NATIONAL DEPARTMENT OF HEALTH

PRESENTATION ON STRATEGIC PLAN 2006/07-

2008/09MR THAMI MSELEKU

(DG-HEALTH)

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FLOW OF PRESENTATION CONTENTS OF THE PLAN VISION & MISSION 10 POINT PLAN SUMMARY OF ACHIEVEMENTS KEY CHALLENGES PRIORITIES FOR 2006/07 CONCLUSIONS

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CONTENTS OF THE PLAN FOCUS ON THE NDOH & NOT

PROVINCES MINISTER’S FOREWORD DG’S STATEMENT VISION, MISSION & SITUATION

ANALYSIS MEASURABLE OBJECTIVES,

INDICATORS, TARGETS AND BUDGETS BY BUDGET PROGRAMME

ANNEXURES (ASSETS, SERVICE IMPROVEMENT PLAN, ICT PLAN)

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VISION AN ACCESSIBLE , CARING AND

HIGH QUALITY HEALTH SYSTEM

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MISSION TO IMPROVE HEALTH STATUS

THROUGH PREVENTION OF ILLNESS AND PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY

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10 POINT PLAN, 2004-2009 IMPROVE GOVERNANCE AND

MANAGEMENT OF THE NHS PROMOTE HEALTHY LIFESTYLES IMPROVE QUALITY OF CARE IMPROVEMENT MANAGEMENT OF

COMMUNICABLE AND NON-COMMUNICABLE DISEASES

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10 POINT PLAN STRENGTHEN PHC, EMS AND

HOSPITAL SERVICES STRENGTHEN SUPPORT SERVICES HR PLANNING, DEVELOPMENT &

MANAGEMENT PLANINNG, BUDGETING, M/E LEGISLATION INTERNATIONAL HEALTH

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ACHIEVEMENTS:MATERNAL, CHILD AND WOMEN’S HEALTH INFANT MORTALITY & UNDER 5

MORTALITY STABLE FROM 1998-2003 AS REPORTED BY THE SOUTH AFRICAN DEMOGRAPHIC AND HEALTH SURVEY

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES PROVIDED IN ALL 53 HEALTH DISTRICTS

EXPANDED PROGRAMME ON IMMUNISATION COVERAGE IS 82% BUT POCKETS OF LOW COVERAGE IDENTIFIED

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MATERNAL, CHILD AND WOMEN’S HEALTH IMPACT OF FOOD FORTIFICATION BEING

MONITORED BY ENVIRONMENTAL HEALTH PRACTITIONERS

HEALTH PROFESSIONALS BEING TRAINED IN HUMAN GENETICS

ACCESS TO SAFE TERMINATIONS IMPROVING

INCREASE IN INFANTS AND MOTHERS OBTAINING VITAMIN A

TRIENNIAL REPORT ON CONFIDENTIAL INQUIRIES INTO MATERNAL DEATHS TO BE RELEASED SHORTLY

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YOUTH & ADOLESCENT HEALTH 10% OF ALL HEALTH FACITIES PROVIDE

YOUTH FRIENDLY SERVICES 50% OF DISTRICTS USE THE YOUTH

FRIENDLY & ADOL HEALTH GUIDELINES 34% OF HEALTH DISTRICTS PROVIDE

PHASE 1 OF SCHOOL HEALTH SERVICES

BY MARCH 2007 60% OF PHC FACILITIES SHOULD PROVIDE YOUTH FRIENDLY SERVICES

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HEALTHY LIFESTYLES & NUTRITION BY SEPT 2005 MORE THAN 21 000

PARTICIPATED IN HEALTHY LIFESTYLE COMPAIGNS HOSTED BY THE NDOH

15 000 PARTICIPATED IN HEALTH WALKS LED BY THE MINISTER

12 COMMUNITY & SCHOOL-BASED GARDENS ESTABLISHED

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HEALTHY LIFESTYLES & NUTRITION

INTEGRATED NUTRITION PROGRAMME NOW RUN IN ALL 53 HEALTH DISTRICTS

NUTRITIONAL SUPPLEMENTATION PROVIDED TO OVER 300 000 PATIENTS WITH DEBILITATING ILLNESSES

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HIV & AIDS AND STIs COMPREHENSIVE PLAN IN ITS 3RD YEAR

WITH 192 SITES (AT LEAST 1 IN EACH HEALTH DISTRICT)

30m MALE CONDOMS DISTRIBUTED EACH MONTH & 1m FEMALE CONDOMS DISTRIBUTED IN 2005/06

77% OF PUBLIC HEALTH FACILITIES OFFERED PMTCT & 88% OFFERED VCT

TARGET FOR VCT & PMTCT IS 100% OF PUBLIC FACILITIES BY MARCH 2007

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HIV & AIDS AND STIs WHO/AFRO DECLARED 2006 AS YEAR

OF ACCELERATED PREVENTION OF HIV (POVERTY ALLEVIATION, GENDER INEQUITIES, SOCIAL MOBILISATION, GREATER FOCUS ON YOUTH ETC)

TREATMENT OF STIs CONTINUES TO FOCUS ON SYNDROMIC MANAGEMENT, PARTNER TRACING

MORE THAN 100 000 PATIENTS INITIATED ON ARVs

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TUBERCULOSIS CONTRIBUTES SIGNIFICANTLY TO HIGH

BURDEN OF DISEASE - CURE RATE IS 56.7%

MOST PATIENTS ON DOTS NATIONAL TB CONTROL PROGRAMME BEING STRENGTHENED (FOCUS ON IMPROVING QUALITY OF DOTS, STRENGTHENING LAB SERVICES, STRENTHEN SUPERVISION ETC)

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TB TB CRISIS PLAN TO BE LAUNCHED ON

24 MARCH (WORLD TB DAY) FOCUS IS ON 2 OF THE WORST

PERFORMING PROVINCES (EC, KZN) AND 4 HEALTH DISTRICTS (ETHEKWENI METRO; NELSON MANDELA METRO; JOBURG METRO; AMATOLE DISTRICT)

TARGET IS TO INCREASE SMEAR CONVERSION RATES AND CURE RATES BY AT LEAST 10% A YEAR

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MALARIA BETWEEN 2004 & 2005 REDUCTION IN

CASES – 46% & REDUCTION IN FATALITIES – 38%

DECLINE DUE TO IN-DOOR SPRAYING, COLLABORATION WITH NEIGHBOURING STATES & REDUCED RAINFALL

INDOOR RESIDUAL SPRAYING INCREASED TO 83% OF TARGETED HOUSES - TO INCREASE TO 90% IN 2006/07

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NON-COMMUNICABLE DISEASES MANY GUIDELINES (HYPERTENSION,

DIABETES, ASTHMA ETC) PRODUCED BUT USE IS SUB-OPTIMAL, THEREFORE MONITORING SYSTEM FOR USE OF GUIDELINES DEVELOPED

ACCESIBILITY OF PUBLIC HEALTH FACILITIES TO PEOPLE WITH DISABILITIES IMPROVED & CONTINOUSLY MONITORED

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NON-COMMUNICABLE DISEASES WHEELCHAIR BACKLOG ELIMINATED NON DISCRIMINATORY RISK MODEL

FOR FOR THE SANBTS DEVELOPED LAB SERVICES STRENGTHENED TRANSFER OF SAPS MEDICO-LEGAL

MORTUARIES TO COMMENCE ON 1 APRIL 2006

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HUMAN RESOURCES FOR HEALTH WHO DECLARED 2006 AS HUMAN

RESOURCES FOR HEALTH YEAR NATIONAL HR PLAN COMPLETED & TO

BE LAUNCHED ON 7 APRIL (WORLD HEALTH DAY)

SCOPES OF PRACTICE OF MID LEVEL WORKERS FINALISED

PREPARATIONS FINALISED FOR INITIATION OF CLINICAL ASSOCIATE PROGRAMME IN 2007

POLICY ON COMMUNITY CARE GIVERS FINALISED

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PHARMACEUTICALS SPECS FOR MEDICINES PRICE

DATABASE IN PLACE PRICING COMMITTEE FINALISED

PROPOSALS ON DISPENSING FEE – MINISTER TO RELEASE FOR PUBLIC COMMENT ON 9 MARCH

MANUFACTURERS, WHOLESALERS & DISTRIBUTORS INSPECTED & LICENSED

REGULATION & CONTROL OF CLINICAL TRIALS STRENGTHENED

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PHC, EMS & HOSPITALS ROLES OF MUNICIPALITIES &

PROVINCES CLARIFIED DISTRICT PLANNING LINKED TO

IDPs STRENGTHENED MOST DISTRICTS PROVIDE FULL

BASKET OF PHC SERVICES USE OF PHC INCREASED FROM

67m VISITS IN 1998 TO 99m IN 2005

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PHC, EMS & HOSPITALS HOSPITAL REVITALISATION IS IN ITS 4TH

YEAR 4 HOSPITALS COMPLETED IN 2004/05

(MP, NW AND 2 IN NC) 45 HOSPITALS TO BE ENROLLED INTO

THE PROGRAMME OVER THE NEXT 3 YEARS

HOSPITAL IMPROVEMENT PLANS TO BE DEVELOPED BY EACH HOSPITAL IN 2006/07

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PHC, EMS & HOSPITALS PLAN FOR IMPLEMENTING

MODERNISATION OF TERTIARY SERVICES TO COMMENCE IN 2006

BY SEPTEMBER 2006 ALL HOSPITAL CEOs WILL HAVE APPROPRIATE DELEGATIONS

TRAINING PROGRAMME FOR CEOs COMMENCED

EMS BEING STRENGTHENED TO REDUCE RESPONSE TIMES – NATIONAL EMS PLAN DEVELOPED

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HEALTH LEGISLATION THANKS TO PARLIAMENT 8 OF 11 BILLS

DRAFTED HAVE BEEN PASSED IMPLEMENTATION OF NHA AND MENTAL

HEALTH CARE ACT PROGRESSING WELL (WITH SOME CHALLENGES)

6 NEW BILLS DRAFTED FOR CONSIDERATION BY PARLIAMENT IN 2006

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HEALTH FINANCING NOTE: DISCUSSION ON BUDGETS TO

FOLLOW HEALTH CHARTER TO GUIDE

PUBLIC/PRIVATE INTERACTIONS – SHOULD BE READY FOR SIGNING IN JUNE 2006

WORK ON RISK EQUALISATION FUND PROCEEDING WITH COUNCIL FOR MEDICAL SCHEMES

SHI WORK PROCEEDING WITH NATIONAL TREASURY

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INTERNATIONAL HEALTH LIAISON

NEW AGREEMENTS SIGNED WITH LESOTHO, MOZAMBIQUE AND SEYCHELLES IN 2005/06

NDOH PARTICIPATED IN A RANGE OF BI, TRI AND MULTI-LATERAL MEETINGS

NEPAD DESK STRENGTHENED & OFFICIAL SECONDED TO SADC TO STRENGTHEN HEALTH DESK

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KEY CHALLENGES IMPLEMENTATION OF POLICIES

WITHIN RESOURCE CONSTRAINTS HEALTH RESOURCES FOR HEALTH

CHALLENGES IMPROVING QUALITY OF CARE STRENGTHENING PRIORITY

HEALTH PROGRAMMES

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KEY PRIORITIES FOR 2006/07 DEVELOPMENT & IMPLEMENTATION OF

SERVICE TRANSFORMATION PLANS IMPLEMENTATION OF THE HR FOR

HEALTH PLAN STRENGTHENING PHYSICAL

INFRASTRUCTURE (PHC, HOSPITALS) IMPROVING QUALITY OF CARE PRIORITY HEALTH PROGRAMMES

(HEALTHY LIFESTYLES, TB CRISIS PLAN, ACCELERATED HIV PREVENTION)

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BUDGETS

The Department requested additional funds in the following areas –

(a)Project Management and Risk Equalization fund – (R 15 m for 2006/07, R 9 m for 2007/08 and R 10 m for 2008/09).

(b) Hospital Revitalization – (R 100 m for 2006/07, R 300 m for 2007/08 and R 500 m for 2008/09).

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BUDGET (c) Forensic Pathology Services – (R

525.176 m for 2006/07, R 551,383 m for 2007/08 and R 466.878 m for 2008/09).

(d) Cost of accommodation – (R 35.021 m for 2006/07, R 38.156 m for 2007/08 and

R 41.062 m for 2008/09). (e) Medical Research Council – R 31.888

m for 2006/07, R 32.057m for 2007/08 and R 30.141 m for 2008/09).

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BUDGET The “earmarked amounts” for the

Department were amended as follows – (a) An amount of R 5m in 2006/07 – R 9

m in 2007/08 and R 10m in 2008/09 per year was earmarked for the following:

Forensic Pathology - R 1.7 m Emergency Medical Services - R1.7 m Community Health Workers) - R1.7 m

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BUDGET(b) The earmarked amounts for the following

activities were reduced –

PreviousEarmarked

Earmarked amount amount

CondomsR 143.280 m R 138.280 m

Global Fund R 20.0 m R 16.0 m

Comprehensive Plan R 48.0 m R 40.0 m

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PROGRAMMES Actual

2002/2003 R' 000

Actual 2003/2004

R' 000

Actual 2004/2005

R' 000

Adjusted Estimate 2005/2006

R' 001

Budget 2006/2007

R' 000

MTEF 2007/2008

R' 000

MTEF 2008/2009

R' 000

Programme 1: Administration

Minister 691 746 791 837 887 934 981

Deputy Minister - 644 593 680 721 759 797

Management 4,966 7,001 10,172 16,543 20,862 21,976 23,075

Corporate Services 83,477 83,115 104,472 117,587 130,571 133,634 139,991

S/Total Progm 1 Admin (excl Property Management ) 89,134 91,506 116,028 135,647 153,041 157,303 164,844

Property Management 23,108 25,928 29,736 32,124 35,026 38,164 41,070

Total: Programme 1 112,242 117,434 145,764 167,771 188,067 195,467 205,914

Programme 2: Strategic Health Programmes

Maternal, Child and Women's Health 19,718 18,950 20,081 25,025 27,093 28,819 30,391

Medicines Regulatory Affairs 20,330 25,807 32,052 20,994 29,093 30,554 32,221

HIV and AIDS 117,173 86,842 56,841 131,449 129,696 155,913 166,725

Pharmaceutical Policy and Planning 18,823 17,980 21,988 29,636 24,863 26,112 27,537

Communicable Diseases 36,354 42,961 29,650 47,219 47,242 49,542 52,354

Total: Programme 2 212,398 192,540 160,612 254,323 257,987 290,940 309,228

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PROGRAMMES Actual 2002/2003

R' 000

Actual 2003/2004

R' 000

Actual 2004/2005

R' 000

Adjusted Estimate 2005/2006

R' 001

Budget 2006/2007

R' 000

MTEF 2007/2008

R' 000

MTEF 2008/2009

R' 000

Programme 3: Health Service Delivery

Non-communicable Diseases 25,479 34,165 61,561 61,969 52,010 54,616 57,342

Hospital Services 5,768 17,628 13,803 14,252 17,694 20,392 26,404

Health Economics 6,443 7,244 7,863 13,947 28,567 16,371 17,190

Health Information Research and Evaluation 14,460 20,833 21,944 22,910 27,756 29,217 30,677

PHC, Districts Health and Development 11,028 13,561 14,575 21,403 24,141 26,279 27,593

Office of the Standards of Compliance 14,725 16,828 9,303 14,475 19,933 20,934 21,981

Total: Programme 3 77,903 110,259 129,049 148,956 170,101 167,809 181,187

Programme 4: Human Resources

Human Resources 6,789 6,923 8,190 9,400 15,866 16,147 16,950

Bargaining Council and Employee Relations 1,034 2,687 2,797 6,984 8,190 9,001 9,490

International Health Liaison 33,737 48,538 26,747 41,151 45,104 49,872 56,394

Total: Programme 4 41,560 58,148 37,734 57,535 69,160 75,020 82,834

Total: Programmes 444,103 478,381 473,159 628,585 685,315 729,236 779,163

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PROGRAMMES Actual 2002/2003

R' 000

Actual 2003/2004

R' 000

Actual 2004/2005

R' 000

Adjusted Estimate 2005/2006

R' 001

Budget 2006/2007

R' 000

MTEF 2007/2008

R' 000

MTEF 2008/2009

R' 000

Conditional Grants:

Integrated Nutrition Programme - - -

Comprehensive HIV and AIDS 210,209 333,556 735,381 1,150,108 1,567,214 1,645,575 1,735,423

Cholera Epidemic KwaZulu-Natal 147,000 - - - - - -

Drought Relief - 34,500 - - - - -

National Tertiary Services 3,727,077 3,994,774 4,273,005 4,709,386 4,981,149 5,221,206 5,482,266

Health Professions Training and Development 1,299,248 1,333,499 1,434,132 1,520,180 1,520,180 1,596,189 1,675,999

Hospital Revitalisation 649,000 717,628 733,802 1,105,427 1,439,647 1,706,629 1,982,663

Hospital Management and Quality Improvement 126,000 133,404 122,200 150,342 - - -

Forensic Pathology Services 124,729 143,436 145,024 271,412 525,176 551,383 466,878

Pretoria Academic 70,000 92,356 - - - - -

Total: Conditional Grants 6,353,263 6,783,153 7,443,544 8,906,855 10,033,366 10,720,982 11,343,229

TOTAL: NATIONAL DEPARTMENT OF HEALTH 7,135,936 7,735,555 8,454,861 10,039,399 11,269,996 12,015,132 12,702,763

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PROGRAMMES Actual

2002/2003 R' 000

Actual 2003/2004

R' 000

Actual 2004/2005

R' 000

Adjusted Estimate 2005/2006

R' 001

Budget 2006/2007

R' 000

MTEF 2007/2008

R' 000

MTEF 2008/2009

R' 000

Compensation of Employees 167,578 177,743 190,808 209,119 240,030 251,827 264,777

Goods & Services 312,923 429,684 442,382 537,711 568,834 610,866 642,999

Total Current payments 480,501 607,427 633,190 746,830 808,864 862,693 907,776

Transfer payments

Current 5,915,561 6,297,832 7,061,475 8,149,564 8,993,443 9,421,616 9,786,893

Capital 719,000 809,984 733,802 1,105,427 1,439,647 1,706,629 1,982,663

Total Transfer payments 6,634,561 7,107,816 7,795,277 9,254,991 10,433,090 11,128,245 11,769,556

Capital Assets 20,874 20,312 26,394 37,578 28,042 24,195 25,431

Total Payments 7,135,936 7,735,555 8,454,861 10,039,399 11,269,996 12,015,133 12,702,763

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CONCLUSIONS DESPITE MANY CHALLENGES NDOH

HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2005/06

NDOH ORGANOGRAM TO BE EXPANDED IN 2006/07 TO INCLUDE A FURTHER 3 BRANCHES

WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2006/07 TARGETS

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THANK YOU FOR YOUR ATTENTION