Presentation to the Ad Hoc Committee on Health on the 2004 / 2005 Budget

Health - Limpopo 1

Presentation to theAd Hoc Committee on Health

on the 2004 / 2005 Budget

Presented by the

Department of Health and Welfare Limpopo for Vote 7 : Health

8 June 2004 in Cape Town

Health - Limpopo 2

VisionA caring and developmental Health and Welfare system which promotes well-being, self-reliance and a humane society in which all people in LIMPOPO have access to affordable and good quality services !”

The above vision statement emphasises the ultimate goal ofthe Department, i.e. a society consisting of

contented individuals, who take charge of their own destinies. The dignity of society and their quality of life

is promoted by their employment of good quality services.

Health - Limpopo 3

Mission

The Department is committed to providing comprehensive, integrated and equitable Health and Welfare services which are sustainable, cost effective and focus on the development of human potential in partnership with relevant stakeholders.

Health - Limpopo 4

Provincial OverviewDEMOGRAPHICS for Limpopo

The Population grew from 4.9m in ’96 to 5.2m in 2001 and is estimated at 5.6 m at present.

This constitutes a 7% growth for both periods 54 % of the population are Women Literacy rate for 20 rye's & older people was 63.1 %

In 1996 89% of the population live in rural areas Unemployment rate was at 36.1% in 2001 The Province is divided in 6 Districts

Health - Limpopo 5

Population of South Africa by Province(Source: STATSSA-Census 2001)

LP12.1%

WC9.7%

MP6.9%

FS6.5%NC

2.2%KZN

20.7%

GP18.1%

EC15.5%

NC8.3%

Health - Limpopo 6

PERCENTAGE (%) OF LIMPOPO POPULATION BY AGE GROUP AND GENDER

5.76.9

7.36.7

4.84.1

3.3

3.2

2.6

2.2

1.71.2

1.3

1.21.1

0.60.6

0.30.10.2

0.30.50.6

0.70.8

1.21.5

1.7

2.12.3

2.94.1

6.6

7.1

6.95.7

-10 -8 -6 -4 -2 0 2 4 6 8

0-4 yrs

5-9 yrs

10-14 yrs

15-19 yrs

20-24 yrs

25-29 yrs

30-34 yrs

35-39 yrs

40-44 yrs

45-49 yrs

50-54 yrs

55-59 yrs

60-64 yrs

65-69 yrs

70-74 yrs

75-79 yrs

80-84 yrs

85+

Females Males

Source: StatsSA-Census 2001

Health - Limpopo 7

0

5

10

15

20

25

30

35

40%

Une

mpl

oym

ent r

ate

UNEMPLOYMENT RATE BY PROVINCE 2001

Unemployment rate 30.2 29.9 28.2 33.5 36.1 29.9 26.1 29.9 18.4 29.5

EC FS GP KZN LP MP NC NW WC SA

Source: Labour Force Survey 2001

Health - Limpopo 8

Top Ten (10) Causes of DeathSource : STATSSA; Advance Release of Recorded Deaths 1997 - 2001

Causes of Death %

Natural Causes : (Ill-defined) 17,0

Lower Respiratory Infections 11,0

Undetermined Injuries 8,1

Tuberculosis 7,5

HIV & AIDS Related Conditions 6,5

Diarrhoeal Conditions 6,2

Cardiovascular Diseases 6,0

Stroke 5,7

Hypertensive Heart Disease 4.0

Ischaemic Heart Disease 2.5

Nkadimeng

Health - Limpopo 9

HEALTH CORE FUNCTIONSFormulate and implement provincial health policies, norms, standards and legislation

Provide regional and specialised hospital services as well as academic Health Services, where relevant.

Render and co-ordinate Medical Emergency Services (including ambulance service)

Render Medico-legal services.

Render health services to those detained, arrested or charged.

Screen applications for licensing and inspection of private facilities.

Health - Limpopo 10

HEALTH CORE FUNCTIONS

Inter-provincial and intersectoral co-ordination and collaboration.

Co-ordinate the funding and financial management (budgetary process) of the district health services.

Provide technical and logistical support to health districts.

Render specific provincial services programmes, e.g. TB programme.

Provide non-personal health services.

Quality control of all health services and facilities.

Health - Limpopo 11

HEALTH CORE FUNCTIONS Cont.Provide and maintain equipment, vehicles and health care services.

Effective consultation on health matters at the community level.

Provide occupational health services.

Research on, and planning, co-ordination, monitoring and evaluation of health services rendered in the Province.

Ensure that functions delegated by the National level are carried out.

Health - Limpopo 12

Ten Point Plan for Health 1. Re-organization of Certain Support Services and Legislative reform

2. Attainment of equity in resource allocation

3. Improving Quality of Care

4. Revitalisation of Hospital Services

5. Speeding up delivery of PHC Services through District Health System

6. Decreasing Morbidity and Mortality Rates through Strategic

Interventions

7. Improving Resource Mobilization and Resource Management

8. Improving Human Resource Development and Management

9. Improving Communication and Consultation between the Health

System and Communities.

10. Strategic Co-operation with our Partners Internationally.

Health - Limpopo 13

Re-organization of Certain Support Services and Legislative reform

Laboratory services via NHLS

7 New EMS stations to total 18

95 New ambulances purchased (2002 – 2004)

New ( Rescue 11 & 13 Response ) vehicles in place

Drug availability in the depot increased from 70% to 93%

and in the hospitals from 85% to 90%

Rreferral Hospitals increased from 2 to 7

Purchased 126 patient transport vehicles in 2003

Review of the Provincial Health Act to align with National

Health - Limpopo 14

Attainment of equity in resource allocation

Under funding of Limpopo Health

Under funding of the Limpopo Health Vote has led to the

department over spending against the budget. The following un-

authorised expenditure resulted that equates to a bank overdraft

for as long as the over expenditure is not funded. R 410 593.

2000 / 2001 R 114 914m

2001 / 2002 R 53 261m

2002 / 2003 R 48 209m

2003 / 2004 R 194 209m

The under funding results from the deviations of budget

allocations as opposed to the Equitable Share Formula

Health - Limpopo 15

Limpopo Provincial Equitable Share Allocations

Limpopo

Provincial Departments

2002/03

R ‘m

%

2003/04

R ‘m

%

Equitable Share Formula

2004/05

R ‘m

%

2005/06

R ‘m

%

2006/07

R ‘m

%

Health 2 726

16.5

3 131

15.9 19 %

3 574

16.4

3 858

16.3

4 174

16.4

Welfare 3 954

23.9

5 027

25.5 18 %

5 609

25.7

6 329

26.7

6 867

26.9

Education 7 218

43.7

8 434

42.9 41 %

8 872

40.7

9 320

39.2

9 897

38.8

Other 2 628

15.9

3 081

15.7 22 %

3 733

17.1

4 223

17.8

4 559

17.8

Equitable Share

16 526

100

19 673

100

100 % 21 788

100

23 730

100

25 496

100

Health - Limpopo 16

Over / ( Short ) Funding on the Equitable Share Formula

Limpopo

Provincial Department

2002/03

R ‘m

%

2003/04

R ‘m

%

Equitable Share Formula

2004/05

R ‘m

%

2005/06

R ‘m

%

2005/06

R ‘m

%

Health ( 414)

- 2.5

(607)

- 3.1 19 %

(566)

- 2.6

(651)

-2.7

(663)

-2.6

Welfare 979

+ 5.9

1 486

+ 7.5 18 %

1 687

+ 7.7

2 058

+ 8.7

2 269

+ 8.9

Education 442

+0.8

368

+ 1.9 41 %

(61)

-0.3

(409)

- 1.8

(561)

- 2.2

Other (1 008)

- 6.1

(1 247)

- 6.3 22 %

(1 060)

- 4.9

(998)

-4.2

(1 045)

-4.1

Equitable Share 0 0 100 % 0 0 0

Health - Limpopo 17

Short Funding on the Equitable Share Formula cont.

Health Vote 7 is under funded as per the Equitable Share

Formula as contained in the IGFR and DORA.

Should the budget allocation be correct as per the formula

which is based on the Census results of the population

distribution within the provinces, then Vote 7 Health would

have received R 566m more for the current year and R

651m more for the next year.

The funding of the additional allocation to Health, Education and the other departments would have to come from Vote 12 Welfare.

The Welfare vote is currently also under funded.

Health - Limpopo 18

Improving Quality of CareCentres of Excellence @ Letaba & Maphuta Malatji

The number of transfers to Gauteng hospitals was reduced by 25%

Establishment of the latest technology Oncology unit

33 Hospitals offer CTOP

400 Active care groups established

Provincial policy on HIV & AIDS / TB / STDI

40 Hospitals and 350 PHC Facilities offer PMTCT

Utilization of community service health professionals, such as pharmacy and medical interns has improved access to services

Health - Limpopo 19

Revitalisation of Hospital ServicesClinic building and upgrading

109 New clinics built for a total of 474

68 Clinics upgraded

5 Health centres built

5 New mobile visiting points

63 Mobile visiting sites upgraded

40 hospitals have health information systems core module

(admission / discharges / transfers & revenue)

One MDR TB Clinic established at Pietersburg

Construction of an MDR Unit for Limpopo has started

3 Hospitals in 3rd and 4th phases of revitalisation

Health - Limpopo 20

Speeding up delivery of PHC Services through District Health System

Free service to all pregnant woman and children below 6 years

129 aditional clinics offer 24 hour service to total 292 Clinics to date

15 Hospitals have a PHC Gateway

Post Exposure Prophylaxis (PEP) Treatment is being provided at all hospitals

7 Sub acute facilities are operational

414 VCT sites established

Health - Limpopo 21

Decreasing Morbidity and Mortality Rates through Strategic Interventions

TB new smear positive cure rate increased from

42 to 68 %

TB Interruption rate decreased from 19 % to 9 %

8 Sites have been designated to provide Antiretroviral

Therapy and other supportive care services

Routine immunization coverage for under 1 year

increased from 64 % to 82 %.

Increased number of households sprayed for Malaria

Health - Limpopo 22

Improving Resource Mobilization and Resource Management

All hospitals have business plans in line with

Provincial Strategic Plan

The UPFS is implemented to improve revenue

collection and medical claims submissions.

Nurses increased from 10 520 to 11 432

Professional nurses increased from 104.6 to110.5

per 100 000

3039 Enrolled nurses translated into Professional N

Health - Limpopo 23

COMMUNITY SERVICE HEALTH PROFESSIONALS

Pharmacists Doctors Dentists

1999 - - -

2000 - 169 10

2001 36 80 25

2002 36 93 14

2003 22 103 19

Health - Limpopo 24

VACANCY RATES

APPROVED POSTS

VACANT POSTS

VACANCY RATE

2001 34 879 11 465 32.8%

2002 38 529 15 078 39.1%

2003 37 909 14 492 41.2%

Health - Limpopo 25

Number of Medical/Dental Officers

Number of Doctors

1996 2003

Medical Officers 357 570

Specialists 58 50

Registrars 2 8

Medical Superintendents

26 21

Dentists 17 32

Total 460 660

Health - Limpopo 26

POSTS FILLED BY RACE & GENDER IN 2003

African White Coloured Indian Totals

Male 7 070 243 17 27 7 357

Female 16 503 441 39 20 17 003

Totals 23 573 684 56 47 24 360

Health - Limpopo 27

Professionals Trained Via Bursary Scheme

FIELD 97 98 99 2000 2001 2002 2003 TOTALS MBCHB 123 128 141 138 140 99 81 850 BDS 12 13 7 6 9 58 8 113 BPHARM 15 13 19 17 18 71 34 187 BSC OT 8 7 8 8 8 37 18 94 PHYSIO 16 12 13 11 8 38 14 112 RADIO 6 4 6 3 9 19 7 54 OPTOM 5 5 4 5 4 14 6 43 B DENT 4 3 4 3 3 11 5 33 S/WORK 18 22 12 6 2 13 4 77 SPEACH 3 3 2 3 4 22 1 38 ORTHO/PROST 1 - 3 2 3 2 - 11 ENVIR health 6 7 8 7 4 5 2 39 B NUTRITION 8 7 6 4 3 3 3 34 TOTAL 225 224 233 213 215 392 183 1685

Health - Limpopo 28

Improving Communication and Consultation between the Health System

and Communities.• Both the intranet and the websites are live.

• All district offices are on e-mail

• IS/IT policy development is co-ordinated with SITA

• Reviving of the Hospital Boards & Clinic Committees

• Established AIDS Councils and PHW Authorities

• Continued and expanded NGO funding

Health - Limpopo 29

Strategic Co-operation with our Partners Internationally

Collaboration with MEDUNSA led to the recognition

of a 2 Years Post – Graduate training in major

Clinical Disciplines.

Twining agreements around issues of PHC with

France

The UK

Mozambique

Health - Limpopo 30

Expenditure Trends: 1997/98 – 2003/04 & MTEF

Financial Budget Expenditure Variance % of Budget % Budget PE PE %Year R 000 R 000 R 000 Spent Increase Costs of Budget

1997 / 1998 2,095,831 1,953,776 142,055 93.22% 2.08% 1,089,839 52.00%1998 / 1999 1,906,185 2,056,569 (150,384) 107.89% -9.05% 1,093,129 57.35%1999 / 2000 2,282,601 2,220,538 62,063 97.28% 19.75% 1,504,640 65.92%2000 / 2001 2,550,064 2,565,894 (15,830) 100.62% 11.72% 1,626,285 63.77%2001 / 2002 2,718,901 2,663,530 55,371 97.96% 6.62% 1,737,625 63.91%2002 / 2003 3,145,774 3,166,277 (20,503) 100.65% 15.70% 1,950,056 62.0%2003 / 2004 3,596,694 3,724,393 (127,699) 103.55% 14.33% 2,375,460 66.0%2004 / 2005 3,976,317 - - 0.00% 10.55% 2,484,350 62.5%2005 / 2006 4,346,466 - - 0.00% 9.31% 2,699,714 62.1%2006 / 2007 4,734,279 - - 0.00% 8.92% 3,005,276 63.5%

Health - Limpopo 31


The departmental budget increased by 46.2 % between 2001/02 to 2004/05.

The Personnel budget for the same period increased by only 43 %.

More funds were thus allocated to Pharmaceuticals, and Non – Personnel costs together with a growth in Conditional Grants.

Personnel Costs reduced from 63.9 % to 62.5 % of the budget for the same period.

An over expenditure of R 150m in 1998/99 was due to the budget allocation being reduced by 9 % over the previous year.

The department could not implement 2nd and 3rd Notches as from 1997/98 due to budget constraints.

Additional budget was allocated in the 2003/04 year ( R 82.5m) to begin to bring the staff to the correct Notches and begin to address the backlogs.

Health - Limpopo 32


The 2003 / 04 year also saw the introduction of the Scarce Skills

and Rural Allowance that was introduced as from July 2003, with

an amount of R 31.8m allocated for this.

As part of Resolution 7, the department had 680 officials

transferred from Dept of Agric together with a budget of R 30m, as

fro April 2004 onwards.

The Personnel budget thus grew with 0.8 % as a result of the

funding received for these three programmes.

The over expenditure of R 127.7m for the past year is attributed to

the payment of most of the arrears for 2nd and 3rd Notches.

The actual over expenditure on the Equitable Share amounted to

R 194m after taking the Conditional Grants into account.

Health - Limpopo 33

Departmental Revenue Collection2001/02 - 2003/04 & MTEF Budget

Revenue

R’000

2001/02

Actual

2002/03

Actual

2003/04

Estimated Actual

2004/05

Budget

2005/06

MTEF

Budget

2006/07

MTEF

Budget

Revenue Targets

Revenue

Received

57 209

58,022

56 990

59,011

60 409

58,267

64 974

N / a

68 876

N / a

72 797

N / a

Health - Limpopo 34

Personnel v/s Non-Personnel Expenditure trends

Personnel % of Non- PE % of TotalYear Costs Costs Costs Costs1997 / 98 1,136,873 58.2% 816,903 41.8% 1,953,776 1998 / 99 1,403,350 68.2% 653,219 31.8% 2,056,569 1999 / 00 1,505,004 67.8% 715,534 32.2% 2,220,538 2000 / 01 1,594,931 63.2% 929,047 36.8% 2,523,978 2001 / 02 1,737,625 65.2% 925,905 34.8% 2,663,530 2002 / 03 1,950,056 61.6% 1,216,221 38.4% 3,166,277 2003 / 04 2,375,460 63.8% 1,348,934 36.2% 3,724,394 Budget2004 /05 2,484,350 62.5% 1,491,967 37.5% 3,976,317 2005/06 2,699,714 62.1% 1,646,752 37.9% 4,346,466 2006/07 3,005,276 63.5% 1,729,003 36.5% 4,734,279

Health - Limpopo 35

Summary of Expenditure & Estimates 2001/02 - 2005/06

Per Programme 2001/02 2002/03 2003/04 % 2004/05 2005/06 2006/07R' 000 Actual Actual Un-Audit of the Current MTEF MTEF

Actual Total Budget Budget BudgetHealth Administration 152,149 173,553 237,538 6.4% 230,163 248,230 269,927District Health Ser 1,412,655 1,665,624 1,979,397 53.1% 2,054,430 2,257,712 2,491,893Emergency Medical Serv 47,833 50,262 95,253 2.6% 103,507 111,818 118,527Provincial Hospital Serv 365,022 380,145 438,964 11.8% 463,240 497,297 544,442Central Hospital Serv 239,890 323,786 346,870 9.3% 396,617 414,618 427,291Health Sciences and Train 77,063 126,503 117,125 3.1% 143,945 173,076 183,461Health Care Support Ser 176,237 219,743 248,058 6.7% 349,459 388,878 428,611Health Facilities Man 192,681 226,661 261,188 7.0% 234,956 254,837 270,127Total 2,663,530 3,166,277 3,724,393 100% 3,976,317 4,346,466 4,734,279

Health - Limpopo 36

Current estimates and the MTEF to 2006/07

Budget Movement Actual2003.04 2004.05 2005.06 2006.07

Personnel 2,219,050 2,484,350 2,699,714 3,005,278 Con Grant 436,346 385,846 470,828 544,282 Pharmaceuticals 240,320 280,320 340,320 420,320 Non - PE 828,678 825,801 835,624 764,399 TOTAL 3,724,394 3,976,317 4,346,486 4,734,279

INCREASEPersonnel 268,995 265,300 215,364 305,564 Con Grant 1,293 (50,500) 84,982 73,454 Pharmaceuticals 23,556 40,000 60,000 80,000 Non - PE 264,273 (2,877) 9,823 (71,225) TOTAL 558,117 251,923 370,169 387,793

Budget allocation

Health - Limpopo 37

Current estimates and the MTEF

The Conditional Grants have increased by R 38.8m but the transfer of INP to DoE results in the reduction.Pharmaceuticals have been ring fenced to show the steady increase over the MTEF.The concern is the decrease in the Non PE budget for the current year and outer year with the 2005/06 showing only a marginal increase.The previous years Non- PE included once off costs of R 93.4m that has been utilised to fund critical areas in the current year.The current year only includes once off costs of R34m that can be rerouted in the next financial yearService delivery over the next three years is being stifled due to the lack of growth in the Non – PE budget.

Health - Limpopo 38

Challenges for the MTEF

Budget for DHS: increased from 49.2 % in 1996/97 to 52.7 % in 2003/04 (excl pharmac. & capex). With pharmac. & capex included = 63.%.

Per capita Health Expenditure: LP is the lowest in 2003/04 @ R627 per uninsured person, which was 36% below the national average. The LP showed an increase of 2.6 % from 1997/98 (R611/ uninsured) to 2003/04 (R627/uninsured). By 1997, LP was spending R24 per person on medicines compared to the National average of R42 per person & currently LP spends R40.7 per person which = 3 times less than that of Gauteng.

Health - Limpopo 39

Challenges for the MTEFInfrastructure service implications

Infrastructure development cannot be fast tracked. It is well known that there are a large number of clinics with no water, no electricity, insufficient equipment and inadequate facilities. The development of the tertiary facilities will also be delayed. Maintenance of medical equipment will still be inadequate. The Hospital Revitalisation Grant and Provincial Infrastructure Grant remain the main source of Capital for the department.The lack of growth in the Non PE budget entails that Equitable Share cannot be allocated to Infrastructure

Health - Limpopo 40

Challenges for the MTEF The health institutions (hospitals, clinics and Health

centres) have not had any increase in Budget for the past two financial years in respect of Non- PE costs.

With Patients as the major cost driver the provision of rations, clothing and linen could not keep track due to the limited resources.

Other major cost relating to patients is the supply of blood and blood products as well as the Laboratory tests.

The increase in cost of communication, water and electricity, repairs and maintenance, security as well as transport costs has made it impossible to expand health services, and extremely difficult to maintain standards of health care.

Health - Limpopo 41

I n R ' 000 2003/04 2004/05 % Growth 2005/06 2006/07

HIV/AIDS/TB/STI 45,150 50,850 12.6% 64,911 68,030 HIV/AIDS and TB 41,708 47,167 13.1% 60,989 63,872 Communicable diseases 3,442 3,683 7.0% 3,922 4,158District Health Services – PHC 1,826,524 2,054,430 12.5% 2,257,712 2,491,893Emergency Medical Services 91,631 103,507 13.0% 111,818 118,527Logistical support services 302,000 323,140 7.0% 344,144 364,793 Pharmaceuticals 250,000 297,000 18.8% 347,000 307,000 Vehicles 15,000 16,050 7.0% 17,093 18,119 HIS 37,000 39,590 7.0% 42,163 44,693Infrastructure development 200,500 234,956 17.2% 254,837 270,127 Hospital Rehabilitation 96,239 106,463 10.6% 110,722 117,365 Clinics 40,000 42,800 7.0% 45,600 48,300 Other inc New Head Office 20,961 79,466 279.1% 76,926 83,825 Maintenance 43,300 46,331 7.0% 49,343 52,303Human Resources Management 3,957 4,234 7.0% 4,509 4,780Human Resources Development 137,948 156,166 13.2% 183,556 194,569 Training 11,820 12,647 7.0% 13,469 14,278 Nursing Training Colleges 51,702 55,321 7.0% 58,917 62,452 Ambulance Training Colleges 4,907 5,250 7.0% 5,592 5,927 Bursaries 29,105 31,142 7.0% 33,167 35,157 Prof Training and Research 40,414 51,805 28.2% 72,411 76,756Communicate/Collaborate/participate 2,533 2,710 7.0% 2,886 3,060Tertiary Service Development 350,784 378,672 8.0% 413,262 438,058Revenue Generation / Targets 61,269 64,974 6.0% 68,676 72,110

Priority funding over the MTEF

Health - Limpopo 42

HEALTH PRIORITIES – M T E F

HIV/AIDS/TB/STI CONTROL & MANAGEMENT:

Reduction of HIV/AIDS infection Caring of the infected and affected by HIV and AIDS Decreasing number of patients infected Decrease Multi Drug Resistance (MDR) COMMUNICABLE DISEASE CONTROL:

Polio Eeradication Expanded Programme on Immunisation Malaria Control

Health - Limpopo 43

HEALTH PRIORITIES - M T E F

PHC SERVICES & DHS DEVELOPMENT: Devolution of Municipal Health services Provide 24 Hour Services at Clinics Provide comprehensive PHC package Referral System

EMERGENCY MEDICAL SERVICES: Increasing access to EMS & Patients transport for rural settings

LOGISTICAL SUPPORT SERVICES: Adequate Medicines at Facilities. Improve Management of Health Technologies & Assistive Devices Functioning health information systems Striving for adequate budget allocation

Health - Limpopo 44


INFRASTRUCTURE DEVELOPMENT: Revitalization of hospitals Uupgrading and building of clinics Improve water, sanitation & electricity at clinics

HUMAN RESOURCE DEVELOPMENT: Development of a Departmental HR Plan Nursing and EMS Training Colleges Skills Development Development of mid-level health worker cadre core

HUMAN RESOURCE MANAGEMENT: Recruitment and retention of scarce and skilled workers

Health - Limpopo 45


COMMUNICATION, COLLABORATION AND PARTICIPATION: Engage in PPP for Phalaborwa hospital, Duiwelskloof hospital,

Laundry, Accommodation and Renal Dialysis unit. Conduct feasibility studies for possible Expansion of PPP Initiatives. Quality Improvement & Management Corporate Communication & Media Liaison Transformation & Inter-governmental Relations & Gender Issues Health Promotion

TERTIARY SERVICES: Fully modernized tertiary services

REVENUE GENERATION: Fully implemented designated provider network

Health - Limpopo 46

HEALTH PRIORITIES – M T E F

INFORMATION MANAGEMENT AND TECHNOLOGY: Improve the management of records Improve the quality of data within departmental

information systems Streamline IT service provision in line with the SITA act

RISK MANAGEMENT: Instill a culture of Risk Management within the

Department Effective management of security and fraud related risks.

Health - Limpopo 47

Strategic Plan to achieve the Health priorities

Pr 1. Health Administration = R230 m Develop and review departmental policies Develop norms and standards Develop an Info and Technology strategy Expand MIS to all clinics and hospitals Ensure effective revenue management Provide and maintain EEE and transparent

Financial Management Procurement and provisioning systems Contract Management system

Health - Limpopo 48


Pr 1. Health Administration cont. Implement EEE, PPP’s as requiredProvide labour relations servicesProvide communication servicesPromote community participation and

partnershipsDevelop an integrated HR planCo-ordinate training & develop HR

Health - Limpopo 49


Pr 1. Health AdministrationPersonnel Performance Management Implement Telemedicine / Telehealth at all

levels of care by 2010To improve the management of RiskTo strengthen the vital registration of births

and deaths.

Health - Limpopo 50


Pr 2 . District Health = R 2 054m Develop DHS devolution strategy Strengthen DHS via partnerships Provide a comprehensive PHC package Improve efficiencies at PHC facilities Improve access to drugs Promote community participation at district level Improve access to PHS services Improvement of the PHC infrastructure Improve the quality of care

Health - Limpopo 51


Pr 2 . District Health cont.Reduce morbidity & mortality:

Maternal , Peri Natal , Infant and Child Improve the Health of:

Woman, children, adolescent and the youthReduce diseases

Communicable, Epidemiology, Environmental & Occupational Health

Reduce Malaria cases

Health - Limpopo 52


Pr 2 . District Health cont. HIV & AIDS, STDI and TB control via

Home based care Sub – Acute care VCT services PMCT services Condom distribution TB services – DOTS and reporting system Improved Laboratory test turnaround time Availability of drugs Outside stakeholder involvement

Health - Limpopo 53


Pr 2 . District Health cont. HIV & AIDS, STDI and TB performance objectives

Reduce HIV PREVALENCE Improve access to ARV drugs Improve PMTCT services

Improve access to care and supportCure 85 % of new smear TB patients at first tryReduce TB treatment interruption rate to < 5 % Improve smear turn around time to 1-2 daysReduce MDR TB to < 1 %

Health - Limpopo 54


Pr 2 . District Health cont.

Performance objectives for Nutrition Improve the populations Nutritional status via INP Reduce micro-nutrient deficiency conditions

District Hospitals Improve efficiencies in health facilities Improve health technology in all facilities To improve the infrastructure Decentralise hospital management Improve quality of care

Health - Limpopo 55


Pr 3. Emergency Medical Services = R104m

Render accessible EMSReliable Ambulance serviceAvailable patient transport serviceWell maintained fleet

Health - Limpopo 56


Pr 4. Provincial Hospitals = R 463m Improve efficiencies in health facilities Improve health technology in all

facilities Improve physical infrastructureDecentralised hospital management Improve the quality of care Improve the quality of Nursing careStandardise the hospital indicators

Health - Limpopo 57


Pr 4. Provincial Hospitals cont

Delivery improvement plan Establish a patients rights charter for the

elderly and children Ensure availability of professional caregivers

for prescribed hours of operations Equal access to health services SLA’s with clients Community participation Safe and Healthy Environment

Health - Limpopo 58


Pr 5 . Central Hospital Services = R 397m

Polokwane / Mankweng Complex renders both secondary and tertiary level of care

Extensive use of Conditional Grants Health Prof Training & Development Man & Q-lity Imp grant Nat Tertiary Services European Union grants are also utilised

Health - Limpopo 59

Strategic Plan to achieve the Health prioritiesPr 5 . Central Hospital Services cont

Improve efficiencies in health facilitiesImprove overall health technologyImprove infrastructure of all facilitiesDecentralisation of hospitals managementImprove the quality of careDevelopment of the Medical School Tertiary services in the complex Develop teaching facilities Improve health technology for tertiary services

Health - Limpopo 60


Pr 6. Health Sciences and Training = R 144mProvide quality nursing education Improve the quality of student nurses Initiate and improve partnerships

Pr 7. Health Care Support = R 349mPharmaceutical services

To increase the drug availability at the depot, hospitals, health centres and clinics

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Pr 8. Health Facility Management = R 235mCapital planning and development of

infrastructure to acceptable levelsProvision of a reliable water, electricity &

sanitation at all clinicsMaintain and retain health facilities in a

serviceable conditionEquitable Share and Conditional Grants

Hospital Revitalisation GrantProvincial Infrastructure Grant

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Health Limpopo thanks You

The

End

Presentation to the Ad Hoc Committee on Health on the 2004 / 2005 Budget

Documents

Transcript of Presentation to the Ad Hoc Committee on Health on the 2004 / 2005 Budget