presentation on key activities to portfolio committee on health 19 february 2002 branch: strategic...

PRESENTATION ON KEY ACTIVITIES TO PORTFOLIO COMMITTEE ON HEALTH

19 FEBRUARY 2002

Branch: Strategic Health Programs

Presented by Ms MK MatsauDeputy Director-General:

Strategic Health Programmes

CLUSTERS IN THE BRANCH The branch comprises 9 Clusters which focus

primarily on is Strategic Health Programs and these include: HIV/AIDS and TB Pharmaceutical Services Medicines Regulatory affairs Maternal, Child and Women’s Health District and Development Health Monitoring and Evaluation Mental Health and Substance Abuse International Health Liaison Gender Focal Point

HIV/AIDS AND TB

STIs AND BARRIER METHODS YOUTH PROGRAMME PARTNERSHIP SUPPORT CARE, COUNSELLING AND SUPPORT GAAP NGO FUNDING INTERDEPARTMENTAL SUPPORT TB

Office of Chief Director and DirectorKey Achievements

Area AchievementsDiflucan Partnership Programme

-Successful phase 1 implementation-More than 4000 health workers trained

SANAC -Successful mobilisation of various SANAC sectors-District AIDS Councils established in 5 provinces

SAAVI -Financial support for SAAVI-Member of SAAVI board

KEY ACTIVITIES FOR THE BRANCH:

STRATEGIC HEALTH PROGRAMS

Presented by Ms MK Matsau

Deputy Director-General:Strategic Health Programs

HIV/AIDS ManagementKey Activities

Key Activities Time LineProvide strategic leadership to all programmesSecretariat to South African National AIDS CouncilManage the Prevention of Mother-to-Child HIV Transmission programmeOversight of resource management (financial and human)Providing support to other government departments

OngoingOngoing

Ongoing

Ongoing

Ongoing

STIs, Barrier Methods and ResearchStaff and Budget

Staff establishment 7

Budget:2001/2002: = R31 851 000

Spending: = R29 649 593 Committed = R12 315 045

Projected Overspend = R10 113 6392002/2003 = R 78 m

STIs, Barrier Methods and ResearchKey Achievements

Area Achievements

Condom distribution

-Purchase and distribute 250 million male condoms (190 sites)-Purchase and distribute 700 000 female condoms (127 sites)-Major improvements to quality assurance-Logistics Management Information System implemented – since then no reported stock-outs

PMTCT - 260 sites providing PMTCT services-Protocol for NVP resistance study finalised-Communication strategy tested in NP and EC

STIs, Barrier Methods and ResearchKey Activities

Key Activities Time LinePolicies

•Finalisation of condom policy•Quality assurance of condoms•Expanding access•Condom social marketing

October OngoingSeptemberSeptember

STIs, Barrier Methods and ResearchKey Activities

Key Activities Time LineGuidelines

•Review and update guidelines for STI treatment•Training of health care workers•Strengthen public-private initiatives•Partner notification project

October OngoingOngoingMarch 2003

STIs, Barrier Methods and ResearchOther key activities

Other Key Activities Time LineStrengthening traditional healers programme

Appointment of 3 traditional healersTraining of traditional healers

Periodic surveillance – monitoring and evaluationExpansion of PMTCT servicesSupport research on PEP for sexual assaultExpansion of TB/HIV pilots

AprilMay – OngoingOngoing

April – Ongoing

Youth ProgrammeStaff and Budget


Budget

2001/2002: = R5 183 000

Spending: = R3 767 337

Committed = R 556 859

Available = R 858 804

2002/2003 = R1.7 m

Youth ProgrammeKey Achievements

Area Achievements

Primary and secondary life skills programme

-320 tutor trainers trained-12 600 teachers trained-Materials developed for teachers, trainers, learners, lay counsellors, and parents-Partnership with loveLife-Youth Risk Behaviour Survey to be conducted in 2002

Youth ProgrammeKey Activities Time Line

CampaignsAdvocacy campaignsMaterial developmentNAFCIYouth Health Risk Behaviour Survey

Life SkillsMaterials developmentSupport to provinces and Education

JuneDecemberMay - OngoingDecember

MayOngoing

Partnership SupportStaff and Budget


Budget2001/2002: = R6,943 000Spending: = R6 069 867

Available = R923,0042002/2003 = R9.6

Partnership SupportKey Achievements

Area AchievementsTraditional Leaders

-Traditional Leaders HIV/AIDS Forum established

Women -Women in Partnership Against AIDS in all provinces-Secured Danish funding (R100m) for:

-Victim empowerment-Economic empowerment

People with Disabilities

-Training in all 9 provinces-Strategic Plan in Braille launched

Partnership SupportKey Achievements

Area Achievements

Trade Unions

-Trained 12 regional NUM educators-More than 1000 health-related union members trained on 9 HIV/AIDS guidelines

Transport -Conducted a study of response of public transport commuters to HIV/AIDS-Funded the equipment for 3 mobile clinics for long-distance truck drivers programme

Partnership SupportKey Activities

Key Activities Time Line High Transmission Areas Transport Sector (RFA) Commuters (trains, taxis, bus stops) Shebeens, taverns Hospitality industry Women’s sector

Violence Income generation Care and support

April – MarchApril – MarchApril – MarchApril – MarchApril – MarchApril – March

Partnership SupportKey Activities

Key Activities Time Line Trade union support Traditional leaders Human rights / legal issues

OngoingApril – MarchOngoing

Care, Counselling and SupportStaff and Budget


Budget2001/2002 = R3 728 000Spending: = R2 436 180

Committed = R 381 850Available = R 909 9702002/2003 = R2.2 m

Care, Counselling and SupportKey Achievements

Area Achievements

HBC -Rapid appraisal concluded-Tender awarded for research into needs of children-Directory for Children Infected and Affected established-90 HBC trainers trained-Social relief to 11 000 children (social grants, food parcels)

Care, Counselling and SupportKey Achievements

Area Achievements

VCT -495 sites identified for implementation – 359 now operational-1800 HIV/AIDS counsellors trained

Care, Counselling and SupportPolicies and Guidelines

Key Activities Time LinePolicies

Develop VCT policyDevelop care and treatment policyDevelop policy on lay workers and volunteersFinalise policy on childrenFinalise policy on support for health workers

OctoberFebruaryApril – NovemberAprilOctober

Care, Counselling and SupportPolicies and Guidelines

Key Activities Time LineGuidelines

Couples counsellingGroup counsellingCounselling for childrenPalliative careProtocols for quality control (rapid tests)

JulyJulyAprilAprilJuly

Care, Counselling and SupportOther key activities

Key Activities Time Line

VCTSupport provincesReview VCT servicesExpansion of VCT sitesTechnical support

OngoingApril – MayMay – MarchOngoing

Government AIDS Action PlanStaff and Budget


Budget2001/2002: = R72 733 000Spending: = R41 315 496

Committed = R40 130 000Available = R02002/2003 = R64 M

Government AIDS Action PlanKey Achievements

Area Achievements

Mass mobilisation

-Improved media coverage for HIV/AIDS (e.g. World AIDS Day)-Secured SABC commitment-Increased calls to AIDS Help Line

Government AIDS Action PlanKey activities


CampaignsPrevention, care and supportAction and dialogue prevention strategyPR and event managementPopularising government activitiesOutdoor media campaign

Life Line (AIDS Help Line)Community/stakeholder mobilisation

April – MarchApril – MarchApril – MarchApril – MarchApril - MarchOngoingOngoing

NGO FundingStaff and Budget


Budget2001/2002 = R32 357 000 (GAAP)Spending = R25 253 838Committed = RAvailable = R7 103 1622002/2003 = R37 M

NGO FundingKey Achievements

Area Achievements

NGO Funding

-Committed R25 million to 118 NGOs-Developed mentor programme for NGOs

NGO FundingKey Activities

Key Activities Time LineDevelop criteria for accounting firms for financial auditsMonitoring and evaluation of funded NGOsSupport to nationally funded NGOsMentoring programme to assist NGOs to develop business plans and budget

August

AugustOngoingOctober

Interdepartmental Support ProgrammeStaff and Budget

Staff 2

Budget2001/2002 = R1 401 000 (GAAP)Spending = R 340 469Committed = R 146 496Available = R 914 0352002/2003: = R 1.6m

Interdepartmental Support ProgrammeKey Achievements

Area Achievements

HIV/AIDS awareness in government departments

-4 workshops for IDC members (including Drug Literacy, Advocacy)-165 master trainers trained for World AIDS Day “door-to-door” campaign-429 Local Government councillors and officials trained-PWA coordinators employed and seconded to 8 national departments-Guidelines on PWA disclosure developed

Interdepartmental Support ProgrammeKey activities

Key Activities Time LineProvide the Secretariat to the IDCProvide technical assistance an support to provinces for Interdepartmental programsTender for service provider to strengthen selected local authorities

April-MarchApril- March

July – March

TuberculosisStaff and Budget

Staff 10

Budget2001/02 = R4 953 000Spent = R2 224 412Committed = R2 648 000Available = R 80 588

TB ControlKey Activities


MTDP Develop provincial implementation plans with all nine provincesQuarterly monitoring of implementation

Electronic TB Register Expansion of electronic district-based reporting and recording systems to five Provinces Develop and pilot a link system between the laboratory data and district-based reporting system

March 2002

March 2003

March

March


Key Activities Time LineTB/HIV Projects Establish one TB/HIV training district in each province Training of health care workers in an integrated TB/HIV approach

External stakeholders Monitor the process of reforms of institutions for inpatient treatment of tuberculosis National review of the tuberculosis situation and control activities in mines and prisons

March 2003

March 2003

Ongoing

August



DOTTraining of home based caregivers and TB treatment supporters in TB/HIV/AIDS training districtsDOTS StrategyExpansion of DTDs in KwaZulu-Natal, Northern Province, Mpumalanga and Northern CapeStrengthen 30 districts that are performing poorly

February 2003

March 2003

March 2003

TB ControlGuidelines


GuidelinesRevision of the MDR-TB treatment guidelinesPrevention of transmission of TB in health care facilitiesDevelop a TB/HIV advocacy documentDevelop a District Managers Training Manual

October 2002June 2003

March 2003June 2002

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CLUSTERHEALTH INFORMATION

EVALUATION & RESEARCH

National Health Information Systems

Quality Assurance Health Systems Research &

Epidemiology Monitoring & Evaluation

FINANCE TOTAL BUDGET – R 14 139 000 SPENT _ R 13 803 000 (83%)

EXPENDITURE

NHIS : : 124% (Personnel prof. & Specs)

QUALITY ASSURANCE : 71%

HSR& E : 76% (PERSONNEL)

CLUSTER MANAGER : 119% (PERSONNEL & M&E)

Cluster Expenditure (proportion of total cluster budget)

0

10

20

30

40

50

60

70

80

90

2000/ 2001 2001/ 2002

3-D Column 13-D Column 2

HUMAN RESOURCES

POSTS NOT FILLED - 1 not advertised -NHIS - 3 advertised & interviewed-

HSR- M&E -2 posts to be filled

To note - Q. A : Motivation for 2 deputy director posts - M&E : Only 1 AD post filled. Difficulty with Head of

unit (DD) assessment

Achieved 2001/2002

HIV prevalence in private sector HIV incidence studies completed Health research policy Outbreak support, assisted in containing cholera Reports- TOP Impact, ENHR: Tenders-beh,disease, P&H Support to health summit Org. framework & institutional set up for M&E unit Work programme established Web - 600 000 thousands of internet visits per month (32

000 regular visitors per month)

Achieved 2001/2002

PAAB in hospitals & adoption of UPFS GP, NW, MP & GP

Telemedicine 34 sites, distance learning, conference Various standards adopted PHC package completed (norms & standards) District hosp near completion (costing & approval) Policy on quality comp. & implementation strategy Assessment & report on quality in PHC settings Initial work on complaints management

Key Programme activities 2002 - 2003

..1

Telemedicine instituted in 8 med. schools (by June)

- distance learning reviewed (by Dec) NHC/MIS - consolidate PAAB & expand to more hosp. Vital registration - increase coverage (HA & SD) MRC Governance: Revise act. (June)

- concordat & governance sys. (June) Integrated disease surveillance

- expanded HIV surveillance -5 arms (full report Dec)

- introduce AIDS mortality sentinel sites

- notifiable diseases, non-communicable diseases.

Key Programme activities 2002/2003

..2

Ethics guidelines, priority setting (ENHR & Ethics council) M&E- quantification of burden of disease (causes of m & m)

- health inequalities (April)

- responsiveness / quality

- national DOH programme monitoring

- data warehouse established. (May)

- report on health status perf. (Nov) Quality Council (March)

- Implementation; policy,packages, QI

Key Programme activities 2002/2003

..3

Complete preparation & costing of regional package

(April/June) Implementation of package, prog. for health rights

(ongoing beginning now) Complaints procedure - paper system functional

(targeted turn around time for complaint)

- electronic system QI training tool & prog. for esp mid-level health workers Support Health Summit recommendations

CLUSTER : Pharmaceutical Policy & Planning

Directorate : Food Control

Directorate : Access to Affordable Medicines

CLUSTER Total No. of personnel 70 Budget 2001/2 R10 427 000 Shortfall 2001/2 R1 372 000 Allocated budget 2002/3 R11 782 000

KEY AREAS ACTIVITY

LEGISLATION Food fortification regulations Nutritional supplements regulations Alcoholic beverages, labeling and

advertising regulations Sampling of groundnuts for aflatoxin Amendments to the microbiological

standards Codex obligations to Regulations

KEY AREAS ACTIVITY

LEGISLATION

Finalize “Ownership of Pharmacies” regulations, Act No.88 of 1997

Amendments to Act No. 90 of 1997.

Finalize regulations, Act No. 90 of 1997

KEY AREAS ACTIVITY

POLICY Framework for ‘New National Food

Control System’ Review of the National Drug Policy, 1996

NORMS AND STANDARDS ( DSM ) Best practice : procurement,

warehousing, distribution of drug products.

Best practice : stock management at all health facilities.

KEY AREAS ACTIVITY PROGRAMMES

EDL Programme

EDL Committee EDL Process Review EDL EDL Impact Study Tender alignment

Codex obligations to Regulations Finalize “Ownership of Pharmacies” regulations, Act No.88 of 1997 Finalize regulations, Act No. 90 of 1997


Research and Survey

10 ‘key’ drugs and major diseases. Budgetary tool for pharmaceutical products. Review EDL. Staffing ,levels and composition for appropriate DSM.



Research and Survey

Toxological evaluations of cooking oil and olive oil. Microbiological quality of milk. Pathogens in food. Toxological evaluation of pesticides and GMO.



Research and Survey

Alpha pyroxybenzenes in olive pomace oils. Microbiological quality of milk. Pathogens in food. Toxological evaluation of pesticides and GMO.



Research and Survey

International tendering, Bulk purchasing. Parallel importation, Compulsory Licensing. WHO Collaboration Centre, Univ W.CP. Codex obligations to Regulations Finalize “Ownership of Pharmacies” regulations, Act

No.88 of 1997 Finalize regulations, Act No. 90 of 1997

KEY AREAS ACTIVITY

LOCAL MANUFACTURE

Explore and develop model Interdepartmental linkages

PRICING COMMITTEE

Terms of Reference for Committee Process, systems and databases.

KEY AREAS ACTIVITY

NEPAD

SADC

Licensing Section 22C ‘The Director General may on application in the

prescribed manner and on payment of the prescribed fee issue to a medical practitioner, dentist, practitioner, nurse or other person registered under the Health Profession’s Act, 1974, a licence to compound and dispense medicines on the prescribed conditions’.

This licence shall not be issued unless the applicant has successfully completed a supplementary course prescribed under the Pharmacy Act, 1974

Generic substitution Section 22F A pharmacist shall inform all members of the public who visit

his/her pharmacy with a prescription for dispensing, of the benefits of the substitution for a branded medicine of an interchangeable multi-source medicine and

Dispense an interchangeable multi-source medicine instead of the medicine prescribed………unless expressly forbidden by the patient to do so. This shall be noted on the prescription by the pharmacist.

No substitution , not substitutable, higher price

Pricing Committee Section 22G – The Minister shall appoint

members of a committee called the Pricing Committee

Introduction of a transparent pricing system, including a single exit price, which shall be the price at which manufacturers shall sell medicines and scheduled substances to any person other than the State.

An appropriate dispensing fee

INTERNATIONAL HEALTH LIAISON

Review current AgreementsFacilitate the utilization of funds from the Global Health Fund to address HIV/AIDS, TB and Malaria in RSA, SADC and NEPADEnsure a smooth transition of work from SADC HSCU to IHLNegotiate with Bilateral Partners on exchange programs for health personnel

IHL contd Negotiate the assistance of studies for post graduate students in

bilateral partner countries Ensure better cooperation between DOH and donor countries

and agencies Prepare a Strategic Framework for Official Development Aid

(ODA) Initiate program of cooperation in the manufacture of

pharmaceuticals

MENTAL HEALTH AND SUBSTANCE ABUSE LEGISLATION

Mental Health Care Act Alcohol Advertising/Counter Advertising

POLICY Child Youth and Mental Health Policy Psycho-social Rehabilitation Women’s Mental health Substance abuse Prevention and Treatment Detoxification guidelines Guidelines for substance abuse prevention in

the workplace

Mental health ASSISTANCE TO PROVINCES

Train for inclusion of substance abuse prevention in the HIV/AIDS life skills program

Prevent and reduce use of alcohol in pregnancy (N. Cape)

Train senior psychiatric Hospital managers Assist provinces with integrated mental

health care and deinstitutionalisation Train PHC workers in mental health,

substance abuse and victim empowerment

Mental Health INJURY PREVENTION

Support non-natural morbidity and mortality surveillance

Develop guidelines for the management of child abuse and neglect within PHC

Continue with implementation and evaluation of violence prevention in schools

Continue with implementation and evaluation of parent/child bonding program

Campaign on awareness of child abuse and neglect

Develop and test manual for suicide prevention

Mental Health HIV/AIDS

Establish extent of HIV infection in psychiatric hospitals

HIV/AIDS education in psychiatric hospitals evaluated in pilot sites

Finalize and print guidelines in HIV infection and mental health

Develop guidelines and interventions for orphans of AIDS

NORMS AND STANDARDS Assist with the implementation of norms for

severe mental illness (hospital) Develop norms for community mental health

care Assess quality of care in fifteen psychiatric

hospitals in order to set national quality standards

Establish the costs to government in providing mental health services

Establish the extent of mental health problems in RSA

CAMPAIGN/ AWARENESS International day against Drug

Trafficking and Abuse International Mental Health Day Harm reduction with respect to home-

brewed concoctions Youth mobilization against substance

abuse (with Central Drug Authority)

MATERNAL, CHILD AND WOMEN’S HEALTH AND NUTRITION NUTRITION

Reduction of micro-nutrient deficiency through targeted interventions

Consultation with role-players, launch of program and development of draft regulations

Training of health workers in Vitamin A supplementation and growth monitoring

Support to provincial program managers National Nutrition Surveillance System Improve infant and child nutrition

BFHI Assessment Printing of Road-to-Health Chart

Improve nutrition for children in schools

MCWH and Nutrition CHILD HEALTH

Reduce morbidity and mortality from common conditions Training of health workers in case management, community aspects

of IMCI Reduce immunisable conditions

EPI training Promotion of school health, prevention of intentional and

unintentional injuries Finalisation of school health policy guidelines Establishment and strengthening of health promoting schools

initiative Care of children in extremely difficult circumstances

Finalization of plan for orphans following AIDS and violence Teenage pregnancy prevention initiatives Youth and adolescent health policy guideline implementation –

training and IEC materials

MCWH AND NUTRITION WOMEN’S HEALTH AND GENETICS

Reduction of genetic and inherited conditions Training of PHC workers Folic Acid supplementation Technical support to provinces implementing PMTCT

Reduction - mortality and morbidity among women Training of TOP service providers Designation of facilities for TOP Training for and implementation of cervical cancer

screening Implementation of management of gender-based violence

– training of forensic staff Development of strategies for promoting health of

commercial sex workers

MCWH and Nutrition SOCIAL MOBILIZATION INITIATIVES

Improve nutritional status of women and children

Nutrition Campaign Reduction of morbidity and mortality in

children National inherited disorders Day 16 Days of Activism on No Violence against

Women and Children National Midwifery Congress

GENDER FOCAL POINT Finalize policy guidelines with clear

mandate, location of Gender Focal Points and functions

Finalize strategic plan for policy implementation

Launch gender policy guidelines Build capacity to make gender-inclusive

policies and plans at all levels of the health sector

Gender Focal point Build capacity of human resource cluster to

offer gender training to all staff at various levels

Develop and use existing mechanisms for ongoing advocacy

Facilitate partnership building among all organizations which influence health outcomes

Build capacity through training of all relevant clusters and agencies in gender analysis

MEDICINES REGULATORY AFFAIRS Improve the efficiency of the

Medicines registration system Registration timelines Screening: review process revise form Evaluation Committee processes

MRA Establish a sustainable program of

medicine regulation Approval of Generic Medicines Approval of new chemical entities

Improve regulation and control of clinical trials Approval times Technical capacity Systems

MRA Expand medicine safety programs

Adverse drug events Medical devices Cosmetics Veterinary medicines

MRA Implement a system for licensing distributors,

manufacturers and wholesalers Establish a system for parallel importation of

medicines Develop a framework for the registration and

control of complementary medicines Ensure continuous monitoring of quality of

medicines through appropriate laboratory services

Establish a framework for the safe prescribing of scheduled medicines by authorized health providers

MRA Establish a communications office to facilitate timely

collation, processing and dissemination of information

Establish a fully equipped and functional resource centre

Establish an effective law enforcement program Tighten medicine export and import control measures Enforce compliance with advertising requirements

and the marketing code of ethics Improve the efficiency of the post registration system Create an effective complaint management system

DISTRICTS AND DEVELOPMENT Provide leadership in DHS, rural

development and urban renewal Ensure active health sector participation in

Integrated rural development and urban renewal programs

Build institutional support for delivery of health services within DHS

Develop and facilitate an implementation strategy for the PHC package

Develop framework for decentralized management of PHC services

DISTRICTS AND DEVELOPMENT Facilitate monitoring, evaluation

and actions to improve quality of PHC services

Monitor and manage donor funded projects

Facilitate effective communication strategy between National, provinces and distrcts

presentation on key activities to portfolio committee on health 19 february 2002 branch: strategic...

Documents

strategic health programs

health workers

strategic health programmes

ec slide

saavi board slide

evaluation mental health

development health monitoring

womens health district