Revitalisation of hospital services

1. Revitalisation of hospital services • Ensure an appropriate inter facility referral system supported by an adequate and appropriate transport system • Empowerment and support of hospital management

2. Speeding up delivery of an essential package of services through the district health system • Gradually increasing the budget to primary health care facilities as cost centres for human and material resources to improve service delivery • Enforcing the implementation of Primary Health Care package at all the clinics and mobile services

3. Speeding up delivery of an essential package of services through the district health system • Commissioning 24 hour facilities to function as intended • Increase number of PHC facilities by 2% per annum • Ensure outreach service by medical officers to all PHC facilities at least once a week by 2007

4. Speeding up delivery of an essential package of services through the district health system • Comprehensively trained PHC nurses available in 50% of the total PHC facilities by 2007 • Establishing a Provincial training school for PHC nursing by April 2005

5. Decreasing morbidity and mortality rates through strategic interventions • Emergency Medical Services • Ensure the improvement of EMS resources (vehicles, human resources and equipment) from a current level of 30% of national norms to 80% over the next 3 years • Establish a fully accredited provincial EMS College providing basic, intermediate, advanced life support and rescue courses

6. Decreasing morbidity and mortality rates through strategic interventions • Continue Acute Flaccid Paralysis (AFP) surveillance • 90% immunisation coverage for children under one year • Sustain and increase IMCI implementation to all Health facilities • Strengthen the cervical cancer screening programme

7. Decreasing morbidity and mortality rates through strategic interventions • Develop a Provincial Specialised Rehabilitation Centre by 2006 • 80% of hospitals rendering rehabilitation services in line with National norms and standards by 2007 • Outreach rehabilitation services available at all CHC’s by 2007

8. Decreasing morbidity and mortality rates through strategic interventions • To implement integrated malnutrition intervention in 50% of the PHC facilities by March 2007

9. Decreasing morbidity and mortality rates through strategic interventions • Ensure fully functional Psychiatric units in the three districts by December 2005 • Establish three Mental Health Review Boards by March 2005 • To ensure that 80% of PHC facilities are rendering integrated Mental Health services by December 2006

10. Decreasing morbidity and mortality rates through strategic interventions • To ensure a Malaria case fatality rate less than 0,5% • To reduce the Malaria case incidence to less than 1,5% by December 2007 • To achieve a spray coverage of 80% in the Malaria high risk area

11. Decreasing morbidity and mortality rates through strategic interventions • To strengthen capacity for health promotion in 17 health promotion units to effect community outreach programmes in respect of preventive and promotive aspects in diseases of lifestyle by March 2007 • To improve the health status of the child by launching 30 health promoting schools by March 2007

12. Decreasing morbidity and mortality rates through strategic interventions • To implement the community component of the IMCI in 13 sites by March 2007 • To implement clinical guidelines for the management of Diabetes and Hypertension in all health facilities in the province by March 2007

13. Decreasing morbidity and mortality rates through strategic interventions • To put monitoring mechanisms in place to identify index Cholera cases towards the early prevention of Cholera outbreaks by October 2004 • To strengthen and maintain a fully functional Epidemic Preparedness and Response(EPR) system by March 2007

14. Decreasing morbidity and mortality rates through strategic interventions • Increase awareness on the benefits of Voluntary Counseling and Testing (VCT) • To continuously strengthen social mobilization using the Abstain, Be faithful and Condomise strategy • Increase awareness on the Prevention of Mother To Child Transmission programme

15. Decreasing morbidity and mortality rates through strategic interventions • Implementation of a HIV and AIDS workplace policy by October 2004 • Increase the utilization of community based health workers including Home Based Care workers to extend community outreach programmes • Reduce the incidence of STI’s using the syndromic approach for management of all STI cases

16. Decreasing morbidity and mortality rates through strategic interventions • Implementation of the Comprehensive, management and treatment of HIV and AIDS patients at all hospitals and some PHC facilities by March 2007 • Reduce the Multiple Drug Resistance (MDR) to TB drugs to less than 1% by March 2007 • Expand the Directly Observed Treatment Programme to all districts by March 2007

17. Improving resource mobilisation and the management of resources without neglecting the attainment of equity in resource allocation • Establish assessment teams to evaluate Certificate of Need applications in conjunction with National Department of Health • Optimally utilise information to equitably allocate resources

18. Improving resource mobilisation and the management of resources without neglecting the attainment of equity in resource allocation • Improve revenue generation at all hospitals • Finalise and implement PPP framework • Develop and implement Donor funding policy using National guidelines

19. Improving human resource development and management • Strengthen and expand the tele-tuition project in the province • Train 30 additional PHC qualified nurses per annum • Train 100 Pharmacist assistants per annum • Empower health managers in Labour Relations management

20. Improving human resource development and management • Strengthen cooperation for training of various health workers by the University of Pretoria, Limpopo, Free State and MEDUNSA • Strengthen the implementation of the Personnel Management and Development System (PMDS)

21. Improving human resource development and management • Improve personnel and administrative filing system as well as developing an electronic filing system • Continuous update of the PERSAL information

22. Improving communication and consultation within the health system and between the health system and communities we serve • Enhance community interaction through IZIMBIZO’s • Produce internal newsletter for the department • Increase the effectiveness of the Departmental Website • Schedule stakeholders meetings/summits with Medical Practitioners, Allied Health Professionals, Traditional Healers and NGO’s

23. Strengthening co-operation with our partners internationally • Implement plans of action with the Maputo Province in Mozambique • Jointly manage Health Information System development and GIS plotting projects with the Italian Corporation • Strengthen the Lebombo Spatial Development Initiative towards eradication of Malaria in the region

24. Brief description of the Budget with Trends 2000/01 – 2006/07

30. Budgetary Trends The Mpumalanga Province had a budget of R1,456 billion for the 2001/2 financial year. For 2002/3 the budget was R1,688 billion and for 2003/4 the budget was R2,152 billion The department provides in addition to the population of the province, health care services to patients from neighboring countries of Swaziland and Mozambique

31. Budgetary Trends • Mpumalanga Province, is the third lowest in terms of per capita spending at R770 • The Head count per capita for the visits to PHC facilities (2001/2) indicates an average of 1,5 visits as opposed to the 3-3,5 national norm • Expenditure has increased by 19% in 2003/4