2015/16 Annual Performance Plan Quarter Four Report

2015/16 ANNUAL PERFORMANCE PLAN 2015/16 QUARTER FOUR STANDING COMMITTEE ON APPROPRIATIONS 14 SEPTEMBER 2016

Purpose • Present Quarter Four Performance Report on the Annual Performance Plan 2015/16. The report is presented by the following programmes: • Programme 1: Administration • Programme 2: Health Planning and Systems Enablement • Programme 3: HIV & AIDS, TB and MCWH • Programme 4: PHC Services • Programme 5: Hospitals, Tertiary Services and Workforce Development • Programme 6: Health Regulation and Compliance Management • Q4 performance is also presented in the background of • 2015/16 performance 2

Medium Term Strategic Framework (MTSF) 2014-2019 The Department Annual Performance Plan is designed to deliver on the MTSF commitments, namely: Sub-outcome 1: Universal Health coverage progressively achieved through implementation of National Health Insurance Sub-outcome 2: Improved quality of health care Sub-outcome 3. Implement the re-engineering of Primary Health Care Sub-outcome 4: Reduced health care costs Sub-outcome 5: Improved human resources for health Sub-outcome 6: Improved health management and leadership Sub-outcome 7: Improved health facility planning and infrastructure delivery Sub-outcome 8: HIV & AIDS and Tuberculosis prevented and successfully managed Sub-outcome 9: Maternal, infant and child mortality reduced Sub-outcome 10 : Efficient Health Management Information System developed and implemented for improved decision making 3

Progress Report PROGRAMME 1 : ADMINISTRATION 4

Programme 1: Administration 5

Programme 1: Administration 8 10

Programme 1 Performance Improvement Strategies • Turn-around time on staff recruitment processes: • The Department measured itself against a stringent 4-months target; however the DPSA target in Public Service is 6 months. For this reporting period, NDoH met the 6 months target, even though there were challenges in meeting the 4 months target. NDoH has engaged the institutions responsible for the prerequisite verification of qualifications of selected candidates in order to improve the processes. In the 2016/17 financial year, the Departmental target will be aligned with the DPSA target of six months.

Progress Report PROGRAMME 2 : HEALTH PLANNING AND SYSTEMS ENABLEMENT 10

Programme 2: National Health Insurance, Health Planning and Systems Enablement 11

Programme 2 Performance Improvement Strategies • To improve numbers of patients receiving medications through the CCMDD programme, additional patients have been identified for enrolment into the programme in eThekwini, Alexandra Clinic, RK Khan Hospital, Potchefstroom Hospital and patients who participate in adherence clubs. • The Financial and Fiscal Commission will be further engaged on the revenue retention model. The Department and the Council for Medical Schemes are working with the Council for Industrial and Scientific Research to ensure that the repository of patients will comply with the National Health Normative Standards for Interoperability. • In order to fast-track the implementation of improved patient administration and web based information systems at health facilities, the NDoH engaged and supplied the Department of Telecommunications and Postal Services with a list of health facilities in the NHI pilot districts for broadband connectivity. The purchase order of new IT hardware for the remaining 200 facilities had been issued in the last quarter of 2015/16 financial year. The process to roll out the implementation of the Health Patient Register System will continue during the 2016/17 financial year once the infrastructure and systemic challenges have been resolved.

Progress Report PROGRAMME 3 : HIV AND AIDS, TUBERCULOSIS , MATERNAL, CHILD AND WOMEN’S HEALTH 21

Programme 3: HIV and AIDS, TB and Maternal Child and Women’s Health 22

Programme 3 Performance Improvement Strategies • Implementation of the adherence strategy will aim to assist in retention of patients on TB treatment • Based on the 2015/16 performance on medical male circumcision, the target for the 2016/17 financial year has been realistically determined • The country operational plan and district-level micro-plans include a demand creation strategy to address social mobilisation at local level by employing social mobilisation teams

Progress Report PROGRAMME 4 : PRIMARY HEALTH CARE SERVICES 33

Programme 4: Primary Health Care Services 34

Programme 4 Performance Improvement Strategies • In order to fast track the Ideal Clinics Initiative implementation as a flagship programme for improving quality in the public sector, NDOH provides support and assistance to provinces, districts and facilities to improve quality by facilitating assessments and the procurement of essential equipment for individual facilities • The implementation of the Policy Framework and Strategy for Rehabilitation and Disability requires detailed analysis of the readiness of districts to implement it and a full costing prior to the allocation of resources, and therefore a change in approach was adopted. This change was required to avoid disorganised expenditure and service delivery • The testing of salt content in foods will be done in the 2016/17 financial year.

Progress Report PROGRAMME 5 : HOSPITALS, TERTIARY SERVICES AND WORKFORCE DEVELOPMENT 42

Programme 5: Hospitals, Tertiary Services and Workforce Development 43

Programme 5: Performance Improve Strategies • The activities to increase the capacity of central hospitals are to: • strengthen local decision making and accountability; • facilitate semi-autonomy of 10 central hospitals; • ensure quality health care by improving compliance with National Core Standards at all Central, Tertiary, Regional and Specialised Hospitals, as well as equitable access to tertiary service through implementation of the National Tertiary services plan are vital, particularly within the context of progressive NHI implementation. • In order to improve performance of the above areas, NDoH is: • benchmarking the strategies and tools to assist the development of hospitals to achieve the required status for semi-autonomy, including a “tool-kit” for the development and training of hospital boards. • Engaging provincial departments of health who have a responsibility for implementation • engaging National Treasury on funding of key interventions such as the appointment of specialists in tertiary hospitals • Regarding toxicology, equipment failures (now fixed) at Pretoria Lab contributed to non-achievement of target. The Pretoria Lab will move to new facility in 2016/17, and capacity at Jhb lab is being expanded, which will address backlogs. • In addition to facilitating the development of staffing norms and standards for the district and specialised hospitals, the sub-programme will mobilise resources from partner organisations to support the work at both national and provincial level

2015/16 Annual Performance Plan Quarter Four Report