On 20 July 2021, the SA NCDs Alliance is co-hosting and coordinating a people’s consultation on universal health coverage (UHC). This is especially for you if you use government health services.
The South African version of UHC is called “national health insurance” or NHI. But are we talking about the same thing? There are some big differences. What do you think?
The event is a virtual focus group lasting 2 hours with 30 participants. You can only participate if you apply. We want to hear your voice especially if you are part of a vulnerable or hard-to-reach group that uses public or government health services. So you need to complete that application form and showing us why your participation is important.
People who are left behind or have trouble having their health needs met before or during COVID-19?
Civil society participants, breakout group facilitators or note-takers.
We want to make sure that we hear from you, the people, and especially if you are in that “seldom heard” and vulnerable group. We can help a few selected participants with data package to participate on the day.
A Stats SA report has revealed that TB remains the main leading cause of death in South Africa between 2016 and 2018.
The report, titled “Mortality and causes of death in South Africa: Findings from death notification, 2018”, provides information on levels, trends and patterns in mortality and cause-of-death statistics by socio-demographic and geographic characteristics.
“The mortality indicators and cause of death indicators presented in this report are critical indicators on the health status of the South African population,” said Stats SA.
“The main focus is on 2018 death occurrences; however, information on deaths that occurred during the period 1997 to 2017 is included in order to show trends in mortality. The cause-of-death statistics in this statistical release provide information on the leading underlying natural causes of death, patterns and trends in non-natural underlying causes of deaths, as well as comparison between immediate, contributing and underlying causes of death,” said Stats SA on Tuesday.
According to the report, mortality levels are declining in the country as indicated by the downward trend in the number of registered deaths since 2007.
The results showed that the total number of deaths registered at the Department of Home Affairs and processed by Stats SA in 2018 were 454 014.
While the occurrence of deaths in the country continued to decline, it differed by age and sex. The age group 65-69 had the highest proportion of deaths in 2018 at 8.4%, followed closely by age group 60-64 at 8.3%. Conversely, the lowest proportions of deaths were observed in age groups 5-9 years and 10-14 years at 0.6 % and 0.8%, respectively.
With regard to sex, between 1997 and 2018, there were more male than female deaths from age 0 to age group 65-69; whereas female deaths consistently exceeded male deaths for ages 70 years and above.
The results further indicate that in 2018, the highest sex ratio (167 male deaths per 100 female deaths) was observed in the age group 20-24 years. The pattern was observed for four consecutive years, between 2015 and 2018.
For the period 2016-2018, Tuberculosis remained the main leading cause of death in South Africa.
Diabetes mellitus, the report found, remained as the second leading underlying cause of death whose proportions have been increasing over the three years.
“According to the global burden of diseases, two of the top five leading underlying causes of death for males were communicable diseases (tuberculosis and HIV) whilst among females, there was only one communicable disease (HIV) with the rest being non-communicable diseases.
Stats SA said the results showed that 9 out of 10 leading causes of death were the same for both sexes, although with different rankings.
“Tuberculosis was the leading underlying cause of death for males, accounting for 7.2% of male deaths while diabetes mellitus was the leading underlying cause of death amongst females accounting for 7.7% of female deaths.
“Human immunodeficiency virus [HIV] disease (4.6%) was the second leading cause of death for the males, followed by other forms of heart disease (4.5%). Cerebrovascular diseases (6.1%) was the second leading underlying cause of death for females.
“In 2018, the most significant decline amongst females were deaths due to tuberculosis which declined from 5.2% in 2016 to 4.8% in 2018. Uniform to this, there was a significant decline in tuberculosis deaths from 7.2% in 2015 to 7.6% in 2018 among males.
Non-natural deaths
Stats SA said although the number of deaths due to natural causes were higher than the number of deaths due to non-natural causes, the proportion of deaths due to non-natural cause have been on a slight increase in the recent years.
Between 2010 and 2018, a consistent increase in the proportions of deaths due to non-natural causes was noted from 9.0% in 2010 to 11.9% in 2018. The age groups mostly affected by non-natural causes of death in 2018 were age group 20-24 years and 15-19, accounting for 49.2% and 42.5%, respectively.
Males had higher proportions of deaths due to non-natural causes compared to females, with a wider difference observed at age group 15-29 where as much as 58,1% of male deaths resulted from non-natural causes compared to 19,8% of female deaths in the same age group.
Deaths due to non-natural causes were mainly dominated by those due to other external causes of accidental injury (68.3%) followed by assault (14.0%) whilst there were 11.4% non-natural deaths due to transport accidents.
In total, KwaZulu-Natal had the highest proportion of deaths due to non-natural causes (13.5%), followed closely by Cape Town (13.0%). In terms of proportions, deaths due to transport accidents were the highest in Limpopo (30.1%), whilst assault was highest in Eastern Cape (22.7%).
Government will in the next financial year avail an additional R8 billion to the health system for the country’s COVID-19 pandemic response.
This will be in addition to the R20 billion the state allocated in the 2020/21 financial year, Finance Minister Tito Mboweni said on Wednesday, while delivering the 2021 Budget Speech, in Parliament.
In a Budget Review document, the National Treasury said the funds were to enable the sector to expand prevention, screening, testing and hospital capacity.
The R8 billion, which will be allocated to provincial health departments through the provincial equitable share, is expected to enable the sector to sustain these activities and respond to possible future waves of COVID-19 infection.
“Provincial governments receive an additional R8 billion in 2021/22 to continue the public health response to the pandemic, and the potential for additional waves of infection. Provinces can mitigate the negative impact of COVID-19 and the associated lockdowns on their revenues by improving efficiency, particularly in the procurement of health equipment,” said the Minister.
In total, the health expenditure function will over the medium term make up 14.2 percent of total government spending, declining from R247 billion in 2020/21 to R245 billion in 2023/24.
“Provincial health departments receive about 92 percent (R678.7 billion) of these medium-term allocations.
Reductions to the sector, mostly focused on compensation spending, are estimated at about R50.3 billion over the 2021 MTEF period,” the document reads.
To achieve this, other reductions would be required from health departments to increase efficiency. This included generating savings through centralised procurement of certain goods, reducing variations in unit costs in HIV programmes and improving management of overtime costs.
The COVID-19 pandemic has had a massive impact on the South African health system. As at 16 February 2021, the country had 1.5 million confirmed cases and over 137 000 excess deaths as reported by the South African Medical Research Council.
Over the MTEF period, R29.4 million is allocated to Tygerberg Regional Hospital and R100 million to Klipfontein Regional Hospital in the Western Cape through the health facility revitalisation grant.
The timeline on NCDs policy development since 2011 with global and national contextual indicators. Its purpose is to show progress on policy developments and will be used as the basis for an advocacy tool. Please make your input and let us have feedback.
On 20 July 2021, the SA NCDs Alliance is co-hosting and coordinating a people’s consultation on universal health coverage (UHC). This is especially for you if you use government health services.
