presentation to select committee on social services district health system jeanette r hunter 30...
TRANSCRIPT
Presentation to Select Committee On Social
ServicesDistrict Health System
Jeanette R Hunter30 July2013
CONTENT
DHS in briefDistrict Hospitals
IntegrationKey indicatorsAreas that require strengthening
DISTRICT HEALTH SYSTEM (DHS)
South Africa has made much progress with
regard to the DHS since the South African
Government of National Unity, through its
adoption of the Reconstruction and
Development Programme (RDP) in 1994,
committed itself to the development of a District
Health System based on the Primary Health Care
Approach as enunciated at Alma Ata in 1978.
DISTRICT HEALTH SYSTEM (DHS)
A National Health System based on this approach is
as concerned with keeping people healthy, as it is
with caring for them when they become unwell.
These concepts of “caring” and “wellness” are
promoted most effectively and efficiently by
creating small management units of the health
system, adapted to cater for local needs. These
units provide the framework for our district-based
health system.
RATIONALE FOR THE DHS
Health System
Jeanette R Hunter
Other sectors
Public Health Care System
Private, Traditional medicine, NGO, Ancillary (Ayurvedic, Homeopathic, etc)
Human Settlement, Water, Sanitation, Agriculture, Education, Social Dev, Public Works, Eskom
DHS IN SOUTH AFRICA
Our health system, currently structurally consisting
of:
National department of health
9 provincial departments of health
52 health districts
Through our primary health care reengineering
initiative firmly committed to the District Health
System with a focus on primary health care (PHC)
DISTRICT HOSPITALS
The district hospital plays a pivotal role in supporting primary health
care on the one hand and being a gateway to more specialist care on the
other
Size of District Hospitals small district hospitals with no less than 50 beds and no more than 150 beds
medium size district hospitals with more than 150 beds and no more than 300 beds
large district hospitals with no less than 300 beds and no more than 600 beds.
In some circumstances primary health care services are rendered where
there is no alternative source of this care within a reasonable distance.
INTEGRATION WITH REGARD TO DISTRICT HOSPITALS
Integration on two levels integration between higher level and PHC facilities from
community level
Integration within the District Hospital
INTEGRATION BETWEEN PHC FACILITIES FROM COMMUNITY LEVEL Ward Based Outreach Teams Health Posts Mobile Clinics Satellite Clinics Clinics with sessional GP support School Health Teams Community Health Centers District Hospital
Regional hospital Tertiary hospital Central hospital Specialized hospital
District Clinical Specialist Teams
Optimally functioning referral system
INTEGRATION WITHIN DISTRICT HOSPITALS
This is the smallest type of hospital providing generalist medical services Package of service includes:
Health Promotion and Preventative care Trauma and Emergency Care Obstetrics and Gynaecology Paediatrics and Child Health General Surgery Oral Health Eye Care Care of the elderly Mental Health Occupational Health Rehabilitation
Except for labour and maternity wards, district hospitals do not have discipline specific wards. Patients are cared for in female, male and children’s wards.
Family physicians (specialist generalist), supported by nurses and other members of the multidisciplinary team provide comprehensive holistic care.
Patients are referred to discipline specific specialists at a higher level when their condition requires
KEY DISTRICT HOSPITAL INDICATORS The following slides contain key indicators from the
2011/12 District Health Barometer Usable bed utilisation Average Length of stay Usable beds per 1000 uninsured population Expenditure per patient day equivalent
DHER presents a clearer picture of funding, distribution and
use of health resources in the District and the province
is a diagnostic tool to assess to what extent allocation (budget) and use of resources (expenditure) advance the district and province objectives of:
Access QualityEfficiencyEquity Sustainability
AREAS REQUIRING FURTHER STRENGTHENING
Services and Service Delivery platformHealth Information Management and UseHuman resourcesPharmaceuticals, equipment and medical suppliesFinancesGovernance and leadershipCommunity ownershipPartnerships for healthNational DHS Strategy to address the above
Thank youThank you
www.doh.gov.zawww.doh.gov.za