Health and related indicators 2021

Abstract

This chapter aims to provide a repository of data, focusing on the national and provincial levels, that describes the broad status of the South African health system (socio-demographic indicators and determinants and health status indicators, as well as health service indicators). Data were sourced primarily from national routine data sources, but also captured major surveys and global reports. The impact of the COVID-19 pandemic was viewed through multiple lenses. COVID-19 hastened the development of new or improved health information systems or modules to track both the disease and health system inputs and responses. Real-time reporting of incident cases, hospitalisations and mortality was enabled, including weekly estimates of the number of excess deaths associated with the pandemic. Ensuring that these innovations are retained after the pandemic will be important. COVID-19 has also emphasised the need to ensure that all data systems use a common unique identifier. COVID-19 has resulted in many collateral impacts on other aspects of health service delivery and outcomes, and selected examples were reported on, using routine data to illustrate the difference between expected and observed measures. Marked impacts were shown on the Primary Health Care utilisation rate and antenatal care, and on specific disease programmes, such as tuberculosis screening, testing and treatment initiation, HIV testing, antiretroviral therapy initiation and continuity of care. Less dramatic impacts on childhood immunisation coverage were evident from routine data. Community Health Workers have been a vital cadre in the response to COVID-19 and in mitigating disruptions to health service delivery as a result of the pandemic, yet their role in the health system is poorly documented and managed, since they are not included in the mainstream information systems. As South Africa transitions from a pandemic response to the means of managing COVID-19 as an endemic disease, a key task will be to retain what is most useful in health information systems and other innovations, and to ensure that these continue to contribute to the unfinished agenda of universal health coverage.