Page 148 - UGU Dstrct Mun IDP Report '21-22

3.7.2.2 Child Mortality Rates
Child mortality is decreasing in South Africa and Ugu district is no exception with the under 5 in facility deaths declining from 4.6 per 1 000 in 15/16 to 3.3 per 1 000 in 2017/18 (Q3). Ugu faces the challenge of poor immunisation coverage at 75.8% below the KZN average of 85.4%. PCR testing is the third highest in the Province at 1.4%. Modifiable factors that will be prioritised for action include close monitoring of immunisation performance, development of counselling skills on and marketing of safe infant feeding and management of shock at accident and emergency units.
Maternal mortality has dropped since 2014/15 in which 112 died per 100 000 live births and 2015/16 in which 92.4 died per 100 000. The 2017/18 quarterly reports project a rate of 80 maternal deaths per 100 000 which is a further drop. At 86%, Ugu is not performing well for the number of HIV positive pregnant women initiated on ART falling both below the district target of 99% and the Provincial target of 98%. The strategies to improve maternal and child outcomes include management of asphyxia related births, correction of data errors in reporting ANC started on ART. Youth friendly services will be prioritised to target teenage pregnancies, and there will be continued support of facility clinical governance strategies.
3.7.2.3 Accessibility to Health Facilities
The access to health facilities has already been covered under section 3.10.7. This section provides only the catchment populations and catchment areas. The District Health Plan projects a Low PHC utilisation rate of 3 vs target of 3.4 for 17/18. Strategies to improve utilisation include optimal management of outreach teams namely tracing teams, school health, ward-based outreach teams and mobile clinics as well as mobilizing men towards early health seeking behaviour. Ugu is the 11th highest district for grade 8 screening coverage in the country and top District in KZN. At fixed facilities, strategies to reduce waiting times and improve client satisfaction will be prioritized. The Provincial changes in TB regime has resulted in improved client outcomes, better community management and the reduced need to hospitalize clients on TB treatment. The resultant drop in hospital efficiency at Dunstan Farrell TB hospital (29%) has led the Province to initiate the decommissioning of the hospital.
Table 3.12.2.3.1: Population to PHC facility (Sub-District)
Source: Ugu DHP, 2018 / 2019
No clinics were commissioned in 2016/17. Gamalakhe CHC in Hibiscus completed phase 2 of 3. Umuziwabantu has the lowest population to clinic ratio. There are 11 fixed clinics to the population of 101 086 hence Umuziwabantu clinics appear to be adequate in terms of population to clinics. Ray Nkonyeni and Umdoni have the highest population to facility ratio and this is typical of an urban area. Umzinto in Umdoni has the highest headcounts for a clinic and is almost as much as the headcounts of a CHC. The clinic’s need is infrastructure upgrades as the building, although conveniently situated in Umzinto town, is very old and unsuitable for a clinic.
The 4 other clinics with the highest headcount are all in Ray Nkonyeni: Ezingolweni, Marburg, Mbunde and Margate clinic. Port Shepstone Hospital is a Regional hospital but due to no Gateway and no CHC in close proximity, the hospital still has non-referred OPD headcounts. In 2016/17, 7 326 clients were non-referred OPD headcounts. The pressure point for the district is a CHC in close proximity that can also assist to decongest the Regional hospital of the clinics that the hospital oversees. Marburg clinic upgrade to CHC is a much-needed project for the district.
3.7.3 Broad Based Community Needs
Based on the community consultations by the District together with its Local Municipalities community needs were categorised into 10 categories. These categories are: Water; Sanitation; Roads; Sport fields; Health; Education facilities; Health Facilities; Public Facilities; Electricity; and Other. Figure 3.12.3.1 below depict a statistical overview of the community needs issues raised during the public consultation sessions. A full public participation report is attached (Annexure 11).
Organisation unit
CHC
Clinic
Mobile
Umzumbe LM
168 396.00
12 953.50
56 132.00
Ray Nkonyeni LM
324 908.00
16 245.40
46 415.40
uMuziwabantu LM
9 285.10
34 045.30
uMuziwabantu LM
16 369.40
40 923.50
146 UGU DISCTRICT MUNICIPALITY