eastern cape department of health strategic plan 2003/4 15 april 2003
TRANSCRIPT
EASTERN CAPE DEPARTMENT OF HEALTH
STRATEGIC PLAN 2003/4
15 April 2003
2
OVERVIEW
The Department’s Strategic Plan: Aims to improve the health status of the Eastern
Cape population through 8 programs with specific objectives, targets and indicators
Is informed by the: Epidemiological profile of the EC population Demand & utilisation of health services Existing backlogs in service delivery
Is aligned with the Ten Point Plan, Batho Pele, EC Provincial Growth and Development Strategic Plan and the Strategic Position Statement of the province
3
VISION
A health service to the people in the Eastern Cape Province promoting a better quality of life for all.
4
MISION
To provide and ensure accessible comprehensive integrated services in the Eastern Cape emphasizing the primary health care approach utilizing and developing all resources to enable all its present and future generation to enjoy health and quality of life.
5
VALUES
The Department formulated a policy to ensure that all its residents have access to essential health services. The policy encapsulated the following VALUES:
Equity of both distribution and quality of services Service excellence including customer satisfaction Fair labour practices Good work ethic and a high degree of accountability Transparency demonstrated through consultations
with all stakeholders in the health industry/field
6
Strategic goals and objectives of the Department of Health
Strategic Goal 1: Ensuring equitable access by all communities to essential package of services through DHS.
Strategic Goal 2: Health services in the province meet quality standards.
Strategic Goal 3: Communities throughout the province become active, responsible partners in health issues which affect them.
Strategic Goal 4: Build capacity in the Department to support improved implementation of its goals.
Strategic Goal 5: Effective utilization of the Department’s finance and assets to achieve effective service delivery.
7
SECTORAL SITUATION ANALYSIS Size of the province 169,580 sq kms and is 13,9% of the
country’s land surface
Table A-1: Land area distribution by Province in SA
Province
EC FS GP KZN MP NC LP NW WC SA
KM2 169580
129480
17010
92100
79490
361830
123910
116320
129370
1 219 090
% 13.9 10.6 1.4 7.6 6.5 29.7 10.2 9.5 10.6 100
Source: Pop census 1996
8
SECTORAL SITUATION ANALYSIS
Urban /Rural distribution
Table A-4: % Urban/Non-urban population distribution by province (1996 census)
Province
EC FS GP KZN MP NC LP NW WC SA
Urban 36.6 68.8 97 43.1 39.1 70.1 11 34.9 88.9 53.7
Non-urban
63.4 31.4 3 56.9 60.9 29.9 89 65.1 11.1 46.3
Source: Pop census 1996
9
SECTORAL SITUATION ANALYSIS
District Health Services facilities by health district
Health District
Facility type No. Average population per facility
Alfred Nzo Clinics and CHCs 57 10789
Amatole Clinics and CHCs 255 7363
Cacadu Clinics and CHCs 98 4275
Chris Hani Clinics and CHCs 159 5846
N Mandela Clinics and CHCs 68 16136
O R Tambo Clinics and CHCs 163 11169
Ukhahlamba Clinics and CHCs 56 6636
Province Clinics and CHCs 856 8330
10
POPULATION PYRAMID COMPARING WESTERN AND EASTERN REGIONS OF THE EC
11
Population by health district
HEALTHDISTRICT
NUMBER % SQ KM % DENSITY
Alfred Nzo 614,973 8.6 8138.20 4.79 78.14
Amatole 1,877,565 26.3 23577.10 13.9 79.64
Cacadu 418,950 5.9 58244.00 34.3 7.19
Chris Hani 929,514 13 36963.70 21.8 25.15
N Mandela 1,097,248 15.4 1952.20 1.2 562.05
O R Tambo 1,820,547 25.5 15946 9.4 114.16
Ukhahlamba 371,616 5.2 26401.20 15.6 14.63
EC 7,130,480 100 169,580 100 41.95
Source: Stats SA Mid-Year Population Estimates 2002
12
EPIDEMIOLOGY CHILD HEALTH
MORBIDITY AND MORTALITYThe IMR of 61.2 per 1000 live births is the highest in the country
with the National figure of 45.2(SADHS 1998). The following conditions accounted for the high morbidity and
mortality rates
Diarrhoea HIV/AIDS Communicable diseases Malnutrition Tuberculosis Injuries and burns
13
WOMEN’S AND MATERNAL HEALTH (epidemiology cont)
The provincial hospital maternal death rate was calculated at 133 maternal deaths per 100 000 hospital deliveries.
In 2000 108 deaths were reported and 53% of these were from the Eastern regions. These occurred in the public hospitals only.
32% of reported maternal deaths were primigravidas.
The recent review of maternal deaths identified AIDS as the most common cause of maternal deaths at all levels of care in SA.
14
EPIDEMIOLOGY CONT MEDICAL CONDITIONS
1. TB Prevalence in the Eastern Cape There has been a dramatic rise in TB cases from
mid-1980s and this rise is directly associated with HIV and improved case-finding.
TB cases reported
2000 2001
28428 30010 TB patients accounted for 10.2% of all medical
admissions This can be attributes to improved case finding
15
ACHIEVEMENTS
Significant improvement in the hospital revitalization and rehabilitation programme
From 1994 to date the following health facilities have been constructed:
Completion of Nelson Mandela and its readiness to admit
patients by the 1st of September 2003.Clinics 130
Community Health Centres 5
Hospital OPDs 16
Academic Health Resource Centres 3
16
ACHIEVEMENTS CONT
An increase in the utilization of primary health care services of 2,287,069 between 1998 an1999. this is increasing yearly.
Management and Administration of the Department has been significantly improved through filling of critical posts, recruitment and appointment of suitable qualified personnel in all fields.
Leave gratuities 90% of backlog cleared.
17
ACHIEVEMENTS CONT
Ante-natal care (ANC) has been offered five days a week in 80% of clinics in 1999, a remarkable increase from the baseline survey when only half of all clinics were providing the service for the five working days.
The utilization of the 9 HIV/AIDS National Policy Guidelines
18
ACHIEVEMENTS CONT
Appointment of CEOs in all the Provincial/Regional Hospitals
Formation of a Provincial Hospitals Coordinating Committee
Implementation of the deinstitutionalization programme in mental health.
PFMA Implementation with ECDOH moving to the third position in the Province in terms of the PFMA compliance matrix applied by Provincial Treasury
19
ACHIEVEMENTS CONT
Budget Review Process
Quarterly budget reviews with all institutions are held by the ECDOH. This has improved the monitoring process.
Policy for nursing education (Nursing Education Bill) to assist with the rationalization of nursing education has been formulated and submitted to the legislature.
Continuous research is taking place with yearly conferences to share results
Nursing Education Bill with the Legislature
20
BUDGETTable 1: Trends in provincial public health expenditure by budget programme in current prices (R million)
Programme 2001/02 (actual)2002/03
(estimate)2003/04
(budget2)
2004/05 (MTEF
projection)
2005/06 (MTEF projection)
Administration 168,947 532,443
273,426
288,692
310,006
District Health Services 2,124,751 2,155,833
2,252,759
2,523,756
2,725,766
Emergency Medical Services 87,314 119,488
364,774
385,110
412,861
Provincial Hospital Services 1,237,958 1,171,894
1,736,779
2,053,528
2,306,945
Health Sciences and Training 76,756 15,531
63,690
67,053
72,561
Health Care Support Services 6,765 7,642
15,197
15,992
17,130
Health Facilities Management 189,962 349,370
411,261
377,026
469,046
Total DOH 3,892,453 4,352,201
5,117,886
5,711,157
6,314,315
Municipal own expenditure 4 4
4
5
5
Department of Public Works 27 28
30
31
33
Total (R million) 3,892,484 4,352,233
5,117,920
5,711,193
6,314,352
21
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
1.Please indicate the total health allocation in 2002/03
R'000
Original Budget 2002/03 3,916,824
Roll-over from 2001/02 298,425
Additional funds allocated in Adjustments Budget
345,677
Total Allocation for 2002/03
4,560,926
22
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
2. What was the percentage real increase between 02/03 and 03/04?
Original Budget Adjusted Rands
R'000 R'000
Budget 2002/03 3,916,824 3,916,824
Budget 2003/04 5,117,886 4,804,376
Difference 1,201,062 887,552
% increase 30.66% 22.66%
23
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
3. What was the total overspending, if any, specify reasons. No over-expenditure was incurred.4. What was the total underspending, if any, specify reasons.
Please note that the above figures are provisional as the books were not closed at the time the figures were prepared however, it is likely that there will no under-expenditure .
R'000
Total Allocation for 2002/03 4,560,926
This is the total represents the net effect of the total under spent by the department of which the main underspending is in infrastructure.
Total 62,800
% under spent 1.38%
24
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
5.Provide variance by programme between budgeted allocation and actual expenditure for 2002/03
Adjusted Budget
Est Actual
Variance
R'000 R'000 R'000
Health Administration242,451
242,451 0,00
District Health Services 2,391,815 2,363,455 -28,360
Provincial Hospital Services 1,405,410 1,405,410 0,00
Academic Health Services 88,756 95,139 -6,383
Health Sciences 48,688 50,136 -1,448
Health Care Support Services 9,231 9,168 63
Health Facilities Development and Maintenance
402,935 302,443 100,492
Total 4,560,926 4,498,126 62,800
25
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
6. Which health programme has received the highest budget increase within 02/03? Provide the reason for this.
Programme 1 Health Administration received the highest budget increase in the 2002/03 financial year.
The reason : the Personnel Budget for Critical posts was managed under this programme; Management contract to be outsourced and managed in
this programme [Increase R46,137m or 23.69%]
7. Which programme has received the least increase, please indicate why?
Programme 6 Health Care Support Services: received the least budget increase in the 2002/03 financial year:
The reason: [Increase R70,000 or 0.75%] is insufficient budget.
26
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
8.Indicate the proportion of the budget that is spent on personnel.
2002/03R’000
2003/04R'000
Budget (excluding transfers)
3,947,148
4,307,850
Personnel budget
2,538,045 2,928,542
Portion of budget
64% 68%
27
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
9.What proportion of your 02/03 budget was transferred to Local Government
3.06 % or R143m - proportion of the 2002/03 budget was transferred to Local Government
10. What was the total amount received in Donor funding, and provide a breakdown of how the money was disbursed and
spent and the criteria used for making the allocations.
This department did not receive any direct or Cash donor funding for the 2002/03 financial year, however the Equity Project, which is
funded by USAID, has provided technical support, training, equipment and donated 22 vehicles with a total value of R24m
28
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
11. Give proportion of budget spending on personnelThe proportion of personnel spending is R2,537,368 or 54.74% of the adjusted budget for 2002/3
12. Give proportion of budget spent on district health services
The proportion of the budget spent on district health services is R2,391,815or 52.44% of the adjusted budget for 2002/3
13. Give proportion spent on Community Health Services and primary health services
The proportion of the budget spent on community health services and primary health services is R1,053,338m or 44,56% of the adjusted budget for 2002/3.
29
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
14. How does the budget accommodate the provision of free care to the Disabled as announced by the President on 14 February 2003
The Department is currently assessing the budgetary implications of the policy
15. What proportion of the Provincial Budget does health account for?
The Eastern Cape Department of Health Budget was 17.49% for the 2002/03 and 18.32% for the 2003/04 financial year of the Eastern Cape Provincial Budget
30
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
16. Based on the 2003/04 budget allocation what is your per capita budget allocation
Expenditure per capita for the Eastern Cape Department of Health 2003/04
Population 7,130,480[1]
Per capita (total Budget)
R717,75 Per Capita (Excluding Conditional Grants
R634,71
In terms of the Inter Governmental Fiscal Review (IGFR) 2003 this province at R769.00 received the third lowest per capita allocation in South Africa.
1 Source: STATS SA Mid Year Population Estimates 2002
31
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
CONDITIONAL GRANTS
17.Give the overall HIV/Aids budget allocations for 2003/04 and the percentage increase from 2002/03
The overall HIV/AIDS budget for 2003/04 is R71,934m which is a 17.46 % increase from 2002/03
32
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
18. Provide variance for 2002/03 between allocated budget and actual expenditure
Conditional Grant Total Allocation (Including Roll-overs) R’000
Estimated Actual Expenditure
R’000
Variance R’000
Central hospitals
National tertiary services 145,506 133,187 12,319
Health Profession’s training & research 88,917 89,188 -271
HIV/AIDS 28,253 24,758 3,495
Hospital rehabilitation 109,586 130,828 -21,242
Integrated Nutrition Programme 168,063 135,463 32,600
Hospital Management Improvement 9,333 5,916 3,417
Total 549,658 519,340 30,318
33
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
19. The Eastern Cape Province breakdown of HIV budget is: (R’000)
Health GrantEducation Grant
Social Development Grant
Eastern Cape 38,934 22,288 6,658
The Health HIV/AIDS grant is for the following programmatic interventions:VCTHBCPMTCTStep-down careProvincial ManagementNon-occupational post-exposure prophylaxisCommercial sex workersCentre of Excellence
The Education Grant is for life skills education and the Social Development Grant for HBC
34
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
20. The following initiatives from the National Department of Health will assist with provincial implementation and improve the capacity to spend:•Appointment of coordinators and administrative staff in the key programmes VCT, HBC and PMTCT.
•Training of master trainers for VCT, Home Based care to fast track training
•Appropriate VCT guidelines were developed and distributed.
•Decentralization of funds to Districts and Hospitals
35
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
21. Areas that have experienced under spending in the last financial year and the reasons therefore
•Infrastructure: Procurement of equipment Maintenance and intervention funds and roll-overs were only received in August 2002. Lack of trained artisans in institutions.
•Personnel: An additional amount of R41,288 for critical post was not able to attract external applicants
•Grants: the under spending occurred mainly on the Integrated Nutrition Programme grant owing to changes in the implementation structure and a roll over amount of R36m from the previous financial year.
36
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
22. An allocation was made for the provision of step-down facilities, please provide a progress report also indication how much of the allocation was spent
The Eastern Cape Department of Health spent R1,314,077 on the provision of step-down facilities.
37
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
29. Inter provincial inequity remains a major area of concern- how is the Department addressing thisThe department address this by interacting with the NDoH who engages the National Treasury; and through the Provincial Budget Committee this is being addressed
30. Intra- provincial inequity still persist how is the Department working to ensure a more equitable distribution of funds especially at district and sub-district level.The allocation of budget is based on the HTP (that took equity into consideration)
38
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
31. Areas of the budget and the budget process, where the Department might require assistance / advocacy of theCommittee in facilitating the necessary changes.It may be necessary in addressing the inequity in per capitaallocation especially because of the historical circumstances andgeographic nature (mostly rural with poor infrastructure).
32. Provide the number of district management posts and howmany are filled – provide reasons for vacanciesThere are 25 District Management posts of which 20 are filled. Thereason for the vacancies is that the department restructured thenumber of districts from 21 to 25 and had to change and loadthe new structure.
39
RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS
33. What guides your district and sub-district budgetallocation e.g. formula etc.
The allocation for district and sub-district is based onthe results of the Hospital Transformation Projectrecommended establishments (based on equity considerations).
34. What steps have been put in place to facilitateimplementation of the rural incentive scheme?
The department has identified the areas and commenced withpayments to the nursing staff only.
40
MAJOR HEALTH CHALLENGES
Escalating HIV/AIDS Escalating TB prevalence Brain drain of health professionals especially doctors
and nurses to countries like UK and Saudi Arabia. Presently the doctor patient ratio is 1 per 3000.
Low immunization coverage Legislative reforms influenced by cultural factors e.g.
circumcision, and recognition of alternative medicine including traditional healing
41
MAJOR HEALTH CHALLENGES CONT
Escalating crime calling for more security for staff working in primary health care facilities, establishment of crisis centers and counseling facilities for victims of abuse as well as calling for more collaborative endeavors with other sectors
The impact of increased motor vehicle accidents on Emergency Medical services and other services
Backlog in health facilities development High Infant and Maternal mortality
42
PRIORITIES FOR 2003/4
To manage and improve health outcomes for HIV/AIDS, STDs and TB
To reduce infant and child mortality To control communicable diseases To develop the district health system and the delivery
of the PHC Package To improve emergency and patient transport To improve logistical and other support To implement the hospital revitalization programme To improve capacity and access to regional and
tertiary services in the province To develop human resources for quality management
and service delivery
43
SERVICE DELIVERY PROGRAMMES
The core services of the department is driven through PROGRAMMES 2 DISTRICT HEALTH and 4 PROVINCIAL HOSPITAL SERVICES with the remainder of the departments programmes offering the necessary support.
There is an overlap between programmes in the provision of services which means that some interventions will not have specific budgets as they cut across the board
44
SERVICE DELIVERY PROGRAMMES CONT
1. PROGRAMME 2 AIM: TO DEVELOP AND SUPPORT DISTRICT HEALTH SERVICES BUDGET (000) 2003/4 2004/5 2005/6 R2,252,759 R2,523,756 R2,725,766
SUBPROGRAMMES District management Community Health Clinic Services Community Health Centers Community Based services Other Community Services HIV/AIDS Nutrition District Hospitals
45
SERVICE DELIVERY PROGRAMMES CONT
2.PROGRAMME 4
AIM : To provide cost effective, good quality, high level specialized services to the people of the Eastern Cape in collaboration with the Health Sciences Faculties
BUDGET (000) 2003/4 2004/5 2005/6 R1,736,779 R2,053,528 R2,306,945
SUBPROGRAMMES General Hospitals: T.B. Hospitals: Psychiatric/Mental Hospitals
46
HIV/AIDS BUDGET (000) 2003/4 2004/5 2005/6 R70,947 R92,988 114,111
IMPROVED MANAGEMENT OF HIV/AIDS EPIDEMIC IMPROVE ACCESS TO VCT BY INCREASING
NUMBER OF TESTING SITES BY 30% IMPLEMENT POST EXPOSURE PROPHYLAXIS
FOR RAPE SURVIVORS EXPAND PMTCT PROGRAMME IMPROVE CARE AND SUPPORT FOR PEOPLE
INFECTED WITH AND AFFECTED BY AIDS/HIV
47
HIV/AIDSCONT
COMMUNITY INVOLVEMENT IN HIV & AIDS MANAGEMENT THROUGH AIDS COUNCILS
PROVIDE SERVICES TO VULNERABLE GROUPS(CSW)
PROVIDE CONTINUUM OF QUALITY CARE THROUGH PROVISION OF STEP DOWN CARE IN DESIGNATED HOSPITALS
SET UP CENTRE OF EXCELLENCE IN PARTNERSHIP WITH A MEDICAL SCHOOL TO PROVIDE MODELS OF PREVENTION TREATMENT AND RESEARCH
48
TB PROGRAMME
REDUCE THE MORTALITY AND MORBIDITY OF TB INCREASE TB CURE RATE BY
IMPROVING AND MONITORING DRUG SUPPLY INCREASE CASE DETECTION BY SMEAR MICROSCOPY
AMONG ALL TB SUSPECTS TO 80% IMPROVE MDR PROGRAMME DECREASE TREATMENT INTERRUPTION EXPAND DIRECT OBSERVED TREATMENT SHORT
COURSE FINALIZE TB ADVOCACY PLAN FOR EASTERN CAPE
49
REDUCE INFANT MORTALITY
DECREASE IMR FROM 61,5 TO 40 PER 1000 LIVE BIRTHS IN 2006
INTERVENTIONS PLANNED IMPROVE IMMUNISATION COVERAGE TO 85% IN 2005/6 IMPROVE ACCESS TO PRIMARY HEALTH CARE FACILITIES PREVENTION OF MOTHER TO CHILD TRANSMISSION OF
HIV/AIDS MANAGEMENT AND FOLLOW UP OF CHILDREN WITH
HIV/AIDS IMPLEMENTATION OF INTEGRATED MANAGEMENT OF
CHILDHOOD ILLNESSES
50
INTEGRATED NUTRITION PROGRAM BUDGET(000) 2003/4 2004/5 2005/6 R172,465 R202,698 R222,133
DECREASE MORBIDITY AND MORTALITY THROUGH STRATEGIC INTERVENTIONS TO PREVENT AND MANAGE MALNUTRITION.
INTERVENTIONS INTENSIFY IMPLEMENTATION OF INP AS GUIDED BY THE
UNICEF CONCEPTUAL FRAMEWORK AND THE TRIPLE A APPROACH. PROMOTE COMMUNITY BASED GROWTH MONITORING. STRENGTHEN NUTRITION INTERVENTIONS AT HEALTH
FACILITY AND COMMUNITY LEVELS, AND REHABILITATE MALNOURISHED CHILDREN.
TO WORK WITH OTHER SECTORS IN TACKLING THE ROOT CAUSES OF MALNUTRITION AND POVERTY.
FACILITATE TRANSFER OF PSNP TO THE DEPARTMENT OF EDUCATION
51
PROFESSIONAL HR RETENTION STRATEGY
ENSURE ATTRACTION AND RETENTION OF
PROFFESSIONAL STAFF DEVELOPMENT OF INCENTIVES: PROVISION OF ACCOMMODATION FOR DOCTORS INDUCTION PROGRAMMES FOR COMMUNITY SERVICE
STAFF AND INTERNS CREATION OF SENIOR POSTS PROMOTION OF DOCTORS
TO HIGHER POSTS FILLING OF CRITICAL POSTS UTILISATION OF THE GRANT TO ATTRACT AND RETAIN
STAFF INTENSIVE MARKETING OF THE PROVINCE
52
LEGISLATIVE REFORM
BUDGET(000)
2003/4 2004/5 2005/6
R282 PRORITY FOR 2003/4 F/Y IS THENURSING
EDUCATION ACT WHICH IS GOING TO GOVERN RATIONALISATION OF NURSING EDUCATION
53
REDUCE MATERNAL MORBIDITY AND MORTALITY
BUDGET : BOTH IN PROGRAMME 2,4 AND HPTD GRANT
ENSURE THAT THE MMR FOR F/Y 2003/4 IS REDUCED FROM 133 TO 110 DEATHS PER 100 000.
INTERVENTIONS INCREASE LEVEL OF REPORTING AND SURVELLIANCE ON
MATERNAL DEATHS IMPLEMENTATION OF MATERNAL HEALTH GUIDELINES INCREASE ACCESS TO MATERNAL SERVICES EXPAND TOP SERVICES
54
DISTRICT HEALTH SERVICES
DELEGATION OF PRIMARY HEALTH CARE SERVICES TO THE DISTRICT MUNICIPALITIES.
DEVELOPMENT AND IMPLEMENTATION OF INTEGRATED PLANNING IN THE DISTRICT
CLUSTERING OF DISTRICT HOSPITALS DEVELOPMENT OF CLINICAL PROGRAM TO
SUPPORT THE DISTRICT HOSPITALS (WITH SPECIALISTS SUPPORT FROM THE COMPLEXES AND THE FLYING DOCTORS PROGRAM)
55
PRIMARY HEALTH CARE SERVICE DELIVERY PLAN IMPROVE ACCESS TO PRIMARY HEALTH CARE SERVICES INTERVENTIONS
INCREASE UTILIZATION RATE BY INCREASING NUMBER OF FACILIITIES
MONITOR POPULATION SERVED PER FIXED CLINIC TO ENSURE THAT IT FITS IT WITH THE NORMS AND PUT IN REMEDIAL ACTION AS NEEDED
ENSURE INCREAS IN NUMBER OF NURSES PER PUBLIC PHC PER 1000 PEOPLE
MONITOR DHS EXPENDITURE PER PERSON INCREASE PERCENTAGE OF FIXED PHC FACILITIES WITH
FUNCTIONING COMMUNITY PARTICIPATION STRUCTURES
56
IMPROVEMENT OF EMERGENCY SERVICE DELIVERY
BUDGET(000) 2003/4 2004/5 2005/6 R364,774 R385,110 R412,861 IMPROVE ACCESS TO EMERGENCY CARE
INTERVENTIONS FILLING OF VACANT POSTS WHICH WILL ENABLE THE SERVICE
TO PROVIDE TWO MEN AMBULANCE CREWS WHICH ARE MORE EFFICIENT
REDUCE RESPONSE TIME BY INCREASING CREW NUMBERS AND VEHICLES HENCE REDUCING MORBIDITY AND MORTALITY
IMPLEMENT AEROMEDICAL EVACUATION PROGRAM TO OVERCOME THE PROBLEM OF INACCESSIBILITY IN CERTAIN RURAL AREAS.
INCREASE THE NUMBER OF STAFF TRAINED IN ADVANCED LIFE SUPPORT
57
PROVINCIAL HOSPITALS
BUDGET(000) 2003/4 2004/5 2005/6 R1,373,953 R1,636,737 R1,798,376
TO PROVIDE COST EFFECTIVE, GOOD QUALITY, HIGH LEVEL SPECIALISED SERVICES
INTERVENTIONS OPEN NELSON MANDELA ACADEMIC HOSPITAL ON 1ST OF
SEPTEMBER STRENGTHEN HOSPITAL MANAGEMENT AND ORGANISATIONAL
DEVELOPMENT IMPLEMENT RATIONALIZATION PROPOSAL IMPROVE IMPLEMENTATION OF REVITALISATION OF HOSPITAL
SERVICES PROGRAMME UTILISATION OF THE HPTD GRANT TO TRAIN DOCTORS IN
SPECIALISED SERVICES.
58
PSYCHIATRIC/MENTAL HOSPITALS
BUDGET(000) 2003/4 2004/5 2005/6 R268,114 R316,869 R402,652 TO PROVIDE COST EFFECTIVE, INTEGRATED AND HIGH
QUALITY SPECIALIZED SERVICES TO THE PEOPLE OF THE EASTERN CAPE
INTERVENTIONS IMPLEMENT LEGISLATIVE FRAMEWORK RATIONALISE PSYCHIATRIC SERVICES DEINSTITUTIONALIZE OF MENTAL HEALTH PATIENTS IMPROVE ACCESS TO MENTAL HEALTH SERVICES
ESPECIALLY IN RURAL AREAS ESTABLISH MENTAL HEALTH REVIEW BOARDS
59
PHARMACEUTICAL SERVICES
Facilitate the training of Pharmacist's Assistants such that all Pharmacies are manned by this mid-level health worker.
Recruitment and retention of Community Service Pharmacists to areas of greatest need.
Monitoring of drug availability on a regular basis. Monitor drug expenditure at all levels. Implement a Public Private Partnership (PPP) for
management support and Distribution of pharmaceutical and surgical supplies.
60
MANAGEMENT AND DEVELOPMENT OF INFRASTRUCTURE
BUDGET(000) 2003/4 2004/5 2005/6 R411,261 R377,026 R469,046
TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY PROVIDING NEW HEALTH FACILITIES, UPGRADING AND MAINTAINING EXISTING FACILITIES.
INTERVENTIONS COMPLETION OF 26 CLINICS ADVANCE PLANNING IN CAPEX PROGRAMMES. IMPLEMENTATION OF PROJECT MANAGEMENT TO IMPROVE
MAINTENANCE OF FACILITIES