Cervical cancer screening coverage by province
Cancer of the cervix (CaCx) is the only NCDs indicator monitored in the District Health Barometer 2013-2014 due its historical focus on Millennium Development Goals.
- Cervical cancer (CaCx) is the 2nd most frequent cancer among SA women
- Most frequent cancer among women between 15-44 years
- 43 million women aged ≥15 years are at risk
- 7,735 women are diagnosed with CaCx every year
- 4, 248 die from CaCx.
- 21% of women in the general population are estimated to have cervical HPV infection at a given time
- Over 60% of invasive CaCx are attributed to HPVs 16 or 18.m
- HPV vaccination of girls before sexual activity is the best primary prevent
It is the nearly 20 million women who are at risk that need the CaCx screening and the ones below are only of women 30 and older. Only screening tests are considered… that is to find those who need further investigation.
- 1st place: KZN is the best performing province for the second year running.
- 2nd place: North West improved increased its performance by 13.1%
- 3rd place: Western Cape
No province meets the all of the criteria for an operational NCDs plan:
- NGOs & PLWNCDs engaged in national NCD plan development
- Provincial budgetary allocation for prevention and treatment
- Intersectoral NCDs mechanism including NGOs, PLWNCDs and private sector
- NCDs plan with a ‘whole of government’ approach, i.e. with areas for action beyond the health sector.
NCDs plans could be standardised if a template existed and that could easily be one of the first tasks of the long delayed NCDs Commission / National Health Commission.
Discouraged NCDs personnel in provinces
Dedicated health officials from the provincial heath head offices work on NCDs despite the low priority given by leaders to fight NCDs. One such worker recently said: “I have been told there is no budget for NCDs health promotion in our province for the rest of the financial year. What am I supposed to do for the next 5 months? It is very discouraging.”
Table 1: NCDs plans available and operational in provinces
| Eastern Cape: Unknown |
No web-based documentation found and no response to request for NCDs plan. |
| Free State Unknown |
No web-based documentation found and no response to request for NCDs plan. |
| Gauteng: Partial |
Completed draft NCDs operational plan that is combined with geriatrics and eye care. (26) Goals, targeted and with budget request. Intersectoral objectives with meetings and district coordinators already take place. Availability of plan not known. |
| KwaZulu-Natal Partial |
Completed draft NCDs plan used to guide activities which presented at the intersectoral KZN–SA NCD Alliance Indaba (workshop) in June 2014.(27). However, support is implied by the attendance of the Member of the Executive Committee (MEC) for Health at the NCDs meeting. (28) |
| Limpopo: unknown |
No web-based documentation found and no response to request for NCDs plan. |
| Mpumalanga partial |
Completed draft NCDs Operational Plan 2014 (29) |
| North West unknown |
No web-based documentation found and no response to request for NCDs plan. |
| Northern Cape unknown |
No web-based documentation found and no response to request for NCDs plan. |
| Western Cape partial |
Plan under construction. (30) |
Source: SA NCD Alliance Benchmarking NCDs for action 2015. Full list of references in benchmarking document (all are all provincial government documents.)
Only 3 provinces have draft (not officially approved) NCDs plans and none have a budgetary allocation that can be traced to NCDs. Assessing the extent of NCDs roll out is difficult as neither budgets nor monitoring mechanisms are available. The three provinces are Gauteng, KwaZulu-Natal and Mpumalanga (see Table 1).