National Strategic Plan - Priority Districts

Where are the 18 Priority Districts?

Province District Most deprived sub-district
Eastern Cape Amathole 1. Mbhashe Local Municipality
Alfred Nzo 2. Umzimvubu Local Municipality
Ukhahlamba 3. Senqu Local Municipality
Cacadu 4. Ikwezi Local Municipality
OR Tambo 5. Ntabankulu Local Municipality
Chris Hani 6. Engcobo Local Municipality
Free State Thabo Mofutsanyane 7. Maluti a Phofung Local Municipality
Gauteng Metsweding 8. Kungwini Local Municipality
Kwazulu-Natal Zululand 9. Nongoma Local Municipality
Ilembe <10. Maphumulo Local Municipality
Umkhanyakude 11. Umhlabuyalingana Local Municipality
Amajuba 12. Dannhauser Local Municipality
Limpopo Mopani

13. Greater Giyani Local Municipality

Mpumalanga Ehlanzeni 14. Bushbuckridge Local Municipality
North West Bojanala 15. Moretele Local Municipality
Bophirima 16. Kagisano Local Municipality
Northern Cape Kgalagadi 17. Moshaweng Local Municipality
Western Cape Cape Town Metrople 18. Khayelitsha sub-district

How were the priority districts identified?

These districts were chosen because they have poor health status, health service delivery and poor access to health services. Districts have been ranked using key indicators data on which are readily available, mostly through the District Health Information system. These are:
  • a deprivation index (as reported in the District Health Barometer)
  • the proportion of pregnant women tested for HIV
  • the proportion of deliveries which take place in a health facility
  • immunization coverage at one year of age
  • Vitamin A supplementation coverage (1-5 years).

The top fourteen (worst performing) districts are located within five provinces – Eastern Cape, Kwazulu-Natal, North West, Limpopo and Mpumalanga. These fourteen districts, plus one district from each of the remaining four provinces, are targeted (total 18 districts). For the Free State and Gauteng, the district with the highest ranking was chosen.

Within each of the districts, the sub-districts with the highest deprivation index (2007 Community Survey) was identified. Although it would have been preferable to use the same system that was used to identify the districts, this was not possible as the health service coverage data were not readily available at sub-district level.

Because all districts in the Northern and Western Cape fell in the lower half of the ranking, a different approach was adopted. In the Northern Cape, Moshaweng sub-district in Kgalagadi District was chosen due to its high deprivation index (at sub-district level). Khayelitsha sub- district within the Cape Town metropole was identified in the Western Cape, due to high levels of deprivation. It was also considered an advantage to include at least one urban sub- district.

How are service delivery and health outcomes monitored at district level?

District-level data is collected through the District Health Information System (DHIS) of the Department of Health. Comparative data on a number of indicators provide the basis for district rankings, and are reported annually in the District Health Barometer, published by Health Systems Trust (see

The quality of district data in the DHIS is known to be quite variable and is limited by data gaps and some implausible data. However there have been efforts to improve the efficiency and accuracy of data collection systems and build the capacity of administrators at district level. The District Health Barometer attempts to improve the data quality by removing outliers and unlikely values.

DHIS data from the priority districts are presented for four indicators on this website:

This district-level information has been extracted from the District Health Barometer. We do not interpret or make comparisons since it is not possible to determine the reasons for variability, which may include variable data collection quality in the sites.