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MPUMALANGA PROVINCE

DEPARTMENT OF HEALTH AND SOCIAL SERVICES

HEALTH COMPONENT BUDGET HEARING

14 June 2004

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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

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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

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Key achievements and challenges against the

Ten point plan 2003/2004

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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

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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

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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

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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

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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%

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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

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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

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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

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Legislative reform

Challenges Draft Provincial Health Bill awaiting

finalisation Participate in the finalisation of the

Health Technology Legislation

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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

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Improving quality of care

Critical, strategic positions at facilities and Provincial office filled.

Launched Patient Hotline (0800 20 40 98)

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Improving quality of care

Challenges Improve attitude and professionalism

of health workers Establish and train governance

structures

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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

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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

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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

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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

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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

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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

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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

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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)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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