2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH 12 OCTOBER 2004.

2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH

12 OCTOBER 2004

annual report.portfolio comm. 12 oct 2004

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CONTENTS

FOREWORD BY THE MINISTER OF HEALTH

DIRECTOR-GENERAL’S OVERVIEW PERFORMANCE REVIEW HUMAN RESOURCE MANAGEMENT FINANCIAL REPORT


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VISION

A CARING AND HUMAN SOCIETY IN WHICH ALL SOUTH AFRICANS HAVE ACCESS TO AFFORDABLE, GOOD QUALITY HEALTH CARE.


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MISSION

TO CONSOLIDATE AND BUILD ON THE ACHIEVEMENTS OF THE PAST FIVE YEARS IN IMPROVING ACCESS TO HEALTH CARE FOR ALL AND REDUCING INEQUITY, AND TO FOCUS ON WORKING IN PARTNERSHIP WITH OTHER STAKEHOLDERS TO IMPROVE THE QUALITY OF CARE OF ALL LEVELS OF THE HEALTH SYSTEM, ESPECIALLY PREVENTIVE AND PROMOTIVE HEALTH, AND TO IMPROVE THE OVERALL EFFICIENCY OF THE HEALTH CARE DELIVERY SYSTEM


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1999-2004: 10 POINT PLAN

DECREASE MORBIDITY AND MORTALITY RATES THROUGH STRATEGIC INTERVENTIONS

IMPROVE QUALITY OF CARE SPEED UP THE DELIVERY OF A PACKAGE OF PRIMARY

HEALTH CARE SERVICES THROUGH THE DISTRICT HEALTH SYSTEM

REVITALISE PUBLIC HOSPITAL SERVICES IMPROVE RESOURCE MOBILISATION AND THE

MANAGEMENT OF RESOURCES WITHOUT NEGLECTING THE ATTAINMENT OF EQUITY IN RESOURCE ALLOCATION


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10 POINT PLAN CONTD

IMPROVE HUMAN RESOURCE DEVELOPMENT AND MANAGEMENT

REORGANISATION OF CERTAIN SUPPORT SERVICES

REFORM OF SPECIFIC PIECES OF LEGISLATION IMPROVE COMMUNICATION AND

CONSULTATION WITH STAKEHOLDERS AND COMMUNITIES

STRENGTHEN CO-OPERATION WITH OUR PARTNERS INTERNATIONALLY


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INFANT & CHILD HEALTH

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES

– COMPREHENSIVE CARE FOR CHILDREN UNDER 5– RANGE OF POLICIES & GUIDELINES PRODUCED– MORE THAN 7 000 HEALTH WORKERS TRAINED IN

CASE MANAGEMENT– 82% OF CHILDREN UNDER 1 FULLY IMMUNISED & 93%

REVIEWED 3RD DOSE OF POLIO VACCINE– ON ROAD TO BE CERTIFIED POLIO FREE BY

DECEMBER 2005


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YOUTH & ADOLESCENT HEALTH

212 FACILITIES ACCREDITED AS YOUTH FRIENDLY

WORKSHOPS ON THE YOUTH AND ADOLESCENT HEALTH POLICY GUIDELINES HELD ON ALL PROVINCES


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WOMEN’S HEALTH

POLICIES AND GUIDELINES ISSUED:– NATIONAL SEXUAL ASSAULT POLICY– MANAGEMENT GUIDELINES FOR SEXUAL ASSAULT

CARE– SEXUAL ASSAULT EXAMINATION FORM– NATIONAL CONTRACEPTIVE SERVICE DELIVERY

GUIDELINES– NATIONAL STRATEGY FOR THE IMPLEMENTATION OF

THE CHOICE ON TERMINATION OF PREGNANCY ACT, ACT NO 92 OF 1996

STRATEGY FOR IMPLEMENTATION OF CERVICAL SCREENING


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MATERAL HEALTH

RECOMMENDATIONS FROM THE SAVING MOTHERS REPORT AND REPORTS ON CONFIDENTIAL INQUIRIES DISTRIBUTED

IMPLEMENTATION OF GUIDELINES ON MANAGING CONDITIONS THAT COMMONLY RESULT IN MATERNAL DEATH

DEVELOPED REFERRAL CRITERIA AND ROUTES, IMPROVED SKILLS IN ANAESTHESIA & ENSURED AVAILABILITY OF SAFE BLOOD SUPPLIES IN ALL HOSPITALS PERFORMING CASEARIAN SECTIONS

WORKSHOPS IN 8 PROVINCES CONDUCTED IN USE OF ARVs IN MATERNAL HEALTH

PROBLEMS: TRANSPORT, INCLUDING EMS & AVAILABILITY OF COMPETENT HEALTH PROVIDERS


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NUTRITION

22% OF 480 MATERNITY FACILITIES ARE BABY FRIENDLY (PROMOTION OF BREAST FEEDING AND MOTHER/BABY CARE)

NUTRITION GUIDELINES FOR PLWHA, TB AND OTHER DEBILITATING CONDITIONS PRODUCED

RANGE OF CHILD NUTRITION GUIDELINES PREPARED & TRAINING DONE IN 4 PROVINCES

HIGH DOSE VITAMIN SUPPLEMENTATION EXPANDED REGULATIONS FOR MANDATORY FORTIFICATION OF MAIZE

MEAL AND WHEAT CAME INTO EFFECT IN OCTOBER 2003 MORE THAN 750 HEALTH WORKERS TRAINED IN GROWTH

MONITORING AND PROMOTION & 1 MILLION ROAD TO HEALTH CHARTS DISTRIBUTED

MORE THAN 16 000 SCHOOLS AND 4,5MILLION CHILDREN REACHED IN THE PRIMARY SCHOOL NUTRITION PROGRAM


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MALARIA

NO OF CASES DECREASED BY 6% CASE FATALITY INCREASED

MARGINALLY & MALARIA AWARENESS CAMPAIGNS INCREASED

WITH 9 OTHER SADC COUNTRIES SA PARTICIPATED IN THE RACE AGAINST MALARIA RALLY


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CHOLERA

5 PROVINCES REPORTED CASES WITH KWAZULU-NATAL, EASTERN CAPE AND MPUMALANGA MOST AFFECTED

INTERSECTORAL OUTBREAK RESPONSE TEAMS STRENGTHENED

GUIDELINES FOR CHOLERA CONTROL, IEC MATERIAL PRODUCED & TRAINING DONE IN 4 PROVINCES


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TB

INCIDENCE OF TB - 551/ 100 000 75% OF TOTAL TB CASES FOUND IN EASTERN

CAPE, GAUTENG, KWAZULU-NATAL AND WESTERN CAPE

DETECTION RATE HIGH (86%) BUT CURE RATE LOW (54%) WITH HIGH INTERRUPTION RATE (13%)

NEED TO STRENGTHEN THE PROGRAMME INCLUDING THE DOTS, APPOINTMENT OF TB CO-ORDINATORS AT HEALTH DISTRICT LEVEL, IMPROVE TURN AROUND TIME (LABS)


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HIV & AIDS AND STIs

2582 FACILITIES PROVIDE VCT (INCREASE FROM 1500 IN 2002/03)

MORE THAN 30 000 PEOPLE RECEIVED COUNSELLING & 70% OF THEM ACCEPTED TESTING

MORE THAN 300 CLINICS IN THE EASTERN CAPE, KWAZULU-NATAL AND MPUMALANGA WILL BE UPGRADED TO CREATE ADDITIONAL SPACE FOR VCT

COMPREHENSIVE PLAN APPROVED, SITE ACCREDITATION UNDERTAKEN & TREATMENT COMMENCED


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PREVENTION OF MOTHER TO CHILD TRANSMISSION

1652 FACILITIES PROVIDE PMTCT (540 IN THE 2002/03 FY)

PMTCT VIDEO PRODUCED IN 4 OFFICIAL LANGUAGES 7 DISTRIBUTED TO PROVINCES


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HOME & COMMUNITY BASED CARE

893 HBC SERVICE POINTS COMPARED TO 466 IN 2002/03

HBC POINTS ARE MAPPED TO LINK THEM TO HEALTH SERVICE DELIVERY POINTS

TENDER TO EVALUATE HBC ISSUED AND WORK COMMENCED DURING 2004/05


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STIs & BARRIER METHODS

SYNDROMIC MANAGEMENT USED – PRIVATE GPs TRAINED

SURVEILLANCE IMPROVED TO IMPROVE ROUTINE MONITORING

302 MILLION MALE CONDOMS AND 194 000 FEMALE CONDOMS DISTRIBUTED


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ADVOCACY, AWARENESS & PROMOTION

RANGE OF ADVACACY ACTIVITIES KHOMANANO MASS COMMUNICATION

CAMPAIGN ASSIST IN A RANGE OF ACTIVITIES– STI WEEK– WORLD TB DAY– WORLD AIDS DAY– PARTNERSHIP AGAINST AIDS


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CHRONIC DISEASES

TARGETS: LIFESTYLE RISKS; OBESITY; HIGH BLOOD PRESSURE

MEN’S HEALTH: PROSTRATE & TESTICULAR CANCER

BARRIERS TO PATIENT ADHERENCE IDENTIFIED & WILL BE INCLUDED IN THERAPEUTIC EDUCATION FOR HEALTH PROFESSIONALS


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DISABILITIES

FREE HEALTH CARE FOR PEOPLE WITH DISABILITIES INTRODUCED IN JULY 2003

R13 M USED TO PURCHASE ASSISTIVE DEVICES ADDITIONAL TO PROVINCIAL EXPENDITURE

4770 WHEELCHAIRS AND 4674 HEARING AIDS DISTRIBUTED

MORE THAN 120 HEALTH WORKERS TRAINED IN SIGN LANGUAGE


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MENTAL HEALTH & SUBSTANCE ABUSE

80% OF HEALTH DISTRICTS INTEGRATING MENTAL HEALTH INTO PHC (40% HAVE INTEGRATED)

REGULATIONS IN TERMS OF MENTAL HEALTH CARE ACT BEING FINALISED, INCLUDING WARNING LABELS

CARE IN PSYCH HOSPITALS BEGINNING TO IMPROVE


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HEALTH PROMOTION

POLICY & STRATEGY DEVELOPED & BEING COSTED RANGE OF HEALTH PROMOTION ACTIVITIES

UNDERTAKEN 18% MORE SCHOOLS IMPLEMENTING THE HEALTH

PROMOTING SCHOOLS PROGRAMME SCHOOL BASED WATER BORNE DISEASE PREVENTION

PROGRAMME PILOTED IN EASTERN CAPE AND KWAZULU-NATAL

SMOKING PREVALENCE IN 13-15 YR OLDS DECREASED FROM 23% IN 1999 TO 18.5% IN 2002


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QUALITY OF CARE

TRAINING OF MORE THAN 360 PEOPLE IN PATIENTS AND HUMAN RIGHTS LINKED TO BATHO PELE

NATIONAL COMPLAINTS CENTRE ESTABLISED (135 COMPLAINTS RECEIVED)

SUPERVISION SYSTEMS STRENGTHENED


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PRIMARY HEALTH CARE

PHC PACKAGE BEING IMPLEMENTED NATIONALLY BUT NO IN EVERY CLINIC

DISTRICT HEALTH PLANS DEVELOPED LINKED TO THE INTEGRATED DEVELOPMENT PLANS IN MOST PROVINCES

R37M OF EU FUNDS OVER PAST 3 YEARS USED TO STRENGTHEN PHC IN 13 RURAL NODES


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HOSPITAL SERVICES

HOSPITAL REVITALISATION PROGRAMME IN ITS 3RD YEAR & 30 HOSPITALS IN PROGRAMME

2 HOSPITALS COMPLETED IN 2003 (COLESBURG AND CALVANIA)

POLICY ON HOSPITAL DECENTRALISATION IN PLACE AND GUIDELINES ON USE DEVELOPED

GUIDELINES TO STRENGTHEN HOSPITAL GOVERNANCE DEVELOPED & NATIONAL REGULATIONS ON HOSPITAL BOARDS FINALISED

41 HOSPITALS ARE IMPLEMENTING COST CENTRE ACCOUNTING TO STRENGTHEN FINANCIAL MANAGEMENT

51 HOSPITAL MANAGERS ARE PART OF THE SA/UK TWINNING ARRANGEMENT AND 20 MANAGERS PART OF THE SA/FRENCH PROGRAMME


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RESOURCE MOBILISATION

PROPOSALS FOR IMPLEMENTATION OF RISK EQUILISATION FUND FINALISED

MOST PROVINCES IMPLEMENTING THE UNIFORM PATIENT FEE SCHEDULE RESULTING IN INCREASES IN REVENUE GENERATION

PROPOSALS FOR THE MODERNISATION OF TERTIARY SERVICES COMPLETED

INTEGRATED HEALTH PLANNING FRAMEWORK STRENGTHENED – 10 YEAR PLANNING HORIZON


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HUMAN RESOURCES

SCARCE SKILLS AND RURAL ALLOWANCES IMPLEMENTED AS OF 1 JULY 2003

EXPANDED COMMUNITY WORKER PROGRAMME LAUNCHED AS PART OF THE EXPANDED PUBLIC WORKS PROGRAMME

COMMONWEALTH CODE OF ETHICAL RECRUITMENT SIGNED

JOINT HEALTH WORKER AWARDS CEREMONY HELD


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PHARMACEUTICAL POLICY & PLANNING

PRICING COMMITTEE ESTABLISHED AND SINGLE EXIT PRICE DETERMINED

LICENCING OF HEALTH PROFESSIONALS TO PRESCRIBE

REVIEW OF THE ESSENTIAL DRUG LIST AND STANDARD TREATMENT GUIDELINES

NORMS AND STANDARDS FOR PHARMACEUTICAL SERVICE DELIVERY DEVELOPED


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MEDICINES REGULATORY AUTHORITY

OF 600 LICENSING APPLICATIONS 400 APPROVED BY MCC

REFERENCE CENTRE FOR AFRICAN TRADITIONAL MEDICINES LAUNCHED

3 PHARMACOVIGILANCE CENTRES ESTABLISHED


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HEALTH INFORMATION

DISTRICT HEALT H INFORMATION SYSTEM ONE OF THE BEST – ROUTINE INFORMATION SYSTEM FOR PHC AND HOSPITALS

TELEMEDICINE SITES INCREASED FROM 28 TO 57

CLOSED HEALTH BROADCAST CHANNEL IN 5 LANGUAGES BROADCASTS TO 56 SITES

100 MOBILE LIBRARIES PURCHASED FOR RURAL NODES


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HEALTH LEGISLATION

MORE THAN 70 REGULATIONS PROCESSED

4 HEALTH BILLS PROCESSED TO PARLIAMENTARY LEVEL INCLUDING THE NATIONAL HEALTH ACT


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COMMUNICATION

MORE THAN 30 CAMPAIGNS AND EVENTS HELD– WORLD HEALTH DAY: HEALTHY

ENVIRONMENTS FOR CHILDREN– RACE AGAINST MALARIA RALLY– WHO REGIONAL COMMITTEE FOR AFRICA

53RD MEETING– 10 YEAR OF FREEDOM CELEBRATION

(BETTER TOGETHER)


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INTERNATIONAL CO-OPERATION

BILATERAL AGREEMENTS WITH MANY COUNTRIES– 463 CUBAN DOCTORS– SA DOCTORS PERFORMED 10 BYPASS

OPERATIONS IN ALGERIA– TWINNING AGREEMENTS WITH UK &

FRANCE RE: HOSPITAL MANAGEMENT– BELGIAN TECHNICAL CO-OPERATION (HR)


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HR

EMPLOYMENT AND VACANCY RATES: 15% VACANCY (TABLE 20)

ANNUAL TURN OVER RATE SMS: 3% (TABLE 28)


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AUDITOR-GENERAL’S REPORT

QUALIFICATION – DORA 2003– TRANSFERS MADE IN SPITE OF UNDER SPENDING– NO SITE INSPECTIONS

EMPHASIS OF MATTER – CONDITIONAL GRANTS

– NO GUIDELINE– NO DISTINCTION BETWEEN EQUITABLE SHARE AND

CONDITIONAL GRANT FUNDING– INADEQUATE MONITORING OF COMPLIANCE WITH

BUSINESS PLAN


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EMPHASIS OF MATTER (CONT.)

ASSET REGISTER - NO INTEGRATION WITH BAS NGO FUNDING

– AUDITED FINANCIAL STATEMENTS NOT SUPPLIED– NO ASSURANCE OBTAINED FROM NGO THAT SOUND

FINANCIAL SYSTEMS ARE IN PLACE

INTERNAL AUDIT– NOT FUNCTIONING AS ENVISAGED – RISK MANAGEMENT NOT FULLY DEVELOPED– LACK OF CAPACITY


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REMEDIAL STEPS

CONDITIONAL GRANTS– DRAFT GUIDELINES– STRENGTHEN STAFF COMPLIMENT TO ENABLE SITE

VISITS AND BETTER FINANCIAL MONITORING– IMPROVED COORDINATION WITH PROVINCES BY

WAY OF STANDING ITEMS AT CONSULTATION FORUMS SUCH AS

CFO, NHCC, PHRC & MIN/MEC

ASSET REGISTER– TO BE DISCUSSED WITH NATIONAL TREASURY


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REMEDIAL STEPS (CONT.)

NGO’S FUNDING– STRENGTHEN UNIT BY MEANS OF APPOINTING

FINANCIAL STAFF– TRAIN ALL STAFF IN UNIT– STRICTLY APPLY TREASURY INSTRUCTIONS– STRICTLY MONITOR COMPLIANCE WITH CONTRACTS

INTERNAL AUDIT– DEVELOP RISK MANAGEMENT– STABILIZE PERSONNEL IN THE UNIT


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NDOH FINANCES – EXCEL SPREADSHEET

2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH 12 OCTOBER 2004.

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