BEMF CEGAA and TAC BMET Update 1 April 2011

Remember the old issues identified through district patient and health facility survey? (2010) Most patients (82%) reported that they received the health care services they needed recently. 17% did not receive the services Most patients (64%) interviewed were happy with the quality of health services they received! Yet 46% of them had problems accessing some health services in the near past - No access due to lack of treatment (30% average, as high as 48% in Lusikisiki), doctor not available (8%) and long waiting queues (27%) And some of them (17%) were not happy with the current quality of service received, due to: Ongoing long queues; Shortage of health workers; Attitudes of health workers (presumably linked to staff shortage and workload); Irregular operating hours; No test results; Lack of basic necessities: sputum bottles, syringes and stationery  Most clinic and hospital health workers (57% average, 83% in Lusikisiki) were not happy with the quality of health care service they provide due to a combination of reasons, but human resources being the main one leading to work overload, fatigue, negative attitudes  Insufficient supply of day-to-day necessities – stationery, patient forms, sputum bottles, syringes  Question: Where’s the clinic budget?? Where is the District in the budget process?

The BMET Update for BEMF: Work in Progress Dissemination process following survey – Public Hearings with governmental and non-governmental stakeholders held in Nov & Dec 2011 at two districts Follow-up Stakeholder Meetings – At local level: DAC, NEHAWU, DENOSA, COSATU, Municipal Health Services, District Health Services, CEGAA and TAC – At provincial level: Provincial HAST Offices, Offices of the Premier: HIV/AIDS Desk and Provincial AIDS Council Secretariat, Provincial DOH DDGs (Clinical Management Services in EC and Strategic Health Programmes in KZN – both pending meeting appointments) Provincial budget analysis in light of NASA and District BMET findings and available costing information Ongoing community monitoring by TAC CHAs and BMET partners NASA data collection complete, but now busy with analysis

The BMET Update for BEMF: Work in Progress – Action Teams nominated and now team members formulating action plans Need for joint citizen-government monitoring initiatives growing Compatibility and agreement between NGOs, grassroots groups and government on the survey findings – good opportunity for collaboration – Public education and media use: the teams raising public awareness of the issues, with a view to changing both public and government attitudes and behaviour, and encouraging support for other corrective actions

Ongoing research and community monitoring provide the necessary information for planning, message development and lobbying Active engagement with provincial and district DOH to allow citizen participation in strategic planning and budgeting for HIV/AIDS and TB at district and community levels – The role of clinic committees and hospital boards Social accountability – through ongoing interactive engagements between DOH officials, health workers and citizens The BMET Update for BEMF: Work in Progress