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2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH

2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH. 12 OCTOBER 2004. CONTENTS. FOREWORD BY THE MINISTER OF HEALTH DIRECTOR-GENERAL’S OVERVIEW PERFORMANCE REVIEW HUMAN RESOURCE MANAGEMENT FINANCIAL REPORT. VISION.

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2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH

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  1. 2003/04 ANNUAL REPORT: NATIONAL DEPARTMENT OF HEALTH 12 OCTOBER 2004

  2. CONTENTS • FOREWORD BY THE MINISTER OF HEALTH • DIRECTOR-GENERAL’S OVERVIEW • PERFORMANCE REVIEW • HUMAN RESOURCE MANAGEMENT • FINANCIAL REPORT annual report.portfolio comm. 12 oct 2004

  3. VISION • A CARING AND HUMAN SOCIETY IN WHICH ALL SOUTH AFRICANS HAVE ACCESS TO AFFORDABLE, GOOD QUALITY HEALTH CARE. annual report.portfolio comm. 12 oct 2004

  4. 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 annual report.portfolio comm. 12 oct 2004

  5. 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 annual report.portfolio comm. 12 oct 2004

  6. 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 annual report.portfolio comm. 12 oct 2004

  7. 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 annual report.portfolio comm. 12 oct 2004

  8. YOUTH & ADOLESCENT HEALTH • 212 FACILITIES ACCREDITED AS YOUTH FRIENDLY • WORKSHOPS ON THE YOUTH AND ADOLESCENT HEALTH POLICY GUIDELINES HELD ON ALL PROVINCES annual report.portfolio comm. 12 oct 2004

  9. 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 annual report.portfolio comm. 12 oct 2004

  10. 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 annual report.portfolio comm. 12 oct 2004

  11. 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 annual report.portfolio comm. 12 oct 2004

  12. 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 annual report.portfolio comm. 12 oct 2004

  13. 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 annual report.portfolio comm. 12 oct 2004

  14. 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) annual report.portfolio comm. 12 oct 2004

  15. 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 annual report.portfolio comm. 12 oct 2004

  16. 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 annual report.portfolio comm. 12 oct 2004

  17. 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 annual report.portfolio comm. 12 oct 2004

  18. 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 annual report.portfolio comm. 12 oct 2004

  19. 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 annual report.portfolio comm. 12 oct 2004

  20. 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 annual report.portfolio comm. 12 oct 2004

  21. 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 annual report.portfolio comm. 12 oct 2004

  22. 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 annual report.portfolio comm. 12 oct 2004

  23. 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 annual report.portfolio comm. 12 oct 2004

  24. 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 annual report.portfolio comm. 12 oct 2004

  25. 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 annual report.portfolio comm. 12 oct 2004

  26. 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 annual report.portfolio comm. 12 oct 2004

  27. 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 annual report.portfolio comm. 12 oct 2004

  28. 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 annual report.portfolio comm. 12 oct 2004

  29. 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 annual report.portfolio comm. 12 oct 2004

  30. MEDICINES REGULATORY AUTHORITY • OF 600 LICENSING APPLICATIONS 400 APPROVED BY MCC • REFERENCE CENTRE FOR AFRICAN TRADITIONAL MEDICINES LAUNCHED • 3 PHARMACOVIGILANCE CENTRES ESTABLISHED annual report.portfolio comm. 12 oct 2004

  31. 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 annual report.portfolio comm. 12 oct 2004

  32. HEALTH LEGISLATION • MORE THAN 70 REGULATIONS PROCESSED • 4 HEALTH BILLS PROCESSED TO PARLIAMENTARY LEVEL INCLUDING THE NATIONAL HEALTH ACT annual report.portfolio comm. 12 oct 2004

  33. 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) annual report.portfolio comm. 12 oct 2004

  34. 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) annual report.portfolio comm. 12 oct 2004

  35. HR • EMPLOYMENT AND VACANCY RATES: 15% VACANCY (TABLE 20) • ANNUAL TURN OVER RATE SMS: 3% (TABLE 28) annual report.portfolio comm. 12 oct 2004

  36. 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 annual report.portfolio comm. 12 oct 2004

  37. 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 annual report.portfolio comm. 12 oct 2004

  38. 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 annual report.portfolio comm. 12 oct 2004

  39. 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 annual report.portfolio comm. 12 oct 2004

  40. NDOH FINANCES – EXCEL SPREADSHEET annual report.portfolio comm. 12 oct 2004

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