1. FLOW OF PRESENTATION
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Transcript of 1. FLOW OF PRESENTATION
NATIONAL DEPARTMENT OF HEALTH’S ANNUAL REPORT FOR 2006/07
PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH
06 NOVEMBER 2007
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1. FLOW OF PRESENTATION
VISION & MISSION
LEGISLATIVE MANDATES
KEY PRIORITIES OF THE NATIONAL HEALTH SYSTEM (NHS)
FOR 2004-2009
SUMMARY OF ACHIEVEMENTS AGAINST THE NHS PRIORITIES FOR 2004-2009
SUMMARY OF ACHIEVEMENTS & CHALLENGES PER BUDGET PROGRAMME, COMPARING PROGRESS BETWEEN 2004/05, 2005/06 AND 2006/07
CONCLUSIONS
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2. VISION & MISSION
VISION
AN ACCESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM.
MISSION
TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS & DISEASES AND THROUGH THE PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY.
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3. LEGISLATIVE MANDATES
51 ACTS MENTIONED IN THE NDOH ANNUAL REPORT 2006/07 INCLUDING:
THE CONSTITUTION OF THE REPUBLIC NATIONAL HEALTH ACT OF 2003 PUBLIC FINANCE MANAGEMENT ACT OF 1999 NURSING ACT OF 2005 MEDICINES & RELATED SUBSTANCES ACT MEDICAL SCHEMES ACT OF 1998 TOBACCO PRODUCTS CONTROL AMENDMENT
ACT OF 1999
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4. BUDGET PROGRAMME STRUCTURE OF THE NDOH IN 2006/07
PROGRAMME 1: ADMINISTRATION
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES
PROGRAMME 3: HEALTH SERVICE DELIVERY
PROGRAMME 4: HUMAN RESOURCES
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5. KEY NHS PRIORITIES FOR 2004-2009
1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS
2. PROMOTE HEALTHY LIFESTYLES
3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE
4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES
5. STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS
6. STRENGTHEN SUPPORT SERVICES
7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT
8. PLANNING, BUDGETING AND MONITORING & EVALUATION
9. PREPARATION AND IMPLEMENTATION OF LEGISLATION
10. STRENGTHEN INTERNATIONAL RELATIONS
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6. KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009
NHS PRIRORITIES 2004-2009
ACHIEVEMENTS IN 2006/07
1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS
REGULAR MEETINGS OF NATIONAL HEALTH COUNCIL (NHC), TO PROVIDE STEWARDSHIP OVER THE HEALTH SECTOR;
CONSOLIDATED BUDGET BID TO NATIONAL TREASURY
2. PROMOTE HEALTHY LIFESTYLES
DIVERSITY OF AWARENESS CAMPAIGNS CONDUCTED INCLUDING: BREAST CANCER AND CERVICAL CANCER AWARENESS CAMPAIGN IN IN MPUMALANGA PROVINCE; NUTRITION AWARENESS WEEK IN THE NORTH WEST; WORLD HEART DAY CELEBRATION IN THE FREE STATE; AND MENTAL HEALTH DAY AND SADC MALARIA DAY, BOTH HELD IN LIMPOPO PROVINCE
3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE
CLOSE TO 40% OF COMPLAINTS FROM USERS ADDRESSED WITHIN 25 DAYS
60% OF REVITALISATION HOSPITALS CONDUCTED CLINICAL AUDITS QUALITY ASSURANCE TRAINING FRAMEWORK COMPLETED AND SENT
TO HWSETA FOR APPROVAL
4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES
84% OF SOUTH AFRICAN CHILDREN UNDER 1 YEAR IMMUNIZED BY MARCH 2007, AN INCREASE FROM 78% IN 2005;
SOUTH AFRICA DECLARED POLIO FREE BY THE AFRICA REGIONAL CERTIFICATION COMMISSION;
SADHS 2003 REFLECTS UNDER-5 MORTALITY AS 57.6/1000 LIVE BIRTHS, SLIGHTLY LOWER THAN THE 60/1000 REPORTED IN THE COUNTRY MDG REPORT OF 2005;
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6. KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009
NHS PRIRORITIES 2004-2009
ACHIEVEMENTS IN 2006/07
5. IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES (CONT.)
2006 ANTENATAL HIV SURVEY SHOWS A STATISTICALLY SIGNIFICANT DECREASE IN HIV PREVALENCE AMONGST PREGNANT WOMEN, FROM 30.2% IN 2005 TO 29.1% IN 2006;
VCT AND PMTCT PROVIDED IN 90% OF PUBLIC HEALTH FACILITIES
OVER 282 200 PATIENTS INITIATED ON ANTIRETROVIRAL TREATMENT ACROSS THE COUNTRY IN 2006/07 (BY MAY 2007, OVER 300 000 PATIENTS WERE ON TREATMENT);
NUTRITION PACKAGES DISTRIBUTED TO PEOPLE LIVING WITH HIV AND AIDS, TB AND OTHER DEBILITATING CONDITIONS;
NATIONAL STRATEGIC PLAN FOR HIV&AIDS 2007-2011 LAUNCHED NO. OF MALARIA CASES DECLINED CONSISTENTLY FROM 51 444
CASES IN 1999 TO 12 098 CASES IN 2006; 84% REDUCTION IN MALARIA CASES ACHIEVED FROM 2005 TO
2006, MAINLY DUE TO INDOOR RESIDUAL SPRAYING AND
SUCCESSFUL COLLABORATION AMONGST AFRICAN COUNTRIES IN IMPROVING THE EFFECTIVENESS OF MALARIA CONTROL PROGRAMME, ESPECIALLY BETWEEN RSA, MOZAMBIQUE AND SWAZILAND.
WORLD DIABETES CONGRESS HELD IN CAPE TOWN IN DEC 2006
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6. KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009
NHS PRIRORITIES 2004-2009
ACHIEVEMENTS IN 2006/07
6. STRENGTHEN SUPPORT SERVICES
TRANSFER OF FORENSIC SERVICES FROM SAPS TO DOH COMPLETED
5O% OF EXISTING MORTUARIES REFURBISHED 20% OF PLANNED MORTUARIES BUILT
7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT
REMUNERATION DISPENSATION FOR ALL CATEGORIES OF NURSES AGREED TO WITH NATIONAL TREASURY AND DPSA, AS PART OF OCCUPATION SPECIFIC DISPENSATION
4 PROVINCES PRODUCED DRAFT HR PLANS (EC, LP, MP & NW)
8. PLANNING, BUDGETING AND MONITORING & EVALUATION
NATIONAL DOH REVIEWD ALL 9 PROVINCIAL ANNUAL PERFORMANCE PLANS FOR 2007/08 AND PROVIDED FEEDBACK TO PROVINCES
48/52 DISTRICTS PRODUCED DISTRICT HEALTH PLANS FIRST ANNUAL NATIONAL HEALTH PLAN PRODUCED IN MAY 2006, IN
TERMS OF THE NATIONAL HEALTH ACT OF 2003 MONITORING OF IMPLEMENTATION OF PLANS BY NATIONAL &
PROVINCIAL DOHs STRENGTHENED, WITH 4 QUARTERLY REPORTS COMPILED DURING 2006/07
9. PREPARATION AND IMPLEMENTATION OF LEGISLATION
TWO PIECES OF LEGISLATION PROCESSED: TOBACCO PRODUCTS CONTROL AMENDMENT BILL & HEALTH PROFESSIONS AMENDMENT BILL
10. STRENGTHEN INTERNATIONAL RELATIONS
DIVERSE MULTILATERAL SUMMITS & CONFERENCES CO-ORDINATED INCLUDING 3RD CONFERENCE OF AFRICAN HEALTH MINISTES
(CAMH 3) AND SADC HEALTH MINISTERS
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7. SUMMARY OF ACHIEVEMENTS IN 2006/07 PER BUDGET PROGRAMME
7.1. PROGRAMME 1: ADMINISTRATION
NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
DEVELOPMENT OF HEALTH LEGISLATION
8 BILLS PROCESSED DURING 2004/05
NATIONAL HEALTH ACT OF 2003 ALSO SIGNED INTO LAW
5 BILLS PROCESSED DURING 2005/06
2 BILLS PROCESSED DURING 2006/07 (TOBACCO PRODUCTS CONTROL AMENDMENT BILL AND HEALTH PROFESSIONS AMENDMENT BILL)
STRENGTHENING COMMUNI-CATION WITH PROVINCIAL & NATIONAL STAKEHOLDERS
NATIONAL CONSULTATIVE HEALTH FORUM (NCHF) HOSTED IN DECEMBER 2005
NCHF HOSTED IN MAY 2006
18 MINISTERIAL IZIMBIZO HELD
NCHF HOSTED IN JULY 2007, FOCUSING ON PROGRESS TOWARDS MDG TARGETS
HEALTH EXHIBITION HELD AT THE WORLD DIABETES CONGRESS IN CAPE TOWN FROM THE 03RD -07TH DECEMBER 2007
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
STRENGTHENING COMMUNICATION WITH PROVINCIAL & NATIONAL STAKEHOLDERS
RANGE OF PUBLICATIONS PRODUCED
RANGE OF PUBLICATIONS PRODUCED
HEALTH RELATED ARTICLES PUBLISHED IN THE PAN AFRICAN HEALTH MAGAZINE
CHILD CARE OPEN DAY HELD IN MPUMALANGA ON THE 10TH NOVEMBER 2006, FOLLOWED BY A TB BLITZ IN THE SAME PROVINCE ON 19-21ST NOVEMBER 2006
PROGRAMME 1: ADMINISTRATION (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
STRENGTHENING HEALTH SECTOR PLANNING
PROVINCIAL ANNUAL PERFORMANCE PLANS (APPs) FOR 2005/06 REVIEWED
ANNUAL REPORTS FOR 2004/05 REVIEWED
APPs FOR 2006/07 AND ANNUAL REPORTS FOR 2005/06 REVIEWED
8/9 PROVINCES PRODUCED SERVICE TRANSFORMATION PLANS (STPs) FOR 2007/08
APPs FOR 2007/08 AND ANNUAL REPORTS REVIEWED
8/9 PROVINCES UPDATED THEIR SERVICE TRANSFORMATION PLANS (STPs) FOR 2007/08, WITH SUPPORT FROM NATIONAL DOH
FIRST ANNUAL NATIONAL HEALTH PLAN (ANHP) PRODUCED IN MAY 2006
NATIONAL HEALTH PRIORITIES IN THE ANHP 2006 USED TO INFORM BUDGET BIDS TO TREASURY
PROGRAMME 1: ADMINISTRATION (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
STRENGTHENING HEALTH SECTOR PLANNING
DISTRICT HEALTH PLANNING (DHP) GUIDELINES REVISED BY MARCH 2005
DHP GUIDELINES PUBLISHED BY JULY 2005 AND USED BY 53 DISTRICTS TO DEVELOP DISTRICT PLANS FOR 2006/07
DESPITE GOOD PROGRESS, QUALITY OF MOST DHPs NEEDS FURTHER STRENGTHENING
4 SUMMARY REPORTS ON THE PERFORMANCE OF THE NATIONAL DEPARTMENT OF HEALTH ON ITS STRATEGIC PLAN FOR 2006/07-2008/09 PRODUCED, FOCUSING ON 2006/07
4 REPORTS ON THE ON THE PERFORMANCE OF THE 9 PROVINCE ON THEIR ANNUAL PERFORMANCE PLANS FOR 2006/07-2008/09 PRODUCED, FOCUSING ON 2006/07
3 POLICY BRIEFS PRODUCED, COVERING A RANGE OF ISSUES SUCH AS THE DEVELOPMENT, IMPLEMENTATION AND ANALYSIS OF HEALTH POLICIES, AND ASSESSING EQUITY IN THE PROVISION OF HEALTH CARE
PROGRAMME 1: ADMINISTRATION (Cont.)
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7. SUMMARY OF ACHIEVEMENTS 7.2. PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES
NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANSION OF THE IMPLEMENTATION OF INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES (IMCI) STRATEGY
ALL 53 DISTRICTS IMPLEMENTING IMCI
IMCI CASCADED TO 136 OF 284 LOCAL (47.8%) MUNICIPALITIES (EXPANDED TO SUB-DISTRICTS)
72% OF DISTRICTS IMPLEMENTING THE SECOND COMPONENT OF IMCI, THE HOUSEHOLD AND COMMUNITY COMPONENT (HHCC)
TRAINING OF HEALTH WORKERS IN THE IMCI STRATEGY
64% OF HEALTH WORKERS PROVIDING SERVICES TO CHILDREN TRAINED IN IMCI
60% OF THOSE WHO PROVIDE SERVICES TO CHILDREN TRAINED IN IMCI
71% OF THOSE WHO PROVIDE SERVICES TO CHILDREN TRAINED IN IMCI
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
IMPROVING IMMUNISATION COVERAGE
NATIONAL IMMUNISATION COVERAGE OF 82% ATTAINED
NATIONAL IMMUNISATION COVERAGE OF 82% ATTAINED
NATIONAL IMMUNISATION COVERAGE OF 84% ATTAINED
37/53 DISTRICTS (69%) OF DISTRICTS HAVE MORE THAN 80% IMMUNISATION COVERAGE
12/53 DISTRICTS (23%) OF DISTRICTS HAVE MORE THAN 90% IMMUNISATION COVERAGE
19/52 DISTRICTS (37%) OF DISTRICTS HAVE MORE THAN 90% IMMUNISATION COVERAGE
ACHIEVE POLIO FREE CERTIFICATION
SOUTH AFRICA’S POLIO ERADICATION STATUS REPORT WAS ACCEPTED BY THE AFRICAN REGIONAL CERTIFICATION COMMITTEE (ARCC) OF THE GLOBAL CERTIFICATION COMMITTEE
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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NATIONAL DOH ACHIEVEMENTS
OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANSION OF SCHOOL HEALTH SERVICES
30% OF PROVINCES WITH 100% OF DISTRICTS PROVIDING PHASE 1 OF SCHOOL SERVICES
72% OF DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES
94% OF DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES
IMPROVING WOMEN’S ACCESS TO CHOICE ON TERMINATION OF PREGNANCY (CTOP) SERVICES
55% OF APPROVED FACILITIES PROVIDED CTOP
60% OF APPROVED FACILITIES PROVIDED CTOP
CTOP CASCADED FROM HOSPITALS TO COMMUNITY HEALTH CENTRES (CHCs)
25% OF CHCs PROVIDED CTOP
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
STRENGTHENING PREVENTION OF HIV AND STIs
347 MILLION MALE CONDOMS AND OVER 1 MILLION FEMALE CONDOMS DISTRIBUTED
413 MILLION MALE CONDOMS & OVER 2 MILLION FEMALE CONDOMS DISTRIBUTED
453 MILLION MALE CONDOMS & OVER 3, 392 MILLION FEMALE CONDOMS DISTRIBUTED
EXPANSION OF VOLUNTARY COUNSELLING AND TESTING (VCT) AND PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES
80% OF PUBLIC HEALTH FACILITIES OFFERED VCT
88% OF FACILITIES OFFERED VCT
91% OF FACILITIES OFFERED VCT
60% OFFERED PMTCT
87% OFFERED PMTCT 90% OF FACILITIES OFFERED PMTCT
EXPANDING THE COMPREHENSIVE PLAN FOR HIV &AIDS CARE, TREATMENT AND MANAGEMENT (CCMT)
139 CCMT SITES ESTABLISHED
210 CCMT SITES ESTABLISHED
245 CCMT SITES ESTABLISHED
65% OF ELIGIBLE PEOPLE LIVING WITH HIV&AIDS, TB AND OTHER DEBILITATING CONDITIONS PROVIDED WITH NUTRITIONAL SUPPORT
81.8% OF ELIGIBLE PEOPLE LIVING WITH HIV&AIDS, TB AND OTHER DEBILITATING CONDITIONS PROVIDED WITH NUTRITIONAL SUPPORT
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2003 2004 2005
STRENGTHENING TB CONTROL AND MANAGEMENT
SUCCESSFUL TREATMENT COMPLETION
62.9% 65.5% 71.1%
CURE RATE 50.1% 50.8% 57.7%
DEAFAULTER RATE
10.1% 10.3% 10.4%
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANDING INTERNATIONAL HEALTH RELATIONS
DIVERSE BILATERAL AND TRILATERAL AGREEMENTS WERE SIGNED INCLUDING THOSE WITH IRAN, RWANDA, MALI, INDIA AND BRAZIL
DIVERSE BILATERAL AND TRILATERAL AGREEMENTS WERE SIGNED INCLUDING: PROGRAMME OF ACTION WITH DRC AND NIGERIA ON TRADITIONAL MEDICINE; 24 CONTRACTS FOR RECRUITMENT OF IRANIAN DOCTORS; THROUGH DFID, UK GOVERNMENT PROVIDED R90 MILLION FOR THE COMPREHENSIVE PLAN FOR HIV AND AIDS; SA-CHINA MOU; ETC.
DIVERSE MULTILATERAL SUMMITS & CONFERENCES
CO-ORDINATED INCLUDING:
3RD CONFERENCE OF AFRICAN HEALTH MINISTERS (CAMH 3) AND SADC HEALTH MINISTERS IN MARCH 2007;
CONSULTATIVE MEETING OF AFRICAN HEALTH MINISTERS ON INJURY PREVENTION AND SAFETY PROMOTION
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
IMPROVING ACCESS TO SAFE AND AFFORDABLE MEDICINES
APPROPRIATE DISPENSING FEE PUBLISHED BUT UNDER CHALLENGE
APPROPRIATE DISPENSING FEE PUBLISHED BUT UNDER CHALLENGE
MEDICINE PRICING REGULATIONS REVIEWED
MEDICINE PRICING REGULATIONS PUBLISHED BUT UNDER CHALLENGE
DRAFT INTERNATIONAL BENCHMARKING METHODOLOGY GAZETTED IN DECEMBER 2006;
100% OF NEW PHARMACIES LICENSED IN LINE WITH THE NEW PHARMACY ACT
INSPECTION OF AUTHORISED PRESCRIBERS LAGGED BEHIND DUE TO DIFFICULTYIN RECRUITING PHARMACISTS
PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
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PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)
NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
REDUCING MALARIA MORBIDITY AND MORTALITY BY 10% EACH YEAR
ALL 3 MALARIA AFFECTED PROVINCES (KWAZULU-NATAL, LIMPOPO & MPUMALANGA) IMPLEMENTED RECOMMENDATIONS FROM THE ROLL BACK MALARIA STRATEGY
ALL MALARIA AFFECTED PROVINCES PROVIDING REGULAR REPORTS ON THE IMPLMENTATION OF THE RECOMMENDATIONS FROM THE ROLL BACK MALARIA STRATEGY
APPROX 84% REDUCTION IN MALARIA CASES COMPARED TO 2005/06
MALARIA CASE FATALITY RATE (CFR) OF 0.5% ATTAINED IN 2006/07
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7. SUMMARY OF ACHIEVEMENTS
7.3. PROGRAMME 3: HEALTH SERVICE DELIVERY
NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
STRENGTHEN THE DELIVERY OF PRIMARY HEALTH CARE SERVICES
PHC UTILISATION RATE OF 2.1. VISITS
PHC UTILISATION
RATE OF 2.2 VISITS
PHC UTILISATION RATE OF 2.11 VISITS
35/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES
48/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES
53/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES
PHC HEADCOUNT OF 97, 993, 394 ATTAINED IN 2004/05
PHC HEADCOUNT OF 101,758,377 ATTAINED
IN 2005/6
PHC HEADCOUNT OF 101,644, 080 ATTAINED IN 2006/07
PHC SUPERVISION RATE OF 60% ATTAINED
PHC SUPERVISION RATE OF 48% ATTAINED
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANSION OF THE HOSPITAL REVITALISATION PROGRAMME
3 HOSPITALS COMPLETED NAMELY:
CALVINIA & COLESBURG IN THE NORTHERN CAPE;
PIET RETIEF IN MPUMALANGA)
5 HOSPITALS COMPLETED NAMELY:
LEBOWAKGOMO &
JANE FURSE IN LIMPOPO;
MARY THERESA IN THE
EASTERN CAPE;
GEORGE HOSPITAL IN WESTERN CAPE & SWARTRUGGENS IN THE NORTH WEST)
9/9 PROVINCES SUBMITTED 2007/08 PROJECT IMPLEMENTATION PLANS.
2 HOSPITALS OPENED:
LEBOWAKGOMO (LIMPOPO) AND
MARY THERESA (MADIKANA KA ZULU) IN THE EASTERN CAPE
11% OF HOSPITALS ARE PART OF THE HOSPITAL REVIT. PROGRAMME
12% OF HOSPITALS ARE PART OF THE HOSPITAL REVITALISATION PROGRAMME (I.E. 46 HOSPITALS)
63 ADDITIONAL BUSINESS CASES ACCEPTED BY NDOH
SEVERAL PROJECTS TEMPORARILY STOPPED DUE TO FUNDING SHORTAGES
DELEGATION OF AUTHORITY TO HOSPITAL MANAGERS
ALL 9 PROVINCES DELEGATED AUTHORITY TO HOSPITAL CEOs
75% OF HOSPITAL CEOs RECEIVED WRITTEN DELEGATIONS
PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANDING ACCESS TO TELEMEDICINE
12% OF HOSPITALS HAVE TELEMEDICINE FACILITIES
ADDITIONAL TELEMEDICINE SITES ESTABLISHED IN EC & MP
IMPLEMENTATION OF THE FIRST 6 OF THE 18 EASTERN CAPE TELEMEDICINE SITES COMPLETED
TRANSFER OF FORENSIC LABORATORIES AND MORTUARIES TO PROVINCIAL DOHs
8 PROVINCIAL BUSINESS PLANS DEVELOPED FOR THE TRANSFER OF FORENSIC LABS AND MORTUARIES FROM SAPS TO DOHs
TRANSFER OF FORENSIC LABS AND MORTUARIES TO DOHs COMPLETED
TRANSFER OF FORENSIC SERVICES FROM SAPS TO DOH COMPLETED
5O% OF EXISTING MORTUARIES REFURBISHED
20% OF PLANNED NEW MORTUARIES BUILT
PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)
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NATIONAL DOH OBJECTIVES AND INTERVENTIONS
ACHIEVEMENTS
2004/05 2005/06 2006/07
EXPANSION OF THE CATARACT SURGERY PROJECT
CATARACT SURGERY RATE OF 1039 OPERATIONS PER MILLION PEOPLE ATTAINED (TARGET 950 PER MILLION)
CATARACT SURGERY RATE OF 1030 OPERATIONS PER MILLION PEOPLE ATTAINED (TARGET 1000 PER MILLION)
CATARACT SURGERY RATE OF 1146 OPERATIONS PER MILLION PEOPLE ACHIEVED
PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)
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7. SUMMARY OF ACHIEVEMENTS
7.4. PROGRAMME 4: HUMAN RESOURCES MANAGEMENT
NATIONAL DOH OBJECTIVES AND INTERVENTIONS
2004/05 2005/06 2006/07
DEVELOPMENT OF A NATIONAL HUMAN RESOURCES (HR) FOR HEALTH PLAN
DRAFT HR PLAN DEVELOPED AND CONSULTATION PROCESS COMPLETED
HR PLAN LAUNCHED IN APRIL 2006
4 PROVINCES PRODUCED DRAFT HR PLANS (EC, LP, MP & NW)
REMUNERATION DISPENSATION FOR ALL CATEGORIES OF NURSES AGREED TO WITH NATIONAL TREASURY AND DPSA, AS PART OF THE OCCUPATION SPECIFIC DISPENSATION (OSD)
TRAINING OF HEALTH WORKERS TO IMPLEMENT THE COMPREHENSIVE PLAN FOR HIV &AIDS CARE, TREATMENT AND MANAGEMENT (CCMT)
MORE THAN
9 000 HEALTH WORKERS TRAINED TO IMPLEMENT THE CCMT
11 958 HEALTH WORKERS TRAINED IN THE IMPLEMENTATION OF CCMT (TARGET WAS 6 233)
17 054 HEALTH WORKERS TRAINED IN THE IMPLEMENTATION OF CCMT (TARGET WAS 6 233)
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8. CHALLENGES
LACK OF SUFFICIENT & SKILLED HUMAN RESOURCES FOR HEALTH (CLINICAL & MANAGEMENT LEVEL)
POOR HEALTH INFRASTRUCTURE
POVERTY, UNEMPLOYMENT, LOW EDUCATION LEVELS, POOR TRANSPORT INFRASTRUCTURE, SOCIAL COHESION ISSUES
TRIPLE BURDEN OF DISEASE (COMMUNICABLE, NON-COMMUNICABLE, INJURIES AND TRAUMA)
INTERSECTORAL COLLABORATION
COMMUNITY MOBILISATION & PATIENT ADHERENCE ISSUES
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ANNUAL FINANCIAL STATEMENTS
2006/07
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Programme 1: AdministrationMinister 887 885 2 99.8Deputy Minister 721 719 2 99.7Management 17,296 16,382 914 94.7Corporate Services 126,403 121,018 5,385 95.7Sub Total 145,307 139,004 6,303 Property Management 35,026 33,838 1,188 96.6Total: Programme 1 180,333 172,842 7,491 95.8
NATIONAL DEPARTMENT OF HEALTH - VOTE 16ANNUAL FINANCIAL STATEMENTS 2006/07
AS AT 31 MARCH 2007
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Programme 2: Strat. Health Prog. Maternal Child & Women's Health & Nutrition 24,222 26,523 -2,301 109.5Medicines Regualatory Affairs 42,922 42,932 -10 100.0HIV and AIDS 2,024,261 1,953,305 70,956 96.5Pharmaceutical Policy & Planning 22,044 20,357 1,687 92.3Communicable Diseases 42,135 37,253 4,882 88.4Total: Programme 2 2,155,584 2,080,370 75,214 96.5
NATIONAL DEPARTMENT OF HEALTH - VOTE 16ANNUAL FINANCIAL STATEMENTS 2006/07
AS AT 31 MARCH 2007
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Programme 3: Health Serv. Del. Non-Communicable Disease 688,422 669,179 19,243 97.2Hospital Services 8,045,949 8,039,812 6,137 99.9Health Economics 24,753 23,369 1,384 94.4Health Info., Research & Evaluation 234,734 233,359 1,375 99.4PHC, District Health & Development 18,465 17,723 742 96.0Office of Standard Compliance 12,850 11,425 1,425 88.9Total: Programme 3 9,025,173 8,994,867 30,306 99.7
NATIONAL DEPARTMENT OF HEALTH - VOTE 16ANNUAL FINANCIAL STATEMENTS 2006/07
AS AT 31 MARCH 2007
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Programme 4: Human Resources Human Resources 55,188 53,864 1,324 97.6Bargaining Council & Employee Relat. 6,183 4,685 1,498 75.8International Health Liaison 31,532 31,419 113 99.6Total: Programme 4 92,903 89,968 2,935 96.8
NATIONAL DEPARTMENT OF HEALTH - VOTE 16ANNUAL FINANCIAL STATEMENTS 2006/07
AS AT 31 MARCH 2007
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Appropriation Statement per program. Administration 180,333 172,842 7,491 95.8 Strategic Health Programmes 2,155,584 2,080,370 75,214 96.5Health Service Delivery 9,025,173 8,994,867 30,306 99.7Human Resources 92,903 89,968 2,935 96.8Total: 11,453,993 11,338,047 115,946 99.0
NATIONAL DEPARTMENT OF HEALTH - VOTE 16ANNUAL FINANCIAL STATEMENTS 2006/07
AS AT 31 MARCH 2007
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NATIONAL DEPARTMENT OF HEALTH
PROGRAMMES Final
Appropriation Actual
Expenditure Variance
Expenditure as % of final
appropriation R '000 R '000 R '000 %
Appropriation Stat. Per Econ. Classif. Current payments 739,620 658,561 81,059 89.0 Transfers & subsidies 10,631,544 10,610,188 21,356 99.8Payments for capital assets 82,829 69,298 13,531 83.7Total: 11,453,993 11,338,047 115,946 99.0
ANNUAL FINANCIAL STATEMENTS 2006/07 AS AT 31 MARCH 2007
NATIONAL DEPARTMENT OF HEALTH - VOTE 16
35
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Qualification Finding:
Reconciliation of fixed asset entries between BAS and Logis System not done
Comment: After the audit it was found that incorrect
classifications on the Logis System resulted in inaccurate asset figures being posted in the Asset Register
36
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Matters of Emphasis:
Transfers made to provinces without business plans
Comment: DORA rules that transfers to provinces in
respect of Schedule 4 grants cannot be withheld hence the transfers were made
37
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Matters of Emphasis:
Transfer of R 35m to the NGO, LoveLife was made contravening the Departments own NGO Funding Guidelines
Comment: The requirement is that an approved contract be
in place between the NDoH and the NGO. In this instance the current contract had expired
38
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Matters of Emphasis:
Amounts in the FPS grant business plans were less than the approved amounts which had been transferred
Comment: The business plans were not adjusted by
provinces to match the approved grant allocation but the grant allocation was not exceeded
39
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Other Matters – Lack of Monitoring:
Late submission of Business Plans Late or non submission of monthly and
quarterly reports Lack of capacity to monitor Inadequate evaluation of reports Presence of inconsistencies between
monthly and quarterly reports
40
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Comment:
Improvement of monitoring and reporting is continuously being worked at and there is improvement
41
NATIONAL DEPARTMENT OF HEALTH
2006/07 Annual Report - Audit findings Other Matters:
Non compliance with NEMA Comment:
The Department did not present the environmental plan as required by the Act
42
CONCLUSION
DESPITE MANY CHALLENGES THE DOH HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2006/07
WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2007/08 TARGETS
HOWEVER, CHANGES IN THE SOCIAL CONTEXTS IN WHICH OUR PEOPLE LIVE AND ADEQUATE RESOURCE AVAILABILITY FOR THE HEALTH SYSTEM (HUMAN RESOURCES & FINANCES) ARE KEY TO THE SUCCESSFUL IMPLEMENTATION OF THIS PLAN;
INTERSECTORAL COLLABORATION ACROSS GOVERNMENT AND WITH KEY STAKEHOLDERS ARE CRUCIAL.