oa South African Health Review - Health and related indicators : indicators
This chapter presents a selection of the best available data on the functioning and performance of the South African health system. It also questions whether the data provide evidence of a system that is truly based on Primary Health Care principles. Accordingly, it draws attention to data on the social determinants of health, which received particular attention at Alma Ata and have been highlighted once again with the release of the World Health Organization's World Health Report this year.
The available evidence reflects enormous variability in the quality of information in the different health information systems as well as variability in the risk factors and determinants of health, health care delivery, as well as health outcomes.
Overall the information available suggests that while progress has been made with policy formulation and some inputs (e.g. financing) and processes (e.g. immunisation), inadequate provision and maldistribution of human resources linked with incomplete implementation of policies has resulted in ongoing inequities. Some outcome and impact indicators, measured in terms of morbidity and mortality, show either little improvement or even deterioration over time.
The implementation of both health care delivery and information systems do not accommodate the interdepartmental and interdisciplinary responses that are required to adequately address the social determinants of poor health and achieve comprehensive Primary Health Care. This challenge has to be faced in relation not only to infectious diseases, but also in relation to the increasing burden of chronic non-communicable diseases.
The sections for which data are included are given in the table of contents following.
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