1. PRESENTATION OF THE NATIONAL DEPARTMENT OF HEALTH’S STRATEGIC PLAN & BUDGET FOR 2007/08-2009/10 PORTFOLIO COMMITTEE ON HEALTH, CAPE TOWN 27 MARCH 2007

2. 2 1. FLOW OF PRESENTATION VISION & MISSION LEGISLATIVE MANDATES KEY PRIORITIES OF THE NATIONAL HEALTH SYSTEM (NHS) FOR 2004-2009 SUMMARY OF ACHIEVEMENTS & CHALLENGES KEY PRIORITIES AS REFLECTED IN THE NDOH STRATEGIC PLAN FOR 2007/08 NDOH BUDGET FOR 2007/08-2009/10 CONCLUSIONS

3. 3 2. VISION & MISSION VISION AN ASSESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM MISSION TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS & DISEASE AND THROUGH THE PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY

4. 4 3. LEGISLATIVE MANDATES 51 ACTS MENTIONED IN THE NDOH STRATEGIC PLAN 2007/08-20091 INCLUDING: THE CONSTITUTION OF THE REPUBLIC NATIONAL HEALTH ACT OF 2003 PUBLIC FINANCE MANAGEMENT ACT OF 1999 NURSING ACT OF 2005 MEDICINES & RELATED SUBSTANCES ACT MEDICAL SCHEMES ACT OF 1998 TOBACCO PRODUCTS CONTROL AMENDMENT ACT OF 1999

5. 5 4. KEY NHS PRIORITIES FOR 2004-2009 1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS 2. PROMOTE HEALTHY LIFESTYLES 3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE 4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON- COMMUNICABLE DISEASES 5. STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS 6. STRENGTHEN SUPPORT SERVICES 7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT 8. PLANNING, BUDGETING AND MONITORING & EVALUATION 9. PREPARATION AND IMPLEMENTATION OF LEGISLATION 10. STRENGTHEN INTERNATIONAL RELATIONS

6. 6 5. SUMMARY OF ACHIEVEMENTS 5.1. PROGRAMME 1: ADMINISTRATION 5 PIECES OF LEGISLATION PROCESSED; CULTURE OF PLANNING STRENGTHENED: ALL PROVINCES PRODUCED SERVICE TRANSFORMATION PLANS (STPS); FEEDBACK PROVIDED TO PROVINCES ON THEIR ANNUAL REPORTS AND STRATEGIC PLANS; KEY CABINET DECISIONS OBTAINED AROUND SHI (E.G. APPROVAL OF REF); DRAFT BILL REVIEWING MEDICAL SCHEMES ACT SUBMITTED TO CABINET; COMMUNICATION WITH PROVINCES & NATIONAL STAKEHOLDERS STRENGTHENED (NHCF HOSTED); 18 IZIMBIZO HELD & RANGE OF PUBLICATIONS PRODUCED.

7. 7 5. SUMMARY OF ACHIEVEMENTS 5.2. PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES IMCI COVERAGE EXPANDED FROM DISTRICTS TO 136 OF 284 LOCAL MUNICIPALITIES SUB-DISTRICTS; 60% OF HEALTH WORKERS THAT SEE CHILDREN WERE TRAINED IN IMCI 72% OF DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES 60% OF APPROVED FACILITIES PROVIDED CTOP 65% OF PEOPLE LIVING WITH HIV AND AIDS AND OTHER DEBILITATING CONDITIONS PROVIDED WITH NUTRITIONAL SUPPORT 88% OF FACILITIES OFFERED VCT AND 87 OFFERED PMTCT INCREASE IN DOTS SUPPORT & HOME-BASED CARE PROGRAMMES

8. 8 5. SUMMARY OF ACHIEVEMENTS 5.2. PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES, (CONTD) REVISED DISPENSING FEE PUBLISHED BUT UNDER CHALLENGE MEDICINE PRICING REGULATIONS REVIEWED 24 000 APPLICATIONS FOR COMPENSATION FROM EX-MINERS PROCESSED (TARGET 20 000) MORE THAN 120 000 SOUTH AFRICANS PARTICIPATED IN HEALTHY LIFESTYLE CAMPAIGNS 1 500 PRIMARY SCHOOLS WERE IDENTIFIED AS HEALTH PROMOTING SCHOOLS

9. 9 5. SUMMARY OF ACHIEVEMENTS 5.3. PROGRAMME 3: HEALTH SERVICE DELIVERY PHC UTILISATION RATE INCREASED FROM 2.1. TO 2.2 VISITS PER PERSON BETWEEN 2004 & 2005 TRANSFER OF FORENSIC LABS AND MORTUARIES TO PROVINCIAL DEPARTMENTS OF HEALTH WAS COMPLETED AS PLANNED CATARACT SURGERY PROJECT EXCEEDED TARGETS (CATARACT SURGERY RATE OF 1030 OPERATIONS PER MILLION PEOPLE, AGAINST A TARGET OF 1000 PER MILLION) NEW HOSPITALS WERE ACCEPTED ONTO THE REVITALISATION PROGRAMME AS PLANNED ALL 9 PROVINCES DELEGATED AUTHORITY TO HOSPITAL MANAGERS THE NATIONAL INFECTION CONTROL POLICY WAS FINALISED & IS BEING IMPLEMENTED ANNUAL ANTE-NATAL SURVEY (HIV) REPORT 2005 PUBLISHED

10. 10 5. SUMMARY OF ACHIEVEMENTS 5.4. PROGRAMME 4: HUMAN RESOURCES MANAGEMENT COUNTRY HUMAN RESOURCE PLAN DEVELOPED 4 PROVINCES PRODUCED DRAFT HR PLANS (EC, LP, MP & NW) SKILLS DEVELOPMENT POLICY ADOPTED SKILLS DEVELOPMENT PROGRAMME ESTABLISHED DRAFT REGULATIONS FOR CHWS DEVELOPED NATIONAL COMMUNITY HEALTH WORKER POLICY FRAMEWORK DEVELOPED 11 958 HEALTH WORKERS TRAINED TO IMPLEMENT THE COMPREHENSIVE PLAN FOR HIV AND AIDS (TARGET WAS 6233) INTERIM TRADITIONAL HEALTH PRACTITIONER COUNCIL ESTABLISHED

11. 11 6. CHALLENGES LACK OF SUFFICIENT & SKILLED HUMAN RESOURCES FOR HEALTH (CLINICAL & MANAGEMENT LEVEL) POOR HEALTH INFRASTRUCTURE TRIPLE BURDEN OF DISEASE (COMMUNICABLE, NON-COMMUNICABLE, INJURIES AND TRAUMA) POVERTY, UNEMPLOYMENT, LOW EDUCATION LEVELS, POOR TRANSPORT INFRASTRUCTURE, SOCIAL COHESION ISSUES

12. 12 7. KEY NHS PRIORITIES FOR 2007/08 NHS PRIORITIES 2004-2009NHS PRIORITIES 2007/08 1. IMPROVE GOVERNANCE & MANAGEMENT 2. PROMOTE HEALTHY LIFESTYLES 3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE 4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES 5. STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS 6. STRENGTHEN SUPPORT SERVICES 7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT 8. PLANNING, BUDGETING AND MONITORING & EVALUATION 9. PREPARATION AND IMPLEMENTATION OF LEGISLATION 10. STRENGTHEN INTERNATIONAL RELATIONS 1. DEVELOP PROVINCIAL SERVICE TRANSFORMATION PLANS 2. STRENGTHEN HUMAN RESOURCES 3. IMPROVE QUALITY OF CARE 4. STRENGTHEN INFRASTRUCTURE 5. STRENGTHEN PRIORITY HEALTH PROGRAMMES (HEALTHY LIFESTYLES, HIV PREVENTION, TB CRISIS MANAGEMENT, MCWH&N)

13. 13 7.KEY NHS PRIORITIES FOR 2007/08 7.1. DEVELOPMENT OF SERVICE TRANSFORMATION PLANS PROVINCES DEVELOPED SERVICE TRANSFORMATION PLANS FOR 2007/08-2014/15 THESE PLANS INFORMED THE BUDGET BID TO NATIONAL TREASURY FOR 2007/08-2009/10 DURING 2007/08, THE NATIONAL DOH WILL PROVIDE SUPPORT TO PROVINCIAL DOHs TO UPDATE THEIR STPs FOR 2008/09 & ENSURE ALIGNMENT BETWEEN THE STPs AND APPs FOR 2008/09-2010/11 STPs AND APPs FOR 2008/9 WILL ONCE MORE INFORM BUDGET DISCUSSIONS WITH TREASURY IN 2007 NATIONAL DOH WILL CONTINUE TO MONITOR THE IMPLEMENTATION OF APPs THROUGH THE QUARTERY REPORTING SYSTEM (QRS)

14. 14 7. KEY NHS PRIORITIES FOR 2007/08 7.2. STRENGTHEN HUMAN RESOURCES DURING 2007/08, THE DEPARTMENT WILL: SUPPORT THE REMAINING 5 PROVINCES TO DEVELOP THEIR PROVINCIAL HR PLANS; FINALISE A NEW REMUNERATION FRAMEWORK FOR HEALTH WORKERS, IN COLLABORATION WITH THE DPSA AND NATIONAL TREASURY; IMPLEMENT COMMUNITY SERVICES FOR NURSES FROM JULY 2007; FINALISE REGULATIONS FOR COMMUNITY HEALTH WORKERS; STRENGTHEN PROVINCIAL SKILLS DEVELOPMENT STRUCTURES TO DELIVER ON THE NATIONAL SKILLS DEVELOPMENT STRATEGY.

15. 15 7. KEY NHS PRIORITIES FOR 2007/08 7.3. IMPROVING QUALITY OF CARE DURING 2007/08, THE DEPARTMENT WILL: ENSURE THAT 80% OF REVITALIZATION HOSPITALS CONDUCT MORBIDITY AND MORTALITY MEETINGS AS WELL AS CLINICAL AUDITS; ENSURE THAT 70% OF PRIMARY HEALTH CARE FACILITIES ARE VISITED BY A SUPERVISOR AT LEAST ONCE A MONTH; ENSURE 0% STOCK OUTS OF DRUGS IN ALL FACILITIES; ENSURE THAT 50 % OF HOSPITALS MANAGERS ARE ENROLLED FOR A FORMAL HOSPITAL MANAGEMENT TRAINING PROGRAMME

16. 16 7. KEY NHS PRIORITIES FOR 2007/08 7.4. STRENGTHEN INFRASTRUCTURE DURING 2007/08, THE DEPARTMENT WILL: ACCEPT 20 NEW BUSINESS CASES INTO THE HOSPITAL REVITALISATION PROGRAMME; COMPLETE A PHC INFRASTRUCTURE AND SERVICES AUDIT (REFLECTING EXTENT TO WHICH THE FULL PACKAGE OF PHC SERVICES IS DELIVERED AT, AND THE LEVELS OF PROVISION OF INFRASTRUCTURE) SUPPORT ALL 9 PROVINCES TO DEVELOP & IMPLEMENT EMS PLANS GUIDED BY THE NATIONAL EMS STRATEGIC FRAMEWORK; FINALISE AND DISSEMINATE THE HEALTH AND EMERGENCY MEDICAL SERVICES PLAN FOR THE 2010 FIFA WORLD CUP

17. 17 7. KEY NHS PRIORITIES FOR 2007/08 7.5. STRENGTHEN PRIORITY HEALTH PROGRAMMES DURING 2007/08 THE DEPARTMENT WILL: IMPLEMENT MASS MEDIA CAMPAIGNS TO PROMOTE NUTRITION THROUGH SABC RADIO (IN ALL 11 LANGUAGES) AND 30 COMMUNITY RADIO STATIONS; SUPPORT MAJOR EMPLOYERS TO DEVELOP EMPLOYEE WELLNESS PROGRAMMES IDENTIFY & WORK TO ENSURE THAT 3500 SCHOOLS BECOME HEALTH PROMOTING SCHOOLS STRIVE TOWARDS A 5% REDUCTION IN SMOKING PREVALENCE AMONGST ADULTS AND YOUTH, COMPARED TO THE 1999 BASELINE ENSURE THAT 65% OF DISTRICTS HAVE MORE THAN 90% OF CHILDREN FULLY IMMUNISED; ENSURE THAT 60% OF HEALTH DISTRICTS HAVE STAFF TRAINED TO IMPLEMENT THE REACH EVERY DISTRICT (RED) STRATEGY; ENSURE THAT 50% OF HEALTH FACILITIES CONDUCT MONTHLY MATERNAL AND PERINATAL MORBIDITY AND MORTALITY REVIEW MEETINGS; SUPPORT 85% OF INSTITUTIONS WITH MATERNITY BEDS TO IMPLEMENT THE 10 RECOMMENDATIONS FROM THE THIRD ‘SAVING MOTHERS’ REPORT.

18. 18 8. NDOH BUDGET FOR 2007/08-2009/10 NEW ALLOCATIONS FOR 2007 INCLUDE AMOUNTS FOR: RE-COMMISSIONING OF CIVITAS BUILDING, INCLUDING THE PROVISIONING OF IT CABLING, FURNITURE ETC (R10M FOR 2007/08); LOVELIFE-R30M FOR 2007/08 -R40M FOR 2008/09 -R50M FOR 2009/10 AN EVALUATION TO BE DONE TO DETERMINE FUTURE FUNDING HOSPITAL REVITALIZATION -R200M FOR 2007/08 -R300M FOR 2008/09 -R500M FOR 2009/10

19. 19 8. NDOH BUDGET FOR 2007/08-2009/10 NEW ALLOCATIONS FOR 2007 INCLUDE AMOUNTS FOR: HIV & AIDS-R300M FOR 2007/08 -R500M FOR 2008/09 -R850M FOR 2009/10 NTSG (MTS SECTION)-R100M FOR 2007/08 -R200M FOR 2008/09 -R250M FOR 2009/10 NTSG (REMUNERATION-R0 FOR 2007/08 DISPENSATION) -R200M FOR 2008/09 -R280M FOR 2009/10

20. 20 9. CONCLUSION NATIONAL DEPARTMENT OF HEALTH IS COMMITTED TO IMPLEMENTING THE PRIORITIES AND ACHIEVING THE OBJECTIVES AND TARGETS OUTLINED IN ITS STRATEGIC PLAN 2007/08-2009/10; HOWEVER, CHANGES IN THE SOCIAL CONTEXTS IN WHICH OUR PEOPLE LIVE AND ADEQUATE RESOURCE AVAILABILITY FOR THE HEALTH SYSTEM (HUMAN RESOURCES & FINANCES) ARE KEY TO THE SUCCESSFUL IMPLEMENTATION OF THIS PLAN; INTERSECTORAL COLLABORATION ACROSS GOVERNMENT AND WITH KEY STAKEHOLDERS ARE CRUCIAL; CONTINUOUS DISCUSSIONS WILL BE PURSUED WITH NATIONAL TREASURY TO ENSURE THAT ADEQUATE RESOURCES ARE MADE AVAILABLE TO THE HEALTH SECTOR.