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Progress in Equitable Resource Allocation for Primary Health Care Financing at District Level

This analysis examines progress in the equitable allocation of resources for primary health care (PHC) financing at the district level in South Africa, focusing on data from June 2008. The study identifies disparities in public sector PHC funding and highlights indicators of deprivation affecting resource allocation. The analysis considers various factors, including demographic variables and non-hospital expenditure per capita. Despite improvements, issues such as data quality and alignment with national treasury figures remain challenges in understanding equitable health financing.

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Progress in Equitable Resource Allocation for Primary Health Care Financing at District Level

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  1. PHC Financing at District level Data, Equity & Analysis June 2008 Candy Day Health Systems Trust

  2. Is there progress in equitable allocation of resources? • Research in 2001 indicated extreme inequity in public sector PHC financing and according to need (deprivation) Stephen Thomas et alCh 4, South African Health Review 2002 PHC Financing – district level

  3. DI vs PCE, 2001 PHC Financing – district level

  4. Health expenditure data • Data generally poorly coded for facility- or district-level analysis • Published data don’t match well with National Treasury data • Calculation of useful indicators requires integration with other data sources PHC Financing – district level

  5. Measurement of Deprivation • Deprivation index (DI) is a measure of relative deprivation across districts in SA • Based on work done by HEU • Normalised DI = 1 (least deprived) PHC Financing – district level

  6. Variables for DI – Proportion: • children<5 • of population Black • female headed households • household head with no schooling • unemployed • traditional/informal dwelling • no piped water • pit/bucket toilet or no toilet • no access to electricity or solar PHC Financing – district level

  7. Non-hospital PHC expenditure per capita Treasury BAS/ Walker StatsSA GHS DHIS from StatsSA PHC Financing – district level

  8. Treasury Budget Programmes PHC Financing – district level

  9. Selected issues • Quality of coding • Geography • Budget programmes • Facilities • Cross-boundary areas • Trend analysis – inflation • Data quality PHC Financing – district level

  10. Data comparison 2005/6 PHC Financing – district level

  11. Selected results • Non-hospital PHC expenditure per capita increased from R222 in 2001/2 to R256 in 2006/7 PHC Financing – district level

  12. PHC Financing – district level

  13. PHC Financing – district level

  14. General improvement in equity PHC Financing – district level

  15. Metros vs ISRDP PHC Financing – district level

  16. Expenditure in relation to need PHC Financing – district level

  17. PHC Financing – district level

  18. Acknowledgements Thanks to others in the team who worked with this data:Peter Barron, Mark Blecher, Fiorenza Monticelli and Elliot Sello PHC Financing – district level

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