Introduction
Methods
Results
Uganda | Mali | Sudan | Botswana | South Africa | Source | |
---|---|---|---|---|---|---|
Population in 2010 (millions) | 33.4 | 15.4 | 33.0 | 2.0 | 50.1 | [30] |
Annual population growth (2000–2010) | 3.2% | 3.1% | 2.4% | 1.3% | 1.1% | [30] |
Total fertility rate (per woman) in 2010 | 6.1 | 6.3 | 4.4 | 2.8 | 2.5 | [7] |
Maternal mortality rate 2013 (per 100 000 live births) | 360 | 550 | 360 | 170 | 140 | [10] |
324.9 | 388.3 | 275.2 | 480.8 | 174.1 | [9] | |
Stillbirth rate 2009 (per 1000 total births) | 25 | 23 | 24 | 16 | 20 | [30] |
Proportion of births attended by skilled personnel, % (year of latest data available) | 58.0 (2011) | 58.2 (2011) | 19.9 (2010) | 99.1 (2010) | 91 (2003) | |
Neonatal mortality rate 2010 (per 1000 live births) | 26 | 48 | 35 | 19 | 18 | [30] |
Under 5 mortality 2010 (per 1000 live births) | 99 | 178 | 103 | 48 | 57 | [30] |
Government health expenditure as % of GDP (2009) | 8.5 | 5.5 | 7.3 | 10.0 | 9.2 | [30] |
Government health expenditure (PPP Int $ per capita) (2009) | 26 | 27 | 44 | 985 | 407 | [30] |
Overall density of doctors, nurses and midwives
Training
Primary health care staffing levels
Level | Details | Uganda | Mali | Sudan | Botswana | South Africa |
---|---|---|---|---|---|---|
Traditional health practitioners (THPs) and traditional birth attendants (TBAs) | Personnel | Many THPs practice although there is no national association. TBAs are banned from conducting deliveries. | 5875 THPs are registered with 135 local associations, and there is a national federation of THPs’ associations. TBAs conduct deliveries. | Traditional healers (TH) are practising all over Sudan. Also, there are many TH centres that belong to special religious groups (Tarriga). TBAs (Habil Midwives) are doing home deliveries. | 3100 THPs are registered with their associations | About 185 500 traditional African healers. 29 000 belong to traditional healer organizations. |
Community health workers | Name | Village health teams (VHTs) | “Relais” and “Agents de Santé Communautaire” (ASCs) | Community health workers (CHWs); mother support groups. | Village health committees, led by nurses from the primary clinic | Community health workers |
Personnel | Volunteer community members | Volunteer community members | CHWs are paid community members, active and motivated to help in providing care | 920 community home-based volunteers and in some places community health nurses | 80 000 – young (mostly matriculants) with basic and non-standardized training of 10 days to 1 year. | |
Roles | Health promotion. Integrated Community Case Management (ICCM) is being piloted. | Relais: mobilizing villagers for vaccination. ASCs: screening for malnutrition; ICCM | Help in providing essential PHC services addressing community needs | Provide basic care to patients with terminal or debilitating conditions in the home setting, under supervision of registered nurses | Mostly health screening and education, follow up on adherence and social problems | |
Lowest level health facility | Name | Health centre II | Maternité | Basic health unit (BHU) | Mobile stops (outreach clinics), health posts | Primary health care clinic (occasionally mobile clinic) |
Personnel | 9 staff, led by enrolled nurse or midwife | Matrone (midwifery assistant) | Medical assistant/nurse/midwife | Registered nurses | 5–23 nurses (professional and enrolled) | |
Services | Basic curative consultations; preventive interventions; emergency deliveries | Basic curative consultations; antenatal care and normal deliveries | Basic comprehensive services, MCH | Basic preventive (immunizations) and curative services | Basic preventive (immunizations) and curative services per standard treatment guidelines for nurse management | |
Population covered | 5000 | Not specified | 5000 | 400–500 | 10 000 | |
Next-level health facility | Name | Health centre III | Centre de Santé Communautaire (CSCOM) | Family health centre (FHC) | Primary care clinics with and without maternity | Community health centre (with and without maternity obstetric units (MOUs)) |
Personnel | 19 staff, led by a generalist doctor; most are led by a nurse or midwife | Usually led by a nurse; few have a doctor. | Planned to be led by family medicine physician/GP or medical officer | Registered nurses and midwives | 1–5 medical officers, 30–92 nurses and midwives | |
Services | As above, plus laboratory services, maternity and small inpatient unit | As above, plus responsible for vaccination, etc. in health subdistrict | Comprehensive services including MCH/non-communicable diseases. | Preventive and curative services and antenatal and postnatal services. | Comprehensive services, usually including deliveries | |
Population covered | 20 000 | 15-km radius, c. 20–30 000 | 20 000 | 1000–3000 | 50 000 |