DOI: 10.14749/1400830118
title: The impact of HIV-AIDS on the health sector 2002: Health facilities data - All provinces in South Africa

description: Description: 
 The questions contained in the health facility questionnaire were asked of 218 respondents (each representing one facility) from each of the facilities in the sample.Topics included in the questionnaires are: facility information, health institution (e.g. type), ownership of the health institution, location, size, services, human resources, turnover, admission rates, HIV/AIDS care, TB treatment, STDs treatment, cost of health care, drug utilization, laboratory supplies and utilization, resistance testing, blood transfusion services.

 The data contains 351 variables and 218 cases.
Abstract: 
 The Nelson Mandela / HSRC study of HIV/AIDS (2002) reported an estimated prevalence of 4.5 million among persons aged two years and older. Given the overall impact of HIV/AIDS on South African society, and the need to make policies on the management of those living with the disease, it was important that studies were undertaken to provide data on the impact on the health system. This study was undertaken by the HSRC in collaboration with the national School of Public Health (NSPH) at the Medical University of South Africa (MEDUNSA)and the Medical Research Council (MRC). It was commissioned by the National Department of Health (DoH) to assess the impact of HIV/AIDS on the health system and to understand its progressive impact over time.

 The principal investigators sought to answer the following questions

 
 To what extent does HIV/AIDS affect the health system?
 
 What aspects or sub-systems are most affected?
 
 How is the impact going to progress over time?


 To answer the questions, a stratified cluster sample of 222 health facilities representative of the public and private sector in South Africa were drawn from the national DoH database on health facilities (1996). A nation-wide, representative sample of 2000 medical professionals including nursing professionals; other categories of nursing staff; other health professionals and non-professional health workers was obtained. In addition to this a representative probability sample of 2000 patients was obtained.

 Data collection methods included a postal survey and telephone interviews

 The major variables are listed below:
 Health institution details, type of health services provided, staff profile, absenteeism, staff turnover, vacancies, admission rates, length of stay, average number of visits made by patient, hospital bed occupancy rates, management of HIV/AIDS services, HIV/AIDS care, TB treatment, treatment for sexually transmitted disease, cost of health care, drug availability, laboratory supplies, blood transfusion services.
description: Postal survey
description: Telephone interview
description: Health facilities in the public and private sector in South Africa.
description: The task was to obtain a representative probability sample of 2000 patients, and at most representative probability sample 2000 health professionals who are in contact with patients undergoing treatment at the selected health facilities. 
The sampling frame was the national DoH's health facilities database (1996). Target population, was selected from two separate sampling frames: - (a) a list of all public clinics in the country (excluding mobile, satellite, part-time and specialized clinics; and (b) a list of all hospitals (public and private) and Private clinics with indication of the number of beds available in each of health facilities from the national DoH database on health facilities (1996).
Provinces and health regions within provinces were considered as explicit strata. Provinces formed the primary stratification variable and the health regions the secondary stratification variable. The Primary sampling unit (PSU) was the magisterial districts within each health region in the case of public clinics, Secondary sampling unit (SSU) were clinics and hospitals- drawn using simple random sampling, and Ultimate/final sampling unit the (USU) the professional and non-professional health workers and patients.
Measure of size (MOS) for public clinics was a monotonic function of the number of clinics per managerial districts. Selected 167 clinics were allocated disproportionately i.e. proportional to MOS. Allocated sample number of clinics within each province was allocated proportionately to the health regions in the province. MOS for hospitals and private clinics was a monotonic function of the number of beds as in DOH's database.
Sample sizes for SSUs:
Public clinics (167)

Public Hospitals (33)
Private Hospitals and clinics (22)

Sample sizes for USUs:

1000 patients
500 nursing personnel 
200 medical doctors
100 other professional health workers
400 non-professional health workers

Public clinics 

1000 patients
500 nursing personnel 
111 nonprofessional personnel( e.g. cleaners)

Public Hospitals 

667 patients
333 nursing Personnel
200 medical doctors
67 other professional
222 non-professionals

Private Hospitals and clinics

333 patients
167 nursing Personnel
100 medical doctors (all to be drawn at hospitals)
33 other professional (all to be drawn at hospitals)
167 non-professionals