1. structure of presentation 1.vision and mission 2.health sector response 3.annual performance plan...
TRANSCRIPT
STRUCTURE OF PRESENTATION
1. Vision and Mission2. Health Sector Response3. Annual Performance Plan Finance Presentation
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1. VISION AND MISSION
VISION
Long and healthy life for all South Africans
MISSION
To improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.
2. HEALTH SECTOR RESPONSE
• Government adopted an outcome-based approach to service delivery
• The Health sector is responsible for the achievement of Outcome 2 : A long and healthy life for all South Africans
• Four Identified outputs:– Output 1 : Increasing Life Expectancy– Output 2 : Decreasing Maternal and Child mortality– Output 3 : Combating HIV and AIDS and decreasing
the burden of disease from Tuberculosis
– Output 4 : Strengthening Health System Effectiveness4
Interrelationship across the Health Sector Negotiated Service Delivery Agreement, the 10 Point Plan and the
National Health Insurance
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Health Sector 10 point PlanHealth Sector 10 point Plan NSDANSDA
A LONG & HEALTHYA LONG & HEALTHY LIFE FOR ALL LIFE FOR ALL
SOUTH AFRICANSSOUTH AFRICANS
A LONG & HEALTHYA LONG & HEALTHY LIFE FOR ALL LIFE FOR ALL
SOUTH AFRICANSSOUTH AFRICANS
Defined TargetsDefined
Timeframes & critical milestonesNHINHI
INCREASED LIFE EXPECTANCY
STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
IMPROVEDACCESS TO
HUMANRESOURCES
FORHEALTH
INTER -SECTORAL
ACTION FOR
SOCIALDETERMI -NANTS OF
HEALTH
IMPROVEDQUALITY
OFSERVICES
NATIONALHEALTH
INSURANCE
IMPA
CT
OU
TC
OM
ES
OU
TPU
T
IMPROVED FINANCIALMANAGE
MENT INPU
TS
PRIMARY HEALTH
CAREORIENTEDSERVICE DELIVERY
HEALTHINFORMA -
TION
IMPROVEDACCESSS
TO HEALTH
FACILITIES
HEALTH SECTOR NSDA 2010 - 2014
Reduced Maternal and
Child mortality rates
Reduce burden from HIV&AIDS
and TB (Mortality and
Morbidity)
Reduce burden from non-communicable diseases
Reduce burden from violence and injury
Primary Health Care
Oriented Service
Delivery
Improved quality of services
Improved Human
Resources for
Health
Improved access to
Health Facilities
Improved financial manage-
ment
National Health Insurance
Health Informa - tion
Inter -sectoral
action for social de -
terminants of Health
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
SCALE UP THE COMBINATION OF PREVENTION INTERVENTIONS TO REDUCE NEW HIV INFECTIONS
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Scaling up condom distribution, with 1 billion male condoms distributed annually during 2011/12-2013/14, and 6 million female condoms distributed annually during 2013/14
• Increase the number of Medical Male Circumcisions to 500 000 during 2011/12 and 600 000 annually during 2012/13 and 2013/14
• Increase the HCT uptake rate from 80% to 90% in 2013/14
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Increasing the number of new patients initiated on Antiretroviral Therapy (ART) to between 625 000 to 675 000 annually during 2011/12-2013/14
• Increasing the proportion of PHC facilities implementing nutritional intervention for People living with HIV and AIDS and TB from 77% in 2010/11 to 88% in 2013/14
IMPROVE THE QUALITY OF LIFE OF PEOPLE LIVING WITH HIV &AIDS BY PROVIDING AN APPROPRIATE PACKAGE OF CARE, TREATMENTS AND SUPPORT
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Maintain the percentage of children under 1-year of age fully immunised at 95% throughout the MTEF period
• Maintain the measles immunisation coverage rate of 95 % throughout the MTEF period
• Increasing the number of sub-districts implementing school health services from 100 to 150 in 2011/12 , 200 in 2012/13 and 232 in 2013/14
• Implementing programmes in secondary schools to address youth risk behaviour with a focus on life skill based HIV and AIDS education in 60 Sub Districts during 2011/12 and 100 Sub Districts during 2012/13
• Increasing the Vitamin Supplementation coverage among children 12 to 59 Months from 38% in 2010/11 to 45% in 2013/14
REDUCE INFANT, CHILD AND YOUTH MORBIDITY AND MORTALITY
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Maintain ante – natal coverage rate of 100 % throughout the MTEF period
• Increasing the antenatal coverage before 20 weeks from 37% in 2010/11 to 60% in 2013/14
• Increasing the proportion of deliveries taking place in health facilities under the supervision of trained personnel from 88% in 2010/11 to 95% in 2013/14
• Increasing the proportion of designated health facilities providing Choice on Termination of Pregnancy (CTOP) from 40% in 2010/11 to 55% in 2013/14;
• Increasing the percentage of mothers and babies who receive post-natal care within 6 days of delivery from 40% in 2010/11 to 80% in 2013/14;
TO REDUCE MATERNAL MORTALITY
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED ACCESS TO REPRODUCTIVE HEALTH
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Increasing the cervical cancer screening coverage from 50% in 2010/11 to 56% by 2013/14
• Increasing the couple year protection rate from 32% in 2010/11 to 37 % by 2013/14
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
EXPAND PMTCT COVERAGE TO PREGNANT WOMEN
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• 100% of pregnant woman to be tested for HIV
• Increasing the antenatal clients initiated on HAART rate from 87% in 2011/12 to 100% in 2013/14
• Decreasing the percentage of babies testing PCR positive 6 weeks after birth from 10% in 2011/12 to 6.5% in 2013/14
• Increasing the uptake rate for HIV Positive antenatal clients on AZT for any period before labour from 86% in 2011/12 to 100% in 2013/14
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
TO REDUCE THE BURDEN OF DISEASE OF TUBERCULOSIS
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Increasing the TB cure rate from 70 % in 2009 to 85% in 2013/14.
• Reducing the TB treatment defaulter rate from 7% in 2010/11 to 5% (or less) in 2013/14
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
COMBATING TB AND HIV BY REDUCING THE CO-INFECTION BURDEN
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Increasing the percentage of HIV positive patients screened for TB from 70% in 2011/12 to 100% in 2013/14
• Increasing the percentage of TB patients tested for HIV from 80% in 2011/12 to 100% in 2013/14
• Increasing the percentage of TB/HIV co-infected patients receiving Cotrimoxazole Prophylaxis Therapy from 90% in 2011/12 to 100% in 2013/14
• Increasing the number of HIV positive patients receiving Isoniazid Preventative Therapy (IPT) from 45 000 in 2011/12 to 80 000 in 2013/1414
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
REDUCE THE BURDEN OF DISEASE FROM COMMUNICABLE AND NON – COMMUNICABLE DISEASES
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Decreasing the incidence of malaria from 0,62 per 1000 population at risk in 2010/11 to 0.54 per 1000 population at risk in 2013/14;
• Chronic care whether from communicable or non-communicable causes will be aligned and a single chronic care model will be rolled out to 3 districts in 2011/12
• The number of districts implementing the long term care model for diabetes and hypertension will be increased to 52 by 2013/14
• The integrated Health Promotion Policy and Strategy with an implementation plan will be finalised during 2011/12
• To strengthen the quality of Environmental Health Services , norms and Standards will be developed during 2011/12
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
RE- ENGINEERING OF PRIMARY HEALTH CARE
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Implementation of community based services in each district by establishing Family Health Teams ; 54 in 2011/12, 100 in 2012/13 and 250 in 2013/14
• Complete the comprehensive audit of Primary Level Services inclusive of District Hospitals by March 2011/12
• Improve community participation to strengthen the governance of the District Health System,
• Increase number of District Health Councils established from 43 in 2010/11 to 52 in 2012/13• Increase the percentage of functional committees established for PHC facilities to 60 % in
2013/14• Improve access to primary health care services, with an increased utilisation rate of
3 visits by 2013/14• Improve health outcomes through ensuring that 52 Districts Health plans are used
for planning, budgeting, monitoring ,reporting and improved programme implementation by providing more direct support to the District Management Teams
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Develop and implement a national infrastructure plan in conjunction with provincial infrastructure units
• Develop a set of Health Infrastructure norms and standards for all levels of care
• Establish an Infrastructure Project Management information system
• Finalisation of the Health Care Technology strategy
• Finalisation of the essential equipment lists for primary health care in 2011/12 and for secondary and tertiary health care in 2012/13
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Accelerating the delivery of health infrastructure through Public Private Partnerships (PPPs)
• All five tertiary hospitals should complete the feasibility study by March 2012. These are:
• Nelson Mandela Academic (Eastern Cape);• Chris Hani Baragwanath (Gauteng); • Dr. George Mukhari (Gauteng); • Limpopo Academic (Limpopo);• King Edward VIII (KwaZulu-Natal);
• Funding will be provided to hospitals through the hospital revitalization grant :
• 41 Hospitals will be under construction• 25 Hospitals will be in the planning phase 18
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED HEALTH WORKFORCE PLANNING, MANAGEMENT AND DEVELOPEMNT
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Finalising the revised Health Workforce Plan responsive to service delivery platforms by the end of 2011/12
• Strategy for rural Health workforce developed by the end of 2011/12
• Norms and Standards for Health Workforce for Primary and Secondary Health Care developed
• Integrate the Community Health Workers into the formal Health
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED HEALTH CARE FINANCING
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• Work in preparation for the implementation of NHI will conitnue. Specific outputs for 2011/12 include:
• Finalization of the NHI policy and legislative framework• NHI Pilot Sites established• Funding model developed
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IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVE THE QUALITY OF HEALTH SERVICES
KEY STRATEGIC INTERVENTIONS DURING 2011/12-2013/14 WILL INCLUDE:
• In 2011/12 new policies related to the legislative amendment governing the establishment an functioning of the Office of Health Standards Compliance and relevant regulation will be finalised
• The Office of Health Standards Compliance as a national certification body will be established by March 2012
• Patient satisfaction will be monitored and a patient satisfaction surveys will be conducted in 60 % of public hospitals during 2011/12 , in 90% during 2012/13 and 100% during 2013/14
• 20% (800) of the 4,333 public health facilities will be assessed for compliance with the 6 priorities of the core standards. This figure grows to 40% in 2012/13 and to 70% by 2013/14;
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Introduction
• During the Medium Term Framework ( MTEF) budget process, the Health Department requested additional funding for both National and Provincial departments for the amount of R19,9 billion for the three year MTEF period.
• Cabinet and National Treasury approved an amount of R18,1 billion made up of R3,4billion for National Health and R14,6 billion for the provincial health departments for earmarked funds additional to the equitable share baseline.
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Expenditure Trends • The Department’s expenditure grew from R13.6 billion in
2007/08 to R23.1 billion in 2010/11 at an average annual rate of 19.4 percent.
• Over the Medium Term period, expenditure is expected to grow to R30.1 billion, at an average annual rate of 9.2 percent.
• The increase in both periods is driven largely by transfers to provinces for the conditional grants, with the main increase being on the HIV and AIDS and the Revitalization of Hospitals grants, while the National Tertiary Services grant (NTSG) increased significantly in the MTEF period.
• The Forensic Pathology Services grant will be phased out in the 2012/13 financial year and has therefore been included in the provincial equitable share allocations.
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Medium Term Allocation for 2011/12 – 2013/14
• The Budget includes new allocations of R442 million for 2011/12, R692 million for 2012/13 and R2.2 billion for 2013/14.
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Additional Funds Allocated to the Baseline for the National Department.
PRIORITY FOCUS AREA11/12R’000
12/13R’000
13/14R’000
Increased distribution of condoms
30,000 30,000 30,000
Improved conditions of service 13,000
15,000
16,000
Quality Office of Standards Compliance: Support for inspectorate and accreditation function
10,000
20,000
10,000
Forensic chemistry laboratories: Equipment and filling of posts
10,000
10,000
10,000
Oversight of hospital revitalization projects
10,000
10,000
10,000
Health technology: Equipment packages and systems
5,000 7,000 9,000
Public private partnership (PPP) projects: Planning and transactional advisor costs
11,000 7,000 3,000 26
Additional Funds Allocated to Baseline PRIORITY FOCUS AREA
11/12R’000
12/13R’000
13/14R’000
Nursing colleges: Planning and coordination of upgrading and recapitalization project 9,000 5,000 5,000 National Health Insurance: Ministerial advisory committee 5,000 5,000 5,000 National workgroup investigations of patient based information technology system 5,000 5,000 5,000 Revenue management: Improved hospital tariff schedules 4,000 4,000 5,000 South African Health Products Regulatory Authority: Establishment and capacity to deal with medicines registration backlogs 10,000 - - Health Systems Trust
3,000 5,000 7,000 CCOD 5,000 6,000 7,000
Unit to support provincial finance 2,000 3,000 4,000
HIV and Aids Conditional grants 60,000 60,000 1,400,000
National Tertiary Services conditional grant to support public hospitals 250,000 500,000 750,000
TOTAL 442,000 692,000 2,276,000 27
Programme Allocations for 2011/12-2013/14 PROGRAMMES R’ million 10/12 11/12 12/13 13/14
Administration
282 326 325 344
Health Planning and Systems Enablement
125 161 178 190
HIV&AIDS, TB and Maternal, Child and Women’s Health
6,669 8,027 9,377 11,188
Primary Health Care Services
700 730 143 150
Hospital Tertiary Services and Workforce Development
13,947 15,963 17,016 17,664
Regulations and Compliance Management
496 525 572 601
Total Budget Allocated
22,219 25,732 27,611 30,137 28
Economic Classifications Allocations for 2012/13 to 2013/14
Economic Classification 10/11 11/12 12/13 13/14
Compensation of Employees
385 424 465 492
Goods and Services
755 785 795 830
Total Transfers & Subsidies
21,034 24,489 26,316 28,778
Payment of Capital Assets
45 33 35 37
Payment of Financial Assets
- - - -
Total 22,219 25,732 27,611 30,137 29
Conditional Grants Allocations 2011/12-2013/14
Grant Schedule2011/12
R'000 2012/13
R'0002013/14
R'000Total R'000
Health Infrastructure Grant 4
1,701,856
1,820,981
1,921,134 5,443,971
Health professions and Development Training 4
1,977,310
2,076,176
2,190,366 6,243,852
National Tertiary Services 4
8,048,878
8,688,822
9,389,207 26,126,907
Comprehensive HIV and Aids 5
7,492,962
8,824,610
10,606,664 26,924,236
Forensic Pathology Services 5
590,380
-
- 590,380
Hospital Revitalization Grant 5
4,136,290
4,335,908
4,067,859 12,540,057
Total
23,947,676
25,746,497
28,175,230 77,869,403 30
Conditional Grants Allocations 2011/12-2013/14
• Schedule 4 grants: specifying allocations to provinces to supplement the funding of programmes or functions funded from provincial budgets;
• Transfer payments cannot be withheld based on non performance or compliance, however, the new Division of Revenue Grant allows a 5% withholding while interventions are put in place.
• Grants included are: - National Tertiary Services, - Health Professions Training and Development - Forensic Pathology Services.
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Conditional Grants Allocations 2011/12 - 2013/14
• Schedule 5 : specifying specific-purpose allocations to provinces.
• Grants included are: - HIV and AIDS grant and the Revitalization of Hospital grant.• Schedule 5 grants may be withheld for non
performance and or compliance. Interventions must also be put in place for compliance.
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Additional Priority focus areas (Earmarked Funds) Allocated directly to Provinces.
R million 11/12 12/13 13/14
Health technology 20 30 40
Nursing colleges upgrading and maintenance 32 32 32
OSD doctor Annexure A top-up 110 119 126
OSD therapeutic top-up 363 426 449
Maternal and child health 228 501 700
Personnel and goods stabilization 522 1,073 1,444
HIV: ARV 350 threshold - 500 500 33
Additional Priority focus areas (Earmarked Funds) Allocated directly to Provinces.
R million 11/12 12/13 13/14
Registrars esp paed, obs and critical posts 100 200 300
Family health team pilots/models 100 400 700
Public hospital norms and standards 240 486 532
Policy priorities subtotal 1,715 3,767 4,823
Improvements in conditions of service 1,556 1,556 1,556
Forensic pathology shift into PES 620 654
Total 3,271 5,943 7,033 34