April 2003April 2003April 2003April 2003----March 2004March 2004March 2004March 2004

Metropole District Health Metropole District Health Metropole District Health Metropole District Health Services Services Services Services

Cape TownCape TownCape TownCape Town 2003200320032003----2004200420042004

Department of HealthDepartment of HealthDepartment of HealthDepartment of Health Western CapeWestern CapeWestern CapeWestern Cape

ANN

UAN

NU

ANN

UAN

NU

AL REPORT

AL REPORT

AL REPORT

AL REPORT

2003200320032003 2004200420042004

The following persons are thanked for their willingness to undertake this journey to turn ignorant curiosity

into general understanding and transforming data into meaning. They are also specifically thanked for their

strategic thinking, ideas, support, enthusiasm, data and information.

- Dr Bitalo and Senior Management of MDHS- Dr B Daya- Ms S Misbach- Dr K Grammer- Dr K Cloete & Dr J Claassen (Provincial Office)- Medical Superintendents/Managers of District and Special Hospitals- Ms C Adonis and the Priority Programme Managers

With special thanks to

Ms L Solomon with the Health Information component for health dataMs N Booysen for financial informationDr R Martell for close editingMs M Soeker for general co-ordination of all the role-players.Ms C Ruiters for Final Typing and Layout

COPYRIGHT

The MDHS Planning Task Team, under direction of Drs Bitalo and le Grange, compiled this report. Thisdocument therefore remains under the copyright of the MDHS and may be used as long as the source isproperly acknowledged. This information was deemed correct in August 2004 and can serve as a basis forfurther discussion with stakeholders. Final verification is however needed for detailed planning.

Contact: METRO DHSPrivate Bag X77915

Dr L Bitalo: 021-460-9119, lbitalo@pgwc.gov.zaDr C le Grange: 021-447-1758, clegrang@pgwc.gov.za

0000 2003200320032003 2004200420042004

AIDS Acquired Immune Deficiency SyndromeAPH Associated Psychiatric HospitalsCHBC Community Home Based CareCHC Community Health CentreCHSO Community Health Services OrganisationCMD Cape Medical DepotCOCT City of Cape Town (LG)DHIS District Health Information SystemDHP District Health PlanDHS District Health ServicesDOH Department of HealthDOTS Directly Observed Treatment Short-courseDPC District Planning CommitteeDPW Department of Public WorksERH EersteRiver HospitalFBH False Bay HospitalFTE Full-time EquivalentGSH Groote Schuur HospitalHAART Highly Active Antiretroviral TherapyHBC Home Based CareHIV Human Immuno-deficiency VirusID Intellectual DisabilityIMLC Institutional Management and Labour committeeIMCI Integrated Management of Childhood IllnessesINP Integrated Nutrition programmeKm kilometreLG Local Government (COCT)MCWH Maternal, Child and Women's healthMDHS Metropole District Health ServicesMDR Multi-drug Resistant TBMMH Mowbray Maternity HospitalMO Medical OfficerMOU Midwife Obstetric UnitMTEF Medium-term expenditure frameworkNGO Nongovernmental organisationNPO Non profit OrganisationPDE Patient Day EquivalentPFMA Public Finance Management ActPGWC Provincial Government Western CapePHC Primary Health CarePMTCT Prevention of mother-to-child transmission of HIVPN Professional NursePPP Public/Private PartnershipPSNP Primary School Nutrition ProgrammePSRG Psycho-social Rehabilitation GroupsPTB Pulmonary tuberculosisRHC Reproductive Health ClinicSLA Service Level AgreementSTI Sexually transmitted infectionTB TuberculosisTOP Termination of pregnancyUCT University of Cape TownUS University of StellenboschUWC University of the Western CapeVCT Voluntary Counselling and TestingWHO World Health Organization

0000 2003200320032003 2004200420042004

0000 2003200320032003 2004200420042004

0000 2003200320032003 2004200420042004

1111 2003200320032003 2004200420042004

2222 2003200320032003 2004200420042004

3333 2003200320032003 2004200420042004

4444 2003200320032003 2004200420042004

5555 2003200320032003 2004200420042004

6666 2003200320032003 2004200420042004

2.1 Eerste River Hospital2.2 False Bay Hospital2.3 Wesfleur Hospital2.4 Brooklyn Chest TB Hospital2.5 DP Marais TB Santa Center2.6 Booth Memorial Hospital2.7 St Lukes Pinelands Hospital

7777 2003200320032003 2004200420042004

8888 2003200320032003 2004200420042004

9999 2003200320032003 2004200420042004

10101010 2003200320032003 2004200420042004

3.1. Geography3.2 Population3.3 Socio-economic status3.4 Health status

3.4.1 Child Health3.4.2 Maternal Health3.4.3 TB3.4.4 HIV/AIDS3.4.5 Non-communicable Diseases3.4.6 Violence and Trauma3.4.7 Mental Health3.4.8 Disabilities3.4.9 Oral Health3.4.10 Causes of death

3.5 DHS development3.6 Challenges

11111111 2003200320032003 2004200420042004

12121212 2003200320032003 2004200420042004

-300000 -200000 -100000 0 100000 200000 300000

0-45-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84

85+

M F

-200000 -150000 -100000 -50000 0 50000 100000 150000 200000

0-45-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84

85+

M F

13131313 2003200320032003 2004200420042004

14141414 2003200320032003 2004200420042004

• *Source: South African Demographic and Health Survey 1998.

Jan – June 2003

15151515 2003200320032003 2004200420042004

it comparesfavourably with the rest of S.A. Low birth weight in particular, is as much of a problem as elsewherein

Metro - Infant Mortality Rate Jan - June 2003

161718

2022

252626

2937

51

Central

Mitchells Plain

Tygerberg West

S Peninsula

Blaauwberg

Oostenberg

Helderberg

Tygerberg East

Athlone

NyangaKhayelitsha

16161616 2003200320032003 2004200420042004

*MRC Report (2001)

3.

* Saving Mothers: Second Report by DOH – 2002

17171717 2003200320032003 2004200420042004

1998 32 2 34 34 -1999 31 3 34 34 -2000 49 1 50 50 -2001 41 1 42 42 -2002 59 1 60 60 -

18181818 2003200320032003 2004200420042004

6 7

1 4 0

1 8 6 1 9 4

3 0 12 8 0

2 4 5

1 4 3

1 8 1

2 2 7

1 1 96 7

5 0 4 7

1 5 8

1 9 1

05 0

1 0 01 5 02 0 02 5 03 0 03 5 0

19871989

19911993

19951997

19992001

2003

Y e a r

No

ofC

ases

* Cape Town TB Control Report (1997-2003)

19191919 2003200320032003 2004200420042004

0

5

10

15

20

25

30

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Per

cent

W Cape

National

20202020 2003200320032003 2004200420042004

21212121 2003200320032003 2004200420042004

Table 3.15Causes of Death – Metropole compared to National

Source CT Mortality, 2001, MRC report - P Groenwald et al 2003 page 17

22222222 2003200320032003 2004200420042004

23232323 2003200320032003 2004200420042004

24242424 2003200320032003 2004200420042004

4.1 Community Based Services

4.2 PHC Physical Facilities - CHCs

4.3. PHC Physical Facilities – District & Specialised Hospitals

4.4 Facility Infrastructure

4.5 Physical Condition of Facilities

4.6 Challenges

25252525 2003200320032003 2004200420042004

•

•

•

26262626 2003200320032003 2004200420042004

* Reproductive Health Clinic** Both Provincial and LG services are rendered in the same building and various degrees of functional integration exist.*** Currently L2 Hospital.

27272727 2003200320032003 2004200420042004

28282828 2003200320032003 2004200420042004

*Source- Mr Kriedeman, Parow Office

29292929 2003200320032003 2004200420042004

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

Central

Eastern

Khayelitsha

Klipfontein

Mitchells

Plain

Northern

Panoram

a Southern

Tygerberg

Metro

Comparisons between sub-district population & types of service

Population/ Service pointPopulation/ Fixed CHC/ClinicPopulation per MDHS's CHC