Paediatric Cardiac Services in South Africa

1. Paediatric Cardiac Services in South Africa A Summary of reports from South African units

2. AIM • Global overview of paediatric cardiac services that we offer in South Africa • To identify the challenges facing units

4. Report Content • Geographic area and population covered by unit • Staffing • ICU • Patient numbers • Echocardiographic and cath volumes • Cardiac surgical volumes and waiting lists • Challenges

5. Limitations • Covers activities of large units/centres predominantly • May not give individual practices/ small centres there due • Limited outputs

6. Units • Jhb Gen/Baragwanath/Coronation (JHB) • Pretoria Academic (Pret) • Bloemfontein (Bloem) • Inkosi Albert Luthuli Central Hospital – Durban(Dbn) • Red Cross /Tygerberg – Western Cape Paediatric Cardiac Services (WC) • Sunninghill Hospital (SH) • Christiaan Barnard Memorial Hospital (CBMH) • Limpopo –Polokwane/Mankweng • Mthatha

7. Unit coverage* * Largely excludes medical aid patients

8. Unit coverage - Private

9. Staffing

10. Intensive Care *Adult and paediatric

11. Patient Load *Excludes mixed practices

12. Cardiology Services

13. Surgical Load *WSPPCA

14. Summary

15. Challenges • Staff shortages : nursing, medical and support staff • Poor salaries and lack of career pathing • Insufficient surgical output: • Intensive care –competing with general paeds/adult cardio • Theatre time • Staff shortages • Inadequate funding for percutaneous interventions • Patient transport • Equipment –ageing, lack of appropriate equipment. • Diagnosis of Congenital Heart Disease in Peripheral Hospitals • Lack of official referral pathways for cardiacs (Limpopo) • Care of CHD patients in adulthood • Public /Private practice relationship • Teaching and training • Research