NATIONAL DEPARTMENT OF HEALTH PRESENTATION ON STRATEGIC PLAN 2006/ /09 MR THAMI MSELEKU (DG-HEALTH)

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6 FLOW OF PRESENTATION CONTENTS OF THE PLAN VISION & MISSION 10 POINT PLAN SUMMARY OF ACHIEVEMENTS KEY CHALLENGES PRIORITIES FOR 2006/07 CONCLUSIONS

7 CONTENTS OF THE PLAN FOCUS ON THE NDOH & NOT PROVINCES MINISTER’S FOREWORD DG’S STATEMENT VISION, MISSION & SITUATION ANALYSIS MEASURABLE OBJECTIVES, INDICATORS, TARGETS AND BUDGETS BY BUDGET PROGRAMME ANNEXURES (ASSETS, SERVICE IMPROVEMENT PLAN, ICT PLAN)

8 VISION AN ACCESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM

9 MISSION TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS AND PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY

10 10 POINT PLAN, IMPROVE GOVERNANCE AND MANAGEMENT OF THE NHS PROMOTE HEALTHY LIFESTYLES IMPROVE QUALITY OF CARE IMPROVEMENT MANAGEMENT OF COMMUNICABLE AND NON- COMMUNICABLE DISEASES

11 10 POINT PLAN STRENGTHEN PHC, EMS AND HOSPITAL SERVICES STRENGTHEN SUPPORT SERVICES HR PLANNING, DEVELOPMENT & MANAGEMENT PLANINNG, BUDGETING, M/E LEGISLATION INTERNATIONAL HEALTH

12 ACHIEVEMENTS: MATERNAL, CHILD AND WOMEN’S HEALTH INFANT MORTALITY & UNDER 5 MORTALITY STABLE FROM AS REPORTED BY THE SOUTH AFRICAN DEMOGRAPHIC AND HEALTH SURVEY INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES PROVIDED IN ALL 53 HEALTH DISTRICTS EXPANDED PROGRAMME ON IMMUNISATION COVERAGE IS 82% BUT POCKETS OF LOW COVERAGE IDENTIFIED

13 MATERNAL, CHILD AND WOMEN’S HEALTH IMPACT OF FOOD FORTIFICATION BEING MONITORED BY ENVIRONMENTAL HEALTH PRACTITIONERS HEALTH PROFESSIONALS BEING TRAINED IN HUMAN GENETICS ACCESS TO SAFE TERMINATIONS IMPROVING INCREASE IN INFANTS AND MOTHERS OBTAINING VITAMIN A TRIENNIAL REPORT ON CONFIDENTIAL INQUIRIES INTO MATERNAL DEATHS TO BE RELEASED SHORTLY

14 YOUTH & ADOLESCENT HEALTH 10% OF ALL HEALTH FACITIES PROVIDE YOUTH FRIENDLY SERVICES 50% OF DISTRICTS USE THE YOUTH FRIENDLY & ADOL HEALTH GUIDELINES 34% OF HEALTH DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES BY MARCH % OF PHC FACILITIES SHOULD PROVIDE YOUTH FRIENDLY SERVICES

15 HEALTHY LIFESTYLES & NUTRITION BY SEPT 2005 MORE THAN PARTICIPATED IN HEALTHY LIFESTYLE COMPAIGNS HOSTED BY THE NDOH PARTICIPATED IN HEALTH WALKS LED BY THE MINISTER 12 COMMUNITY & SCHOOL-BASED GARDENS ESTABLISHED

16 HEALTHY LIFESTYLES & NUTRITION INTEGRATED NUTRITION PROGRAMME NOW RUN IN ALL 53 HEALTH DISTRICTS NUTRITIONAL SUPPLEMENTATION PROVIDED TO OVER PATIENTS WITH DEBILITATING ILLNESSES

17 HIV & AIDS AND STIs COMPREHENSIVE PLAN IN ITS 3 RD YEAR WITH 192 SITES (AT LEAST 1 IN EACH HEALTH DISTRICT) 30m MALE CONDOMS DISTRIBUTED EACH MONTH & 1m FEMALE CONDOMS DISTRIBUTED IN 2005/06 77% OF PUBLIC HEALTH FACILITIES OFFERED PMTCT & 88% OFFERED VCT TARGET FOR VCT & PMTCT IS 100% OF PUBLIC FACILITIES BY MARCH 2007

18 HIV & AIDS AND STIs WHO/AFRO DECLARED 2006 AS YEAR OF ACCELERATED PREVENTION OF HIV (POVERTY ALLEVIATION, GENDER INEQUITIES, SOCIAL MOBILISATION, GREATER FOCUS ON YOUTH ETC) TREATMENT OF STIs CONTINUES TO FOCUS ON SYNDROMIC MANAGEMENT, PARTNER TRACING MORE THAN PATIENTS INITIATED ON ARVs

19 TUBERCULOSIS CONTRIBUTES SIGNIFICANTLY TO HIGH BURDEN OF DISEASE - CURE RATE IS 56.7% MOST PATIENTS ON DOTS NATIONAL TB CONTROL PROGRAMME BEING STRENGTHENED (FOCUS ON IMPROVING QUALITY OF DOTS, STRENGTHENING LAB SERVICES, STRENTHEN SUPERVISION ETC)

20 TB TB CRISIS PLAN TO BE LAUNCHED ON 24 MARCH (WORLD TB DAY) FOCUS IS ON 2 OF THE WORST PERFORMING PROVINCES (EC, KZN) AND 4 HEALTH DISTRICTS (ETHEKWENI METRO; NELSON MANDELA METRO; JOBURG METRO; AMATOLE DISTRICT) TARGET IS TO INCREASE SMEAR CONVERSION RATES AND CURE RATES BY AT LEAST 10% A YEAR

21 MALARIA BETWEEN 2004 & 2005 REDUCTION IN CASES – 46% & REDUCTION IN FATALITIES – 38% DECLINE DUE TO IN-DOOR SPRAYING, COLLABORATION WITH NEIGHBOURING STATES & REDUCED RAINFALL INDOOR RESIDUAL SPRAYING INCREASED TO 83% OF TARGETED HOUSES - TO INCREASE TO 90% IN 2006/07

22 NON-COMMUNICABLE DISEASES MANY GUIDELINES (HYPERTENSION, DIABETES, ASTHMA ETC) PRODUCED BUT USE IS SUB-OPTIMAL, THEREFORE MONITORING SYSTEM FOR USE OF GUIDELINES DEVELOPED ACCESIBILITY OF PUBLIC HEALTH FACILITIES TO PEOPLE WITH DISABILITIES IMPROVED & CONTINOUSLY MONITORED

23 NON-COMMUNICABLE DISEASES WHEELCHAIR BACKLOG ELIMINATED NON DISCRIMINATORY RISK MODEL FOR FOR THE SANBTS DEVELOPED LAB SERVICES STRENGTHENED TRANSFER OF SAPS MEDICO-LEGAL MORTUARIES TO COMMENCE ON 1 APRIL 2006

24 HUMAN RESOURCES FOR HEALTH WHO DECLARED 2006 AS HUMAN RESOURCES FOR HEALTH YEAR NATIONAL HR PLAN COMPLETED & TO BE LAUNCHED ON 7 APRIL (WORLD HEALTH DAY) SCOPES OF PRACTICE OF MID LEVEL WORKERS FINALISED PREPARATIONS FINALISED FOR INITIATION OF CLINICAL ASSOCIATE PROGRAMME IN 2007 POLICY ON COMMUNITY CARE GIVERS FINALISED

25 PHARMACEUTICALS SPECS FOR MEDICINES PRICE DATABASE IN PLACE PRICING COMMITTEE FINALISED PROPOSALS ON DISPENSING FEE – MINISTER TO RELEASE FOR PUBLIC COMMENT ON 9 MARCH MANUFACTURERS, WHOLESALERS & DISTRIBUTORS INSPECTED & LICENSED REGULATION & CONTROL OF CLINICAL TRIALS STRENGTHENED

26 PHC, EMS & HOSPITALS ROLES OF MUNICIPALITIES & PROVINCES CLARIFIED DISTRICT PLANNING LINKED TO IDPs STRENGTHENED MOST DISTRICTS PROVIDE FULL BASKET OF PHC SERVICES USE OF PHC INCREASED FROM 67m VISITS IN 1998 TO 99m IN 2005

27 PHC, EMS & HOSPITALS HOSPITAL REVITALISATION IS IN ITS 4 TH YEAR 4 HOSPITALS COMPLETED IN 2004/05 (MP, NW AND 2 IN NC) 45 HOSPITALS TO BE ENROLLED INTO THE PROGRAMME OVER THE NEXT 3 YEARS HOSPITAL IMPROVEMENT PLANS TO BE DEVELOPED BY EACH HOSPITAL IN 2006/07

28 PHC, EMS & HOSPITALS PLAN FOR IMPLEMENTING MODERNISATION OF TERTIARY SERVICES TO COMMENCE IN 2006 BY SEPTEMBER 2006 ALL HOSPITAL CEOs WILL HAVE APPROPRIATE DELEGATIONS TRAINING PROGRAMME FOR CEOs COMMENCED EMS BEING STRENGTHENED TO REDUCE RESPONSE TIMES – NATIONAL EMS PLAN DEVELOPED

29 HEALTH LEGISLATION THANKS TO PARLIAMENT 8 OF 11 BILLS DRAFTED HAVE BEEN PASSED IMPLEMENTATION OF NHA AND MENTAL HEALTH CARE ACT PROGRESSING WELL (WITH SOME CHALLENGES) 6 NEW BILLS DRAFTED FOR CONSIDERATION BY PARLIAMENT IN 2006

30 HEALTH FINANCING NOTE: DISCUSSION ON BUDGETS TO FOLLOW HEALTH CHARTER TO GUIDE PUBLIC/PRIVATE INTERACTIONS – SHOULD BE READY FOR SIGNING IN JUNE 2006 WORK ON RISK EQUALISATION FUND PROCEEDING WITH COUNCIL FOR MEDICAL SCHEMES SHI WORK PROCEEDING WITH NATIONAL TREASURY

31 INTERNATIONAL HEALTH LIAISON NEW AGREEMENTS SIGNED WITH LESOTHO, MOZAMBIQUE AND SEYCHELLES IN 2005/06 NDOH PARTICIPATED IN A RANGE OF BI, TRI AND MULTI-LATERAL MEETINGS NEPAD DESK STRENGTHENED & OFFICIAL SECONDED TO SADC TO STRENGTHEN HEALTH DESK

32 KEY CHALLENGES IMPLEMENTATION OF POLICIES WITHIN RESOURCE CONSTRAINTS HEALTH RESOURCES FOR HEALTH CHALLENGES IMPROVING QUALITY OF CARE STRENGTHENING PRIORITY HEALTH PROGRAMMES

33 KEY PRIORITIES FOR 2006/07 DEVELOPMENT & IMPLEMENTATION OF SERVICE TRANSFORMATION PLANS IMPLEMENTATION OF THE HR FOR HEALTH PLAN STRENGTHENING PHYSICAL INFRASTRUCTURE (PHC, HOSPITALS) IMPROVING QUALITY OF CARE PRIORITY HEALTH PROGRAMMES (HEALTHY LIFESTYLES, TB CRISIS PLAN, ACCELERATED HIV PREVENTION)

34 BUDGETS The Department requested additional funds in the following areas – (a)Project Management and Risk Equalization fund – (R 15 m for 2006/07, R 9 m for 2007/08 and R 10 m for 2008/09). (b) Hospital Revitalization – (R 100 m for 2006/07, R 300 m for 2007/08 and R 500 m for 2008/09).

35 BUDGET (c)Forensic Pathology Services – (R m for 2006/07, R 551,383 m for 2007/08 and R m for 2008/09). (d)Cost of accommodation – (R m for 2006/07, R m for 2007/08 and R m for 2008/09). (e) Medical Research Council – R m for 2006/07, R m for 2007/08 and R m for 2008/09).

36 BUDGET The “earmarked amounts” for the Department were amended as follows – (a) An amount of R 5m in 2006/07 – R 9 m in 2007/08 and R 10m in 2008/09 per year was earmarked for the following: Forensic Pathology - R 1.7 m Emergency Medical Services - R1.7 m Community Health Workers) - R1.7 m

37 BUDGET (b) The earmarked amounts for the following activities were reduced – PreviousEarmarked Earmarked amount amount CondomsR mR m Global Fund R 20.0 m R 16.0 m Comprehensive PlanR 48.0 mR 40.0 m

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42 CONCLUSIONS DESPITE MANY CHALLENGES NDOH HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2005/06 NDOH ORGANOGRAM TO BE EXPANDED IN 2006/07 TO INCLUDE A FURTHER 3 BRANCHES WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2006/07 TARGETS

43 THANK YOU FOR YOUR ATTENTION