PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH

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Presentation transcript:

PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH THE DISTRICT HEALTH SYSTEM AND LOCAL GOVERNMENT DR YOGAN PILLAY (ACTING CLUSTER MANAGER: DHS & DEVELOPMENT)

Parliamentary.Portfolio Committee_June2003 WHAT IS THE DHS? TARIMO (1991) A DHS BASED ON PHC IS A MORE OR LESS SELF-CONTAINED SEGMENT OF THE NHS. IT COMPRISES A WELL DEFINED POPULATION LIVING WITHIN A CLEARLY DELINEATED ADMINISTRATIVE AND GEOGRAPHIC AREA AND INCLUDES ALL HEALTH ACTIVITIES IN THE AREA, BOTH PUBLIC AND PRIVATE Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 DHS:RATIONALE PART OF THE NATIONAL HEALTH SYSTEM VEHICLE TO DELIVER PHC IN INTEGRATED AND NON-FRAGMENTED MANNER Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 RATIONALE CONTD UNGER & CRIEL (1995) DISTRICT CONCEPT DERIVES FROM TWO RATIONALES…THE IMPLEMENTATION OF THE PHC STRATEGY, REQUIRING DECENTRLAISED MANAGEMENT, (AND) THE ORGANISATION OF INTEGRATED SYSTEMS WHICH IMPLIES THAT ONE SINGLE TEAM MANAGES THE DISTRICT HOSPITAL AND CLINICS Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 PRINCIPLES EQUITY OVERCOME FRAGMENTATION ELIMINATE DUPLICATION COMPREHENSIVE SERVICES EFFECTIVENESS & EFFICIENCY QUALITY IMPROVED ACCESS LOCAL ACCOUNTABILITY & COMM PARTICIPATION DEVELOPMENTAL AND INTERSECTORAL SUSTAINABILITY Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 STRATEGY A POLICY FOR THE DISTRICT HEALTH SYSTEM FOR SOUTH AFRICA (DECEMBER 1995) NATIONAL DHS COMMITTEE PROVINCIAL DHS COMMITTEES REGIONS (ALIGNED WITH LG) DISTRICTS (ALIGNED WITH LG) Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 IMPLEMENTATION (BY 2000) ALL PROVINCES ESTABLISHED HEALTH REGIONS WITH REGIONAL MANAGEMENT 174 HEALTH DISTRICTS ESTABLISHED MANY PROVINCES APPOINTED DISTRICT MANAGERS (OTHERS INTERIM/ACTING MX) Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 IMPLEMENTATION CONTD OPERATIONAL PLANS DEVELOPED SOME FUNCTIONAL INTEGRATION WITH LG FACILITIES ANNUAL DHS COMPETITION COMMENCED IN 1998 ISRDP – R 30 M CONTRACT UR – AUDIT OF SERVICES CROSS BOUNDARY MUNICIPALITIES Parliamentary.Portfolio Committee_June2003

CURRENT STATUS & NEXT STEPS (2000 - ) LOCAL GOVERNMENT REORGANISED IN DECEMBER 2000 (BOUNDARIES, NEW COUNCILS) HEALTH DISTRICTS REALIGNED WITH METROS AND DISTRICT MUNICIPALITIES MUNICIPAL HEALTH SERVICES DEFINED – ENVIRONMENTAL HEALTH SERVICES (FUNCTION OF METROS AND Cs) Parliamentary.Portfolio Committee_June2003

DISTRICT DEVELOPMENT: PROGRESS ON SELECTED ISSUES – APRIL 2003 PROVINCE DISTRICTS SUB-DISTRICTS DISTRICT MANAGERS SLA PHC DHCs EC 8 25 19 Appointed 6 Acting Signed Established 5 FS None GP 6 27 3 2 Interim KZN 11 50 No LP 26 Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 PROVINCE DISTRICTS SUB-DISTRICTS DISTRICT MANAGERS SLA PHC DHCs MP 3 16 No Established NC 5 None NW 4 22 WC 6 24 Signed Inter-governmental Council - metro TOTAL 54 190 62 2 provinces 8 provinces 15 of 54 districts Parliamentary.Portfolio Committee_June2003

TABLE: PHC FACILITIES BY TYPE PER PROVINCE, DHIS PROVINCE CHC CLINIC MOBILE DISTRICT HOSPITALS POPULATION EASTERN CAPE 28 679 142 63 7 130 427 FREE STATE 16 241 123 25 2 857 519 GAUTENG 22 293 59 7 8 641 635 KZN 13 489 144 39 9 215 201 Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 PROVINCE CHC CLINIC MOBILE DISTRICT HOSPITALS POPULATION LIMPOPO 25 382 111 33 5 424 585 MPUMALANGA 29 228 99 18 3 537 334 NORTH WEST 56 304 95 16 3 085 164 NORTHERN CAPE 17 83 62 24 961 353 WESTERN CAPE 75 264 141 28 4 314 196 Parliamentary.Portfolio Committee_June2003

Parliamentary.Portfolio Committee_June2003 CURRENT ACTIVITIES STATUS QUO REMAINS RE: SERVICE PROVISION AND FUNDING DISCUSSION WITH NT RE: R1,5 B SINGLE PUBLIC SERVICE FUNCTIONAL INTEGRATION WITH SLAs AS TRANSITION MEASURE DISTRICT HEALTH PLANNING Parliamentary.Portfolio Committee_June2003