% of deaths, followed by birth asphyxia and HIV and AIDS. Tuberculosis moved down the ranks, while protein-energy malnutrition, poisonings and other perinatal conditions remained unchanged. Meningitis/encephalitis replaced other respiratory conditions in the top 10 leading causes of death.

5–14 years

Tuberculosis, diarrhoeal diseases, HIV and AIDS and lower respiratory infections remained the leading causes of death, followed by road injuries, which moved up the ranks along with drowning and epilepsy. Meningitis/encephalitis and accidental threats to breathing moved down the ranks, while asthma replaced exposure to natural forces.

15–24 years

Tuberculosis and HIV and AIDS were the top leading causes of death, followed by accidental threats to breathing, which moved from sixth to third position, and interpersonal violence, which moved from eighth to fourth position. Road injuries and mechanical forces remained constant, while lower respiratory infections moved down. Epilepsy replaced endocrine nutritional, blood and immune diseases in the leading causes of death.

25–64 years

Over 60% of all deaths in this age group were due to TB, HIV and AIDS, lower respiratory infections and diarrhoeal diseases. The other deaths were due to meningitis/encephalitis, diabetes mellitus and hypertensive heart disease. Road injuries appeared in the top 10 causes, in eighth position, while nephritis/nephrosis replaced endocrine nutritional, blood and immune diseases.

464


464


65 years and older

Cerebrovascular disease and hypertensive heart disease were the top two leading causes of death in this age category, followed by TB (which moved up the ranks) and lower respiratory infections. Diabetes mellitus moved up, while ischaemic heart disease shifted down three positions. Diarrhoeal diseases and nephritis/nephrosis remained the same, while cardiomyopathy replaced HIV and AIDS in the top 10 leading causes of death.

Indicator performance: Zululand (DC26)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



71.3 84.2 77.5 27 60.5 66.4 73.5



6.1 6.2 5.9 37 5.8 5.5 4.6


1 967.5 1 962.3 2 031.1 14 2 004.3 2 136.4


66.0 67.5 67.0 25 62.8 62.7 65.8


57.0 61.7 35.6 11 53.0 60.7



4.8 5.1 4.7 40 3.0 3.6 3.2 3.3 3.5 3.0


5.7 6.5 4.5 41 2.7 2.9 2.4 2.9


19.3 26.9 20.3 47 10.4 10.2 8.0 11.6 8.0 7.0


6.4 6.1 5.7 30 5.1 5.2


24.2 25.4 24.8 27.8 22.7


10.8 10.2 10.1 44 8.9 9.0 7.4


7.9 7.6 10.2 25 10.3 9.7 10.1 0


111.6 123.3 60.3 7 124.9 133.0 119.5 132.5 100 80.0


42.5 51.2 58.3 38 66.4 74.4 74.3 80.0 85.0


21.4 21.9 15.8 8 21.1 20.7


48.3 58.1 60.7 15 57.3 60.0 60.0 53.9 65.0 70.0


84.9 85.6 98.1 6 95.2 95.0 91.2 93.0 96.0


117.8 135.6 126.9 2 107.9 100.6


2.5 2.0 2.4 47 1.3 1.0 1.5 1.8 2.0


23.0 22.7 24 20.7 55.0 23.2 30.0 35.0


32.4 48.3 54.3 21 54.5 55.0 60.0 52.2 55.0


78.1 80.6 87.9 18 89.9 96.0 90.0 89.8 95.0 91.0


74.2 70.3 88.9 10 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


73.9 78.0 60.9 22 70.3 79.7 75.0 54.5 60.0 64.0


30.9 37.0 43.2 31 57.8 45.0 46.8 55.0


17.9 15.6 12.0 51 8.3 6.4


40.4 37.9 15 39.0 32.1


26.6 33.6 41.3 18 58.9 62.9 38.4


465


465

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16Non-communicable diseases


17.7 12.8 13.9 19.1 22.8 13.9


1.1 1.3 1.0 1.1 1.2

Human Resources


22.9 17.8 17.1 36 29.0 26.9


29.0 30.8 31.8 14 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



1 044.1

936.8 801.1 36 864.4 592.5



77.9 81.1 83.3 11 82.8 76.8



5.6 3.8 3.4 8 4.1 4.5 5.8 6.0 5.5


75.4 77.5 80.5 16 81.8 85.0 77.9 82.0 83.0


94.4 97.2 97.0 5 92.5 92.8


70.6 89.2 82.6 25 74.8 78.9


26.2 10 31.1 31.8

Burden of disease


10.9 12.5 12.9 17 14.8 14.5


14.1 15.4 12.7 31 11.4 14.0


27.9 27.5 23.9 32 20.8 22.1


40.8 37.1 41.5 51 34.2 27.9


9.6 10.9 10.6 11 12.6 13.1


21.7 24.5 24.1 1 32.4 36.9




The district performed very well with regard to nine indicators, which ranked among the 10 best in the country in the last reporting period. These indicators were:




✦ Infant 1st PCR test around 6 weeks uptake rate (second best in the country)

✦ Measles 2nd dose coverage (although below the provincial target)



✦ Hypertension prevalence rate

✦ Percentage of years of life lost (YLLs) due to non-communicable diseases (lowest in the country)

466


466






✦ TB Rifampicin resistance confirmed client rate (second highest in the country)

✦ Percentage of YLLs due to HIV and TB (second highest in the country)






















✦ Percentage of YLLs due to communicable, maternal, perinatal and nutritional causes


Annual indicators for district: Zululand: DC26Va

lue

30

40

50

60

70

80

2006 2008 2010 2012 2014


4.5

5.0

5.5

6.0

6.5

7.0

2006 2008 2010 2012 2014


5

10

15

2006 2008 2010 2012 2014


4

6

8

2008 2010 2012 2014 2016


10

15

20

25

2008 2010 2012 2014 2016


5.0

5.5

6.0

6.5

7.0

2008 2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014


35

40

45

50

55

60

65

2008 2010 2012 2014 2016


55

60

65

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

2

4

6

8

10

12

14

2006 2008 2010 2012 2014


100

200

300

400

500

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


20

25

30

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


50

100

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

2010 2012 2014 2016 2018




467


467

Annual indicators for district: Zululand (DC26)

Annual indicators for district: Zululand: DC26

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

2006 2008 2010 2012 2014


20

30

40

50

60

70

80

2006 2008 2010 2012 2014


20

30

40

50

2006 2008 2010 2012 2014


4

5

6

7

2008 2010 2012 2014


10

15

20

25

2008 2010 2012 2014 2016


50

60

70

80

2006 2008 2010 2012 2014


7

8

9

10

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014


30

35

40

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

50

60

70

80

90

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

26

27

28

29

30

31

32

2006 2008 2010 2012 2014


0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


18

20

22

24

26

28

2010 2012 2014 2016


29

30

31

32

33

34

2010 2012 2014 2016


11

12

13

14

15

2006 2008 2010 2012 2014

13_Garbage codes


468


468


Annual indicators for district: Zululand (DC26)


469


469

uMkhanyakude District Municipality (DC27) Naomi Massyn and Noluthando Ndlovu

uMkhanyakude District is located in the far north of KwaZulu-Natal Province and borders with Swaziland and Mozambique. The district comprises five sub-districts, namely Hlabisa, Jozini, Mtubatuba, The Big 5 False Bay and uMhlabuyalingana. The district has a population of 643 760, with a population density of 46.5 persons per km2 and falls in socio-economic Quintile 1, among the poorest districts.

Population distribution, sub-district boundaries and health facility locations: uMkhanyakude (DC27)


<5 years

5-14

15-24

25-64

65+

Total 36.5%41.3%17.7%

14.9%17.6%

11.7%

22.4%

74.2%

19.6%

36.1%

63.0%

62.1%

65.1%

31.4%

15.2%

12.1%

13.6%

11.6%27.8%43.7%16.8%

22.0%

48.1%

18.2%

13.9%

19.7%

66.8%

18.6%

33.1%

28.2%

58.6%

17.3%

64.7%

26.7%

11.9%

9.8%

KZN, uMkhanyakude: DC27

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

18.5%

26.3%

13.9%

11.7%

18.6%

69.6%

20.1%

36.4%

49.0%

62.2%

13.1%

66.0%

31.3%

12.9%

12.6%

13.6%

18.7%

27.8%

22.6%

14.0%

24.4%

73.2%

17.5%

32.4%

45.5%

57.4%

11.0%

63.3%

26.3%

12.7%

12.2%

9.5%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Poisonings (including herbal) (2.6%)Sepsis/other newborn infectious (2.4%)Adverse effects medical/surgical (1.7%)

Protein-energy malnutrition (6.4%)Birth asphyxia (6.7%)Preterm birth complications (7.4%)



Tuberculosis (4.4%)Other perinatal conditions (4.3%)Poisonings (including herbal) (3.4%)



Septicaemia (2.0%)



Tuberculosis (6.3%)

Leukaemia (1.7%)

Drowning (8.3%)


Asthma (2.5%)





Other neurological conditions (3.1%)

Drowning (8.7%)






Drowning (2.1%)

Interpersonal violence (4.7%)Mechanical forces (5.5%)Accidental threats to breathing (6.4%)





Drowning (2.1%)










Meningitis/encephalitis (1.7%)Diabetes mellitus (1.6%)



Cerebrovascular disease (3.0%)Lower respiratory infections (4.7%)


Mechanical forces (1.8%)Accidental threats to breathing (1.7%)






Fires, hot substances (1.9%)Nephritis/nephrosis (2.8%)






HIV/AIDS (3.9%)

Tuberculosis (9.3%)

Prostate (2.4%)Nephritis/nephrosis (3.3%)







HIV/AIDS (3.9%)

Tuberculosis (7.2%)

Prov, DistrictKZN, uMkhanyakude: DC27

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


470


470



Percentage of deaths by broad cause and leading causes, 2008–2013: uMkhanyakude (DC27)


471


471


In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for about 65% of deaths. HIV and TB mortality was higher among females than males, while more males than females died from non-communicable diseases. There were slightly more injury-related deaths among males than females.

In the 5–14-year age group, HIV and TB mortality was higher among females than males, and more females than males died from communicable diseases together with maternal, perinatal and nutritional conditions (31.4% versus 26.7%). Non-communicable disease mortality and injury-related deaths were higher among males.

In the 15–24-year age group, HIV and TB accounted for the majority of deaths among females (63.0% versus only 28.2% among males), while injury accounted for the majority of deaths among males (48.1% versus only 10.1% among females). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for 15.2% of deaths among females and 9.8% among males. More males died from non-communicable diseases.

In the 25–64-year age group, the majority of deaths were due to HIV and TB (62.1% for females and 58.6% for males). Deaths due to non-communicable diseases and communicable diseases together with maternal, perinatal and nutritional conditions were higher among females than males. Injury-related deaths were over three times higher among males than females (10.2% versus 3.4%).

In the 65-years-and-older age group, non-communicable diseases accounted for 74.2% of deaths among females and 66.8% of deaths among males.


In children under 5 years, communicable diseases together with maternal, perinatal and nutritional conditions remained the leading broad cause of death, but there was a decline from 66% to 63.3% between 2008–2010 and 2011–2013. HIV and TB mortality also declined, from 20.1% to 17.5%, while non-communicable disease mortality increased moderately from 6.0% to 10.8%. Injury-related deaths increased by only a very small proportion. In the 5–14-year age group, HIV and TB mortality declined from 36.4% to 32.4%, and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions diminished from 31.3% to 26.3%. Non-communicable disease mortality increased by almost 10 percentage points, while injury-related deaths remained approximately the same. In the 15–24-year age group, HIV and TB deaths declined from 49.0% to 45.5%, while non-communicable disease mortality increased from 11.7% to 14%. Deaths due to communicable diseases and maternal, perinatal and nutritional conditions remained relatively the same, as did injury-related deaths. In the 25–64-year age group, there were decreases in both HIV and TB mortality and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions, while non-communicable disease mortality increased from 18.6% to 24.4% and injury-related deaths increased from 6.6% to 8.7%. In the 65-years-and-older age group, non-communicable disease mortality increased from 69.6% to 73.2%, while all other broad causes declined.


Under 5 years

Diarrhoeal diseases, HIV and AIDS, lower respiratory infections and preterm birth complications remained the leading causes of death. Protein-energy malnutrition moved up, while birth asphyxia moved down the ranks to sixth position. Tuberculosis remained the seventh leading cause of death, while poisonings shifted down. Other perinatal conditions and septicaemia replaced sepsis/other newborn infectious diseases and adverse effects from medical/surgical conditions in the top 10 causes.

5–14 years

HIV and AIDS and TB continued to rank highest in the leading causes of death. Drowning moved up to third position, and diarrhoeal diseases and lower respiratory infections shifted down to fourth and fifth positions respectively. Meningitis/encephalitis and road injuries still ranked high in the top 10 leading causes of death. Other neurological conditions, accidental threats to breathing and nephritis/nephrosis replaced deaths due to fires and hot substances, asthma and leukaemia in the ranking.

15–24 years

The top leading causes of death did not change over the two periods, and remained HIV and AIDS, TB and accidental threats to breathing. Mechanical forces, road injuries and lower respiratory infections moved down the ranks, while interpersonal violence and road injuries moved up. Meningitis/encephalitis and drowning remained in the same place in the ranking.

472


472


25–64 years

The top five leading causes of death were HIV and AIDS, TB, cerebrovascular disease, diarrhoeal diseases and lower respiratory infections. Most notably, diabetes mellitus went from being the ninth leading cause of death to being the sixth leading cause. Hypertensive heart disease and accidental threats to breathing remained the same in seventh and 10th places respectively. Mechanical forces moved down the ranking the most, while road injuries replaced meningitis/encephalitis in the top 10.

65 years and older

Cerebrovascular heart disease and hypertensive heart disease continued to be the top leading causes of death. Most notably, ischaemic heart disease moved down the ranking from third to eighth place, and was replaced by TB. Most of the other leading causes of death remained the same; these included lower respiratory infections, diarrhoeal diseases, HIV and AIDS and nephritis/nephrosis. Prostate conditions replaced deaths due to fires and hot substances.

Indicator performance: uMkhanyakude (DC27)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



86.0 83.5 89.7 6 60.5 66.4 73.5



5.5 5.5 6.0 40 5.8 5.5 4.6


2 012.3 2 028.2 2 170.5 4 2 004.3 2 136.4


59.8 60.7 60.2 39 62.8 62.7 65.8


51.4 50.3 46.9 18 53.0 60.7



8.0 4.5 4.8 41 3.0 3.6 3.2 3.3 3.5 3.0


1.9 2.9 3.0 29 2.7 2.9 2.4 2.9


10.0 12.2 10.8 25 10.4 10.2 8.0 11.6 8.0 7.0


5.2 4.7 4.9 16 5.1 5.2


21.2 21.6 20.4 27.8 22.7


11.3 11.3 11.1 48 8.9 9.0 7.4


5.7 4.0 5.5 5 10.3 9.7 10.1 0


96.7 53.6 59.4 6 124.9 133.0 119.5 132.5 100 80.0


69.9 87.4 73.1 16 66.4 74.4 74.3 80.0 85.0


18.2 16.3 16.8 13 21.1 20.7


54.2 61.2 59.3 18 57.3 60.0 60.0 53.9 65.0 70.0


83.7 73.1 90.0 32 95.2 95.0 91.2 93.0 96.0


120.1 115.5 115.1 9 107.9 100.6


3.3 1.8 1.2 8 1.3 1.0 1.5 1.8 2.0


7.7 10.7 45 20.7 55.0 23.2 30.0 35.0


33.1 39.4 47.5 37 54.5 55.0 60.0 52.2 55.0


77.0 74.3 83.0 26 89.9 96.0 90.0 89.8 95.0 91.0


71.5 69.8 87.2 14 86.3 94.6 85.0 82.8 85.0 85.0


473


473

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16Reproductive health


71.9 51.4 43.8 36 70.3 79.7 75.0 54.5 60.0 64.0


30.1 32.6 41.0 36 57.8 45.0 46.8 55.0


21.5 16.2 13.2 52 8.3 6.4


37.1 35.8 21 39.0 32.1


17.3 22.0 35.8 28 58.9 62.9 38.4



23.0 22.1 22.0 19.1 22.8 13.9


0.3 0.7 1.0 1.1 1.2

Human Resources


26.8 34.2 32.8 21 29.0 26.9


40.6 46.0 48.9 52 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



1 050.6 907.0 730.4 31 864.4 592.5



63.8 75.7 80.9 14 82.8 76.8



2.6 3.6 1.3 3 4.1 4.5 5.8 6.0 5.5


64.0 74.4 84.0 6 81.8 85.0 77.9 82.0 83.0


86.9 87.8 92.2 31 92.5 92.8


49.4 52.4 77.6 33 74.8 78.9


27.0 12 31.1 31.8

Burden of disease


12.2 11.4 11.9 11 14.8 14.5


16.0 14.6 13.3 32 11.4 14.0


17.6 18.9 17.6 16 20.8 22.1


48.7 45.2 43.5 52 34.2 27.9


9.8 9.9 11.5 16 12.6 13.1


23.9 26.1 27.4 4 32.4 36.9




The district performed very well with regard to nine indicators, which ranked among the 10 best in the country in the last reporting period. These indicators were:


✦ Expenditure per patient day equivalent (district hospitals)

✦ Inpatient early neonatal death rate




✦ TB defaulter rate (new smear positive) (third lowest in the country)

474


474


✦ TB treatment success rate (all TB) (although below the provincial target)





✦ TB Rifampicin resistance confirmed client rate (highest in the country)

✦ Percentage of YLLs due to HIV and TB (highest in the country)

























Annual indicators for district: uMkhanyakude: DC27Va

lue

40

60

80

2006 2008 2010 2012 2014


5

6

7

2006 2008 2010 2012 2014


0

5

10

15

2006 2008 2010 2012 2014


2

3

4

5

6

7

2008 2010 2012 2014 2016


10

15

20

25

30

35

2008 2010 2012 2014 2016


5.0

5.5

6.0

2008 2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2200

2006 2008 2010 2012 2014


35

40

45

50

55

60

65

2008 2010 2012 2014 2016


60

65

70

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


8

9

10

11

12

2006 2008 2010 2012 2014

04_Deliv in fac <18

4

6

8

10

2006 2008 2010 2012 2014


50

100

150

200

2006 2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016


16

18

20

22

24

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

60

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


40

60

80

100

120

140

2006 2008 2010 2012 2014


2

4

6

8

10

12

2006 2008 2010 2012 2014


10

15

20

2010 2012 2014 2016 2018




475


475

Annual indicators for district: uMkhanyakude (DC27)

Annual indicators for district: uMkhanyakude: DC27

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

2006 2008 2010 2012 2014


20

30

40

50

60

70

80

2006 2008 2010 2012 2014


20

30

40

50

2006 2008 2010 2012 2014


2

3

4

5

6

7

2008 2010 2012 2014


0

5

10

15

20

2008 2010 2012 2014 2016


40

50

60

70

80

2006 2008 2010 2012 2014


6.5

7.0

7.5

8.0

8.5

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

85

2006 2008 2010 2012 2014


30

35

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

50

60

70

80

90

2008 2010 2012 2014


20

30

40

50

60

70

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

24

26

28

30

32

2006 2008 2010 2012 2014


0.4

0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


24

26

28

30

32

34

2010 2012 2014 2016


30

35

40

45

2010 2012 2014 2016


10

12

14

2006 2008 2010 2012 2014

13_Garbage codes


476


476


Annual indicators for district: uMkhanyakude (DC27)


477


477

uThungulu District Municipality (DC28) Naomi Massyn and Noluthando Ndlovu

uThungulu District lies in the north-eastern area of KwaZulu-Natal Province and includes six sub-districts, namely uMlalazai, Mthonjaneni, Nkandla, Mbonambi, Ntambanana and uMhlathuze. The district has a population of approximately 947 926, with a population density of 115.4 people per km2 and falls in socio-economic Quintile 2, among the poorer districts.

Population distribution, sub-district boundaries and health facility locations: uThungulu (DC28)


<5 years

5-14

15-24

25-64

65+

Total 38.7%34.1%22.5%

14.7%

11.1%

24.1%

14.1%

26.7%

78.7%

13.6%

29.2%

51.1%

50.1%

70.7%

32.0%

23.6%

18.9%

12.5%

14.3%29.0%35.6%21.1%

23.7%

56.4%

14.0%

16.0%

11.3%

23.7%

69.9%

11.7%

29.8%

22.2%

47.2%

12.0%

72.3%

30.5%

15.2%

13.7%

KZN, uThungulu: DC28

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

19.8%

31.4%

17.6%

22.5%

75.0%

14.3%

28.9%

39.3%

49.6%

72.0%

33.6%

18.3%

19.0%

13.2%

8.9%

18.7%

32.5%

12.1%

22.6%

15.3%

28.7%

75.5%

30.3%

36.0%

46.9%

71.0%

28.4%

16.3%

13.9%

12.7%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910





Septicaemia (2.5%)



Tuberculosis (4.6%) Other perinatal conditions (3.9%)





Septicaemia (2.7%)


HIV/AIDS (7.2%)

Tuberculosis (3.3%)


Drowning (4.5%)

Fires, hot substances (2.3%)Accidental threats to breathing (3.3%)




Drowning (3.8%)

Epilepsy (3.2%)Asthma (3.8%)



Road injuries (9.3%)Diarrhoeal diseases (9.5%)












Nephritis/nephrosis (1.7%)Diarrhoeal diseases (2.7%)
















Asthma (1.8%)Endocrine nutritional,blood, immune (1.5%)








Tuberculosis (7.2%)

Oesophagus (1.5%)






HIV/AIDS (1.7%)

Tuberculosis (6.3%)

Prov, DistrictKZN, uThungulu: DC28

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


478


478



Percentage of deaths by broad cause and leading causes, 2008–2013: uThungulu (DC28)


479


479


In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for 72.3% of deaths among males versus 70.7% among females. HIV and TB mortality was higher among females than males (13.6% versus 11.7%). Non-communicable diseases accounted for 10.4% of deaths among females versus 8.9% among males, while there were more injury-related deaths among males than females.

In the 5–14-year age group, HIV and TB mortality was almost the same in both genders, at about 29%. Deaths due to communicable diseases and maternal, perinatal and nutritional conditions were slightly higher among females than males (32.0% versus 30.5%), while non-communicable disease mortality was considerably higher among females (24.1% versus 16.0% among males). Injuries accounted for 23.7% of deaths among males versus only 14.7% among females.

In the 15–24-year age group, HIV and TB mortality accounted for over 50% of deaths among females (versus 22.2% among males), while injury accounted for over 55% of deaths among males (versus only 11.1% among females). The proportion of deaths due to communicable diseases and maternal, perinatal and nutritional conditions was almost twice as high in females, while non-communicable disease mortality was only slightly higher among females than males (14.1% versus 11.3%).

In the 25–64-year age group, HIV and TB mortality accounted for over 50% of deaths among females and 47.2% of deaths among males. Deaths due to communicable diseases and maternal, perinatal and nutritional conditions were higher among females, as was non-communicable disease mortality, while more males died from injuries than females.

In the 65-years-and-older age group, non-communicable disease mortality was almost 10 percentage points higher in females than males, at 78.7%.


Deaths due to communicable diseases and maternal, perinatal and nutritional conditions declined in children under 5, and HIV and TB mortality also decreased. Both non-communicable disease mortality and injury-related deaths increased over the two periods. In the 5–14-year age group, deaths due to communicable diseases and maternal, perinatal and nutritional conditions declined from 33.6% to 28.4%, and injury-related deaths declined from 19.8% to 18.7%. HIV and TB mortality and non-communicable disease mortality both increased. In the 15–24-year age group, HIV and TB mortality decreased from 39.3% to 36.0%, and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions also declined, from 18.3% to 16.3%. Comparatively, both injuries and non-communicable diseases accounted for more deaths in the 2011– 2013 period than in 2008– 2010. In the 25–64-year age group, HIV and TB deaths were about three percentage points less than before, at 46.9%, and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined significantly from 19.0% to 13.9%. Non-communicable disease mortality also dropped by nearly six percentage points, while injury-related deaths increased partially. In the 65-years-and-older age group, non-communicable disease mortality remained high at nearly 76%, while deaths due to communicable diseases and maternal, perinatal and nutritional conditions declined slightly from 13.2% to 12.7%. The other broad causes remained the same.


Under 5 years

Preterm birth complications, diarrhoeal diseases and lower respiratory infections were among the top leading causes of death. HIV and AIDS dropped from fourth to sixth position, and sepsis/other newborn infections moved up. Birth asphyxia remained the fifth leading cause of death. Other leading causes included protein-energy malnutrition, other perinatal conditions, TB and septicaemia.

5–14 years

The top leading causes of death remained HIV and AIDS, TB and diarrhoeal diseases, followed by road injuries, which moved up from sixth position. Lower respiratory infections and meningitis/encephalitis moved down the ranks, while drowning stayed the same. Asthma, epilepsy, and endocrine, nutritional, blood and immune diseases replaced accidental threats to breathing, fires and hot substances and other neurological conditions in the ranking.

15–24 years

HIV and AIDS and TB remained the top leading causes of death, followed by road injuries, which moved up the ranks from fifth position. Interpersonal violence remained the fourth leading cause of death, followed by mechanical forces, which moved down from third place. Lower respiratory infections remained in the top 10, as did accidental threats to breathing, meningitis/encephalitis and diarrhoeal diseases. Nephritis/nephrosis replaced endocrine nutritional, blood and immune diseases in the ranking.

480


480


25–64 years

HIV and AIDS, TB, lower respiratory infections, diarrhoeal diseases and cerebrovascular disease remained the top five leading causes of death, followed by road injuries and diabetes mellitus (which moved up the ranks). Mechanical forces dropped from sixth to 10th position, while hypertensive heart disease moved up to ninth place. Nephritis/nephrosis replaced meningitis/encephalitis in the ranking.

65 years and older

The top leading causes of death remained cerebrovascular disease, hypertensive heart disease and diabetes mellitus. Lower respiratory infections moved up from sixth to fourth position, and TB moved down the ranks. Diarrhoeal diseases and nephritis/nephrosis remained in the same position, while HIV and AIDS and oesophageal conditions replaced asthma and endocrine, nutritional, blood and immune diseases in the ranking.

Indicator performance: uThungulu (DC28)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



70.3 64.2 71.6 36 60.5 66.4 73.5



6.8 6.1 6.2 47 5.8 5.5 4.6


1 985.8 2 084.7 1 960.6 22 2 004.3 2 136.4


52.3 47.2 50.0 49 62.8 62.7 65.8


59.4 62.6 64.2 33 53.0 60.7



3.0 3.3 3.8 33 3.0 3.6 3.2 3.3 3.5 3.0


5.8 5.1 5.3 47 2.7 2.9 2.4 2.9


16.0 11.7 16.9 43 10.4 10.2 8.0 11.6 8.0 7.0


6.8 6.3 6.4 41 5.1 5.2


27.7 28.8 28.7 27.8 22.7


8.0 8.0 7.9 25 8.9 9.0 7.4


12.1 14.9 12.4 40 10.3 9.7 10.1 0


266.5 186.6 216.5 46 124.9 133.0 119.5 132.5 100 80.0


64.6 60.1 70.0 25 66.4 74.4 74.3 80.0 85.0


28.4 26.8 24.3 41 21.1 20.7


46.0 57.1 58.3 21 57.3 60.0 60.0 53.9 65.0 70.0


80.3 94.0 96.5 11 95.2 95.0 91.2 93.0 96.0


97.6 104.4 99.4 25 107.9 100.6


1.7 1.3 1.4 15 1.3 1.0 1.5 1.8 2.0


19.9 29.8 17 20.7 55.0 23.2 30.0 35.0


37.1 41.7 51.3 26 54.5 55.0 60.0 52.2 55.0


88.0 81.2 88.5 17 89.9 96.0 90.0 89.8 95.0 91.0


76.5 76.1 86.6 15 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


67.2 68.0 64.3 17 70.3 79.7 75.0 54.5 60.0 64.0


31.3 36.0 45.8 27 57.8 45.0 46.8 55.0


481


481

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



12.9 10.0 9.6 49 8.3 6.4


43.3 41.5 13 39.0 32.1


22.5 28.8 38.4 22 58.9 62.9 38.4



34.4 22.9 18.3 19.1 22.8 13.9


0.1 0.4 1.0 1.1 1.2

Human Resources


24.2 19.5 20.5 23 29.0 26.9


34.9 31.5 37.9 41 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



1 194.6 1 100.1 887.9 44 864.4 592.5



86.3 93.8 95.7 1 82.8 76.8


3.3 0.5 0.2 1 4.1 4.5 5.8 6.0 5.5


85.2 88.0 90.1 1 81.8 85.0 77.9 82.0 83.0


74.6 85.2 91.1 38 92.5 92.8


30.1 65.2 83.3 24 74.8 78.9


32.1 22 31.1 31.8

Burden of disease


14.0 13.8 14.5 39 14.8 14.5


11.3 11.1 8.4 16 11.4 14.0


24.3 21.7 22.9 29 20.8 22.1


37.4 39.2 35.4 44 34.2 27.9


11.4 11.3 12.3 23 12.6 13.1


26.9 27.8 29.4 10 32.4 36.9




The district performed very well with regard to some indicators (especially the TB outcome indicators), which ranked among the 10 best in the country in the last reporting period. The TB cure rate (new smear positive), TB defaulter rate (new smear positive), and TB treatment success rate (all TB) were the best in the country, and the TB death rate (all TB) ranked second. The percentage of years of life lost (YLLs) due to non-communicable diseases ranked 10th.

However, the performance of 10 indicators ranked among the 10 worst in the country. These indicators were:

✦ Average length of stay (district hospitals) (second longest in the county)






482


482




























✦ Percentage of YLLs due to communicable, maternal, perinatal, nutrition causes


Annual indicators for district: uThungulu: DC28Va

lue

30

40

50

60

70

80

2006 2008 2010 2012 2014


4.5

5.0

5.5

6.0

6.5

7.0

2006 2008 2010 2012 2014


5

10

15

20

25

30

2006 2008 2010 2012 2014


10

20

30

2008 2010 2012 2014 2016


8

10

12

14

16

18

2008 2010 2012 2014 2016


5.0

5.5

6.0

6.5

7.0

2008 2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014


35

40

45

50

55

60

65

2008 2010 2012 2014 2016


50

55

60

65

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014


100

200

300

400

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


22

24

26

28

2006 2008 2010 2012 2014

04_Stillbirth rate

30

35

40

45

50

55

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


20

40

60

80

100

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

25

30

2010 2012 2014 2016 2018




483


483

Annual indicators for district: uThungulu (DC28)

Annual indicators for district: uThungulu: DC28

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


65

70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

80

90

100

2006 2008 2010 2012 2014


20

40

60

80

2006 2008 2010 2012 2014


20

30

40

50

2006 2008 2010 2012 2014


0

2

4

6

2008 2010 2012 2014


6

8

10

12

14

2008 2010 2012 2014 2016


60

70

80

90

2006 2008 2010 2012 2014


3

4

5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

0

500

1000

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

85

90

2006 2008 2010 2012 2014


30

35

40

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

60

80

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

30

31

32

33

34

2006 2008 2010 2012 2014


0.2

0.4

0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


20

22

24

26

28

2010 2012 2014 2016


30

32

34

36

38

2010 2012 2014 2016


13.0

13.5

14.0

14.5

15.0

15.5

2006 2008 2010 2012 2014

13_Garbage codes


484


484


Annual indicators for district: uThungulu (DC28)


485


485

iLembe district (DC29 ) Naomi Massyn and Noluthando Ndlovu

iLembe District is situated on the east coast of KwaZulu-Natal Province; it is the smallest of the province’s districts and includes four sub-districts, namely Mandeni, KwaDukuza, Maphumulo and Ndwedwe. It has a population of 640 790, with a population density of 196.0 persons per km2 and falls in socio-economic Quintile 2, among the poorer districts.

Population distribution, sub-district boundaries and health facility locations: iLembe (DC29)


<5 years

5-14

15-24

25-64

65+

Total 39.7%33.4%22.2%

13.2%17.8%

11.3%

28.4%

76.7%

11.7%

22.3%

57.2%

49.5%

74.1%

46.8%

20.7%

17.8%

13.9%

13.9%30.7%35.3%20.2%

21.8%

52.7%

13.8%24.9%

71.4%

24.8%

24.6%

46.4%

12.6%

74.9%

42.8%

12.8%

15.0%

12.2%

9.9%

KZN, iLembe: DC29

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

17.8%

29.8%

15.3%

24.8%

72.2%

11.6%

23.3%

41.7%

48.2%

76.1%

43.6%

17.3%

17.7%

15.2%

9.3%

9.3%

17.1%

30.9%

13.1%

28.6%

77.2%

23.7%

42.5%

47.1%

72.4%

46.1%

16.7%

14.3%

9.5%

9.9%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910





Septicaemia (3.3%)


HIV/AIDS (7.8%)

Tuberculosis (4.2%)




Septicaemia (3.6%)


HIV/AIDS (7.1%)

Tuberculosis (3.7%)


Drowning (5.9%)


Asthma (2.4%)




Drowning (3.4%)

Epilepsy (2.1%)







Epilepsy (1.5%)









Epilepsy (1.5%)

Interpersonal violence (4.8%)Mechanical forces (6.2%)Accidental threats to breathing (6.7%)






Meningitis/encephalitis (2.1%)Diabetes mellitus (2.1%)Hypertensive heart disease (1.9%)











Asthma (2.7%)COPD (1.7%)







Tuberculosis (7.9%)

Asthma (2.3%)Septicaemia (1.6%)






Prov, DistrictKZN, iLembe: DC29

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


486


486



Percentage of deaths by broad cause and leading causes, 2008–2013: iLembe (DC29)


487


487


In the under-5-year age group, almost 75% of deaths were due to communicable diseases together with maternal, perinatal and nutritional conditions, while injury-related deaths were slightly higher among males than females.

In the 5–14-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for 46.8% of deaths among females versus 42.8% of deaths among males. HIV and TB mortality and injury-related deaths were higher among males than females, while non-communicable disease mortality was over seven percentage points higher among females (17.8% versus 10.6% among males).

In the 15–24-year age group, HIV and TB accounted for the majority of deaths among females (57.2% versus 24.6% among males), while injuries accounted for the majority of deaths among males (52.7% versus only 10.8% among females). Deaths due to communicable diseases together with maternal, perinatal and nutritional conditions accounted for 20.7% of deaths among females versus 12.8% of deaths among males.

In the 25–64-year age group, the majority of deaths were due to HIV and TB, with a slightly higher percentage among females than males (49.5% versus 46.4%). Non-communicable disease mortality was 28.4% among females and 24.9% among males, while deaths due to communicable diseases together with maternal, perinatal and nutritional conditions accounted for 17.8% of deaths among females and 15.0% of deaths among males. Injury-related deaths were higher among males than females (13.8% versus 4.3% respectively).

In the 65-years-and-older age group, non-communicable diseases accounted for 76.7% of deaths among females versus 71.4% of deaths among males. Injury-related deaths were more or less the same for both genders (under 4%).


In children under 5, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased from 76.1% to 72.4%. HIV and TB mortality declined, while non-communicable disease mortality increased. Injury-related deaths also increased from 4.9% to 7.5% between 2008–2010 and 2011–2013. In the 5–14-year age group, the highest increase was seen in deaths due to communicable diseases together with maternal, perinatal and nutritional conditions, which increased from 43.6% to 46.1%. HIV and TB mortality and injury-related deaths increased very slightly, while non-communicable disease mortality declined from 15.3% to 13.1%. In the 15–24-year age group, HIV and TB deaths increased slightly, while injury-related deaths increased by approximately one percentage point to 30.9%. In the 25–64-year age group, HIV and TB mortality decreased to 47.1%, and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions also decreased, from 17.7% to 14.3%. Both injury-related deaths and non-communicable disease mortality increased over the two periods. In the 65-years-and-older age group, non-communicable disease mortality increased to 77.2%.


Under 5 years

The top leading causes of death remained largely unchanged, namely diarrhoeal diseases, lower respiratory infections, preterm birth complications, birth asphyxia and HIV and AIDS. Protein-energy malnutrition moved up the ranks, while sepsis/other newborn infectious diseases moved down. Tuberculosis, septicaemia and other perinatal conditions remained the same.

5–14 years

Diarrhoeal diseases remained the top leading cause of death, while TB moved up to second position ahead of lower respiratory infections and HIV and AIDS, which moved down. Meningitis/encephalitis climbed the ranks to fifth place and replaced drowning, which became the seventh leading cause of death. Road injuries remained in the same position, while mechanical forces, cerebrovascular disease and epilepsy replaced fires and hot substances, other neurological conditions and asthma in the ranking.

15–24 years

Tuberculosis and HIV and AIDS were the top leading causes of death in this group, followed by road injures which moved up to third place from a previous sixth position. Diarrhoeal diseases and accidental threats to breathing remained constant, while mechanical forces replaced road injuries in sixth position. All other leading causes of death in the top 10 remained the same, namely lower respiratory infections, meningitis/encephalitis and epilepsy.

25–64 years

Tuberculosis, HIV and AIDS and diarrhoeal diseases made up nearly 50% of the leading causes of death; they were followed by cerebrovascular disease and lower respiratory infections. Mechanical forces dropped out of the top 10, replaced by

488


488


ischaemic heart disease as the sixth leading cause of death followed by nephritis/nephrosis (not previously in the top 10). Diabetes mellitus moved up the ranks, while meningitis/encephalitis moved down. Road injuries replaced hypertensive heart disease among the leading causes of death.

65 years and older

Cerebrovascular disease, ischaemic heart disease, hypertensive heart disease and diabetes mellitus remained the top five leading causes of death. Diarrhoeal diseases dropped from sixth to eighth position, replaced by lower respiratory infections, which moved up. Nephritis/nephrosis also moved up the ranks, while asthma remained in ninth place. Septicaemia replaced chronic obstructive pulmonary disease in 10th place.

Indicator performance: iLembe (DC29)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



66.7 71.7 76.5 29 60.5 66.4 73.5



6.8 6.3 6.0 39 5.8 5.5 4.6


2 035.7 2 467.4 2 612.3 41 2 004.3 2 136.4


63.9 56.7 56.5 43 62.8 62.7 65.8


81.7 84.9 66.5 35 53.0 60.7



5.5 2.5 1.9 15 3.0 3.6 3.2 3.3 3.5 3.0


2.0 1.1 1.2 10 2.7 2.9 2.4 2.9


8.3 3.2 6.7 10 10.4 10.2 8.0 11.6 8.0 7.0


5.4 4.8 4.1 9 5.1 5.2


26.5 28.1 31.4 27.8 22.7


9.3 10.7 10.1 43 8.9 9.0 7.4


9.3 11.8 11.7 37 10.3 9.7 10.1 0


95.5 194.1 151.2 33 124.9 133.0 119.5 132.5 100 80.0


137.4 158.4 70.2 23 66.4 74.4 74.3 80.0 85.0


21.8 23.2 23.3 36 21.1 20.7


45.3 52.1 57.6 22 57.3 60.0 60.0 53.9 65.0 70.0


78.2 96.2 100.3 1 95.2 95.0 91.2 93.0 96.0


126.0 126.0 123.7 5 107.9 100.6


2.8 2.7 1.5 20 1.3 1.0 1.5 1.8 2.0


3.6 18.0 32 20.7 55.0 23.2 30.0 35.0


48.9 52.5 58.0 14 54.5 55.0 60.0 52.2 55.0


74.3 75.2 81.0 31 89.9 96.0 90.0 89.8 95.0 91.0


75.5 73.4 79.5 26 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


62.2 53.2 65.4 14 70.3 79.7 75.0 54.5 60.0 64.0


28.4 32.7 36.2 45 57.8 45.0 46.8 55.0


23.3 9.9 8.1 45 8.3 6.4


489


489

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target


(including ANC)33.9 32.1 32 39.0 32.1


15.9 16.3 24.2 41 58.9 62.9 38.4



16.2 17.9 17.5 19.1 22.8 13.9


0.7 1.0 1.0 1.1 1.2

Human Resources


30.7 32.1 32.9 22 29.0 26.9


46.4 41.8 35.6 31 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



999.2 932.6 874.2 42 864.4 592.5



84.5 86.4 88.6 3 82.8 76.8


3.4 2.9 2.0 5 4.1 4.5 5.8 6.0 5.5


75.3 77.9 79.5 19 81.8 85.0 77.9 82.0 83.0


86.7 89.4 90.9 39 92.5 92.8


30.9 53.4 65.9 45 74.8 78.9


24.4 7 31.1 31.8

Burden of disease


16.7 17.4 19.0 50 14.8 14.5


11.1 11.0 8.5 18 11.4 14.0


24.5 23.4 19.6 22 20.8 22.1


38.9 36.9 38.9 50 34.2 27.9


10.6 10.7 13.4 33 12.6 13.1


26.0 29.1 28.0 7 32.4 36.9








✦ Antenatal client initiated on ART rate (best in the country)

✦ Infant 1st PCR test around 6 weeks uptake rate (although rate exceeds 100%)






490


490


However, the performance of nine indicators ranked among the 10 worst in the country. These indicators were:






✦ Percentage of deaths garbage codes (third highest in the country)

✦ Percentage of YLLs due to HIV and TB (third highest in the country)




















✦ PHC doctor and PHC professional clinical workloads








Annual indicators for district: iLembe: DC29Va

lue

20

40

60

2006 2008 2010 2012 2014


4

5

6

7

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


1

2

3

4

5

6

2008 2010 2012 2014 2016


5

10

15

20

2008 2010 2012 2014 2016


4.5

5.0

5.5

2008 2010 2012 2014 2016

03_Crude death rate

1500

2000

2500

2006 2008 2010 2012 2014


50

60

70

80

2008 2010 2012 2014 2016


58

60

62

64

66

68

2006 2008 2010 2012 2014


10

15

20

25

30

2006 2008 2010 2012 2014


8

9

10

11

12

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

8

10

12

14

2006 2008 2010 2012 2014


100

150

200

250

300

2006 2008 2010 2012 2014


0

50

100

150

2008 2010 2012 2014 2016


22

24

26

28

30

2006 2008 2010 2012 2014

04_Stillbirth rate

30

35

40

45

50

55

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


40

60

80

100

120

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


5

10

15

20

2010 2012 2014 2016 2018




491


491

Annual indicators for district: iLembe (DC29)

Annual indicators for district: iLembe: DC29

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


80

90

100

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

2006 2008 2010 2012 2014


20

40

60

80

2006 2008 2010 2012 2014


20

30

40

50

2006 2008 2010 2012 2014


2

3

4

5

6

7

2008 2010 2012 2014


10

15

20

25

2008 2010 2012 2014 2016


40

60

80

2006 2008 2010 2012 2014


5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

400

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

65

70

75

80

2006 2008 2010 2012 2014


30

35

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

50

60

70

80

90

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

26

28

30

32

2006 2008 2010 2012 2014


0.6

0.7

0.8

0.9

1.0

1.1

1.2

2010 2012 2014 2016 2018


24

26

28

30

32

2010 2012 2014 2016


30

35

40

45

2010 2012 2014 2016


14

15

16

17

18

19

2006 2008 2010 2012 2014

13_Garbage codes


492


492


Annual indicators for district: iLembe (DC29)


493


493

Harry Gwala District Municipality (DC43) Naomi Massyn and Noluthando Ndlovu

Harry Gwala District (previously known as Sisonke) is situated in the south of KwaZulu-Natal Province and comprises five sub-districts, namely Ingwe, KwaSani, uMzimkhulu, Greater Kokstad and Ubuhlebezwe. The district has a population of 478 535, with a population density of 45.4 persons per km2 and falls in socio-economic Quintile 1, among the poorest districts in South Africa.

Population distribution, sub-district boundaries and health facility locations: Harry Gwala (DC43)


<5 years

5-14

15-24

25-64

65+

Total 42.3%31.0%23.2%

13.8%14.7%

14.5%

31.7%

78.4%

24.9%

53.4%

45.4%

78.5%

46.5%

22.6%

19.7%

13.0%

9.5%

9.2%

10.7%31.8%35.5%22.0%

21.1%

47.8%

10.3%

16.5%

15.4%

26.8%

69.0%

25.7%

24.1%

46.3%

14.0%

76.1%

36.6%

12.7%

16.6%

14.4%

KZN, Harry Gwala: DC43

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

19.4%

23.1%

14.6%

13.1%

26.3%

75.3%

11.8%

29.9%

41.5%

46.7%

78.2%

36.0%

22.2%

21.0%

12.9% 9.9%

16.4%

27.3%

16.5%

16.7%

31.9%

74.7%

22.1%

41.3%

45.0%

76.2%

45.0%

14.7%

14.8%

14.0%

9.9%

Rank.. 2008-10 2011-13

<5 y

ears

12345678910

5-14

12345678910

15-2

4

12345678910

25-6

4

12345678910

65+

12345678910

Poisonings (including herbal) (1.3%)Sepsis/other newborn infectious (2.6%)





HIV/AIDS (7.9%)

Tuberculosis (4.1%)

Other perinatal conditions (2.6%)Poisonings (including herbal) (2.2%)




HIV/AIDS (5.2%)

Tuberculosis (2.7%)


Drowning (4.9%)

Epilepsy (3.0%)Asthma (4.1%)





Drowning (5.0%)

Asthma (3.2%)Meningitis/encephalitis (4.7%)







Asthma (2.8%)








Epilepsy (3.0%)







Asthma (3.8%)








Asthma (2.3%)





Other musculo-skeletal (1.8%)

Asthma (9.5%)







Tuberculosis (9.2%)

Asthma (5.3%)







Prov, DistrictKZN, Harry Gwala: DC43

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


494


494



Percentage of deaths by broad cause and leading causes, 2008–2013: Harry Gwala (DC43)


495


495


In the under-5-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for 78.5% of deaths among females and 76.1% of deaths among males, while HIV and TB mortality was 10.6% among males and 9.2% among females. Injury-related deaths were more prevalent among males than females (5.5% versus 3.9%).

In the 5–14-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions were higher among females than males (46.5% versus 36.6%), while deaths due to HIV and TB were slightly higher among males than females (25.7% versus 24.9%). Injury-related deaths were higher among males than females (21.1% versus 13.8%).

In the 15–24-year age group, HIV and TB accounted for 53.4% of deaths among females and 24.1% of deaths among males, while injuries accounted for 47.8% of deaths among males and only 9.5% among females.

In the 25–64-year age group, HIV and TB accounted for 46.3% of deaths among males and 45.4% of deaths among females. Non-communicable disease mortality was higher among females than males (31.7% versus 26.8%). Injury-related deaths accounted for 10.3% deaths among males and 3.2% among females.

In the 65-years-and-older age group, the majority of deaths were due to non-communicable diseases (78.4% among females and 69.0% among males). HIV and TB mortality was 14% for males and 6.8% for females.


In children under 5 years, deaths due to communicable diseases and maternal, perinatal and nutritional conditions declined from 78.2% to 76.2% between 2008–2010 and 2011–2013, and HIV and TB mortality also declined from 11.8% to 7.7%. In the 5–14-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions increased from 36.0% to 45.0%, and non-communicable disease mortality increased from 14.6% to 16.5%. HIV and TB mortality declined to 22.1%, and injury-related deaths to 16.4%. In the 15–24-year age group, HIV and TB deaths remained constant at around 41%, while deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased from 22.2% to 14.7%. Non-communicable disease mortality increased to 16.7%, while injury-related deaths also increased from 23.1% to 27.3%. In the 25–64-year age group, HIV and TB deaths decreased slightly, and deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased from 21.0% to 14.8%. The other two broad causes increased: non-communicable disease mortality increased from 26.3% to 31.9% and injury-related deaths increased from 5.9% to 8.3%. In the 65-years-and-older age group, non-communicable disease mortality declined from 75.3% to 74.7%. Deaths due to communicable diseases together with maternal, perinatal and nutritional conditions increased from 12.9% to 14.0%.


Under 5 years

The top six leading causes of death remained unchanged, namely diarrhoeal diseases, lower respiratory infections, preterm birth complications, birth asphyxia, HIV and AIDS and protein-energy malnutrition. Sepsis/other newborn infectious diseases moved up, while TB moved down, along with poisonings (including herbal).

5–14 years

Diarrhoeal diseases moved up to become the first leading cause of death, replacing TB, which fell to second place. HIV and AIDS dropped from second to fourth position, while lower respiratory infections moved up to third place. Road injuries and drowning moved ahead of meningitis/encephalitis, while asthma remained constant in eighth position. Cerebrovascular disease and exposure to natural forces replaced epilepsy and self-inflicted injuries in the top 10 ranking.

15–24 years

Tuberculosis and HIV and AIDS were the top leading causes of death, followed by interpersonal violence, which moved up from fifth position. Lower respiratory infections dropped down the ranks, and self-inflicted injuries moved up from seventh to fifth position. Road injuries moved up, while diarrhoeal diseases fell three positions. Mechanical forces and epilepsy replaced meningitis/encephalitis and asthma in the top 10, while accidental threats to breathing dropped to 10th position.

25–64 years

Tuberculosis and HIV and AIDS remained the top leading causes of death, followed by lower respiratory infections, cerebrovascular disease and diarrhoeal diseases. Diabetes mellitus and hypertensive heart disease moved up the ranks, while meningitis/encephalitis stayed constant in eighth position. Nephritis/nephrosis replaced road injuries in the top 10, while asthma moved down the ranks the most from sixth to 10th position.

496


496


65 years and older

Cerebrovascular disease and hypertensive heart disease remained the top leading causes of death, followed by diabetes mellitus, which moved up two positions in the ranks. Lower respiratory infections moved from sixth to fourth position, followed by TB and asthma. Nephritis/nephrosis moved to seventh place, replacing diarrhoeal diseases. Ischaemic heart disease moved down one place, while endocrine, nutritional, blood and immune diseases replaced other musculoskeletal diseases to complete the top 10.

Indicator performance: Harry Gwala (DC43)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



81.1 81.7 85.4 13 60.5 66.4 73.5



5.4 5.5 5.1 15 5.8 5.5 4.6


2 026.0 2 012.1 2 126.3 2 2 004.3 2 136.4


60.9 66.8 64.9 29 62.8 62.7 65.8


59.1 69.1 78.0 46 53.0 60.7



5.6 3.4 3.1 29 3.0 3.6 3.2 3.3 3.5 3.0


2.6 4.3 1.8 16 2.7 2.9 2.4 2.9


17.6 7.3 8.7 15 10.4 10.2 8.0 11.6 8.0 7.0


6.2 6.1 5.4 22 5.1 5.2


25.2 25.8 26.7 27.8 22.7


10.8 10.0 9.7 38 8.9 9.0 7.4


11.1 14.4 16.4 48 10.3 9.7 10.1 0


92.5 84.0 137.9 30 124.9 133.0 119.5 132.5 100 80.0


53.9 65.1 72.0 20 66.4 74.4 74.3 80.0 85.0


22.1 18.0 15.6 7 21.1 20.7


45.6 53.5 57.1 25 57.3 60.0 60.0 53.9 65.0 70.0


74.8 96.3 97.6 8 95.2 95.0 91.2 93.0 96.0


128.8 121.4 125.3 3 107.9 100.6


2.2 1.6 1.5 26 1.3 1.0 1.5 1.8 2.0


9.6 32.3 15 20.7 55.0 23.2 30.0 35.0


46.3 51.3 49.4 34 54.5 55.0 60.0 52.2 55.0


85.9 80.9 77.0 45 89.9 96.0 90.0 89.8 95.0 91.0


83.8 80.2 79.1 27 86.3 94.6 85.0 82.8 85.0 85.0

Reproductive health


77.1 79.7 77.2 7 70.3 79.7 75.0 54.5 60.0 64.0


32.3 51.7 54.1 11 57.8 45.0 46.8 55.0


7.7 8.5 7.2 40 8.3 6.4


52.8 46.3 7 39.0 32.1


26.8 57.1 59.9 5 58.9 62.9 38.4


497


497

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/15 2015/16 2014/15 2014/15 2015/16Non-communicable diseases


29.9 37.7 25.8 19.1 22.8 13.9


1.8 3.3 1.0 1.1 1.2

Human Resources


18.0 27.9 30.9 14 29.0 26.9


28.2 29.9 28.8 4 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



997.1 937.7 832.7 40 864.4 592.5



70.1 83.1 78.6 20 82.8 76.8



6.2 4.9 4.8 23 4.1 4.5 5.8 6.0 5.5


70.2 71.9 74.3 36 81.8 85.0 77.9 82.0 83.0


91.6 92.6 94.2 19 92.5 92.8


49.8 65.2 70.2 40 74.8 78.9


23.9 6 31.1 31.8

Burden of disease


12.3 12.8 11.7 10 14.8 14.5


15.8 17.6 15.3 40 11.4 14.0


25.8 22.3 21.9 28 20.8 22.1


36.2 37.7 35.8 46 34.2 27.9


8.8 9.9 10.2 5 12.6 13.1


29.2 30.0 32.0 17 32.4 36.9








✦ Infant 1st PCR test around 6 weeks uptake rate (although rate exceeds 100%) (third highest in the country)


✦ HIV testing coverage (including ANC)






498


498
































Annual indicators for district: Harry Gwala: DC43Va

lue

40

60

80

2006 2008 2010 2012 2014


4.5

5.0

5.5

2006 2008 2010 2012 2014


4

6

8

10

12

2006 2008 2010 2012 2014


2

4

6

8

2008 2010 2012 2014 2016


10

15

20

25

2008 2010 2012 2014 2016


5.0

5.5

6.0

6.5

7.0

2008 2010 2012 2014 2016

03_Crude death rate

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014


50

55

60

65

70

75

2008 2010 2012 2014 2016


58

60

62

64

66

68

2006 2008 2010 2012 2014


15

20

25

2006 2008 2010 2012 2014


8

9

10

11

2006 2008 2010 2012 2014

04_Deliv in fac <18

5

10

15

20

2006 2008 2010 2012 2014


100

150

200

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


16

18

20

22

24

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


50

100

150

2006 2008 2010 2012 2014


2

4

6

8

10

2006 2008 2010 2012 2014


10

15

20

25

30

2010 2012 2014 2016 2018




499


499

Annual indicators for district: Harry Gwala (DC43)

Annual indicators for district: Harry Gwala: DC43

Valu

e

20

30

40

50

2006 2008 2010 2012 2014


70

75

80

85

90

2006 2008 2010 2012 2014

07_Imm cov <1 yy

60

70

80

90

2006 2008 2010 2012 2014


20

40

60

80

2006 2008 2010 2012 2014


30

40

50

2006 2008 2010 2012 2014


4

5

6

7

2008 2010 2012 2014


6

8

10

12

14

2008 2010 2012 2014 2016


40

50

60

70

80

2006 2008 2010 2012 2014


6.5

7.0

7.5

8.0

8.5

9.0

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

50

60

70

80

2006 2008 2010 2012 2014


25

30

35

40

45

50

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

50

60

70

80

90

2008 2010 2012 2014


20

30

40

50

60

70

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

24

26

28

30

32

2006 2008 2010 2012 2014


0.5

1.0

1.5

2.0

2.5

3.0

2010 2012 2014 2016 2018


20

25

30

2010 2012 2014 2016


28

30

32

34

2010 2012 2014 2016


10

11

12

13

14

15

2006 2008 2010 2012 2014

13_Garbage codes


500


500


Annual indicators for district: Harry Gwala (DC43)


501


501

eThekwini Metropolitan Municipality (ETH) Naomi Massyn and Noluthando Ndlovu

eThekwini Metro is situated in KwaZulu-Natal Province and has a population of 3 492 345, with a population density of 1 524.2 persons per km2. The metro falls into socio-economic Quintile 5, placing it among the wealthiest districts in South Africa.

Population distribution, sub-district boundaries and health facility locations: eThekwini (ETH)


<5 years

5-14

15-24

25-64

65+

Total 49.1%26.3%20.1%

16.6%

13.1%

11.9%

23.5%

14.3%

36.9%

85.0%

11.2%

23.4%

46.9%

39.9%

71.8%

36.4%

25.7%

18.9%

9.6%

16.1%40.7%26.0%17.2%

25.6%

62.7%

16.5%

12.7%

20.9%

11.8%

33.5%

82.3%

22.2%

16.3%

35.8%

70.7%

31.2%

14.2%

9.2%

9.5%

KZN, eThekwini: ETH

Broad age.. 2008-10 2011-13

<5 years

5-14

15-24

25-64

65+

19.0%

37.8%

21.3%

12.3%

32.6%

83.6%

12.0%

25.1%

30.7%

38.2%

72.4%

34.6%

19.2%

18.6%

9.8%

25.5%

40.3%

12.2%

16.1%

23.9%

14.4%

39.0%

84.2%

18.6%

31.9%

36.5%

68.8%

32.1%

13.5%

12.4%

9.3%

Rank.. 2008-10 2011-13

<5 y

ears

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5-14

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15-2

4

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25-6

4

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65+

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Congenital heart anomalies (1.8%)



Septicaemia (2.2%)



Other congenital abnormalities (2.8%)





Septicaemia (3.2%)



HIV/AIDS (5.4%)

Tuberculosis (2.6%)

Drowning (4.2%)

Fires, hot substances (2.3%)Asthma (2.8%)Accidental threats to breathing (3.1%)





Other unintentional injuries (2.4%)

Drowning (6.3%)










Meningitis/encephalitis (3.8%)Road injuries (4.5%)Diarrhoeal diseases (5.7%)Lower respiratory infections (6.1%)

HIV/AIDS (10.9%)


Drowning (1.6%)


Mechanical forces (12.9%)Accidental threats to breathing (9.6%)



















Trachea/bronchi/lung (2.4%)

COPD (2.8%)







Tuberculosis (3.4%)

Trachea/bronchi/lung (2.6%)COPD (2.8%)







Prov, DistrictKZN, eThekwini: ETH

Show History

BroadcauseInjury

NCD

HIV and TB

Comm_mat_peri_nut


502


502



Percentage of deaths by broad cause and leading causes, 2008–2013: eThekwini (ETH)


503


503


In the under-5-year age group, communicable diseases and maternal, perinatal and nutritional conditions accounted for around 71% of deaths among females and males. Non-communicable diseases accounted for 12.7% of deaths among males and 11.9% among females, while HIV and TB deaths were higher among females than males. Injuries accounted for more deaths among males than females at 6.3% and 5.0% respectively.

In the 5–14-year age group, communicable diseases together with maternal, perinatal and nutritional conditions accounted for 36.4% of deaths among females compared with 31.2% among males. HIV and TB deaths were higher among females than males. Non-communicable diseases accounted for 23.5% of deaths among females and 20.9% among males, while injury-related deaths were higher among males than females (25.6% versus 16.6%).

In the 15–24-year age group, most deaths among females were due to HIV and TB (46.9% compared with 16.3% among males), while among males most deaths were due to injuries (62.7% compared with only 13.1% among females). Communicable diseases together with maternal, perinatal and nutritional conditions accounted for 25.7% of deaths among females and 9.2% of deaths among males.

In the 25–64-year age group, HIV and TB accounted for almost 40% of deaths among females and 35.8% among males, while non-communicable disease mortality was 36.9% among females and 33.5% among males. Communicable diseases together with maternal, perinatal and nutritional conditions accounted for 18.9% of deaths among females compared with 14.2% among males. Injury-related deaths were slightly more common among males (16.5%) than females.

In the 65-years-and-older age group, the majority of deaths were due to non-communicable diseases (85% among females and 82.3% among males). Gender differences were relatively minor for the other three broad causes as well.


In children under 5 years, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined from 72.4% to 68.8%. HIV and TB mortality also declined (to 8.0%) between 2008–2010 and 2011–2013. However, non-communicable disease mortality increased to 16.1%, and injury-related deaths increased from 5.0% to 7.1%. In the 5–14-year age group, deaths due to communicable diseases together with maternal, perinatal and nutritional conditions declined slightly, while HIV and TB deaths also decreased from 25.1% to 18.6%. Non-communicable disease mortality increased to 23.9%, and injury-related deaths increased to 25.5%. In the 15–24-year age group, injury-related deaths were predominant and increased from 37.8% to 40.3%, followed by HIV and TB deaths from 30.7% to 31.9%. Deaths due to non-communicable diseases also increased, from 12.3% to 14.4%, while deaths due to communicable diseases together with maternal, perinatal and nutritional conditions decreased to 12.4%. In the 25–64-year age group, HIV and TB deaths declined from 38.2% to 36.5%, while non-communicable disease mortality went up from 32.6% to 39.0%, and injury-related deaths decreased to 12.2%. In the 65-years-and-older group, non-communicable diseases still dominated and increased from 83.6% to 84.2%.


Under 5 years

Diarrhoeal diseases, preterm birth complications, lower respiratory infections, birth asphyxia and HIV and AIDS were the leading causes of death over both periods. Most notably, TB fell from sixth to 10th in the ranks and was replaced by sepsis/other newborn infectious diseases. Septicaemia moved up, while protein-energy malnutrition stayed the same. Other congenital abnormalities replaced congenital heart anomalies in the top 10 causes of death.

5–14 years

Most notably, TB dropped from the top leading cause of death to fourth place in the ranks; the first three places were filled by lower respiratory infections, diarrhoeal diseases and HIV and AIDS. Drowning moved up the ranks to fifth position, followed by road injuries and accidental threats to breathing. Meningitis/encephalitis and other unintentional injuries replaced asthma and fires and hot substances.

15–24 years

Tuberculosis, HIV and AIDS, mechanical forces, accidental threats to breathing, interpersonal violence and lower respir-atory infections were the top leading causes of death. Road injuries moved up, while diarrhoeal diseases moved down. Meningitis/encephalitis remained in the same position, while drowning replaced fires and hot substances in 10th position.

504


504


25–64 years

Tuberculosis and HIV and AIDS were the top leading causes of death over the two periods. Lower respiratory infections moved down the ranks, while ischaemic heart disease moved up from fifth to third in the ranks. Most notably, diarrhoeal diseases dropped from fourth to ninth in the ranks, while mechanical forces remained in the same position. Nephritis/nephrosis moved up, as did diabetes mellitus. Meningitis/encephalitis dropped out of the top 10 causes of death and was replaced by accidental threats to breathing.

65 years and older

The top four leading causes of death remained the same, namely ischaemic heart diseases, cerebrovascular disease, diabetes mellitus and hypertensive heart disease. Lower respiratory infections moved down, while nephritis/nephrosis moved up. Tuberculosis and chronic obstructive pulmonary disease remained in seventh and eighth places. Diarrhoeal diseases moved up and tracheal/bronchial/lung diseases dropped down.

Indicator performance: eThekwini (ETH)

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/152015/16

2014/15 2014/15 2015/16

Management PHC


50.3 56.7 41.2 51 60.5 66.4 73.5



4.3 6.1 6.1 43 5.8 5.5 4.6


1 494.2 1 756.1 1 610.7 46 2 004.3 2 136.4


76.5 83.2 74.5 9 62.8 62.7 65.8


51.8 50.1 68.4 37 53.0 60.7

MortalityInpatients


4.2 1.6 1.8 13 3.0 3.6 3.2 3.3 3.5 3.0


1.1 3.2 2.6 25 2.7 2.9 2.4 2.9


4.1 5.8 7.2 12 10.4 10.2 8.0 11.6 8.0 7.0


5.1 4.4 4.2 10 5.1 5.2


37.0 40.6 36.4 27.8 22.7


8.0 8.0 7.6 19 8.9 9.0 7.4


9.6 9.8 11.4 35 10.3 9.7 10.1 0


174.8 174.4 100.1 19 124.9 133.0 119.5 132.5 100 80.0


69.0 69.9 66.4 31 66.4 74.4 74.3 80.0 85.0


22.9 21.9 21.9 31 21.1 20.7


45.3 53.5 54.1 37 57.3 60.0 60.0 53.9 65.0 70.0


89.6 72.9 92.1 28 95.2 95.0 91.2 93.0 96.0


110.6 106.4 100.9 23 107.9 100.6


1.8 1.3 1.1 6 1.3 1.0 1.5 1.8 2.0


2.1 21.2 27 20.7 55.0 23.2 30.0 35.0


53.7 60.9 58.3 13 54.5 55.0 60.0 52.2 55.0


104.5 104.7 106.5 5 89.9 96.0 90.0 89.8 95.0 91.0


90.2 92.3 94.3 7 86.3 94.6 85.0 82.8 85.0 85.0


505


505

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target

Category Indicator 2012/13 2013/14 2014/15 2014/15 2014/15 2014/152015/16

2014/15 2014/15 2015/16

Reproductive health


80.7 81.0 76.7 8 70.3 79.7 75.0 54.5 60.0 64.0


26.4 30.4 42.2 33 57.8 45.0 46.8 55.0


7.6 7.7 7.6 41 8.3 6.4


30.8 35.0 23 39.0 32.1


9.8 14.6 27.7 36 58.9 62.9 38.4



21.7 23.5 17.9 19.1 22.8 13.9


0.3 0.6 1.0 1.1 1.2

Human Resources


26.2 27.3 35.3 33 29.0 26.9


37.9 40.7 33.0 22 33.3 29.4

District value

District ranking

Provincial average

Provincial target

Provincial target

National average

National target

National target



1 155.7 1 093.9 916.3 45 864.4 592.5



70.8 75.9 79.5 19 82.8 76.8



8.2 7.6 6.2 32 4.1 4.5 5.8 6.0 5.5


76.2 78.3 80.9 12 81.8 85.0 77.9 82.0 83.0


77.7 84.9 89.8 45 92.5 92.8


48.8 57.7 66.1 42 74.8 78.9


32.8 26 31.1 31.8

Burden of disease


18.0 19.1 17.5 47 14.8 14.5


12.1 12.4 15.4 41 11.4 14.0


18.6 16.8 18.3 18 20.8 22.1


30.7 29.9 29.2 30 34.2 27.9


12.8 14.7 14.0 39 12.6 13.1


37.9 38.6 38.5 34 32.4 36.9





✦ Inpatient bed utilisation rate in district hospitals







506


506



✦ PHC supervisor visit rate (fixed clinic/CHC/CDC) (second lowest in country)






Although the district recorded an improvement in the performance of several indicators over the past three years, improvement strategies are needed urgently for the following indicators, especially when compared with the district ranking, 2014/15 provincial and national averages and the 2014/15 and 2015/16 provincial and national targets. These indicators are:

























✦ Percentage of YLLs due to non-communicable diseases

Annual indicators for district: eThekwini: ETHVa

lue

20

30

40

50

60

70

2006 2008 2010 2012 2014


4.5

5.0

5.5

6.0

2006 2008 2010 2012 2014


2

4

6

8

2006 2008 2010 2012 2014


1

2

3

4

5

6

2008 2010 2012 2014 2016


5

10

15

20

2008 2010 2012 2014 2016


4.5

5.0

5.5

2008 2010 2012 2014 2016

03_Crude death rate

1000

1200

1400

1600

1800

2000

2006 2008 2010 2012 2014


50

60

70

80

2008 2010 2012 2014 2016


65

70

75

80

2006 2008 2010 2012 2014


15

20

25

30

35

40

2006 2008 2010 2012 2014


7.5

8.0

8.5

9.0

9.5

2006 2008 2010 2012 2014

04_Deliv in fac <18

6

7

8

9

10

11

2006 2008 2010 2012 2014


100

150

200

250

2006 2008 2010 2012 2014


20

40

60

2008 2010 2012 2014 2016


21

22

23

24

25

26

2006 2008 2010 2012 2014

04_Stillbirth rate

30

40

50

2006 2008 2010 2012 2014


80

100

120

140

160

2008 2010 2012 2014 2016


40

60

80

100

2006 2008 2010 2012 2014


2

4

6

8

10

12

2006 2008 2010 2012 2014


5

10

15

20

2010 2012 2014 2016 2018




507


507

Annual indicators for district: eThekwini (ETH)

Annual indicators for district: eThekwini: ETH

Valu

e

20

30

40

50

60

2006 2008 2010 2012 2014


60

70

80

90

100

110

2006 2008 2010 2012 2014

07_Imm cov <1 yy

70

75

80

85

90

95

2006 2008 2010 2012 2014


20

30

40

50

60

70

80

2006 2008 2010 2012 2014


30

40

50

2006 2008 2010 2012 2014


4

6

8

10

2008 2010 2012 2014


6.5

7.0

7.5

8.0

8.5

2008 2010 2012 2014 2016


40

50

60

70

80

2006 2008 2010 2012 2014


5

6

7

8

2008 2010 2012 2014 2016

09_TB deaths all TB

600

800

1000

1200

2006 2008 2010 2012 2014

09_TB inc all TB

55

60

65

70

75

80

2006 2008 2010 2012 2014


30

35

2010 2012 2014 2016 2018


10

20

30

40

50

60

2006 2008 2010 2012 2014


40

60

80

2008 2010 2012 2014


20

40

60

80

2008 2010 2012 2014 2016

10_TB/HIV on ART

28

29

30

31

32

33

2006 2008 2010 2012 2014


0.4

0.6

0.8

1.0

1.2

2010 2012 2014 2016 2018


24

26

28

30

32

34

2010 2012 2014 2016


30

32

34

36

38

40

2010 2012 2014 2016


14

15

16

17

18

19

2006 2008 2010 2012 2014

13_Garbage codes


508


508


Annual indicators for district: eThekwini (ETH)

Documents

18 KwaZulu-Natal Province - Health Systems Trust Health Barometers/18... · Section B: National and District ProfilesSection B: Profile KwaZulu-Natal Province 18 KwaZulu-Natal Province