Per capita spending on primary health care (PHC) ranges from R389 in richer districts of South Africa to a mere R42 in the poorest.
This is according to the ninth South African Health Review, released on Wednesday by the NGO Health Systems Trust.
The difference in spending, the review said, meant many districts were simply unable to afford the PHC package estimated at about R220 per person.
Though spending on health in the public sector in 2005/6 was projected to increase by R8,7-billion in real terms over a decade, much of the funding had been absorbed by HIV/Aids, medical inflation and relatively higher salaries.
This had resulted in stagnation of real per capita spending.
On a positive note, the review found that 94% of pregnant women received antenatal care and there had been an improvement in the quality and quantity of health data for planning and policy-making.
Launched together with the review on Wednesday was a survey of PHC facilities, including equipment, immunisation provision and response time of emergency medical transport.
This survey showed that substantial inequities continue to exist between provinces.
In its reaction to the document, the department of health said funding for the health system was ”clearly” not sufficient.
This included per capita funding for PHC and hospital services.
”Related to this is the criticism that we have not done enough to bring equity in use of resources between the public and private sectors. This is a valid criticism,” the department said.
It noted the review’s point that the impact of the HIV and Aids epidemic had reversed many of the early health status gains.
”We need to better understand this impact and the extent to which our interventions are reversing this trend,” it said.
The 2003 district health survey results which should be available later this year should help here.
The Health Systems Trust, which has been in existence since 1992, says it aims to promote scientific research to create a comprehensive national health system based on equity. – Sapa