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National Department of Health's Progress Report & Budget Plan

Presentation of the NDOH's annual report 2004/05 and strategic plan & budget 2006/07-2008/09 to the National Council of Provinces. Covers vision, mission, achievements, challenges, legislative mandates, key priorities, budget structure, and program achievements.

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National Department of Health's Progress Report & Budget Plan

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  1. PRESENTATION OF THE NATIONAL DEPARTMENT OF HEALTH’S ANNUAL REPORT 2004/05 AND THE STRATEGIC PLAN & BUDGET2006/07-2008/09 NATIONAL COUNCIL OF PROVINCES 09 MAY 2006

  2. FLOW OF PRESENTATION • VISION & MISSION • LEGISLATIVE MANDATES • KEY PRIORITIES, 2004-2009 (THE 10 POINT PLAN OF THE NHS) • SUMMARY OF ACHIEVEMENTS AND KEY CHALLENGES AS REFLECTED IN THE NDOH ANNUAL REPORT 2004/05

  3. FLOW OF PRESENTATION • PRIORITIES FOR 2006/07 AS REFLECTED IN THE NDOH STRATEGIC PLAN FOR 2006/07-2008/09 • NDOH BUDGET FOR 2006/07-2008/09 • CONCLUSIONS

  4. VISION & MISSION • VISION • AN ASSESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM • MISSION • TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS & DISEASE 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

  5. LEGISLATIVE MANDATES • 49 ACTS MENTIONED IN THE ANNUAL REPORT, INCLUDING: • THE CONSTITUTION OF THE REPUBLIC • NATIONAL HEALTH ACT • MENTAL HEALTH CARE ACT • PUBLIC FINANCE MANAGEMENT ACT • MEDICINES & RELATED SUBSTANCES ACT • MEDICAL SCHEMES ACT

  6. KEY PRIORITIES, 2004-2009 • IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS • PROMOTE HEALTHY LIFESTYLES • CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE • IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES • STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS

  7. KEY PRIORITIES, 2004-2009 (CONTD) • STRENGTHEN SUPPORT SERVICES • HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT • PLANNING, BUDGETING AND MONITORING & EVALUATION • PREPARATION AND IMPLEMENTATION OF LEGISLATION • STRENGTHEN INTERNATIONAL RELATIONS

  8. BUDGET PROGRAMME STRUCTURE OF THE NDOH IN 2004/05 • PROGRAMME 1: ADMINISTRATION (OFFICE OF MINISTER. DEPUTY MINISTER,LEGAL, PLANNING, COMMUNICATION) • PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (DISTRICTS; HEALTH PROGRAMMES; IHL; M/E) • PROGRAMME 3: HEALTH SERVICE DELIVERY (HOSPITALS; COMMUNICABLE & NCDs; HR)

  9. KEY ACHIEVEMENTS 2004/05: PROGRAMME 1 • AS REFLECTED ON P22 A NUMBER OF BILLS WERE TABLED DURING THE 04/05 FINANCIAL YEAR • NATIONAL HEALTH ACT SIGNED INTO LAW • COURTS UPHELD RIGHT OF DOH TO SET POLICY RE: LICENSING OF DESPENSERS & SINGLE EXIT PRICING • RANGE OF PUBLICATIONS, RADIO AND TV INTERVIEWS TO ENHANCE COMMUNICATION (PP24-25)

  10. KEY ACHIEVEMENTS 2004/05: PROGRAMME 1(CONT) • IMPROVED INTEGRATED PLANNING WITH PROVINCES & DISTRICTS • REVIEW OF ANNUAL REPORTS OF PROVINCES • PACKAGES OF CARE (PHC, DISTRICT HOSPITALS AND TERTIARY CARE) HAVE BEEN COSTED • INTER-PROVINCIAL EQUITY ANALYSED

  11. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • 66% OF HEALTH DISTRICTS PROVIDE FULL BASKET OF PHC SERVICES WITH INCREASING PHC UTILISATION (P 29) • PROVINCES ARE MOVING TOWARDS FUNCTIONAL INTEGRATION USING A NATIONAL CHECKLIST • ALL DISTRICTS HAVE STARTED TO USE THE NATIONAL DISTRICT HEALTH PLANNING GUIDELINES

  12. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • A NUMBER OF BI AND TRILATERAL AGREEMENTS HAVE BEEN SIGNED INCLUDING THOSE WITH IRAN, RWANDA, MALI, INDIA AND BRAZIL TO NAME A FEW (P 31) • ADDITIONAL RESOURCES FROM DONORS HAVE BEEN MOBILISED E.G., R80M FROM THE ITALIAN GOVERNMENT

  13. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • 30% OF HEALTH INSTITUTIONS HAVE A FUNCTIONAL HEALTH INFORMATION SYSTEM & MORE THAN 17% RECEIVE HEALTH BROADCASTS • 12% OF HOSPITALS HAVE TELEMEDICINE FACILITIES • SIGNIFICANTLY MORE BIRTHS AND DEATHS ARE BEING REGISTERED

  14. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • A NUMBER OF HEALTH REPORTS HAVE BEEN PUBLISHED (E.G., QUARTERLY REPORTS ON THE COMPREHENSIVE PLAN, ANTENATAL SURVEY, SADHS, CONFIDENTIAL INQUIRIES INTO MATERNAL DEATHS)

  15. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES STRATEGY EXPANDED TO ALL 53 HEALTH DISTRICTS • 8 000 HEALTH PROVIDERS TRAINED (64% OF THOSE WHO PROVIDE SERVICES TO CHILDREN) • 70% OF DISTRICTS REACHED IMMUNISATION COVERAGE OF 80% • SCHOOL HEALTH SERVICES EXTENDED - 30% OF PROVINCES PROVIDE 100% OF PHASE 1 SERVICES

  16. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • 80% OF PUBLIC HEALTH FACILITIES OFFER VCT & 60% OFFER PMTCT • MORE THAN 347m MALE & OVER 1m FEMALE CONDOMS DISTRIBUTED • BUSINESS CASES APPROVED BEFORE FUNDING FROM CONDITIONAL GRANT FOR HIV AND AIDS ARE DISBURSED TO PROVINCES – 97% OF FUNDS WERE USED

  17. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • NUMBER OF ACCREDITED SITES – 139 (AGAINST TARGET OF 113) • 74 NGOs FUNDED WITH CLOSE MONITORING

  18. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • 57% OF NEW SMEAR-POSTIVE CASES OF TB CURED AT THE FIRST ATTEMPT (TARGET IS 65%) • 12% OF TB PATIENTS DEFAULT (TARGET IS 10%) • 42% OF TB PATIENTS OFFERED VCT & 59% OF THESE ACCEPT

  19. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • USER-FRIENDLY SERVICE NORMS FOR PHC LAUNCHED • PROCESS PUT IN PLACE TO STRENGTHEN THE NATIONAL COMPLAINTS CENTRE • PRIORITY AREAS FOR QA TRAINING DEVELOPED

  20. KEY ACHIEVEMENTS 2004/05: PROGRAMME 2 • ALL NEW PHARMACIES HAVE BEEN LICENSED • WORK ON REVIEW OF HOSPITAL EDL BOOKS LARGELY COMPLETED • 75% COMPLIANCE REACHED ON COMPLETION OF EXPEDITED APPLICATIONS FOR DRUG REGISTRATION WITHIN 9 MONTHS

  21. KEY ACHIEVEMENTS 2004/05: PROGRAMME 3 • COVERAGE OF INDOOR RESIDUAL SPRAYING INCREASED TO 83% OF TARGETED HOUSES • GOOD COLLABORATION WITH NEIGHBOURING STATES ACHIEVED • 10 407 WHEELCHAIRS AND 4 547 HEARING AIDS DISTRIBUTED – BACKLOG ELIMINATED • NO OF CATARACT SURGERIES EXCEEDED TARGET (1 039/M DONE)

  22. KEY ACHIEVEMENTS 2004/05: PROGRAMME 3 • 11% OF HOSPITALS ARE PART OF THE HOSPITAL REVITALISATION PROGRAMME • CONDITIONAL GRANT FOR REVITALISATION OF HOSPITALS EFFECTIVELY MANAGED (BUSINESS CASES, REPORTS ETC) • 60% OF HOSPITALS ADOPTED GUIDELINES TO IMPROVE MANAGEMENT

  23. KEY ACHIEVEMENTS 2004/05: PROGRAMME 3 • DRAFT HR PLAN COMPLETED AND CONSULTATION PROCESS UNDERWAY • WORK ON MID LEVEL WORKERS ADVANCED EG. MEDICAL ASSISTANTS • CO-ORDINATION OF POLICY ON COMMUNITY CARE GIVERS WITH SOCIAL DEVELOPMENT COMPLETED • ON MORE THAN 9 000 HEALTH WORKERS TRAINED TO IMPLEMENT THE COMPREHENSIVE PLAN

  24. KEY ACHIEVEMENTS 2004/05: PROGRAMME 3 • IMPROVING EMPLOYEE RELATIONS WITHIN THE NDOH: • 55% OF GRIEVANCES RESOLVED INTERNALLY • 83% OF DISCIPLINARY HEARINGS FINALISED WITHIN 6 MONTHS

  25. CHALLENGES 2004/05 • IMPLEMENTATION OF POLICIES WITHIN RESOURCE CONSTRAINTS • RECRUITMENT & RETENTION OF HUMAN RESOURCES • TB CONTROL REMAINS A CHALLENGE –- CURE RATE IS 56.7%

  26. CHALLENGES 2004/05 • IMPROVEMENT OF EMERGENCY MEDICAL SERVICES REQUIRED • FURTHER STEPS NEEDED TO IMPROVE SERVICES IN PUBLIC HOSPITALS

  27. BUDGET AND EXPENDITURE FOR 2004/05

  28. NATIONAL DEPARTMENT OF HEALTH: 2004/05Appropriation per programme • Programme 1: Administration - 94% • Programme 2: Strategic Health Programme - 91% • Condoms ordered but not delivered • HIV/Aids Conditional Grant transferees withheld • Programme 3: Health Services Delivery - 96% • Laboratory equipment ordered but not delivered • Conditional Grant transfers withheld

  29. KEY PRIORITIES FOR 2006/07 – 2006/07 STRAT PLAN • DEVELOPMENT & IMPLEMENTATION OF SERVICE TRANSFORMATION PLANS • IMPLEMENTATION OF THE NATIONAL HUMAN RESOURCES FOR HEALTH PLAN • STRENGTHENING PHYSICAL INFRASTRUCTURE (PHC, HOSPITALS) • IMPROVING QUALITY OF CARE • PRIORITY HEALTH PROGRAMMES (HEALTHY LIFESTYLES, TB CRISIS MANAGEMENT PLAN, ACCELERATED HIV PREVENTION STRATEGY)

  30. DEVELOPMENT & IMPLEMENTATION OF SERVICE TRANSFORMATION PLANS • ALL PROVINCIAL DOHs TO FINALISE SERVICE TRANSFORMATION PLANS BY MAY 2006 • THESE WILL BE ANALYSED AND COLLATED INTO AN ANNUAL NATIONAL HEALTH PLAN FOR 2007/08 (IN TERMS OF SECTION 21(5) OF THE NHA OF 2003) • EMS BEING STRENGTHENED TO REDUCE RESPONSE TIMES

  31. IMPLEMENTATION OF THE NATIONAL HUMAN RESOURCES FOR HEALTH PLAN • WHO DECLARED 2006 AS HUMAN RESOURCES FOR HEALTH YEAR • NATIONAL HR PLAN COMPLETED & LAUNCHED ON 7 APRIL (WORLD HEALTH DAY) • SCOPES OF PRACTICE OF MID LEVEL WORKERS FINALISED

  32. HR PLAN • PREPARATIONS FINALISED FOR INITIATION OF CLINICAL ASSOCIATE PROGRAMME IN 2007 • POLICY ON COMMUNITY CARE GIVERS FINALISED • DISCUSSIONS WITH TREASURY AND DPSA ABOUT REMUNERATION LEVELS AND CONDITIONS OF SERVICE INITIATED

  33. STRENGTHENING PHYSICAL INFRASTRUCTURE (HOSPITALS & PHC) • HOSPITAL REVITALISATION IS IN ITS 4TH YEAR • 4 HOSPITALS COMPLETED IN 2004/05 (MP, NW AND 2 IN NC) • 45 HOSPITALS TO BE ENROLLED INTO THE PROGRAMME OVER THE NEXT 3 YEARS • HOSPITAL IMPROVEMENT PLANS TO BE DEVELOPED BY EACH HOSPITAL IN 2006/07

  34. STRENGTHENING PHYSICAL INFRASTRUCTURE (HOSPITALS & PHC) • PLAN FOR IMPLEMENTING MODERNISATION OF TERTIARY SERVICES TO COMMENCE IN 2006 • BY SEPTEMBER 2006 ALL HOSPITAL CEOs WILL HAVE APPROPRIATE DELEGATIONS • TRAINING PROGRAMME FOR CEOS COMMENCED • PHC FACILITIES AUDIT TO BE CONDUCTED PER PROVINCE IN 2006, INCLUDING IDENTIFICATION OF FACILITIES REQUIRING ACCOMMODATION FOR STAFF • REQUIRED PROFILE AND DISTRIBUTION OF CHC’S BY PROVINCE WILL BE COMPILED AND COSTED

  35. IMPROVING QUALITY OF CARE • CLINICAL AUDITS WILL BE ROUTINELY MONITORED IN ALL TERTIARY HOSPITALS AND 25% OF LEVEL 2 HOSPITALS; • COMPLAINTS MECHANISMS WILL BE ROUTINELY MANAGED IN ALL TERTIARY HOSPITALS AND 25% OF LEVEL 2 HOSPITALS; • INFECTION CONTROL MANAGEMENT WILL BE EFFECTED IN ALL LEVEL 1 HOSPITALS AND CHCS AND ALL CLINICS; • PLANNED PATIENT TRANSPORT DEPLOYED FLEET WILL INCREASE BY 10%

  36. STRENGTHENING PRIORITY HEALTH PROGRAMMES • IN KEEPING WITH WHO-AFRO RESOLUTIONS AN ACCELERATED HIV PREVENTION PLAN WILL BE DEVELOPED • TB CRISIS MANAGEMENT PLAN WILL BE IMPLEMENTED TO OBTAIN IMPROVEMENT OF 10% IN SMEAR CONVERSION RATES AND TB CURE RATES IN THE NELSON MANDELA METRO, AMATOLE DISTRICT, ETHEKWINI METRO AND CITY OF JOHANNESBURG • ALL PROVINCES WILL DEVELOP DETAILED, CONTEXT SPECIFIC IMPLEMENTATION PLANS FOR THE HEALTH LIFESTYLES CA\MPAIGN INCLUDING, COMMUNITY-BASED HEALTH PROGRAMMES WILL BE IMPLEMENTED IN ALL 53 DISTRICTS & THE NUMBER OF HEALTH PROMOTING SCHOOLS WILL BE ESCALATED AND 60% OF SCHOOLS WILL IMPLEMENT THE SCHOOL HEALTH POLICY.

  37. RESOURCE ALLOCATION TO THE HEALTH SECTOR 2006/07-2008/09: NATIONAL DOH (INCLUDING PROVINCIAL CONDITIONAL GRANTS)

  38. NATIONAL DEPARTMENT OF HEALTH

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  45. RESOURCE ALLOCATION TO THE HEALTH SECTOR 2006/07-2008/09: PROVINCIAL DOHs (INCLUDE GRANTS)

  46. RESOURCE ALLOCATION TO THE HEALTH SECTOR 2006/07-2008/09: NATIONAL AND PROVINCIAL DOHs (INCLUDING GRANTS)

  47. CONCLUSION • DESPITE MANY CHALLENGES THE DOH HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2004/05 (AND IN 2005/06) • NDOH ORGANOGRAM TO BE EXPANDED IN 2006/07 TO INCLUDE A FURTHER 3 BRANCHES (WAS EXPANDED IN 2004/05 TO INCLUDE AN HR BRANCH) • WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2006/07 TARGETS

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