NIRVASHA MOODLEY 6 – 7 July 2016 KZN REPORT - NHISSA AGSA/WEBDHIS 1

2 Presentation Outline Progress Report on AGSA Audit WebDHIS General notes

3 DHMIS IMPLEMENTATION FOLLOW UP ActionResponsibilityIndicatorStatus/ProgressComments Establish core Provincial Team to be responsible for the management of the DHMIS HoDProvincial Data Management structure in place and functional Work in progress Not all posts are filled/created Are these posts still relevant? Directive from NDoH (Repeat comment)

4 DHMIS IMPLEMENTATION FOLLOW UP ActionResponsibilityIndicator Status/Progres s Comments Review of Data Capturers post levels NDoH Provincial HR Manager: Data Management and GIS Services Job evaluation results Work in progress Submitted JDs and post information to NDoH. This is still an agenda item on chamber. (Repeat comment)

5 DHMIS IMPLEMENTATION FOLLOW UP ActionResponsibilityIndicator Status/Prog ress Comments Review of the DHMIS Policy NDOH, Province and Partners Draft of the new/revised policy - There is a need to revise the policy due to previous concerns raised. Eg. Data capturer levels (Repeat comment)

6 ACTION PLAN AND PROGRESS REPORT ON AGSA AUDIT

All facilities have been audited (14 facilities) 4 clinics including 1 CHC 2 schools 1 TB hospital 4 District Hospitals 2 Tertiary Hospitals 1 Central Hospital 7 Audited Health Facilities

Patient held cards and no facility held files Provinces await the implementation of the national patient records. Need direction regarding the start date. KZN is again requesting for sharing of this document prior to implementation. This was a huge contributing factor to the possible disclaimer for Programme 2. 8 Current Challenges

No.Sub - programme namePerformance indicatorTarget 1 District Health Services (DHS) PHC utilisation rate (annualised)3.00 2PHC utilisation rate under 5 years (annualised)4.70 3Expenditure per PHC headcountR Maternal, Neonatal, Child & Woman’s Health and Nutrition (MNCWH) Antenatal 1st visit before 20 weeks rate60.00% 5Mother postnatal visit within 6 days rate74.40% 6Infant 1st PCR test positive around 6 weeks rate<1.00% 7Immunisation coverage under 1 year (annualised)90.00% 8Measles 2nd dose coverage (annualised)85.00% 9DTaP-IPV/Hib 3 - Measles 1st dose drop-out rate7.00% 10Couple year protection rate (annualised)55.00% 11Cervical cancer screening coverage (annualised)75.00% 12Vitamin A months coverage (annualised)60.00% 13HIV and AIDS, STI and TB (HAST)TB symptom 5yrs and older screened rate20.00% 14 Disease Prevention and Control (DPC) Clients screened for hypertension – 25 years and olderEstablish baseline 15 Clients screened for diabetes – 5 years and olderEstablish baseline 16 Percentage of people screened for mental disordersEstablish baseline 17 Percentage of people treated for mental disorders - newEstablish baseline 9

Missing files at facilities Another huge contributor to the possible disclaimer is the unavailability of files at the hospitals. (Missing files) Corporate governance unit in talks with service providers to introduce record management system. 10 Current Challenges

Quality Assurance Data – Discrepancies continue annually on the audit of complaints data. – The same was reported in this years audit. – There is a need for Information Management to understand the complaints management system. 11 Current Challenges

Inpatient days is no longer a finding. The finding is only with discrepancies with data due to manual counting. Discrepancies between source document and DHIS have been reduced but continue to exist due to manual collation. Auditors are the same from last year and are familiar with data processes. 144 visits done to facilities with AIPs drawn for most of the facilities, 35 visits done in Quarter 1 12 Successes

Data that was used for the audit was from the Provincial file as the National file shared with the auditors was not the most recent. Recommendation is for provinces to share the data with the auditors, and NDoH to share the files only after the clean up. 13 Data from the NDoH

– Concern over late recombination of data files at NDoH. Data was only shared with KZN on the 27 May Annual reports are due on the 31 st May. – Communication still a challenge between NDoH and Provinces. – Revision of DHMIS policy – There is an urgent need for an SOP to outline data flow for WBOT, Chronic clubs and CCMDD. Data is currently excluded in routine reports from the DHIS. 14 General notes

– Meeting held on the 19 April – Spreadsheet shared with HISP on training needs as well as assessment – Two trainings to be held (one in July and one in August). This will be training of the trainers (Province, District and Partners) – Concern over post implementation support (technical). – Lack of technical support was found for DDC and webdhis at NHI districts post implementation. – WEBDHIS to include PIDS data elements as well. – Is there any funding for this project? Filling of data capturer posts etc. There is currently a moratorium for filling of posts. – There is a need for NDoH to be represented at some of the provincial meetings. 15 WEBDHIS

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