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Gauteng Department of Health Presentation to the national Health portfolio Committee

Gauteng Department of Health Presentation to the national Health portfolio Committee. 23 August 2005. Presented by Dr A Rahman (Acting HOD) and Ms T Majaja (CFO). Overview. Strategic overview Departmental achievements highlights and key priorities for the MTEF period Strategic Focus Areas

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Gauteng Department of Health Presentation to the national Health portfolio Committee

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  1. Gauteng Department of Health Presentation to the national Health portfolio Committee 23 August 2005 Presented by Dr A Rahman (Acting HOD) and Ms T Majaja (CFO)

  2. Overview • Strategic overview • Departmental achievements highlights and key priorities for the MTEF period • Strategic Focus Areas • Key Challenges • Financial Highlights • Conclusion

  3. Strategic Overview

  4. Vision Health for a better life

  5. Mission • The Gauteng Health Department aims to promote and protect the health of our people, especially those most vulnerable to illness and injury • Through innovative leadership and management we provide quality health services and strive to: • Ensure a caring climate for service users • Implement best practice health care strategies • Create a positive work environment of staff • Provide excellent and appropriate training for health workers • Listen to, and communicate with our communities and staff • Establish management systems for effective decision making • Forge partnerships with others • Obtain the greatest benefit from public monies

  6. Mission (continued) • Our work is reflected in the enhanced well being of our clients and staff, the social and economic development of our province and a more just society

  7. Health Strategic Goals • Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors • Effective implementation of the comprehensive HIV and AIDS strategy • Strengthen the district health system and provide caring, responsive and quality health services at all levels • Implement the people’s contract through effective leadership and governance • Become a leader in human resource development and management for health • Operate smarter and invest in health technology, communication and management information systems

  8. 2004/05 and 2005/06 1st quarter achievements Highlightsand Key priorities for the MTEF priod (2006-09)

  9. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors • Health promotion implementation framework approved and health promoters trained • Mindset Health Channel launched and 58 sites operational (DSTV channel 82) • Provincial Infections Control initiative

  10. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… • Bana Pele launched in June 2005 • Integrated management of childhood illnesses: important strategy for improving child health • Mass immunisation campaign in 2004 • 2 million doses of polio and measles administered with overall 90% coverage in the first round • Contribute to the goal of declaring South Africa ‘Polio-free’ by the year 2005 • 85% immunisation coverage first Quarter 2005/06 • WHO investigation and implementation of recommendations

  11. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… • Youth friendly services increased from 34 in 2003/04 to 40 in 2005/06 financial year • Youth Summit with 560 participants held in June 2005 • Launched third edition of Classroom Health Guide for Teachers as part of Bana Pele launched in June 2005 • More than 150 000 learners were screened for obstacles of learning • More than 2 000 received spectacles school health guidelines

  12. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… • 8 facilities accredited with WHO/UNICEF Baby Friendly Hospital Initiative in the province • Vitamin A supplementation supplied to children and post-partum women in all facilities • 1 695 crèches funded benefiting 58 219 children

  13. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… • Maternal and neonatal clinical care unit established • Perinatal Problem Identification Programme (PPIP) implemented at 20 sites in the province • 17 Kangaroo Mother Care units operational in the province • Campaign for Cervical and Breast cancer targeting farm areas conducted in October 2004 • Cervical Cancer screening increased from 24 204 in 2001/02 to 50 033 in 2004/05

  14. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… • 53 health facilities provide post-exposure prophylaxis for HIV • 56% of facilities provide 24 hour service • Benefited 28 181 clients since the inception of the programme • Provided 3 541 assistive devices in 2004/05 • 1 793 Wheelchairs increasing • 1 244 Hearing aids • 504 Artificial limbs

  15. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… Key Priorities for the MTEF Period • Implementation of strategies for reducing avoidable deaths • Maternal and Neonatal care unit implementing recommendations from the saving mothers’ report • Health implementation of Bana Pele programme • Interventions for Immunisation and polio count-down for Gauteng and outcomes

  16. Goal 1: Promote health, prevent and manage illnesses or conditions with emphasis on poverty, lifestyle, trauma and violence and psychosocial factors cont… Key Priorities for the MTEF period • Implementation of the WHO model for integrated diseases surveillance and response • Increasing TB cure rate • Provision of capacity, • HIV/TB collaboration • Provincialisation of TB beds • Implementation of health promotion and prevention illnesses • Non communicable diseases • Healthy lifestyles

  17. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • HIV sero-prevalence rate among pregnant women in Gauteng shows 3% increase, from 29.6% in 2003, to 33.1% in 2004 • Syphilis rate decrease from .1% in 2003 to 0.9% in 2004

  18. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • A joint health and treasury national task team was set up in September 2002 to investigate feasibility of introducing ART as a component of treatment • Report was presented to National Cabinet on 8th August 2003 • Request to compile a national operational plan for implementation of comprehensive HIV and AIDS includingART programme • Gauteng prepared a provincial operational plan aligned with the national plan • Implementation of comprehensive HIV and AIDS including ART programme commenced on 1st April 2004 in 5 facilities Comprehensive HIV and AIDS plan

  19. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • Currently a comprehensive treatment and care programme, including anti-retroviral treatment (ART) implemented in 27 health facilities • More than 200 000 clients assessed • More than 20 000 on treatment • 1 078 health professional trained on comprehensive HIV and AIDS including ARV in 2004/05 • 11 000 Philani food supplements for adults and 3 000 children distributed to patients with TB and HIV and AIDS in 2004/05 • No drug stock outs have been reported

  20. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Monitoring of side effects • Pharmacovigilance system being implemented to monitor side effects from patients receiving ART • Out of more than 20 000 patients on treatment since the inception of the programme approximately 75 patients experienced side effects such as • Skin Rash, Diarrhoea, Anaemia; • Fatigue, Headache, Lactic Acidosis, Loss of Weight/Appetite; • Abdominal pains, Nausea, Vomiting; • Lipoatrophy, Peripheral Neuropathy and IRS • Training of monitoring and evaluation for comprehensive HIV and AIDS programme conducted in July 2005

  21. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Accredited facilities implementing comprehensive treatment and care programme, including ART • Johannesburg Metro (09) Sub-District • Johannesburg Hospital (TH) SUB 8 • Chris Hani Baragwanath Hospital (TH) SUB 10 • Helen Joseph Hospital (RH) SUB 4 • Coronation Hospital (RH) SUB 4 • Discoverer Clinic (CHC) SUB 5 • Hillbrow (CHC) SUB 8 • Lillian Ngoyi (CHC) SUB 10 • Zola (CHC) SUB 6 • Sizwe Tropical Disease Hospital (SP) SUB 7

  22. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Accredited facilities implementing comprehensive treatment and care programme, including ART • West Rand (03) Sub-district • Leratong Hospital (RH) Mogale City • Carletonville Hospital (DH) Mogale City • Khutsong Main (CHC) Mogale City • Ekurhuleni Metro ( 06) • Natalspruit Hospital (RH) Ekurhuleni • Tembisa Hospital (RH) Ekurhuleni Far East • Rand Hospital (RH) Ekurhuleni Daveyton • Main (CHC) Ekurhuleni • Tambo Memorial Hospital (RH) Ekurhuleni • Pholosong Hospital (DH) Ekurhuleni

  23. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Accredited facilities implementing comprehensive treatment and care programme, including ART • Sedibeng District (05) Sub-District • Sebokeng Hospital (RH) Emfuleni • Kopanong Hospital (DH) Emfuleni • Empilisweni Clinic (CHC) Emfuleni • Heidelberg Hospital (RH) Lesedi • Levai Mbata (CHC) • Tshwane / Metsweding (04) • Pretoria Academic Hospital (TH) Central) Tshwane • Kalafong Hospital (RH) Central) Tshwane • Dr George Mukhari Hospital (TH) North) Tshwane • Laudium CHC South) Tshwane

  24. ARV Facilities Staff compliment Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Staffing for ART sites

  25. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • Prevention of Mother to Child Transmission (PMTCT) implemented in 100% of hospitals and CHCs and 71% (144) of all other clinics • Outcome of the PMTCT programme • Out of 112 490 women enrolled on the programme from April to December 2004, 17 315 of these women received Nevirapine and 12 495 babies were born from these women • Out of 12 355 babies who received Nevirapine, 1 427 babies were tested after 12 months and only 12% (171) of these babies tested HIV positive

  26. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • Voluntary Counselling and testing (VCT) sites increased from 202 sites in 2003 to 320 sites to date • Average of 11 million male and distributed per month in 2005/06 • Average of 30 000 female condoms distributed per month in 2004/05 and 19 000 for 1st quarter • Syndromic management of sexually transmitted infections implemented in 97% of health facilities Free condoms

  27. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy • Funded 132 NGOs for home based care and 236 hospice beds in 23 hospices • NGOs cared for 51 994 homebound patients • Cared for 2 854 terminally ill patients in hospices

  28. Goal 2: Effective implementation of the comprehensive HIV and AIDS strategy Key Priorities for the MTEF period • Reducing of HIV new infections focusing on prevention • Expansion of sites for distribution of female condom • Expansion of comprehensive HIV and AIDS including ARV to • 45 sites and 25 000 patients on treatment by March 2006 • Monitoring implementation of AIDS strategy including ARV programme • Implementation of strategies to reduce the impact of HIV and AIDS in hospitals and clinics • Implementation of step down beds • Strengthening the HR capacity through partnerships and recruitment strategies

  29. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels • Final draft of SLA with City of JHB • Implementation of full clinic supervisory manual in each sub-districts • Extension of hours in 65% of sub-districts • Phola Park and Esangweni Maternity Midwife Obstetric Unit opened • Monitoring of MOU’s and joint District Health Plans on quarterly basis

  30. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels • EMS Public awareness campaign through radio • 104 EMS vehicles replaced since 2004/05 • Trained ambulance staff attend more than 420 000 incidents and transport more than 430 000 patients in 2004/05 • 65% reduction in the surgical backlog since 2004/05 • 670 Joint (hip and knee) • 582 cardiac • 208 spine • 4 398 cataract

  31. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels • Stabilisation of selected hospitals that meet risk identification criteria • Standard criteria • Management support and intervention • Critical post filling • Equipment • Monitoring and evaluation • Expansion of centres of excellence in the province • Breast disease services consolidated at Helen Joseph hospital • New hand surgery unit at Chris Hani Baragwanath in partneship with leading mining and engineering companies nearing completion

  32. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels • New Mental Health Care Act implemented • Mental Health Review Boards Operational • 10 bed child and adolescent beds opened at Sterkfontein • Implementation of Pharmacy Act • Rational Pharmacy Management Survey completed and shows 27 hospitals are between 70% and 90% compliant • Training of Pharmacist assistants, Doctors and nurses

  33. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels cont… • Six hospitals fully accredited • Complaints hotline functional 24 hours, including weekends and public holidays: 0800 203 886 • Continue to excel in the Premier’s Service Excellence Awards and others • Won both the Gold and the Silver award for the Face of Government awards • silver award for the Service Delivery Innovation award • Best Practice and Batho Pele programme being implemented in four hospitals and all Tshwane Clinics • Initiated staff satisfaction survey

  34. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels cont… Key Priorities for the MTEF period • Implementation of the Service Improvement Plan with special focus on modernization of tertiary services • Improving efficiency indicators • Establishment of Gateway Clinics • Primary Health Services • Changing model of primary health care service provision • Provincialisation of District Health Services • Ensure optimal functioning and • Taking pressure from hospitals

  35. Goal 3: Strengthen the district health system and provide caring, responsive and quality health services at all levels cont… Key Priorities for the MTEF period • Extension of extended hours of service at sub district levels • Provincialisation of Emergency Medical Services • Implementation of the new National Health Act • Implementation of quality assurance programme focusing on • Service excellence • Improving frontline services • Improving clinical care • Management accountability • Reduce the unequal power relations between service users and providers i.e true meaning of Batho Pele • Accreditation of all facilities

  36. Goal 4: Implement the people’s contract through effective leadership and governance • All hospitals have functional hospital boards • 1 000 Community Health Care workers trained and another 208 commenced training in May 2005 • Various partnerships e.g. • Sanofi Aventis and Sizwe hospital, TB free centre • Mining sector and hand unit at Chris Hani Baragwanath • Italian cooperation in information systems • Mandela Foundation • Other • Commended by Public Service Commission in State of the Public Service Report on community participation model • MECs 28 sub- districts imbizos and visits • MEC’s 14 monthly roving meetings in districts since April 2005

  37. Goal 4: Implement the people’s contract through effective leadership and governance Key Priorities for the MTEF period • Rollout of the CEO training and development programme including training of middle managers • Improve functioning of community participation structures • Community health workers (CHW) expansion programme • Building partnerships including Public Private Partnerships (PPPs) • Ensuring compliance with the Pharmacy Act, New Mental Health Act and New national Act

  38. Goal 5: Become a leader in human resource development and management for health • Gauteng trains 1/3 of country’s doctors and 25% of country nurses • 5 024new employees in past year • Aggressive recruitment drive through block advertisement • Recruitment of retired nurses

  39. Goal 5: Become a leader in human resource development and management for health • 1 840 people in learnership/ internship programme 2004/05 • 1 589 1st quarter 2005/06 • Uniform allowance implemented • Launched wellness programme in 2004 being extended • 61% of staff participate in provincial Employee Assistance Programme with 16% utilisation rate

  40. Goal 5: Become a leader in human resource development and management for health Key Priorities for the MTEF period • Ensure recruitment & training of personnel in line with the SIP with emphasis on health professionals • Implementation of retention strategy focusing on • Reducing attrition rate of doctors and nurses • Retention of community service professionals • Increasing the production of nurses by 20% in each year of the MTEF period • Building partnerships with Universities for Emergency Medical Services and production of nurses

  41. Goal 5: Become a leader in human resource development and management for health Key Priorities for the MTEF period • Expansion of teaching platform to include Family Medicine in district health services • Mainstreaming of Gender and Disability as part of the Employment Equity Plan • 5 100 beneficiaries on Learneships and internships programme by 2009 • Strengthening implementation of Performance Management System • Expansion of Employee Wellness Programme • Strengthening capacity development

  42. Goal 6: Operate smarter and invest in health technology, communication and management information systems • Came within budget in 2004/05 • Unqualified audit report for 2004/05 for medical supplies Depot • 12.5% increase of revenue from previous year • Implementation of BAUD Asset Management System • Launched an internal newsletter addressing staff issues Rands and cents

  43. Goal 6: Operate smarter and invest in health technology, communication and management information systems • Two PPP projects for procurement of equipment approved • New Pretoria Academic Hospital • New Radiation Oncology for Johannesburg Hospital • Bought or ordered more than R100 million worth of medical equipment • CT scanners at Johannesburg, Pretoria Academic • Coronation, Sebokeng, Helen Joseph and Kalafong hospitals • MRI scanners at Chris Hani Baragwanath, Pretoria Academic and Johannesburg hospitals • Gamma cameras at Dr George Mukhari, Pretoria Academic and Johannesburg hospitals • Radiological equipment at Pretoria Academic, Far East Rand, Heidelburg, Tembisa and Mamelodi hospitals • Linear accelerators at Pretoria Academic and Johannesburg hospitals

  44. Goal 6: Operate smarter and invest in health technology, communication and management information systems Key Priorities for the MTEF period • Strengthen control and management of Budget and Expenditure including conditional Grants • Strengthen institutional capacity on financial management • Revenue collection policies and strategies • CAPEX • Revitalisation of health infrastructure • Infrastructure improvement • Equipment • Strengthen monitoring of capital projects through SLA • Alignment of budget with expenditure for revitalisation and capital projects

  45. Goal 6: Operate smarter and invest in health technology, communication and management information systems Key Priorities for the MTEF period • Investigate , develop and implement models of PPP’s in accordance with prescribed BBBEE polices • Implementation of the BBEE strategy • Monitoring and implementation of the Supply Chain Management guidelines • Implementation of IM/IT strategy including Roll out MEDICOM to other facilities • Implementation of external and internal communication strategy • Alignment of planning, implementation monitoring and evaluation

  46. Strategic focus areas

  47. Management of Tuberculosis (TB) • Signed SLAs with three Gauteng Anti-Tuberculosis Association (SANTA) hospitals and three Life Care hospitals (total of 6) • Cure rate increased from 58% end of 2004/05 to 62.4% in 1st quarter of 2005/06 • TB Free Centre launched in partnership with National Department of Health, Sanofi-Avertis and Nelson Mandela Foundation in 2004 at Sizwe Hospital • TB/HIV collaboration programme implemented in all sub-districts

  48. Management of Tuberculosis (TB) • 89% (35 330) of TB patients with DOTS support • 15 879DOT patients in clinics • 20 642DOT patients in the Community • 3 176DOT patients at workplace • 4 367DOT patients self supervised • All sub districts have started using TB electronic register • TB advocacy • Developed integrated social mobilisation and advocacy plan • Collaboration with all role players • Established TB focal point in all provincial hospitals • Adherence to National TB control programme guidelines and protocols

  49. Management of other chronic diseases • Implementation of national policy guidelines and protocols in all facilities • Availability of EDL chronic medication in all facilities • Provision of fast queues for older patients in all community Health Centres • Implement chronic registers for follow up of defaulting patients in all facilities • Support groups established in all sub districts • Conduct healthy lifestyles awareness campaigns annually • Public Private Partneship with NGOs and pharmaceutical companies

  50. Management of other chronic diseases • Patients with Chronic Obstructive Airway Diseases are benefiting fromLong term domiciliary oxygen therapy • Flue Vaccine is made available to all state subsidies old age homes and to the facilities for the older persons and debilitating conditions • Treated over 2.5 million patients with chronic conditions in 2004/05 • Sight restored to 8 221 people through cataract surgery in 2004/05 • 3297 from public hospitals • 207 for World Sight Day • 4 717 from private hospitals

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