BEMF CEGAA and TAC BMET Update

1. BEMFCEGAA and TAC BMET Update 1 April 2011

2. Remember the old issues identified through district patient and health facility survey? (2010) • Most patients (82%) reported that they received the health care services they needed recently. 17% did not receive the services • Most patients (64%) interviewed were happy with the quality of health services they received! Yet 46% of them had problems accessing some health services in the near past - No access due to lack of treatment (30% average, as high as 48% in Lusikisiki), doctor not available (8%) and long waiting queues (27%) • And some of them (17%) were not happy with the current quality of service received, due to: Ongoing long queues; Shortage of health workers; Attitudes of health workers (presumably linked to staff shortage and workload); Irregular operating hours; No test results; Lack of basic necessities: sputum bottles, syringes and stationery • Most clinic and hospital health workers (57% average, 83% in Lusikisiki) were not happy with the quality of health care service they provide due to a combination of reasons, but human resources being the main one leading to work overload, fatigue, negative attitudes • Insufficient supply of day-to-day necessities – stationery, patient forms, sputum bottles, syringes • Question: Where’s the clinic budget?? Where is the District in the budget process?

3. The BMET Update for BEMF: Work in Progress • Dissemination process following survey • Public Hearings with governmental and non-governmental stakeholders held in Nov & Dec 2011 at two districts • Follow-up Stakeholder Meetings • At local level: DAC, NEHAWU, DENOSA, COSATU, Municipal Health Services, District Health Services, CEGAA and TAC • At provincial level: Provincial HAST Offices, Offices of the Premier: HIV/AIDS Desk and Provincial AIDS Council Secretariat, Provincial DOH DDGs (Clinical Management Services in EC and Strategic Health Programmes in KZN – both pending meeting appointments) • Provincial budget analysis in light of NASA and District BMET findings and available costing information • Ongoing community monitoring by TAC CHAs and BMET partners • NASA data collection complete, but now busy with analysis

4. The BMET Update for BEMF: Work in Progress • Action Teams nominated and now team members formulating action plans • Need for joint citizen-government monitoring initiatives growing • Compatibility and agreement between NGOs, grassroots groups and government on the survey findings – good opportunity for collaboration • Public education and media use: the teams raising public awareness of the issues, with a view to changing both public and government attitudes and behaviour, and encouraging support for other corrective actions

5. The BMET Update for BEMF: Work in Progress • Ongoing research and community monitoring provide the necessary information for planning, message development and lobbying • Active engagement with provincial and district DOH to allow citizen participation in strategic planning and budgeting for HIV/AIDS and TB at district and community levels • The role of clinic committees and hospital boards • Social accountability – through ongoing interactive engagements between DOH officials, health workers and citizens