1. NDOH Perspectives on Regulated Norms and Standards
Yvonne Mokgalagadi
NDoH - DHS

2. Presentation Outline Legislative Framework Institutional Arrangements
DOH measures
NDOH views of OHSC Roles and Responsibilities
Suggested Approach
Wy Forward

3. Legislative Framework
Constitution and Bill of Rights
National Health Act
Regulations
Norms and Standards
Other related legislation e.g. Medicines Control Act, PFMA, OHSA etc
Related Professional Acts and regulations
Policies and guidelines
Frameworks

4. Legislative Imperatives for quality of health care

5. Institutional Arrangements
NATIONAL –Governance &leadership /M& E / Regulatory/ policy setting
(Central Hospitals)
PROVINCES –Co-ordination /governance/ monitoring
(Regional and Tertiary Hospitals ,DHS)
DISTRICTS-Implementation of services
(PHC facilities, CHC, CDC, Hospitals)

6. NDOH Measures
Internal Mechanisms for quality assurance like the Internal Audit mechanisms
Ideal Clinic Framework
Ideal Hospital Framework-
Aligned to the OHSC
Provincial Consultations and Orientations completed.
In the final stages of approval
Ready for implementation.

7. OHSC Roles and Responsibilities (NDOH Perspectives )
External Audit function –”ÄG “
Inspection
Compliance
Certification
Enforcement
Purpose : To assure the public that the specific HE is safe and delivers minimum standard of care as measured against the norms and standards set by the NDOH

8. IHRM-F Link to OHSC measures
OHSC has 586 measures
IHF elements and checklist match to 562 measures
24 OHSC measures relating to case management, billing, outsourcing of labour and other specific services are not applicable at the current stage

9. Ageing infrastructure Inadequate revenue collection
Challenges affecting health system in South Africa- impact on the hospitals
Funding constraints
Inadequate human resource distribution and allocation (correct skills and numbers)
Ageing infrastructure
Inadequate revenue collection
Inefficient supply chain management
Poor quality of care
Poor Health Technology Management

10. Developmental Approach Contextual to SA Evidence- based
Guiding Principles /Approach
Collaborative, less confrontational and less competitive but synergistic
Developmental Approach
Contextual to SA
Evidence- based
Robust measures that have the same intent (expected outcome) to ensure same standard measured
Trust relationship between OHSC & DOH /HE

11. Way Forward
OHSC measures to incorporate / take cognizance of existing Health System developments that are aligned to current regulations,
Norms and Standard-must measure with same intent
Suggest a small Technical Working Group from OHSC and NDOH to meet to reach common ground