1
MPUMALANGA PROVINCE
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
HEALTH COMPONENT BUDGET HEARING
14 June 2004
2
Mpumalanga Provincial team MEC SW Lubisi Member of Executive
CouncilMr HE Verachia Deputy Director
GeneralMr R Mnisi Chief Financial OfficerDr K Michael Chief Director:
Hospital ServicesMs G Mathebula Chief Director:
Primary Health Care
3
Mpumalanga Provincial team Ms R MonyamaneDirector: Human
ResourcesMr. J Mlangeni Deputy Director:
CommunicationsMs P Gwala Deputy Director:
Finance (Strategic planning)
Ms P Rousseau Deputy Director: Office of the DDG
5
The Health Sector Strategic Framework1999-2004 also known as the 10 point plan identified the following major elements:1. Reorganisation of certain support services2. Legislative reform3. Improving quality of care4. Revitalisation of Public hospital 5. Speeding up delivery of an essential package of services through the district health system
6
6. Decreasing morbidity and mortality rates through strategic intervention7. Improving resource mobilisation and the management or resources
without neglecting the attainment of equity in resource allocation8. Improving human resource development and management9. Improving communication and
consultation within the health system and communities we serve10. Strengthening co-operation with our partners internationally
7
Reorganisation of support services
Health information Working relationship established with Italian
Corporation to strengthen Health Information Systems at all levels
Telemedicine Completed pilot phase of PHC (Naas Clinic) to
hospital (Tonga Hospital) support programme Reduction of Neurosurgical referrals to
Gauteng through effective use of Tele-radiology linkages
8
Reorganisation of support services
Medico-legal Mortuaries Provincial Project manager and task team
established Negotiations commenced with SAPS
National Health Laboratory Service (NHLS) Provincial staff absorbed into NHLS structure Equipment transferred to NHLS Negotiations to conclude Service Level
agreement with NHLS Two sites for CD 4/Viral load investigations
established
9
Reorganisation of support services
Blood transfusion services Successfully aligned the blood
transfusion needs of the Province with the restructured National Blood Transfusion Services.
Occupational Health Services Backlog on ex-miner compensation
claims with Medical Bureau of Diseases reduced from 70% to 50%
10
Improving Pharmaceutical ServicesRevival of the Therapeutic Committee.
All institutions provided with new stock cards.
Trained 42 staff members regarding the operations of the Therapeutic Committee.
After benchmarking with other provinces, plans are underway to build the provincial medical depot.
Reorganisation of support services
11
Challenges To ensure compliance with Pharmacy Act requirements by May 2005 Need to establish an inter-sectoral plan so as to develop an integrated food safety and control system Need to capacitate the Health Information Unit
Reorganisation of support services
12
Legislative reform Public hearings on the National
Health BillPresentations made to the
Provincial Portfolio committee Implementation of Free Health
services to the DisabledUniform Patient Fee Schedule
(UPFS) presented to Provincial Treasury and Portfolio committee
13
Legislative reform
Challenges Draft Provincial Health Bill awaiting
finalisation Participate in the finalisation of the
Health Technology Legislation
14
Improving quality of care
Complaints procedure implemented at all health facilities
Ongoing training on: Code of Conduct Batho Pele Patients Rights Charter
Tender board approval obtained for 3 year contract with COHSASA
15
Improving quality of care
Critical, strategic positions at facilities and Provincial office filled.
Launched Patient Hotline (0800 20 40 98)
16
Improving quality of care
Challenges Improve attitude and professionalism
of health workers Establish and train governance
structures
17
Revitalisation of hospital services
CEO’s appointed for hospital complexes Cost Centre Accounting introduced at 4
pilot sites 4 revitalisation projects on track and
next 4 priority hospitals identified Tertiary services rendered at 2 hospitals Provincial Hospital plan aligned with
National Modernisation of Tertiary services (MTS) model
18
Revitalisation of hospital services
Challenges Appoint project manager and project
steering committees (Provincial and local)
Establish a fully functional health technology unit
Recruitment of level 2 and 3 specialists Assign a dedicated budget (3%) for
maintenance of health facilities
19
Speeding up delivery of an essential package of services through the
District Health System
4 new PHC facilities commissioned (increase of 2,1%)
Outreach service by medical and allied personnel from Hospitals to feeder PHC facilities strengthened through increased numbers of community service personnel
Services at PHC level delivered according to National PHC package
20
Speeding up delivery of an essential package of services through the
District Health System
Training of PHC nurses through the University of Pretoria and South African Military Health Services (SAMHS)
Training on forensic nurses at the University of the Free State
Training of health promoters at the University of Limpopo
21
Speeding up delivery of an essential package of services through the
District Health System
Challenge Increase the number of newly
qualified PHC nurses Establish governance structures for
PHC facilities Finalise the exchange of PHC services
between the Province and municipalities
22
Decreasing morbidity and mortality rates through strategic interventions
Primary school feeding
Successful feeding for 171 days
457 248 learners in 1 378 schools benefited
Provided income to 35 suppliers, 55 sub-suppliers and 2 664 helpers
23
Decreasing morbidity and mortality rates through strategic interventions
Immunisation 90% coverage of children under one
yearYouth Friendly services
16 new sites established as National Adolescent Friendly Clinic Initiative (NAFCI) sites
24
Decreasing morbidity and mortality rates through strategic interventions
Improving Child Health
19 Pilot sites for (IMCI) Integrated Management of Childhood Illnesses were identified
157 Health Workers trained in Integrated Management of Childhood Illnesses (IMCI)
25
Decreasing morbidity and mortality rates through strategic interventions
Improving Women's Health 20 midwives from Gert Sibande were
provided with in-service training on maternity care guidelines
Increase of hospitals implementing Peri- natal Problem identification programme from 50% to 71%
Provincial Launch of National Contraceptive Policy
26
Decreasing morbidity and mortality rates through strategic interventions
Cholera
Limited the cholera outbreak in December 2003. By the end of March 2004 the total cases reported was 1680 and the weekly incidence declined rapidly
All municipal Medical Joint Operations Committee (MJOC) meet once every week to deal with the outbreak
27
Decreasing morbidity and mortality rates through strategic interventions
Malaria Inter-country and Intersectoral Collaboration and Support – visited Mozambique to actively fight malaria
across the borders
28
Decreasing morbidity and mortality rates through strategic interventions
Malaria Disease Management – planned and still currently studying the efficacy of combination therapy. 91 patients currently enrolled in the in vivo study. Conducted a confidential inquiry into the deaths notified in the risk areas
29
Malaria Information Education
Communication – provided public health education to all health professionals in the high risk areas. Health facilities in the high risk areas were visited and given treatment guidelines
Decreasing morbidity and mortality rates through strategic interventions
30
Malaria Educated and mobilized communities to
use protection measures against mosquito bites to reduce the risk of infection by attending 7 community meetings and visiting 1500 households. Conducted a Knowledge, Attitudes and Practices (KAP) survey to determine children’s knowledge concerning malaria
Decreasing morbidity and mortality rates through strategic interventions
31
Malaria Disease Surveillance and Monitoring –
visited 40 health facilities monthly to collect passive notifications. 100% of high-risk areas under GIS surveillance
Outbreak Response – visited 385 households to treat, educate and test patients. Epidemic and response plans developed and implemented
Decreasing morbidity and mortality rates through strategic interventions
32
Malaria
Vector Control – sprayed 126 400 structures in the highest risk localities to curb malaria transmission. Achieved a 88% coverage rate of structures targeted for spraying
Decreasing morbidity and mortality rates through strategic interventions
33
Decreasing morbidity and mortality rates through strategic interventions
Tackling HIV and AIDS
33 surveillance sites established and training provided
Policy on Post Exposure Prophylaxis available and implemented at all institutions
2 500 Home-based care kits were ordered and distributed to facilities
34
Decreasing morbidity and mortality rates through strategic interventions
Tackling HIV and AIDS
245 775 units of Pelargon were purchased and distributed to the PMTCT sites
680 home-based care volunteers were funded
35
Decreasing morbidity and mortality rates through strategic interventions
Tackling HIV and AIDS Launch of the Home-based care
month was held at Elukwatini on the 1st November 2003. Promotional Material was distributed at the Stadium
2 900 boxes of tablets and 1 320 bottles of Nevarapine syrup were bought and distributed
36
Decreasing morbidity and mortality rates through strategic interventions
Tackling HIV and AIDS 1 059 rapid screening tests were
purchased and distributed 7 000 Rapid Confirmatory Test kits
were bought and distributed
37
Decreasing morbidity and mortality rates through strategic interventions
Tackling HIV and AIDS 60 Health Care Workers and 30
Lay Counsellors were trained on VCT services
221 community volunteers from 14 areas were trained on condom use as peer educators
Identification of 12 sites for ARV roll out were done