Health Cards (39)
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I would like to comment (from a South African viewpoint) on a few of the
points made by Bill in Health Cards (36).
I agree that we should strive towards equity in the health system,
however there are some problems (challenges) to deal with along the way.
A properly designed HIS will always know who makes up this TARGET
group. If a district has an immunization coverage rate of 95% the HIS
should be able to generate a roster showing the names and address of all
the remaining 5% in order that action can be taken to see that the
remaining children are immunized. When coverage rates are summarized
through aggregation you cannot possibly individualize your target.
We are attempting to work out our target population for various services
per district and eventually also per facility catchment area, but our
census information is very poor - we simply do not know how many people
are really living within a district, and even less so per facility
catchment area.
Yes, we do have censuses, and had one in 1991 while South Africa was in
transition to a democracy - certain areas were not well covered, due to
a so called lack of safety. We had another census in 1996, and this
time enumerators were striking, apart from logistic problems - some
areas were again not covered, for unclear reasons. Word is that we
should not hope for accurate results (hopefully available sometime next
year). Thus, we have to work with the data we have and make some rough
estimates, and use that for indicators, and adjust population figures if
they do not make sense.
Ideally identification of all potential beneficiaries should occur
through the process of a "family registration" [.]
I am not sure whether we have the human and other resources, or time to
register every family in our districts. Are their ways of doing this
without interfering with other priority activities in our districts?
Regards
Arie
Dr Arie Verburgh
Department of Health
Private Bag X11285
1200 Nelspruit
Mpumalanga
South Africa
Tel: +27 13 7552291
Fax: +27 13 7553549
Cell: 083 229 1107
mailto:ariev@social.mpu.gov.za
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