AMAJUBA DISTRICT DISTRICT HEALTH PLAN 2018/19 - 2020/21€¦ · Amajuba District Health Plan...
Transcript of AMAJUBA DISTRICT DISTRICT HEALTH PLAN 2018/19 - 2020/21€¦ · Amajuba District Health Plan...
AMAJUBA DISTRICT
DISTRICT HEALTH PLAN
2018/19 - 2020/21
KWAZULU-NATAL
Amajuba District Health Plan 2018/19 – 2020/21
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1. EXECUTIVE SUMMARY BY THE DISTRICT MANAGER
Strategic overview
Vision
Optimum health for all people of Amajuba District and beyond
Mission
To develop and implement a sustainable, coordinated, integrated and
comprehensive health system at all levels, based on the Primary Health Care
approach through the District Health System, to ensure universal access to health
care.
Position Statement
Amajuba District Department of Health is a learning organisation striving for
continuous quality improvement.
Core Values
Legacy Value
• Leading in District Health Services, professionalism, accountability and
commitment to excellence
Foundation Values
• Respect, trustworthiness, honesty and integrity, open communication,
transparency and consultation, loyalty and compassion
Service Value
• Efficiency, Flexibility, Reconciliation, Courage, continuous learning, amenable to
change and innovation.
Resultant Benefit Values
• Empowerment, Skills Development, Poverty Alleviation, Role Model
District Priorities
The burden of disease that affects the Amajuba citizens is mainly in the following four
(4) areas: HIV and TB, Maternal and Child morbidity and mortality, NCDs, Trauma
and injuries. Over the next years the Amajuba district health programmes aim to
address this burden of disease as well as other health priorities, through;
Implementation of the robust 90-90-90 strategy phase 3
Focus on prevention and management of chronic disease especially Diabetes
and improve access to mental health
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Provision of differentiated care through Central Chronic Medication Distribution
and Dispensing (CCMDD)
Improving quality through monitoring the NCS in all facilities.
Scale-up Ideal Clinic Realization and Maintenance (ICRM)
Collection of municipal ward based health data at Primary Health Care level
Strengthening community based primary health care service with emphasis on
health promotion and disease prevention
Primary Healthcare & Universal Coverage
The majority of the citizens in Amajuba district are solely reliant on the public sector
services, mainly delivered through the Primary Healthcare (PHC) services. Of the
total population 90.6% of the citizens are not medically insured leaving only 9.4% with
medical or health insurance. Our primary healthcare services are delivered through
8 mobile services, within our 25 fixed PHC facilities and 1 CHC. We will work to:
promote health, prevent illness and injury, and influence our stakeholders on the
change towards improving the social determinants that affect health. Our success in
achieving better health outcomes as Amajuba district depends on our collective
ability to build relationships and work across sectors to create cohesive communities
and enabling environments that promote health. Few other challenges relates to
human resources for health and physical infrastructure, with the high burden of
disease resulting in immense strain on the health system. We remain committed to
forge ahead with the implementation of the National Health Insurance (NHI)
initiatives. In order to progress towards the accreditation of facilities to implement
NHI in Amajuba district a concerted effort is required to understand population
health, increase responsiveness to community needs, improve the quality of services
provided, and to work collaboratively with the community served.
Service Delivery through Strategic Health Programmes (SHP)
HIV
The district has had significant strides in improving access to treatment and reducing
mother to child transmission, however this scourge is a serious concern. There have
been and still are successes with regard to ART initiations with a total of 53 646 clients
remaining on ART at the end of the financial year 2016/17. The district did not do well
with regard to HIV prevention interventions, both male and female condom
distribution and Male Medical Circumcision (MMC), with the latter recording only 4
471 males circumcised. This is a challenge as it hampers efforts and interventions
towards reducing HIV incidence. It is estimated that a total of 88 000 citizens in
Amajuba are People Living with HIV (PLHIV), HIV Tembisa Estimates; 2016.
Tuberculosis (TB)
Tuberculosis (TB) continues to be the leading cause of deaths affecting the citizens
of Amajuba district and also contributes to maternal deaths. Despite the efforts and
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resources injected towards fighting TB, declining treatment success rate from 77.8%
to 77.6% that was achieved in 2015/16 is a worrying concern. It is estimated that
more than 4000 people had TB in Amajuba in 2017 (WHO TB estimates). This places TB
at the top of public health problems in Amajuba. Renewed focus will be directed
towards reducing the detrimental impact that the disease has on many
communities within our boarders.
Maternal, Neonatal, Child & Women’s Health and Nutrition
Maternal deaths remain a concern for Amajuba district with the previous financial
year recording 11 maternal deaths i.e. 130.3/100 000 live births in 2016/17 Financial
Year. This affects our progress toward the Sustainable Development Goals (SDGs)
which envisions the reduction of Maternal mortality Rate (MMR) to less than 70/100
000 live births. Child health is another area of service delivery concern includes the
challenge to deal adequately with malnutrition, which along with other related
diseases like, HIV and Diarrhoeal Diseases (DD) make-up child morbidity and
mortality concerns. The uptake of vaccines is not as high as it should be to a need to
improve our mass immunisation campaign to reach as many children as possible.
Improve health by reducing preventable diseases and injuries are another strategic
area of focus in the current strategic term.
Non-communicable Diseases (NCDs)
The NCDs are becoming a global threat. The success of HIV treatment also
contributes to people living longer some eventually developing NCDs. The Amajuba
district citizens are not immune to the burden posed by the diseases of lifestyle.
Among these, Diabetes has since been among the top four (4) leading causes of
deaths in Amajuba District. There are however worrying signs of the dangers posed
by these global threats, the increasing incidence and the number of amputations
that were performed as a result of complications. We will need to be instrumental in
promoting healthy lifestyle and health seeking behaviour in order to have healthy
communities. We will adopt a Life Course approach in dealing with all the risks and
our interventions will have to cover everything from pre-natal and post-natal care
services that promote healthy lifestyle, eating and encourage active living. Palliative
care will be an integral part of the management of the NCDs.
e-Health Technology
Despite numerous IT related challenges the district has achieved 100% in network
connectivity and has taken an initiative to have all fixed PHC facilities connected or
having access to the internet. This therefore allows seamless capturing of data on
webDHIS and will therefore support real-time access to data. These initiatives are
however hampered by the problematic Health Patient Registration System (HPRS)
which has numerous technical challenges and longer tur-around time in resolving
these challenges. Our focus will be on making the system work to our advantage,
reduce patient waiting times and thus contribute to patient delight.
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Monitoring and Evaluation
Data inaccuracy and quality remains a challenge. Targeted interventions will be
implemented in order to inculcate the culture of using information for action. The
annual Operational plan will be developed based on this 3 year District Health Plan
and set targets and indicators will be used to monitor progress towards the
implementation of this plan. Both monitoring and evaluation will remain a collective
responsibility in all levels of health care system to enable responsibility and
accountability for the implementation of the Amajuba District health Plan. The
quarterly reports through the District Operational Plan will be used as a basis for
monitoring and evaluation of programmes. The quarterly reports will be used for
monitoring and evaluation of programmes based on the District Operational Plan.
Conclusion
Despite the limited funding and the shrinking envelope, the district will continue with
the implementation of this plan and remain committed to the delivery of DHS
through the PHC approach. This approach is seen as the most appropriate in
responding to the burden of disease thus enabling a long and healthy life for all
citizens in Amajuba district and beyond. The district of Amajuba commits through
this plan to render services that are efficient, effective, accessible, acceptable and
client-centred, equitable and free from harm to the users.
I call upon all our health workers together with the District Health Management Team
(DHMT) to combine our efforts and play our part in implementing this plan and move
the district towards realizing the vision of Optimum health for all the citizens in
Amajuba and beyond.
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2. ACKNOWLEDGEMENTS
The Amajuba District Health Plan (DHP) 2018/19 – 2020/21 was developed by the
Amajuba District Health Management Team, supported by the provincial Strategic
Planning Unit, M & E and NCD programme. Primary acknowledgement is due to the
dedicated Amajuba District Planning, Monitoring and Evaluation Team who were the
principal collators of the Amajuba District Health Plan 2018/19 – 2020/21. This team
included the following officials:
Nzuza MS : Deputy Director DHS Planning
Khanyi BF : District Information Officer
Mpungose BM : Assistant Manager M & E
Special acknowledgement extended to several Managers who provided detailed
inputs and feedback to the draft versions of the Amajuba DHP 2017-18. Their feedback
and comments have been integrated into the current version and their contributions are
duly acknowledged. This team includes the following managers:
Tshabalala AMET : Amajuba District Director
Khumalo CM : Deputy Director Clinical Programs
Le Roux HP : Deputy Director Finance
Cassim AS : Deputy Director Pharmaceutical Services
Buthelezi GC : Acting Deputy Director Human Resource
Ntuli AN : District Clinical Specialist Advanced Midwifery
Langa MP : District Clinical Specialist PHC
Nyaba TLF : District Clinical Specialist (Paeds)
Hlela HA, Dr : Act CEO/Medical Manager Madadeni Hospital
Gumede Z : Nursing Manager Madadeni Hospital
Nkosi GN : Nursing Manager Niemeyer Hospital
Sakyi TBT : CEO Newcastle Regional Hospital
Ndumo DM : Nursing Manager Newcastle Hospital
Nkosi SB, Dr : CEO Niemeyer Memorial Hospital
Shezi WT : EMS Manager Amajuba District
Xaba SK : District QA
Finance and HR Managers
M&E Managers
Program Managers
PHC Managers
Systems Managers
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3. OFFICIAL SIGN OFF
It is hereby certified that this District Health Plan:
Was developed by the district management team of Amajuba District with the
technical support from the district health services and the strategic planning Units
at the Provincial head office.
Was prepared in line with the current Strategic Plan and Annual Performance
Plan of the KwaZulu Natal Department of Health.
_________________________
Dr AMET Tshabalala Date
District Director
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4. EPIDEMIOLOGICAL PROFILE
District Map & Demarcation (Wards)
The Amajuba District Municipality is located in the north-western corner of KwaZulu-
Natal, bordering on the Free State Province and Mpumalanga. It is one of the
smallest districts in the province, making up only 8% of its geographical area. The
municipality comprises three local municipalities: Newcastle (31 wards),
Emadlangeni (6 wards) and Dannhauser (11 wards). The main transportation routes
linking the district to its surrounds are the N11, which is the alternative route to
Johannesburg from Durban, and the rail line, which is the main line from the Durban
harbour to Gauteng. The R34 also bisects the district in an east-west direction and
provides a linkage from the port city of Richards Bay to the interior.
Area: 7 102km² (3 539km2; 1 707 km2 and 1 856 km2)
Cities/Towns: Charlestown, Dannhauser, Hattingspruit, Newcastle, Utrecht
Population distribution and population pyramid
It is estimated that there is a total of 565 227 people living in Amajuba District (Stats SA
Mid-Year population estimates, 2016). The population growth is estimated to grow to
595 573 by 2020, an estimated average growth of 15 173. The following pyramid depicts
the population distribution across different ages categorized in 5 year cohorts.
Population category 2016 2017 2018 2019 2020
under 1 year 14 207 14 556 14 917 15 231 15 421
under 5 years 72 717 73 293 73 900 74 479 74 981
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Population category 2016 2017 2018 2019 2020
05-09 years 71 778 72 416 72 806 73 087 73 474
10-14 years 64 637 66 904 68 968 70 732 72 117
15-19 years 54 691 55 255 56 965 59 358 62 072
20-24 years 56 751 55 828 54 635 53 420 52 739
25-29 years 53 152 54 020 54 606 55 044 55 041
30-34 years 42 295 44 501 46 635 48 764 50 956
35-39 years 32 699 34 428 36 029 37 436 38 535
40-44 years 23 813 24 908 26 121 27 441 28 855
45-49 years 18 604 19 014 19 521 20 141 20 886
50-54 years 16 091 16 076 16 136 16 257 16 443
55-59 years 15 012 14 857 14 636 14 411 14 238
60-64 years 12 350 12 521 12 668 12 769 12 794
65-69 years 9 072 9 252 9 429 9 595 9 745
70-74 years 6 101 6 218 6 325 6 435 6 553
75-79 years 3 449 3 564 3 673 3 766 3 844
80 years and older 2 131 2 170 2 211 2 257 2 306
Total 555 347 565 227 575 265 585 389 595 573
Estimated pregnant women* 15 201 15 575 15 961 16 297 16 500
Source: Stats SA Mid-Year population Estimates, 2016
under 1 year
5-9 yrs
10-14 yrs
15-19 yrs
20-24 yrs
25-29 yrs
30-34 yrs
35-39 yrs
40-44 yrs
45-49 yrs
50-54 yrs
55-59 yrs
60-64 yrs
65-69 yrs
70-74 yrs
75-79 yrs
80 + yrs
under 1 year
5-9 yrs
10-14 yrs
15-19 yrs
20-24 yrs
25-29 yrs
30-34 yrs
35-39 yrs
40-44 yrs
45-49 yrs
50-54 yrs
55-59 yrs
60-64 yrs
65-69 yrs
70-74 yrs
75-79 yrs
80 + yrs
40 000 30 000 20 000 10 000 0 10 000 20 000 30 000 40 000 50 000
Population Pyramid for Amajuba District - 2017
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Social Determinants of Health – Amajuba District
Unemployment ratea 39.1%
Youth unemployment rate (15-34 years)a 50.3%
No schooling 6.1%
Matric 36.6%
Higher education 9.0%
Households 117256
Female headed households 48.4%
Formal dwellings 84.4%
Flush toilet connected to sewerage 52.0%
Weekly refuge removal 53.8%
Piped water inside dwellings 37.3%
Electricity for lighting 92.0%
Blue drop water score 58.2%
Source: Blue Drop Report, Stats SA, 2014
Unemployment is a major problem in Amajuba District. It does not only affects an
individual’s living standards but it cripples the economic growth of the country and is a
major social determinant for health that has a negative impact on the lives of the
citizens within Amajuba. It contributes to the quick loss of skills and knowledge through
disuse; it is also a contributing factor in inequality of income distribution. People without
pipe water use boreholes or services provided by both local municipalities and the
Amajuba District Municipality by the water tanker service. From the figures below it is
evident that there is progress in terms on ensuring that water is accessible to the
communities.
Causes of Mortality
Source: Stats SA – mortality report, 2013
10.4
9.1
8.4
6.4
6
5.5
5.4
5.3
4.7
4.3
3.4
0 2 4 6 8 10 12
Tuberculosis
HIV
Non-natural causes
Heart Diseases
Cerebrovascular…
Other viral diseases
Influenza &…
Diabetes Mellitus
Hypertension
Intestinal infestious…
Other Acute LRTI
Deaths by Broad causes - Amajuba District - 2013
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Source: Stats SA – mortality report, 2014
Source: Stats SA – mortality report, 2015
Tuberculosis was the leading cause of death during the three years, averaging at
least 9.4% of all deaths each year in 2013; 2014 and 2015. This indicates the
increasing proportion of deaths due to tuberculosis over the years. Diabetes mellitus
assuming a higher rank than Hypertension and there has been a notable constant
rise over the past three years. Advances in HIV management and treatment has
seen the disease being displaced further out of the top five (5) leading causes of
deaths in Amajuba.
8.9%
6.7%
6.4%
6.2%
5.3%
5.1%
4.0%
3.1%
2.7%
2.5%
14.6%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0%
Tuberculosis
Cerebrovascular diseases
Other forms of heart diseases
Influenza & Pneumonia
Diabetes Mellitus
Hypertension
Intestinal infestious diseases
Other Acute LRTI
HIV related
Other viral diseases
Non-natural causes
Deaths by Broad causes - Amajuba District - 2014
9.0%
6.5%
6.4%
6.4%
6.2%
6.0%
4.9%
4.7%
3.6%
2.8%
9.9%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0%
Tuberculosis
Other forms of heart diseases
Cerebrovascular Diseases
Diabetes Mellitus
Other viral diseases
HIV related
Hypetensive diseases
Influenza and pneumonia
Other Acute LRTI
Intestinal Infectious diseases
Non-natural causes
Deaths by Broad causes - Amajuba District - 2015
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5. SERVICE DELIVERY PLATFORM AND MANAGEMENT
Number of facilities per sub-district
Wa
rd b
ase
d
ou
tre
ac
h
tea
ms
Clin
ic
CH
C
Dis
tric
t
Ho
spita
l
Re
gio
na
l
Ho
spita
l
Ce
ntr
al/
Tert
iary
Ho
spita
ls
Oth
er
Ho
spita
ls
Dannhauser SD 5 10 1 0 0 0 0
Emadlangeni SD 2 2 0 1 0 0 0
Newcastle SD 5 14 0 0 2 0 1
Amajuba 12 26 1 1 2 0 1
The status of health facilities remained the same and there are no plans for expansion in
the upcoming financial years leading to the end of the 3 year term of the DHP. The other
hospital that exists in Newcastle sub-district represents Medi clinic which is a 130 bed
private health facility. Status remained for the WBOTs, though the teams are currently not
complete with many being led by the Enrolled Nurses instead of Professional Nurses.
Plans are in place for their replacement.
List of fixed PHC facilities per sub-district
Dannhauser sub-district Emadlangeni sub-district Newcastle sub-district
1) Durnacol Clinic
2) Thandanani Clinic
3) Verdriet Clinic
4) Ladybank Clinic
5) Nelliesfarm Clinic
6) Sukumani Clinic
7) Thembalihle Clinic
8) Greenock Clinic
9) Naasfarm Clinic
10) Emfundweni Clinic
11) Dannhauser CHC
1) Groenvlei Clinic
2) Niemeyer Gateway
1) Charlestown Clinic
2) Ingogo Clinic
3) Newcastle PHC
4) Madadeni 1 Clinic
5) Madadeni 5 Clinic
6) Madadeni 7 Clinic
7) Madadeni Gateway
8) Stafford Clinic
9) Rosary Clinic
10) Osizweni 1 Clinic
11) Osizweni 2 Clinic
12) Osizweni 3 Clinic
13) Mndozo Clinic
Human Resources for Health (filled posts)
Co
mm
un
ity
He
alth
Wo
rke
rs
Nu
rsin
g
ass
ista
nts
En
rolle
d
nu
rse
Pro
fess
ion
al
nu
rse
Me
dic
al
pra
ctitio
ne
rs
Ph
arm
ac
ists
De
nta
l
pra
ctitio
ne
rs
Oc
cu
pa
tio
na
l th
era
py
Ph
ysi
oth
era
p
y
Sp
ee
ch
The
rap
y a
nd
Au
dio
log
y
Amajuba District - Total 560 361 347 620 94 24 07 8 16 4
Source: Persal
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6. QUALITY OF CARE
Ideal Clinic worst performing
elements
NCS (Hospitals) worst performing
elements
Patient surveys top 5 challenges
reported by patients
i. Sign indicating NO
WEAPONS, NO SMOKING,
NO ANIMALS (except for
service animals), NO
LITTERING and NO
HAWKERS
ii. Patient record content
adheres to ICSM
prescripts
iii. Patient are consulted,
examined and
counselled in privacy
iv. TB treatment success rate
is at least 85% or has
increased by at least 5%
from the previous year
v. Immunisation coverage
under one year
(annualised) is at least
87% or has increased by
at least 5% from the
previous year
vi. Quality Improvements
plans are signed off by
the facility manager and
updated quarterly
vii. Adolescent and youth
friendly services are
provided
viii. 80% of professional nurses
have been trained on
Basic Life Support
ix. The patient safety
incident records show
compliance to the
National Guideline for
Patient Safety Incident
Reporting
x. The National Clinical
Audit guideline is
available
xi. The National Policy for
The Management Of
Waiting Times is available
xii. The National Patient
Experience of Care
Guideline is available
xiii. Medicine
room/dispensary is neat
and medicines are stored
to maintain quality
xiv. The laboratory results are
received from the
i. Security measures are
adequate to safeguard
new born and
unaccompanied children.
ii. Emergency trolleys are
standardised/
appropriately stocked and
regularly checked
iii. Appropriate isolation
accommodation exists for
patients with
communicable diseases
iv. Appropriate isolation
accommodation exists for
patients with
communicable diseases -
as a minimum for viral
haemorrhagic disease.
v. A report (from within the
last 12 months) shows that
adverse events involving
medical equipment are
reported
vi. All sterilisation equipment is
validated / licensed
vii. Random selected scripts in
pharmacy are correlated
with medication dispensed
viii. With respect to 72 hour
observation of patients /
the required criteria are
met
ix. Minutes of the forum
reviewing infection control
(from within the last
quarter) indicate that
infection control
surveillance data and
control measures are
regularly discussed
x. A random selection of 3
prescriptions audited shows
that prescribing is done to
facilitate rational use of
medicine and in
accordance with
prescribing guidelines and
policies
xi. Staff members interviewed
are able to explain how the
cold chain is ensured for all
blood products including
ordering / storage / issuing
i. Long waiting time
ii. Non availability of
handwashing soap
iii. Non availability of
medicines
iv. Loss of medical records
v. Poor quality of food
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Ideal Clinic worst performing
elements
NCS (Hospitals) worst performing
elements
Patient surveys top 5 challenges
reported by patients
laboratory within the
specified turnaround
times
xv. Staffing is in line with WISN
xvi. Staff satisfaction survey is
conducted annually
xvii. Disinfectant, cleaning
materials and equipment
are available
xviii. There is a standard
security guard room OR
the facility has an alarm
system linked to armed
response
xix. There is access for people
in wheelchairs
xx. There is a functional
clinic committee
xii. There is a system in place to
monitor that items requiring
replacement or ordering
are received within 3
months
xiii. Up to date records within
the last 12 months show
that the equipment listed
has been maintained
according to a planned
schedule or manufacturer
instruction
xiv. A report (from within the
last 12 months) shows that
adverse events involving
medical equipment are
reported
xv. Staff- patient ratios in key
areas are in accordance
with the approved staffing
plan for emergency unit /
outpatients / medical/
surgical / paediatrics / ICU
wards as applicable
xvi. Minutes of the
occupational health and
safety committee / forum
(from within the last 6
months) indicate that
occupational risks are
regularly discussed
xvii. Evidence shows that
medical examinations are
performed for all health
care workers who are
exposed to potential
occupational hazards
when performing their
duties (e.g. radiation /
infectious diseases
including TB/ chemicals)
xviii. There is a security system
documented in the security
policy and in place in the
establishment that covers
the buildings and
premises/grounds
xix. Security systems are
positioned at vulnerable
patient areas such as
maternity / paediatric /
psychiatric and emergency
units and access and
egress points
xx. There is evidence that exit
interviews are conducted
with all managers who
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Ideal Clinic worst performing
elements
NCS (Hospitals) worst performing
elements
Patient surveys top 5 challenges
reported by patients
have resigned and action
plans are put in place that
address issues raised
7. ORGANISATIONAL STRUCTURE OF THE DISTRICT MANAGEMENT
TEAM
The district organizational structure depicts a number of critical posts that are vacant
that could not be filled in the financial year 2017/18 due to moratoriums and
freezing of posts. These posts are critical for the functioning of the organization, in
particular the Human Resource component. These will be prioritized, and have been
submitted in the minimum post establishment.
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8. DISTRICT HEALTH EXPENDITURE
Sub-Programme Budget: Adjusted Appropriation Expenditure TOTAL % Overspent
(Underspent)
Province Transfer to
LG *
LG Own Province Transfer to
LG
LG Own Budget Expendi
ture
2.1 District Management 24 198 000 0.00 0.00 24 028 495 0.00 0.00 24 198 000 24 028 495 0.8%
2.2 Clinics 191 202 000 0.00 0.00 190 568 014 0.00 0.00 191 202 000 190 568 014 0.1%
2.3 Community Health Centres 35 439 000 0.00 0.00 34 810 099 0.00 0.00 35 439 000 34 810 099 1.8%
2.4 Community Services (incl. PAH) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%
2.5 Other Community Services 60 563 000 0.00 0.00 56 881 045 0.00 0.00 60 563 000 56 881 045 6.1%
2.6 HIV/AIDS 148 265 000 0.00 0.00 142 912 590 0.00 0.00 148 265 000 142 912 590 3.6%
2.7 Nutrition 2 800 000 0.00 0.00 2 450 476 0.00 0.00 2 800 000 2 450 476 12.5%
2.9 District Hospitals 67 892 000 0.00 0.00 68 012 181 0.00 0.00 67 892 000 68 012 181 -0.2%
2.12 Other Donor Funding 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%
TOTAL DISTRICT 530 359 000 0.00 0.00 519 662 900 0.00 0.00 530 359 000 519 662 900 2.0%
Source: District Health Expenditure Review (2016/17) or BAS
Slight underspending under sub-programme 2.1 was due to terminations of services by the DD: P, M & E, ASD: HRD, resignations and
the transfer of DD: HR. PHC facilities were unable to fill posts due to moratorium. Underspending on HIV/AIDS was due to resignation
of two (2) doctors from the roving team, though overspending was noted on ARV budget. Underspending on sub-programme 2.6
was due to resignation of two (2) doctors from the roving team and incorrect linking of CCGs under voted funds instead of
conditional grant. UTT impact initiative also resulted in fewer clients with less body mass index and terminally ill. Overspending was
noted on ARV budget which could be attributed to implementation of differentiated models of care: Adherence clubs, spaced
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fast lane and CCMDD Medipost clients for review on their six monthly basis and others that sometimes don’t get their medication
on the specified pick-up points. Overspending on sub-programme 2.6 was also incurred due to the assignment of VMMC Doctor
as Chief Medical Officer as well as appointment of HAST Finance Manager, HAST Facility Information Officer and seven (7) data
capturers linked to facilities.
9. DISTRICT ASPIRATIONS
# District Aspiration Provincial Strategic Plan 2015-2020 Goal(s)
1. Reduced maternal deaths and improved women health Reduce the burden of disease
2. Reduce child under 1 year mortality rate Reduce the burden of disease
3. Reduce HIV incidence Reduce the burden of disease
4. Reduced mortality due to TB Reduce the burden of disease
5. Reduced diabetes and hypertension incidence Reduce the burden of disease
7. Increase the number of WBOTs Strengthen health systems effectiveness
8. Reduced expenditure per PDE – Niemeyer Hospital Strengthen health systems effectiveness
9. Increase clinical workforce Strengthen human resources for health
10. Improved compliance to ICRM and NCS Improved quality of health care
Amajuba District Health Plan 2018/19 – 2020/21
Page 18 of 63
9.1 KEY INTERVENTIONS
District Aspiration #1: Reduced maternal deaths and Improved women health
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
Pregnant women and
women of child bearing
age
Newcastle and
Dannhauser sub-
districts
High number of unplanned
pregnancies associated with poor
uptake of contraceptive methods
Poor integration of services Strengthen sexual and
reproductive services
Clinical
Limited health promotion on Sexual
and Reproductive health services
Poor linkage of pregnant
women pre and post- delivery
to PHC facilities/CCGs /WBOTS
Early diagnosis of pregnancy and
initiation of antenatal care
services
Systems
Increased burden of HIV and TB
among pregnant women
Late presentation of clients to
health care facilities due to
socio economic factors
Increase access to health
services
Systems
Targets for all Theory of Change (impact, outcome and output) indicators for District aspirations, to reach health outcomes
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Imp
ac
t
Maternal mortality IN FACILITY
ratio (per 100 000)
143.2 161.7 130.3 113.9 77.5 70.6 50.5
Maternal death in facility 20 14 11 10 7 7 5
Live birth in facility plus Born alive 13 965 8 660 8 875 8 774 9 029 9 920 9 906
Amajuba District Health Plan 2018/19 – 2020/21
Page 19 of 63
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
before arrival at facility
Ou
tco
me
Antenatal client initiated on ART
rate (%)
94.2% 92.6% 94.0% 96.1% 94% 94% 96%
Antenatal client start on ART 2 370 1 875 1 685 1 450 1 837 2 002 2 229
Antenatal client known HIV positive
but not on ART at 1st visit
2 516 2 024 1 793 1 508 1 954 2 130 2 322
Ou
tco
me
Delivery in 10 to 19 years in
facility rate (%)
8.9% 8.3% 8.1% 12.9% 10.3% 8.1% 6.8%
Delivery 10 to 19 years in facility 1 250 726 691 1 112 951 808 722
Delivery in facility - total 14 089 8 745 8 495 8 602 9 228 10 024 10 687
Ou
tpu
t
Antenatal 1st visit before 20
weeks rate (%)
52.8% 58.8% 70.2% 70% 70.3% 70.5% 70.6%
Antenatal 1st visit before 20 weeks 5 615 5 408 6 361 6 760 6 983 7 668 8 421
Antenatal 1st visit total 10 636 9 200 9 066 9 696 9 930 10 882 11 931
Ou
tpu
t
Cervical screening coverage
(%)
62.8% 57.8% 89.0% 89.5% 90% 91% 92%
Cervical cancer screening in woman
30 years and older
6 599 6 201 9 830 9 858 10 026 10 227 10 431
Population 30 years and older
female/10
15 326 10 722 10 975 11 015 11 085 11 195 11 307
O u t p u t Couple year protection rate (%) 51.9% 52.7% 52.3% 53% 54% 55.3% 57%
Amajuba District Health Plan 2018/19 – 2020/21
Page 20 of 63
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Couple year protection 73 957 76 070 77 482 79 339 82 449 85 398 89 371
Population 15-49 years females 141 827 144 261 146 806 149 696 152 683 154 427 156 791
Ou
tpu
t
Mother postnatal visit within 6
days rate (%)
75.9% 71.9% 66.9% 72.2% 66% 69.5% 71.8%
Mother postnatal visit within 6 days
after delivery
7 057 6 289 5 684 6 336 6 090 6 965 7 717
Delivery in facility total 9 300 8 745 8 495 8 774 9 228 10 025 10 750
Identified Risks Mitigation Strategy
Increased removal of long term reversible contraceptives e.g. implants Improved training and supervision of Professional Nurses (PHC level) on Family Planning
9.2 KEY INTERVENTIONS
District Aspiration #2: Reduced child under 1 year mortality
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
Early life (0-28 days) Newcastle Extreme prematurity resulting from
poor service delivery at PHC
Negative attitude by health
workers, community and Faith
Based Organizations on CTOP
due to personal beliefs
Value clarification to all
stakeholders bi-annually
Systems
Amajuba District Health Plan 2018/19 – 2020/21
Page 21 of 63
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
Poor accountability by OM
facility, PHC supervisor and
district on implementation of
BANC plus
Monthly reporting at PHC
management meeting every
second week of the month after
nerve centre meeting
Clinical
Child under 1 year All three (3) sub-
districts
Children left under the care of
elderly parents
Children under 1 year not
brought for immunization
Strengthen universal health
coverage by reaching all people
in the population with essential
services and protecting them
from financial hardship owing to
the cost of these services
Systems
Child Health Theory of Change (impact, outcome and output) indicators for District aspirations, to reach health outcomes
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Imp
ac
t
Death in facility under
1 year rate
(annualized)
9.0% 6.6% 5.8% 5.8% 5% 4% 3%
Death in facility under 1
year total
180 144 140 114 120 103 89
Inpatient separations
under 1 year
1 990 2 190 2 345 1 970 2 533 2 735 2 954
I m p a c t Neonatal death rate 10.1% 13.6% 13.9% 10.5% 7.0% 7.3% 7.0%
Amajuba District Health Plan 2018/19 – 2020/21
Page 22 of 63
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
per 1K
Neonatal 0-28 days death
in facility
96 118 117 88 63 72 69
Live birth in facility 13 965 8 660 8 440 8 308 9 029 9 920 9 906
Ou
tpu
t
Infant 1st PCR test
positive around 10
weeks rate (%)
1.0% 1.9% 1.0% 0.8% 0.5% 0.3% 0.3%
Infant PCR test positive
around 10 weeks
32 40 21 16 12 9 7
Infant PCR test around 10
weeks
3 079 2 082 3 301 2 042 2 450 2 940 2 528
Ou
tpu
t
Immunization
coverage under 1 year
(%)
79.2% 81.6% 76.6% 66% 78.3% 80.9% 84.3%
Immunised fully under 1
year new
9 265 9 957 9 723 9 584 11 680 12 321 12 999
Population under 1 year 11 699 12 200 14 207 14 556 14 917 15 231 15 421
Identified Risks Mitigation Strategy
Poor infrastructure preventing optimal neonatal care Closer collaboration between Provincial Infrastructure and Department of Public Works
Amajuba District Health Plan 2018/19 – 2020/21
Page 23 of 63
9.3 KEY INTERVENTIONS
District Aspiration #3: Reduced HIV incidence
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
15-49 years All sub-districts Myths and misconceptions around
MMC and fear of HTS during MMC
Communication barrier Appoint MMC champions on the
same age group as target
population
Community
HIV - Theory of Change (impact, outcome and output) indicators for District aspirations, to reach health outcomes
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Ou
tco
me
Proportion of viral load
suppressed (%)
- - - - 90.4% 91.5% 95.2%
Numerator - - - - - - -
Denominator - - - - - - -
Ou
tco
me
Proportion of viral load
done (%)
- - - - 80.6% 72.2% 81.2
Numerator - - - - - - -
Denominator - - - - - - -
O u t p u t Total remaining on ART 41 272 46 388 48 846 59 466 66 171 74 290 76 048
Amajuba District Health Plan 2018/19 – 2020/21
Page 24 of 63
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
- Adult
Total remaining on ART
- child
2 261 2 134 1 948 2 172 2 372 2 660 3 005
Ou
tpu
t Medical Male
Circumcision
performed
8 664 6 332 4 471 6 584 7 002 5 137 4 022
Ou
tpu
t
Male condom
distribution coverage
65.3 68.9 62.6 41.2 68.0 64.8 62.9
Numerator 8 406 885 9 057 802 8 419 270 5 664 000 9 592 080 9 435 000 9 400 000
Denominator 128 636 131 392 134 442 137 527 140 956 145 436 149 385
Identified Risks Mitigation Strategy
Failing HIV prevention efforts to reduce new infections Intensified focus on Condom distribution and MMC
Linking of newly diagnosed patients to Palliative Care service package Implementation of Palliative Care package at all levels of health care
Amajuba District Health Plan 2018/19 – 2020/21
Page 25 of 63
9.4 KEY INTERVENTIONS
District Aspiration #4: Reduced mortality due to TB
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
Adult males and females
(24 years and older)
All sub-districts Late presentation of patients for
initiation on TB treatment and
defaulting while on treatment
Poor health seeking behaviour
by patients
Improve access to health
services at all levels
Systems
TB - Theory of Change (impact, outcome and output) indicators for District aspirations, to reach health outcomes
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Imp
ac
t
TB death rate (%) 5.4% 13.7% 11.5% 10.6% 6.4% 4.7% 4.0%
Numerator 156 336 263 238 168 140 136
Denominator 2 881 2 435 2 285 2 238 2 605 2 970 3 385
Ou
tco
me
TB treatment success
rate (%)
79.4% 79.4% 82.7% 74% 81% 80% 82%
Numerator 2 277 2 279 1 896 1 660 2 105 2 376 2 776
Denominator 2 881 2 435 2 285 2 238 2 605 2 970 3 385
Ou
t
co
me
TB client loss to follow-
up rate (%)
6.5% 5% 5.4% 6.8% 5% 5% 4%
Amajuba District Health Plan 2018/19 – 2020/21
Page 26 of 63
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Numerator 190 143 123 152 129 135 142
Denominator 2 881 2 435 2 285 2 238 2 605 2 970 3 385
Ou
tpu
t
TB client initiated on
treatment rate (%)
97.4% 95.6% 97% 97.6% 98% 99.1% 99.4%
Numerator 2 881 2 329 2 212 2 184 2 543 2 925 3 364
Denominator 2 959 2 435 2 285 2 238 2 605 2 970 3 385
9.5 KEY INTERVENTIONS
District Aspiration #5: Reduced Diabetes and Hypertension incidence
Life Course Group (Sub-district/Ward)** Bottlenecks / Challenges Root Cause
Public Health Intervention
Key Intervention
(Specify targeted population)***
Dimension
(Clinical/
Community/
Systems)
Adult males and females
(40yrs and older)
All three (3) sub-
districts
Unhealthy lifestyle including
sedentary lifestyle
Lack of awareness campaigns
to targeted population
Coordinate social mobilization &
community awareness on the
dangers of sedentary lifestyle
Community
Amajuba District Health Plan 2018/19 – 2020/21
Page 27 of 63
NCD - Theory of Change (impact, outcome and output) indicators for District aspirations, to reach health outcomes
Indicator Audited
performance
2014/15
Audited
performance
2015/16
Audited
performance
2016/17
Estimated
performance
2017/18
Target
2018/19
Target
2019/20
Target
2020/21
Type
Ou
tco
me
Diabetes incidence
per 1K
0.8 0.9 1.3 0.9 1.0 1.2 1.2
Numerator 370 467 676 517 574 637 714
Denominator 514 977 522 642 530 477 566 862 576 906 585 389 595 573
Ou
tco
me
Hypertension
incidence per 1K
14.9 13.6 26.9 9.8 10.9 38.2 37.4
Numerator 1 692 1 593 2 875 1 096 1 243 1 330 1 306
Denominator 514 977 522 642 106 623 110 720 113 072 115 664 118 781
Identified Risks Mitigation Strategy
Limited Community Resources to support physical exercise programmes Mobilize community resources
Lost focus on NCD for improved chronic patient outcomes Promote self-management and prevention
Amajuba District Health Plan 2018/19 – 2020/21
Page 28 of 63
ANNEXURE A – CUSTOMISED INDICATOR TABLES ALIGNED TO APP (2018/19 – 2020/21)
Table 1: (DHS3) Strategic Objectives, Indicators & Targets
Strategic
Objective
Statement
Indicator Source Frequency/
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Scale up implementation of Operation Phakisa ICRM
100% Provincial
fixed PHC
facilities score
above 70% on
the Ideal Clinic
Dashboard by
March 2021
1. Ideal clinic status
rate
Assessment
records; Ideal
Clinic
dashboard;
DHIS
Annual
%
Not reported 38% 100% 100% 100% 100% 100% -
Ideal clinic status Assessment
records; DHIS
No - 10 26 26 26 26 26
Fixed clinics plus fixed
CHCs/CDCs
DHIS No - 26 26 26 26 26 26
Strategic Objective: Accelerate implementation of PHC re-engineering
PHC utilisation
rate of at least
2.2 visits per
person per year
by March 2021
2. PHC utilization rate
- total (annualized)
DHIS Quarterly
No
2.4 2.6 2.2 2.3 2.2 2.2 2.2
PHC headcount total DHIS/ PHC
tick register
No 1 217 741 1 219 715 1 118 515 1 198 566 1 260 000 1 265 000 1 268 075
Population total DHIS/ Stats SA
Population 507 468 514 976 522 638 530 449 566 862 576 906 587 035
Strategic Objective: Improve compliance to the Ideal Clinic and National Core Standards
Increase
complaint
resolution within
25 working days
rate to 95% (or
more) in all
public health
3. Complaint
resolution within 25
working days rate
(PHC)
Complaints
register; DHIS
Quarterly
%
75.5% 96.5% 96.5% 89.5% 90% 95% 95% -
Complaint resolved
within 25 working
days
Complaints
Register
No 172 108 112 120 115 121 119
Amajuba District Health Plan 2018/19 – 2020/21
Page 29 of 63
Strategic
Objective
Statement
Indicator Source Frequency/
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
(PHC) facilities
by March 2021 Complaint resolved Complaints
Register
No 228 112 116 134 128 127 126
Strategic Objective: Improve compliance to the Ideal Clinic and National Core Standards
Increase
complaint
resolution to
90% (or more) in
all (PHC)
facilities by
March 2021
4. Complaint
resolution rate
(PHC)
Complaints
register; DHIS
Quarterly
%
90% 66.9% 67% 77% 80% 85% 90%
Complaint resolved Complaints
register
No 178 116 116 134 128 127 126
Complaint received Complaints
register
No 197 174 174 174 160 150 140
Strategic Objective: Accelerate implementation of PHC re-engineering
Maintain PHC
under 5years
utilisation rate
of at least 3.3
visits per child
per year
5. PHC utilisation rate
under 5 years
(annualised)
PHC register;
DHIS
Quarterly
No
3.3 3.4 3.3 3.4 2.9 3.1 3.3 3.3
PHC headcount under
5 years
PHC register;
DHIS
No 198 373 172 453 194 881 202 662 215 798 231 492 244 240
Population under 5
years
Stats SA; DHIS No 57 047 57 832 58 834 59 944 73 334 73 933 74 494
Increase the
expenditure per
PHC
headcount to
R 328 by March
2021
6. Expenditure per
PHC headcount
DHIS; BAS Quarterly
R
110 267.7 341.6 300 308 315 328 -
Total expenditure
PHC (Sub-
Programmes 2.2-
2.7)
BAS R’000 140 000 000 326 486 015 382 055 736 359 569 800 388 000 000 398 475 000 415 164 750
PHC headcount
total
DHIS No 1 250 000 1 219 715 1 118 515 1 198 566 1 260 000 1 265 000 1 268 075
Increase School
Health Teams to
15 by March
2021
7. Number of school
health teams
(cumulative)
Persal; BAS Annual
No
12 12 12 8 12 14 15 -
Amajuba District Health Plan 2018/19 – 2020/21
Page 30 of 63
Strategic
Objective
Statement
Indicator Source Frequency/
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Increase the
number of
ward based
outreach teams
to 13 by March
2021
8. Number of ward
based outreach
teams 1
(cumulative)
Persal; BAS Annual
No
11 9 9 12 12 12 13 -
Increase the
accredited
Health
Promoting
Schools to 56
(or more) by
March 2021
9. Number of
accredited health
promoting schools
(cumulative)
Accreditation
Certificate;
Health
Promotion
database
Annual
No
13 15 15 53 54 55 56 -
Accelerate
implementation
of PHC re-
engineering by
increasing
household
registration
coverage to at
least 6.9% per
annum
10. Outreach
household
registration visit
coverage
(annualised)
Outreach
registers; DHIS
Quarterly
%
New
indicator
New
indicator
New
indicator
4.5% 5.2% 6% 6.9%
Outreach households
registration visit
Outreach
Registers
No - - - 4 894 6 215 7 315 8 580
Households in the
population
Stats SA No - - 110 963 117 181 119 524 121 914 124 352
1The 2 (Emadlangeni sub-district) wards worst affected by poverty is targeted as part of the Poverty Eradication Master Plan
Amajuba District Health Plan 2018/19 – 2020/21
Page 31 of 63
Table 3: Strategic Objectives, Indicators and Targets – District hospitals
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Improve compliance to the Ideal Clinic and National Core Standards
100% public
health hospitals
achieved 75%
and more on
the National
Core Standards
self-assessment
rate by March
2021
1. Hospital
achieved 75%
and more on
National Core
Standards self-
assessment rate
(District Hospitals)
Self-assessment
records; QA
records; DHIS
Quarterly
%
Not reported Not reported Not reported 100% 100% 100% 100% 100%
Hospital achieved
75% and more on
National Core
Standards self-
assessment
NCS
Assessment
records
No - - - 1 1 1 1
National Core
Standards self-
assessment
NCS
Assessment
records
No - - - 1 1 1 1
Strategic Objective: Improve hospital efficiencies
Improve
hospital
efficiencies by
reducing the
average length
of stay to 4.5
days (District
Hospital) by
March 2021
2. Average length
of stay - total
DHIS Quarterly
Days
3.7 4.8 4.4 4.5 4.5 4.5 4.5 -
In-patient days - total Midnight
census
No 9 040 11 452 11 300 12 578 12 626 13 257 13 920
½ Day patients Admission/
Discharge
Register
No 420 856 492 838 944 991 1 041
Inpatient separations Admission/
Discharge
Register
No 2 904 2 456 2 625 2 726 2 672 2 787 2 907
Increase bed
utilisation rate
to 70% (or
3. Inpatient bed
utilization rate -
total
DHIS Quarterly
%
44.3% 62.6% 60.8% 62% 70% 70% 70%
Amajuba District Health Plan 2018/19 – 2020/21
Page 32 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
more) by
March 2021 In-patient days - total Midnight
census
No 9 040 11 452 11 300 12 578 12 626 13 257 13 920
½ Day patients Admission/
Discharge
Register
No 420 856 492 838 944 991 1041
Inpatient bed days
available
DHIS No 52 624 624 624 624 624 624
Strategic Objective: Improve hospital efficiencies
Maintain
expenditure per
PDE within the
provincial
norms
4. Expenditure per
patient day
equivalent (PDE)
BAS; DHIS Quarterly
R
1 981.2 2 046 2 283 2 203 2 126 2 252 2 295 -
Expenditure total BAS R’000 68 259 505 68 937 966 63 347 394 69 682 133 76 650 347 82 069 815 86 994 000
Patient day
equivalent
DHIS No 34 454 33 693 27 748 31 633 36 061 36 442 37 900
Strategic Objective: Improve compliance to the Ideal Clinic and National Core Standards
Sustain a
complaint
resolution within
25 working days
rate of 100% in
all public health
facilities from
March 2019
onwards
5. Complaint
resolution within
25 working days
rate
DHIS/ QA
database
Quarterly
%
88.2% 100% 100% 100% 100% 100% 100% -
Complaints resolved
within 25 working days
Complaints
Register
No 15 14 32 70 75 78 80
Complaints resolved Complaints
Register
No 17 14 32 70 75 78 80
Sustain
complaint
resolution rate
of 100% in all
public health
facilities from
March 2019
onwards
6. Complaints
resolution rate
DHIS/ QA
database
Quarterly
%
86% 100% 48.5% 85% 100% 100% 100%
Complaints resolved Complaints
Register
No 19 14 32 70 75 78 80
Complaints received Complaints
Register
No 22 14 66 82 75 78 80
Amajuba District Health Plan 2018/19 – 2020/21
Page 33 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Reduce maternal mortality
Reduce the
caesarean
section rate to
25% (District),
40% (Regional),
March 2021
7. Delivery by
caesarean
section rate
DHIS Quarterly
%
23% 28.9% 29.4% 30% 25% 25% 25% -
Delivery by caesarean
section
Delivery&
Theatre
registers
No 157 165 171 192 148 151 154
Delivery in facility total Delivery
register
No 685 571 582 636 594 605 617
Strategic Objective: Improve hospital efficiencies
Reduce the un-
referred
outpatient
department
(OPD)
headcounts
with at least 7%
per annum
8. OPD headcount-
total
DHIS/ OPD tick
register
Quarterly
No
62 273 44 727 23 270 58 000 26 000 26 496 27 000 -
9. OPD headcount
not referred new
DHIS/ OPD tick
register
Quarterly
No
6 312 3 643 2 768 3 355 2 355 1 850 1 890 -
Amajuba District Health Plan 2018/19 – 2020/21
Page 34 of 63
Table5: Strategic Objectives, Indicators and Targets
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic Plan
Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Manage HIV prevalence
Increase the
number of
patients on ART
to at least
76 000 by
March 2021
(cumulative)
1. ART client remain
on ART end of
month - total
DHIS/ ART
Register
Quarterly
No
41 272 48 522 48 830 57 750 62 472 69 672 76 000
2. TB/ HIV co-
infected clients
on ART rate
ART register;
TIER.Net;
DHIS
Quarterly
%
73.2% 81.2% 90% 82% 90% 90% 90% -
TB/HIV co-infected
clients on ART
ART Register;
ETR.Net
No 667 1 375 1 914 1 625 1 653 1 691 1 703
HIV positive TB client ART Register;
ETR.Net
No 911 1 694 2 015 1 979 1 837 1 879 1 892
Strategic Objective: Reduce HIV Incidence
Test at least 159
922 people for
HIV by March
2019
(cumulative)
3. HIV test done -
total
DHIS/ HIV
Register
Quarterly
No
155 515 141 189 167 608 121 478 159 922 114 193 116 900
Increase the
male condom
distribution to
9 952 080 by
March 2021
4. Male condoms
distributed
Stock/ Bin
Cards
No 8 406 885 9 057 802 9 038 166 9 500 000 9 592 080 10 076 100 10 310 700 -
Increase the
medical male
circumcisions by
circumcising
19 341 males by
March 2021
(cumulative)
5. Medical male
circumcision –
total
MMC
Register;
Theatre
register; DHIS
Quarterly
No
8 644 6 332 6 230 5 008 7 002 6 556 5 783 -
Strategic Objective 2.4: Improve TB outcomes
Amajuba District Health Plan 2018/19 – 2020/21
Page 35 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic Plan
Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Increase the TB
clients 5 years
and older start
on treatment to
99% by March
2021
6. TB 5 years and
older start on
treatment rate
TB/HIV
Registers;
TIER.Net;
Quarterly
%
New
indicator
New
indicator
New
indicator
99.7% 99.5% 99.5% 99% -
TB client 5 years and
older start on
treatment
TB/HIV
Registers;
TIER.Net
No - - - 2 450 2165 2 058 2 254
TB symptomatic client
5 years and older
tested positive
TB/HIV
Registers;
TIER.Net;
No - - - 2 455 2 175 2 069 2 262
Increase the TB
client treatment
success rate to
88% (or more)
by March 2021
7. TB client
treatment
success rate
TB register;
ETR.Net
Quarterly
%
79.4% 79.4% 80% 85% 85% 87% 88% 90% or more
TB client successfully
completed
treatment
TB Register No 2 277 2 279 1 960 801 2 508 2 644 2 754
TB client start on
treatment
TB Register No 2 869 2 870 2 450 942 2 951 3 040 3 130
Decrease TB
client lost to
follow up to 5%
(or less) by
March 2021
8. TB client lost to
follow up rate
TB register;
ETR.Net
Quarterly
%
5% 5% 5% 4.6% <4% <4% 4% -
TB client on treatment
lost to follow up
TB Register No 143 143
123 43 106 106 125
TB client start on
treatment
TB Register No 2 869
2 870
2 450 942 2 951 3 040 3 130
Decrease TB
death rate to
5% by March
2021
9. TB client death
rate
ETR.Net Annual
%
11.7% 11.6% 11% 5.5% 5% 5% 5% 5%
TB client death during
treatment
TB Register No 336
336
269 52 147 152 157
TB client start on
treatment
TB Register No 2 869
2 870
2 450 942 2 951 3 040 3 130
Amajuba District Health Plan 2018/19 – 2020/21
Page 36 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic Plan
Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Increase the
MDR-TB
treatment
success rate to
75% (or more)
by March 2021
10. TB MDR
treatment
success rate
MDR
register; EDR
Web
Annual
%
Not reported Not reported Not reported 50% 62.7% 70% 75% 62% or more
TB MDR client
successfully
completing treatment
MDR
Register
No - - - 59 96 122 143
TB MDR confirmed
client start on
treatment
MDR
Register
No - - - 118 153 174 190
Reduce the TB
incidence to
450 (or less) per
100 000 by
March 2021
11. TB incidence TB register;
ETR.Net
Annual
No per
100,000 pop
527/100000 468/100000 408/100000 460/100000 470/100000 481/100000 450/100000 450 (or less)
per 100 000
New confirmed TB
cases
TB Register No 2 714 2 450 2 165 2 612 2 717 2 826 2 691
Total population in
KZN
DHIS; Stats
SA
Population 514 976 522 639 530 477 566 862 576 906 587 035 595 573
Improve Drug
Resistant TB
outcomes by
ensuring that
90% (or more)
diagnosed
MDR/XDR-TB
patients are
initiated on
treatment by
March 2020
12. TB XDR confirmed
client start on
treatment
XDR TB
register; EDR
Web;
TIER.Net
Quarterly
No
Not reported Not reported Not reported Not reported Not reported Not reported Not reported -
Strategic Objective: Reduce HIV Incidence
Decrease male
urethritis
syndrome to at
13. Male urethritis
syndrome
incidence
DHIS; Stats
SA
Quarterly
No per 1000
37.1 26.5 19.5 22.7 26.0 20.5 18.1 -
Amajuba District Health Plan 2018/19 – 2020/21
Page 37 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic Plan
Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
least 38 / 1000
by March 2021 Male urethritis
syndrome
treated – new
episodes
PHC Register No 4 875 3 564 2 688 3 200 3 762 3 325 2 752
Male population 15-
49 years
DHIS; Stats
SA
Population 131 392 134 442 137 527 140 956 144 687 148 616 152 643
Strategic Objective: Manage HIV prevalence
Increase the
number of
patients on ART
to at least 76
000 by March
2021
(cumulative)
14. ART adult remain
on ART end of
period
ART Register;
TIER.Net
Quarterly
No
Not reported Not reported 46 388 50 469 55 161 66 171 73 620 -
15. ART child under
15 years remain
on ART end of
period
ART Register;
TIER.Net
Quarterly
No
Not reported Not reported 2 134 2 350 2 253 2 300 2 380 -
TB Indicators: Reporting for TB has changed from reporting only New Smear Positive PTB cases in the denominator to reporting all TB cases as part of the denominator
Amajuba District Health Plan 2018/19 – 2020/21
Page 38 of 63
Table 7: Strategic Objectives, Indicators and Targets – MCWH & N
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Reduce maternal mortality
Increase the
antenatal 1st
visit before 20
weeks rate to
73% (or more)
by March 2021
1. Antenatal 1st visit
before 20 weeks
rate
PHC
register;
DHIS
Quarterly
%
52.8 58.8% 67% 66.3% 65% 70% 73% -
Antenatal 1st visit
before 20 weeks
PHC register No 5 615 5 408 5 970 5 970 6103 8 078 8 176
Antenatal 1st visit total PHC register No 10 636 9 200 8 914 8 914 9 200 12 429 11 200
Increase the
postnatal visit
within 6 days
rate to 65% (or
more) by
March 2021
2. Mother postnatal
visit within 6 days
rate
PHC &
Delivery
register;
DHIS
Quarterly
%
79.1 50.1 71.9% 71.9% 66% 65%
66%
-
Mother postnatal visit
within 6 days after
delivery
PHC register No 7 184 7 057 6 289 6 289 5 810 5 684 6 395
Delivery in facility total Delivery
Register
No 9 083 9 300 8 745 8 745 8 756 8 745 9 690
Strategic Objective: Reduce maternal mortality
Initiate 98 %
eligible
antenatal
clients on ART
by March 2021
3. Antenatal client
start on ART rate
ART & PHC
register;
DHIS
Annual
%
93.1 94.2 92.6% 92% 98.2% 98% 98%
Antenatal client start
on ART
ART & PHC
register
No 2 319 2 370 1 875 1 696 1 987 2 688 2 968
Antenatal client
known HIV positive
but not on ART at 1st
visit
ART & PHC
register
No 2 511 2 516 2 024 1842 2 024 2 830 3029
Strategic Objective: Reduce infant mortality
Amajuba District Health Plan 2018/19 – 2020/21
Page 39 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Reduce the
mother to child
transmission of
HIV to less than
0.8% by March
2021
4. Infant 1st PCR test
positive around 10
weeks rate
PHC
register;
TIER.Net;
DHIS
Quarterly
%
1.0% 1.9% 1.8% 1.15% <1% 0.6% 0.8%
Infant PCR test
positive around 10
weeks
PHC register No 32 40 30 24 18 15 17
Infant PCR test around
10 weeks
PHC register No 3 079 2 082 1 880 2 082 2 639 2 500 2 312
Strategic Objective: Reduce under 5 mortality
Increase
immunisation
coverage to
85% or more by
March 2021
5. Immunization under
1 year coverage
(annualized)
PHC
register;
DHIS
Quarterly
%
79.2% 81.6% 75% 79.3% 79% 79.1% 85% -
Immunised fully under
1 year new
PHC register No 11 422 9 957 9 484 11 604 11 835 12 072 13 107
Population under 1
year
DHIS; Stats
SA
No 11 699 12 200 12 641 14 624 14 973 15 257 15 421
Maintain the
measles 2nd
dose coverage
of 88% (or
more) by
March 2021
6. Measles 2nd dose
coverage
(annualised)
PHC
register;
DHIS
Quarterly
%
98.8 85.8% 95.8% 88.2% 83% 84% 88% -
Measles 2nd dose PHC register No 13 507 10 463 12 116 12 924 12 493 12 742 13 313
Population 1 year DHIS; Stats
SA
No 11 699 12 200 12 641 14 657 14 823 14 988 15 129
Reduce the
under-5
diarrhoea case
fatality rate to
2% (or less) by
March 2020
7. Diarrhoea case
fatality under 5
years rate
PHC &
Death
register;
DHIS
Quarterly
%
3.0 1.3% 0.9% 2.3% 2.0% 1.5% 2% -
Diarrhoea death
under 5 years
Death
Register
No 16 6 6 11 14 10 13
Amajuba District Health Plan 2018/19 – 2020/21
Page 40 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Diarrhoea separation
under 5 years
Admission &
Discharge
register
No 730 469 624 469 705 690 698
Reduce the
under-5
pneumonia
case fatality
rate to less than
1% by March
2021
8. Pneumonia case
fatality under 5
years rate
DHIS Quarterly
%
0.9 1.5% 1.4% 1.5% 0.9 0.7 1% -
Pneumonia death
under 5 years
Tick
Register/
Death
Register
No 6 8 12 8 8 6 9
Pneumonia
separation under
5 years
Admission
records
No 691 539 878 539 870 895 900
Reduce the
under-5 severe
acute
malnutrition
case fatality
rate to 6% by
March 2020
9. Severe acute
malnutrition case
fatality under 5
years rate
DHIS Quarterly
%
11.0% 6.5% 4.6% 9.8% 7.5% 7.0% 6%
-
Severe acute
malnutrition
death in facility
under 5 years
Tick
Register/
Death
Register
No 23 12 6 18 19 19 16
Severe acute
malnutrition
separation under
5 years
Admission &
Discharge
records
No 228 184 130 184 263 276 268
Strategic Objective: Accelerate implementation of PHC re-engineering
Increase the
number of
learners
screened with
10. School Grade 1
learners
screened
School
Health
register;
DHIS
Quarterly
No
- - 2 861 12 612 13 242 13 746 14 021 -
Amajuba District Health Plan 2018/19 – 2020/21
Page 41 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
at least 5% per
annum 11. School Grade 8
learners
screened
School
Health
register;
DHIS
Quarterly
No
- - 1 274 3 761 3 949 4 146 4 353 -
Strategic Objective: Reduce maternal mortality
Reduce
deliveries under
19 years to 9.0%
or less by March
2021
12. Delivery in 10 to
19 years in
facility rate
DHIS Quarterly
%
Not reported Not reported 8.3% 8.6% 8.8% 9.2% 9%
Delivery 10 to 19 years
in facility
Tick Register No - - 726 760 770 810 800
Delivery in facility -
total
DHIS/Stats
SA
No - - 8 745 8 756 8 745 8 779 8 890
Strategic Objective: Improve women’s health
Increase the
couple year
protection rate
to 55% by
March 2021
13. Couple year
protection rate
(international)
DHIS Quarterly
%
51.9 52.7% 54% 50% 52% 53% 55% 36%
Couple year
protection
Tick Register
PHC/
Hospital
Register
No 73 957 76 070 78 654 98 135 99 243 101 229 88 256
Population 15-49 years
females
DHIS/Stats
SA
No 141 827 144 261 146 806 150 977 154 157 157 560 160 466
Maintain the
cervical cancer
screening
coverage of
14. Cervical cancer
screening
coverage 30
years and older2
DHIS Quarterly
%
62.8 57.8% 85% 67% 74.4% 79% 85% 75%
2 Replaced the approved customised indicator “Cervical cancer screening coverage 20 years and older” as per communicate from the Director General Health dates 09 February 2017
Amajuba District Health Plan 2018/19 – 2020/21
Page 42 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
75% (or more) Cervical cancer
screening in woman
30 years and older
Tick Register
PHC/
Hospital
Register
No 6 599 6 201 9 420 7 086 8 093 8 845 9 725
Population 30 years
and older female/10
DHIS/Stats
SA
No 10 444 10 722 10 975 10 576 10 883 11 191 11 441
Strategic Objective: Improve women’s health
Maintain
programme to
target 9 year
old girls with
HPV vaccine 1st
and 2nd dose as
part of cervical
cancer
prevention
programme
17. Human
papilloma virus
(HPV) 1st dose
HPV register;
DHIS
Annual
No
3 806 4 830 4 865 4 757 4 564 4 660 4 612
18. HPV 2nd dose HPV register;
DHIS
Annual
No
3 087 4 323 4 163 4 068 3 910 3 989 3 949 -
Strategic Objective: Reduce under 5 mortality
Increase the
Vitamin A dose
12-59 months
coverage to
62% or more by
March 2021
19. Vitamin A dose
12-59 months
coverage
(annualised)
PHC
register;
DHIS; Stats
SA
Quarterly
%
50.2% 53% 55.4% 57% 60% 62% 62%
-
Vitamin A dose 12 - 59
months
PHC register No 54 727 49 349 52 402 66 929 70 752 73 454 73 854
Population 12-59
months (multiplied by
2)
DHIS; Stats
SA
No 115 664 93 270 94 604 117 420 117 920 118 474 119 120
Strategic Objective: Reduce maternal mortality
Amajuba District Health Plan 2018/19 – 2020/21
Page 43 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Reduce the
maternal
mortality in
facility ratio to
110 (or less) per
100 000 live
births by March
2021
20. Maternal
mortality in
facility ratio
(annualised)
Midnight
census;
Maternity &
Death
register DHIS
Annual
No per
100,000
143.2 161.7 91.9 119 112 112 110 100 (or less)
per 100 000
live births
Maternal death in
facility
Midnight
census/
Death
Register
No 20 14 8 11 10 10 10
Live birth in facility plus
Born alive before
arrival at facility
Maternity
Register
No 13 965 8 660 8 706 9 219 9 058 9 239 9 297
Strategic Objective: Reduce infant mortality
Reduce the
neonatal death
in facility rate to
at least
10.5/1000 by
March 2021
21. Neonatal death
in facility rate
Midnight
census;
Maternity &
Death
register;
DHIS
Annual
No per 1000
6.8 10.4 13.8 12.4 7.5 7.5 7.5 -
Neonatal 0-28 days
death in facility
Midnight
census/
Death
Register
No 96 90 120 107 68 65 69
Live birth in facility Maternity
register
No 13 965 8 660 8 706 8 660 9 058 9 239 9 278
Strategic Objective: Reduce under 5 mortality
Reduce the
under 5
mortality rate to
4.5 per 1000 live
births by March
2021
22. Under 5 mortality
rate
Bethesda
Model
Annual
No per 1000
pop
5.9 2.3 2.6 4.2 4.0 4.5 4.5 4.5/1000 live
births
Amajuba District Health Plan 2018/19 – 2020/21
Page 44 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Reduce under-
5 diarrhoea
with
dehydration
incidence to 8
(or less) per
1000 by March
2021
23. Diarrhoea with
dehydration in
child under 5
years incidence
(annualised)
PHC
register;
DHIS; Stats
SA
Annual
No per 1000
31.8 31.3 12.1 9.1 8.5 8.7 8.0
Diarrhoea with
dehydration new in
child under 5 years
PHC register No 1 843 1 843 724 670 610 498 723
Population under 5
years
DHIS; Stats
SA
No 57 831 58 834 59 944 73 334 73 933 74 494 90 402
Reduce the
under-5
pneumonia
incidence to
65(or less) per
1000 by March
2021
24. Pneumonia in
child under 5
years incidence
(annualised)
PHC
register;
DHIS; Stats
SA
Annual
No per 1000
77.9 76.6 47.7 66.4 66.0 65 65 -
Pneumonia new in
child under 5 years
PHC register No 4 507 4 507 2 860 4 872 4 881 4 853 5 876
Population under 5
years
DHIS; Stats
SA
No 57 831 58 834 59 944 73 334 73 933 74 494 90 402
Reduce severe
acute
malnutrition
incidence
under 5 years to
3.4 (or less) per
1000 by March
2021
25. Child under 5
years severe
acute
malnutrition
incidence
(annualised)
DHIS Annual
No per 1000
4.4 4.9 5.5 3.7 3.7 3.4 3.3 4.6/1 000
Child under 5 years
with severe acute
malnutrition new
DHIS/ Tick
Register
PHC
No 255 293 330 269 274 244 271
Population under 5
years
DHIS/Stats
SA
No 57 831 58 834 59 944 73 334 73 933 74 494 90 402
Amajuba District Health Plan 2018/19 – 2020/21
Page 45 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Reduce the
death in facility
under 1 year
rate to 6% or
less by March
2021
27. Death in facility
under 1 year
rate (annualised)
Midnight
census;
Admission
Discharge &
Death
register;
DHIS
Annual
%
9.0% 6.7% 5.9% 6.4% 5.9% 5.6% 6%
-
Death in facility under
1 year total
Death
Register
No 180 147 142 149 143 138 149
Inpatient separations
under 1 year
Midnight
census/
Admissions,
Discharge &
Death
registers
No 1 990 2 190 2 422 2 335 2 393 2 453 2 488
Reduce the
death in facility
under 5 years
rate to 4% (or
less) by March
2021
28. Death in facility
under 5 years
rate
Midnight
census;
Admission
Discharge &
Death
register;
DHIS
Annual
%
6.2% 4.2% 3.6% 4.1% 3.9% 3.6% 4% -
Death in facility under
5 years total
Death
Register
No 196 155 156 159 156 152 171
Inpatient separations
under 5 years
Midnight
census/
Admissions,
Discharge &
Death
registers
No 3 118 3 619 4 298 3 841 4 033 4 235 4 277
Reduce early
neonatal death
Early neonatal death
in facility rate
Midnight
census/
Quarterly % 0.8 1.0% 1.3% 0.9% 1.0% 1.0% 1%
109 90 114 79 91 92 96
Amajuba District Health Plan 2018/19 – 2020/21
Page 46 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
in facility rate to
1 % by March
2021
Admissions,
Discharge &
Death
registers
13 965 8 660 8 706 8 660 9 058 9 239 9 690
Amajuba District Health Plan 2018/19 – 2020/21
Page 47 of 63
Table 9: Strategic Objectives, Indicators and Targets - NCD
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Reduce incidence of non-commutable diseases
Increase the
cataract surgery
rate to at least
599.1 per 1 mil
uninsured
population by
March 2021
1. Cataract surgery
rate (annualised)
DHIS Quarterly
No per 1mil
uninsured
population
547.5 344.2 7.9 568.2 571.3 571.3 599.1 -
Total number of
cataract surgeries
completed
DHIS/Theatre
Register
No 283 163 4 294 300 306 324
Population uninsured DHIS/Stats SA No 494 377 473 509 509 257 517 422 525 109 535 611 524 104
Strategic Objective: Eliminate malaria
Maintain the
malaria case
fatality rate to
less than 0% by
March 2021
2. Malaria case
fatality rate
Malaria
Information
System
Quarterly
%
0 0 0 0 0 0 0 0%
Deaths from malaria Malaria
register/Tick
sheets PHC
No 0 0 0 0 0 0 0
Total number of
Malaria cases
reported
Malaria
register/Tick
sheets PHC
No 0 0 0 0 0 0 0
Zero new local
malaria cases by
March 2020
3. Malaria
incidence per
1000 population
at risk
Malaria
Register; Stats
SA
Annual
No per 1000
pop at risk
0 0 0 0 0 0 0 Zero new
local
infections
Number of malaria
cases (new)
Malaria
Register/Tick
Register PHC
No 0 0 0 0 0 0 0
Population Amajuba
DHIS; Stats
SA
Population 0 0 0 0 576 906 585 389 595 573
Amajuba District Health Plan 2018/19 – 2020/21
Page 48 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
Strategic Objective: Reduce mortality and morbidity of non-communicable diseases
Screen at least
118 657 people
(40 years and
older) per
annum for
hypertension by
March 2021
4. Clients 40 years
and older
screened for
hypertension
DHIS/ Tick
Register
Quarterly
No
Not reported Not reported Not reported 117 479 140 000 119 839 120 800 -
Hypertension
incidence of 11
per 1000
population by
March 2021
5. Hypertension
incidence
(annualised)
PHC register;
DHIS
Annual
No per 1000
14.9 13.8 30.2 9.9 11 11.5 11 23/ 1000
Hypertension client 40
years and older
new
PHC register No 1 692 1 603 3 544 1 096 1 243 1 330 1 306
Population 40 years
and older
DHIS; Stats
SA
Population 113 286 116 149 117 310 110 720 113 072 115 664 118 781
Screen at least
2.5 million
people (40 years
and older) per
annum for
diabetes by
March 2020
6. Clients 40 years
and older
screened for
diabetes
DHIS/ Tick
Register
Quarterly
No
Not reported Not reported Not reported 117 479 140 000 119 839 120 800 -
Diabetes
incidence of 1.2
per 1000
population by
March 2021
7. Diabetes
incidence
(annualised)
PHC register;
DHIS
Annual
No per 1000
0.7 0.9 1.3 0.9 1.0 1.2 1.2 3.1/ 1000
Diabetes client
treatment new
PHC register No 370 467 676 517 574 637 714
Population total DHIS; Stats
SA
Population 514 977 522 642 530 477 566 862 576 906 585 389 595 573
Screen at least
35% of PHC
8. Mental disorders
screening rate
PHC register;
DHIS
Quarterly
%
Not reported - 37% 45% 39.6% 35% 35% -
Amajuba District Health Plan 2018/19 – 2020/21
Page 49 of 63
Strategic
Objective
Statement
Performance
Indicators Data Source
Frequency
Type
Audited/ Actual Performance Estimated
Performance
2017/18
Medium Term Targets Strategic
Plan Target
2019/20 2014/15 2015/16 2016/17 2018/19 2019/20 2020/21
clients annually
for mental
disorders by
March 2021
PHC client screened
for mental disorders
PHC register No - - 451 435 516 600 499 058 442 750 443 826
PHC headcount - total PHC register No - 1 219 715 1 118 515 1 134 629 1 260 000 1 265 000 1 268 075
Increase the
number of
wheelchairs
issued to 255 by
March 2019
9. Wheelchairs
issued
PHC & OPD
register; DHIS
Quarterly
No
123 102 295
172 255 260 270 -
Strategic Objective: Improve quality of care
Improve the
restoration to
extraction ratio
to 12:1 or less by
March 2021
10. Dental extraction
to restoration
ratio
PHC register;
OPD &
Theatre
register; DHIS
Quarterly
No
21.3 19.3 11.7 17.4 11.6 10.3 11:0 -
Tooth extraction PHC register;
OPD &
Theatre
register
No 36 398 35 642 39 448 38 252 40 165 40 173 40 300
Tooth restoration PHC register;
OPD &
Theatre
register
No 1 711 1 849 3 362 2 202 3 470 3 864 3 650
Strategic Objective: Reduce mortality and morbidity of non-communicable diseases
Improve access
to palliative care
services
11. Number of
patients offered
Palliative Care
services
Palliative
care register
No Not reported Not reported Not reported Not reported 700 800 900
12. Number of
Health Workers
trained in
Palliative Care
Skills
Development
register
No Not reported Not reported Not reported Not reported 60 70 80
Amajuba District Health Plan 2018/19 – 2020/21
Page 50 of 63
ANNEXURE B – CUSTOMISED INDICATOR TABLES ALIGNED TO APP (2018/19 – 2020/21)
Social determinants of health
Sub-Districts Data Source
Tota
l n
um
be
r o
f h
ou
seh
old
s
Un
em
plo
ym
en
t ra
te
Pe
rce
nta
ge
of
po
pu
latio
n
liv
ing
be
low
po
ve
rty
lin
e o
f
R28
3 p
er
mo
nth
Nu
mb
er
of
ho
use
ho
lds
in
Info
rma
l d
we
llin
g
Nu
mb
er
of
ho
use
ho
lds
in
form
al d
we
llin
g
Pe
rce
nta
ge
of H
ou
seh
old
s
with
ac
ce
ss t
o s
an
ita
tio
n
Ho
use
ho
lds
with
ac
ce
ss t
o
po
tab
le w
ate
r
Pe
rce
nta
ge
of H
ou
seh
old
s
with
ac
ce
ss t
o e
lec
tric
ity
Ad
ult lite
rac
y r
ate
Dannhauser
Census 2001 19 320 70% - 598 12 895 17% 2 798 43.5% 77%
Community Survey 2016 20 167 21% - 261 13 992 - 18 392 92.4% 90%
Census 2011 20 439 47.6% - 493 16 905 23% 10 175 80.7% -
Emadlangeni
Census 2001 6 187 56% - 184 2 836 29% 1 947 30.6% 75%
Community Survey 2016 6 667 27% - 89 4 494 - 4 273 57% 86%
Census 2011 6 252 37.6% - 148 3 644 45% 2 410 48.5% -
Newcastle
Census 2001 71 164 40% - 6 851 59 423 62% 43 886 84% 87%
Community Survey 2016 90 347 21% - 5 803 80 473 - 89 057 94.8% 93%
Census 2011 84 272 37.4% - 4 459 76 792 63% 71 635 87% -
District Total
Census 2001 96 671 55% - 7 633 75 154 51% 48 631 - 84%
Community Survey 2016 110 963 41.9% - 6 153 98 958 - 111 623 97.4% 92%
Census 2011 110 963 40.8% - 5 100 97 341 54% 84 220 - -
Source: Stats SA (Local Government Handbook)
Amajuba District Health Plan 2018/19 – 2020/21
Page 51 of 63
Population per selected category
Population category 2016 2017 2018 2019 2020
under 1 year 14 207 14 556 14 917 15 231 15 421
under 5 years 72 717 73 293 73 900 74 479 74 981
05-09 years 71 778 72 416 72 806 73 087 73 474
10-14 years 64 637 66 904 68 968 70 732 72 117
15-19 years 54 691 55 255 56 965 59 358 62 072
20-24 years 56 751 55 828 54 635 53 420 52 739
25-29 years 53 152 54 020 54 606 55 044 55 041
30-34 years 42 295 44 501 46 635 48 764 50 956
35-39 years 32 699 34 428 36 029 37 436 38 535
40-44 years 23 813 24 908 26 121 27 441 28 855
45-49 years 18 604 19 014 19 521 20 141 20 886
50-54 years 16 091 16 076 16 136 16 257 16 443
55-59 years 15 012 14 857 14 636 14 411 14 238
60-64 years 12 350 12 521 12 668 12 769 12 794
65-69 years 9 072 9 252 9 429 9 595 9 745
70-74 years 6 101 6 218 6 325 6 435 6 553
75-79 years 3 449 3 564 3 673 3 766 3 844
80 years and older 2 131 2 170 2 211 2 257 2 306
Total 555 347 565 227 575 265 585 389 595 573
Estimated pregnant women* 15 201 15 575 15 961 16 297 16 500
Source: Mid-Year Population Estimates 2016, StatsSA (as per 2016 demarcations)
Amajuba District Health Plan 2018/19 – 2020/21
Page 52 of 63
Management and efficiency indicators for the service delivery platform - PHC
Sub-districts
Efficiency Management
Pro
vin
cia
l a
nd
lo
ca
l
go
ve
rnm
en
t d
istr
ict
he
alth
serv
ice
s e
xp
en
ditu
re p
er
ca
pita
(u
nin
sure
d
po
pu
latio
n)
(Ra
nd
)
Pro
vin
cia
l a
nd
lo
ca
l
go
ve
rnm
en
t p
rim
ary
he
alth
ca
re e
xp
en
ditu
re
pe
r c
ap
ita
(u
nin
sure
d
po
pu
latio
n)
(Ra
nd
)
Pro
vin
cia
l a
nd
lo
ca
l
go
ve
rnm
en
t e
xp
en
ditu
re
pe
r p
rim
ary
he
alth
ca
re
he
ad
co
un
t (R
an
d)
Pe
rce
nta
ge
of
ass
ess
ed
PH
C f
ac
ilitie
s w
ith
90%
of
the
tra
ce
r m
ed
icin
es
av
aila
ble
(%
)
Pe
rce
nta
ge
Id
ea
l C
linic
s
(%)
PH
C f
ac
ilitie
s u
sin
g H
ea
lth
Pa
tie
nt
Re
gis
tra
tio
n (
No
)
PH
C U
tilis
atio
n R
ate
(N
o)
PH
C <
5 U
tilis
atio
n R
ate
(No
)
8 7 6 5 4 3 2 1
Dannhauser SD Indicator - - - 100% 100% 100% 2.4
Numerator - - - 10 11 10 261 239
Denominator - - - 10 11 10 1 297 671
Emadlangeni SD Indicator - - - 100% 50% 100% 2.6
Numerator - - - 2 1 2 97 094
Denominator - - - 2 2 2 440 499
Newcastle SD Indicator - - - 100% 100% 100% 2.0
Numerator - - - 13 13 13 775 442
Denominator - - - 13 13 13 4 652 817
Amajuba District
Indicator 1 216 1 006 431 100.0 96.2 100% 2.1
Numerator 590 984 146 488 952 668 488 952 668 26 25 26 1 133 775
Denominator 486 142 486 142 1 133 775 26 26 26 6 390 987
Source: DHIS, BAS, Ideal Clinic Information System
Amajuba District Health Plan 2018/19 – 2020/21
Page 53 of 63
Management and efficiency indicators for the service delivery platform - Hospitals
Hospital
District Hospital Regional Hospital
Av
era
ge
len
gth
of
sta
y -
to
tal (
Da
ys)
Exp
en
ditu
re p
er
pa
tie
nt
da
y
eq
uiv
ale
nt
(Ra
nd
)
Inp
atie
nt
be
d
utilis
atio
n r
ate
- t
ota
l
(%)
Inp
atie
nt
cru
de
de
ath
ra
te (
%)
OP
D n
ew
clie
nt
no
t
refe
rre
d r
ate
(%
)
Av
era
ge
len
gth
of
sta
y -
to
tal (
Da
ys)
Exp
en
ditu
re p
er
pa
tie
nt
da
y
eq
uiv
ale
nt
(Ra
nd
)
Inp
atie
nt
be
d
utilis
atio
n r
ate
- t
ota
l
(%)
Inp
atie
nt
cru
de
de
ath
ra
te (
%)
OP
D n
ew
clie
nt
no
t
refe
rre
d r
ate
(%
)
2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17 2016/17
Emadlangeni SD Indicator 4.5 3 788 71.5 7.2 48.2 - - - - -
Numerator 12 442 84 302 443 12 442 200 3 224 - - - - -
Denominator 2 760 22 258 17 400 2 670 6 690 - - - - -
Newcastle SD Indicator - - - - - 7.6 2 880 66.7 5.7 40.1
Numerator - - - - - 262 051 994 064 337 262 051 1 976 31 490
Denominator - - - - - 34 612 345 118 393 057 34 612 78 550
Amajuba Indicator 4.5 3 788 71.5 7.2 48.2 7.6 2 880 66.7 5.7 40.1
Numerator 12 442 84 302 443 12 442 200 3 224 262 051 994 064 337 262 051 1 976 31 490
Denominator 2 760 22 258 17 400 2 760 6 690 34 612 345 118 393 057 34 612 78 550
Amajuba District Health Plan 2018/19 – 2020/21
Page 54 of 63
Annual trends Deaths and Patient day equivalent, 2014/15 - 2016/17
2014/15 2015/16 2016/17
Data Element
(Number)
PH
C
/ C
HC
/
MO
U*
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
Ho
spita
l
Dis
tric
t To
tal
PH
C /
CH
C /
MO
U
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
Ho
spita
l
Dis
tric
t To
tal
PH
C /
CH
C /
MO
U
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
ho
spita
l
Dis
tric
t To
tal
Maternal deaths - - 20 - 20 - - 14 - 14 2 9 - 11
Live births 685 630 12650 - 13965
601 582 7477 - 8660 718 537 7185 - 8440
Still births 21 10 284 - 315 8 5 216 - 229 6 6 198 - 210
Ch
ild (
un
de
r 5 y
ea
rs)
Infa
nt
(un
de
r 1
ye
ar)
Ne
on
ata
l
Death in
facility 0-7days
- 2 107 - 109 1 2 87 - 90 1 5 96 - 102
Death in
facility 8-28
days
- 4 28 - 32 - 2 26 - 28 - 1 14 - 15
Death in
facility 29 days
- 11 months
- 7 32 - 39 - 1 25 - 26 - 1 22 - 23
Death in
facility 12 – 59
months
- 2 14 - 16 - 2 6 - 8 - 1 19 - 20
Diarrhoea death under 5 years - 3 13 - 16 - - 6 - 6 - - 3 - 3
Pneumonia death under 5 years - 1 4 - 5 - - 8 - 8 - - 8 - 8
Amajuba District Health Plan 2018/19 – 2020/21
Page 55 of 63
2014/15 2015/16 2016/17
Data Element
(Number)
PH
C
/ C
HC
/
MO
U*
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
Ho
spita
l
Dis
tric
t To
tal
PH
C /
CH
C /
MO
U
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
Ho
spita
l
Dis
tric
t To
tal
PH
C /
CH
C /
MO
U
Dis
tric
t H
osp
ita
l
Re
gio
na
l H
osp
ita
l
Ce
ntr
al/
tert
iary
ho
spita
l
Dis
tric
t To
tal
Severe acute malnutrition death under 5
years
- - 20 - 20 - 3 9 - 12 - - 7 - 7
TB Deaths 324 159 519 - 1 002 261 147 459 - 867 - - - - -
Inpatient death total 183 1 962 2 145 - - 186 1 989 2 175 - - 200 1 976 2 176 - 183
Patient day equivalent - 33 693 35548
4
- 38917
7
7 27748 32962
2
- 357
377
3 592 22258 34511
8
- 37096
8
Amajuba District Health Plan 2018/19 – 2020/21
Page 56 of 63
Burden of disease profile
Amajuba District Health Plan 2018/19 – 2020/21
Page 57 of 63
Amajuba District Health Plan 2018/19 – 2020/21
Page 58 of 63
Women and Maternal Health
Impact Outcome Output
Inst
itu
tio
na
l
ma
tern
al
mo
rta
lity
ratio
(P
er
10
0K
)
An
ten
ata
l c
lie
nt
initia
ted
o
n
AR
T
rate
(%
)
De
live
ry
in
fac
ility
un
de
r 1
8
ye
ars
rate
(%
)
An
ten
ata
l 1
st
vis
it
be
fore
2
0
we
ek
s
rate
(%
)
Ce
rvic
al
scre
en
ing
co
ve
rag
e (
%)
Co
up
le
ye
ar
pro
tec
tio
n r
ate
(%
)
Mo
the
r p
ost
na
tal
vis
it
with
in
6
da
ys
rate
(%
)
7 6 5 4 3 2 1
Dannhauser SD
Indicator - 97.3 8.1 72.6 114.8 62.6 538.6
Numerator - 285 17 1 211 2 351 17 281 1 131
Denominator 218 293 210 1 669 2 033 27 615 210
Emadlangeni SD
Indicator 372.4 67.4 10.0 64.5 83.5 117.1 57.6
Numerator 2 122 54 427 578 10 699 312
Denominator 537 181 542 662 688 9 134 542
Newcastle SD
Indicator 117.1 96.9 8.0 70.1 83.1 44.9 54.8
Numerator 9 1 278 620 4 723 6 901 49 501 4 241
Denominator 7 685 1 319 7 743 6 735 8 254 110 055 7 743
Amajuba District
Indicator 130.3 94.0 8.1 70.2 89.0 52.8 66.9
Numerator 11 1 685 691 6 361 9 830 77 481 5 684
Denominator 8 440 1 793 8 495 9 066 10 974 146 804 8 495
Amajuba District Health Plan 2018/19 – 2020/21
Page 59 of 63
Annual trends Child Health
Impact Outco
me
Output
Ch
ild u
nd
er
5 y
ea
rs
dia
rrh
oe
a c
ase
fa
tality
rate
(%
)
Ch
ild u
nd
er
5 y
ea
rs
pn
eu
mo
nia
ca
se f
ata
lity
rate
%
Ch
ild u
nd
er
5 y
ea
rs
sev
ere
ac
ute
ma
lnu
tritio
n c
ase
fa
tality
rate
%
Inp
atie
nt
de
ath
< 1
ye
ar
rate
Inp
atie
nt
de
ath
< 5
ye
ars
rate
Inp
atie
nt
ea
rly
ne
on
ata
l
de
ath
ra
te P
er
1K
Inp
atie
nt
ne
on
ata
l d
ea
th
rate
Pe
r 1K
Infa
nt
1st
PC
R t
est
po
sitiv
e a
rou
nd
10
we
ek
s
rate
(%
)
Sc
ho
ol G
rad
e 1
scre
en
ing
co
ve
rag
e (
%)
Sc
ho
ol G
rad
e 8
scre
en
ing
co
ve
rag
e (
%)
HPV
1st
do
se c
ov
era
ge
(%)
HPV
2n
d d
ose
co
ve
rag
e
(%)
Vita
min
A c
ove
rag
e 1
2-
59 (
%)
Imm
un
isa
tio
n c
ov
era
ge
un
de
r 1
ye
ar
(%)
Me
asl
es
2n
d d
ose
co
ve
rag
e (
%)
Infa
nt
ex
clu
siv
ely
bre
ast
fed
at
DTa
P-I
PV
-
Hib
-HB
V 3
rd d
ose
ra
te
(%)
Dannhauser SD
Indicator - - - - - - - 1.1 46.3 15.5 - - 84.1 66.2 85.4 64.9
Numerator - - - - - - - 4 1 323 484
- -
18
571
2 025 2 478 1 058
Denominator - - - - - 218 218 371 2 856 3 128
- -
21
988
3 044 2 889 1 629
Emadlangeni SD
Indicator - - - 4.0 2.3 9.3 11.2 - 51.8 28.4 - - 52.6 60.6 104.6 59.5
Numerator - - - 7 8 5 6 - 427 341 - - 3556 532 896 336
Denominator 86 104 12 173 343 537 537 138 825 1 199 - - 6 734 873 855 565
Newcastle SD
Indicator 0.7 1.1 6.8 6.1 4.0 12.6 14.4 1.1 62.7 12.4 - - 58.6 81.9 93.2 55.7
Numerator 3 8 7 133 152 97 111 17 5 273 838
- -
38
771
7 166 7 930 3 800
Denominator 455 707 103 2 172 3 766 7 685 7 685 1 595 8 411 6 744
- -
65
876
8 720 8 472 6 818
Amajuba District Indicator 0.6 1.0 6.1 6.0 3.9 12.1 13.9 1.0 58.1 15.0 - - 64.1 76.6 92.1 57.6
Amajuba District Health Plan 2018/19 – 2020/21
Page 60 of 63
Impact Outco
me
Output
Ch
ild u
nd
er
5 y
ea
rs
dia
rrh
oe
a c
ase
fa
tality
rate
(%
)
Ch
ild u
nd
er
5 y
ea
rs
pn
eu
mo
nia
ca
se f
ata
lity
rate
%
Ch
ild u
nd
er
5 y
ea
rs
sev
ere
ac
ute
ma
lnu
tritio
n c
ase
fa
tality
rate
%
Inp
atie
nt
de
ath
< 1
ye
ar
rate
Inp
atie
nt
de
ath
< 5
ye
ars
rate
Inp
atie
nt
ea
rly
ne
on
ata
l
de
ath
ra
te P
er
1K
Inp
atie
nt
ne
on
ata
l d
ea
th
rate
Pe
r 1K
Infa
nt
1st
PC
R t
est
po
sitiv
e a
rou
nd
10
we
ek
s
rate
(%
)
Sc
ho
ol G
rad
e 1
scre
en
ing
co
ve
rag
e (
%)
Sc
ho
ol G
rad
e 8
scre
en
ing
co
ve
rag
e (
%)
HPV
1st
do
se c
ov
era
ge
(%)
HPV
2n
d d
ose
co
ve
rag
e
(%)
Vita
min
A c
ove
rag
e 1
2-
59 (
%)
Imm
un
isa
tio
n c
ov
era
ge
un
de
r 1
ye
ar
(%)
Me
asl
es
2n
d d
ose
co
ve
rag
e (
%)
Infa
nt
ex
clu
siv
ely
bre
ast
fed
at
DTa
P-I
PV
-
Hib
-HB
V 3
rd d
ose
ra
te
(%)
Numerator 3 8 7 140 160 102 117 21 7 023 1 663
- -
60
898
9 723 11
304
5 194
Denominator 541 811 115 2 345 4 109 8 440 8 440 2 104 8 954 11
071 - -
94
598
12
637
12
216
9 012
Annual trends HIV
3rd 90
Outcome
2nd 90
Output
1st 90
Process and Input
Sub-District
Pro
po
rtio
n V
ira
l lo
ad
do
ne
- A
du
lt (
%)
Pro
po
rtio
n v
ira
l lo
ad
do
ne
- C
hild
(%
)
Pro
po
rtio
n V
ira
l lo
ad
sup
pre
sse
d
- A
du
lt
(%)
Pro
po
rtio
n V
ira
l Lo
ad
Su
pp
ress
ed
-
ch
ild
(%)
Pro
po
rtio
n r
em
ain
ing
in c
are
- A
du
lts
(%)
Pro
po
rtio
n r
em
ain
ing
in c
are
- c
hild
(%
)
Clie
nts
re
ma
inin
g o
n
AR
T ra
te -
all (
%)
H
IV
test
p
osi
tiv
e
clie
nt
15
y
ea
rs
an
d
old
er
rate
(in
clu
din
g
AN
C)
(%
HIV
te
stin
g
co
ve
rag
e (i
nc
lud
ing
an
ten
ata
l c
are
) (%
)
Me
dic
al
ma
le
circ
um
cis
ion
ra
te
(%)
Ma
le
co
nd
om
dis
trib
utio
n
co
ve
rag
e
(co
nd
om
s)
Fe
ma
le
co
nd
om
dis
trib
utio
n
co
ve
rag
e
(co
nd
om
s)
12 11 10 9 8 7 6 5 4 3 2 1
Dannhauser SD Indicator 34.4 51.6 94.1 75.0 80.5 81.6 - - 36.7 10.3 79.8 1.8
Amajuba District Health Plan 2018/19 – 2020/21
Page 61 of 63
3rd 90
Outcome
2nd 90
Output
1st 90
Process and Input
Sub-District
Pro
po
rtio
n V
ira
l lo
ad
do
ne
- A
du
lt (
%)
Pro
po
rtio
n v
ira
l lo
ad
do
ne
- C
hild
(%
)
Pro
po
rtio
n V
ira
l lo
ad
sup
pre
sse
d
- A
du
lt
(%)
Pro
po
rtio
n V
ira
l Lo
ad
Su
pp
ress
ed
-
ch
ild
(%)
Pro
po
rtio
n r
em
ain
ing
in c
are
- A
du
lts
(%)
Pro
po
rtio
n r
em
ain
ing
in c
are
- c
hild
(%
)
Clie
nts
re
ma
inin
g o
n
AR
T ra
te -
all (
%)
H
IV
test
p
osi
tiv
e
clie
nt
15
y
ea
rs
an
d
old
er
rate
(in
clu
din
g
AN
C)
(%
HIV
te
stin
g
co
ve
rag
e (i
nc
lud
ing
an
ten
ata
l c
are
) (%
)
Me
dic
al
ma
le
circ
um
cis
ion
ra
te
(%)
Ma
le
co
nd
om
dis
trib
utio
n
co
ve
rag
e
(co
nd
om
s)
Fe
ma
le
co
nd
om
dis
trib
utio
n
co
ve
rag
e
(co
nd
om
s)
Numerator - 16 - 12 - 40 - - 19 337 385 2 436
629
65 602
Denominator 1 039 31 357 16 1 367 49 - - 52 408 24 793 30 369 38 703
Emadlangeni SD
Indicator 48.6 54.3 93.1 73.7 79.2 87.8 - - 33.8 31.8 135.9 1.1
Numerator - 19 - 14 - 36 - - 6 387 452 1 625
919
12 497
Denominator 479 35 233 19 611 41 - - 18 779 9 645 11 901 12 475
Newcastle SD
Indicator 34.6 70.5 93.9 79.9 70.2 77.7 - - 38.6 25.4 35.5 1.0
Numerator - 134 - 107 - 205 - - 82 265 3 634 4 356
722
144 617
Denominator 3 829 190 1 323 134 6 030 264 - - 212 136 102 081 121 949 152 018
Amajuba District
Indicator 35.8 66.0 93.8 78.7 72.7 79.4 62.1 9.2 37.9 23.0 51.0 1.2
Numerator - 169 - 133 - 281 53 646 10 761 107 989 4 471 8 419
270
222 716
Denominator 5 347 256 1 913 169 8 008 354 86354 116 765 283 323 136 519 164 219 203 196
Amajuba District Health Plan 2018/19 – 2020/21
Page 62 of 63
Annual trends TB
Impact Outcome Output Process
Sub-district
TB d
ea
th r
ate
(ETR
.ne
t)
(%)
Dru
g-r
esi
sta
nt
TB c
lie
nt
de
ath
ra
te (
%)
TB/H
IV c
o-i
nfe
cte
d
clie
nt
on
AR
T ra
te
(ETR
.Ne
t) (
%)
TB c
lie
nt
tre
atm
en
t
suc
ce
ss r
ate
(ETR
.ne
t)
(%)
TB c
lie
nt
loss
to
fo
llo
w
up
ra
te (
ETR
.Ne
t) (
%)
TB r
ifa
mp
icin
resi
sta
nc
e c
on
firm
ed
clie
nt
rate
(%
)
TB r
ifa
mp
icin
re
sist
an
t
co
nfirm
ed
tre
atm
en
t
sta
rt r
ate
(%
)
Dru
g-r
esi
sta
nt
TB
tre
atm
en
t su
cc
ess
rate
(%
)
Dru
g-r
esi
sta
nt
TB c
lie
nt
loss
to
fo
llow
-up
ra
te
(%)
TB c
lie
nt
initia
ted
on
tre
atm
en
t ra
te (
%)
TB s
ym
pto
m 5
ye
ars
an
d o
lde
r sc
ree
ne
d in
fac
ility
ra
te (
%)
11 10 9 8 7 6 5 4 3 2 1
Dannhauser SD
Indicator 6.9 - 81.4 87.2 4.4 - - - - - 59.3
Numerator 22 - 92 279 14 - - - - - 129 604
Denominator 320 - 113 320 320 - - - - - 218 491
Emadlangeni SD
Indicator 18.1 - 69.9 68.8 6.2 - - - - - 76.9
Numerator 50 - 102 190 17 - - - - - 59 359
Denominator 276 - 146 276 276 - - - - - 77 151
Newcastle SD
Indicator 12.2 - 86.4 77.2 6.2 - - - - - 92.3
Numerator 218 - 758 1 380 110 - - - - - 586 288
Denominator 1 787 - 877 1 787 1,787 - - - - - 634 966
Amajuba District
Indicator 12.2 21.6 83.8 77.6 5.9 55.6 8.0 58.3 18.7 52.0 83.3
Numerator 290 30 952 1 849 141 95 171 81 26 1 113 775 251
Denominator 2 383 139 1 136 2 383 2 383 171 2 141 139 139 2 141 930 608
Amajuba District Health Plan 2018/19 – 2020/21
Page 63 of 63
Annual trend Non-communicable diseases 2016/17
Sub-districts Outcome
Diabetes incidence (Per 1K) Hypertension incidence (Per 1K)
2 1
Dannhauser SD
Indicator 0.7 7.0
Numerator 74 160
Denominator 59 062 59 062
Emadlangeni SD
Indicator 3.5 31.0
Numerator 127 253
Denominator 21 386 21 386
Newcastle SD
Indicator 1.3 27.7
Numerator 522 2 462
Denominator 239 955 239 955
Amajuba District
Indicator 6.7 26.9
Numerator 723 2 875
Denominator 106 623 106 623