Health

Update on progress and achievements in 2014/15
Government on health
National Health Insurance
Delivery agreements
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Update on progress and achievements in 2014/15

Minister of Health, Dr Aaron Motsoaledi, pointed out the following achievements in his Budget Vote speech for 2015/16:

  • The introduction of two new vaccines in our routine immunisation programme, namely the pneumococcal conjugate vaccine and the rotavirus vaccine, in 2009, has led to a 70% decline in invasive pneumococcal disease in children under the age of five. Pneumococcal diseases include very dangerous diseases like meningitis and severe pneumonia. These are the leading causes of death of children 5 years and under globally. In South Africa, pneumococcal disease comes only second to HIV and AIDS in causing death of under-fives. The NICD also found a decline in unvaccinated adults, including HIV-infected individuals in whom pneumococcus is a leading bacterial cause of sepsis. This demonstrates the indirect protection conferred by what is called herd immunity.

    The NICD further documented a 66% reduction in rotavirus diarrhoea hospitalisation in the first two years after we introduced rotavirus vaccine in 2009.

    One shot of vaccine for pneumococcus is R600.00 but to treat pneumonia will cost R6 930.00 and to treat meningitis will cost R17 903.00. These are 2009 figures.
     

  • In August 2014 the Department of Health launched the MomConnect project.

    This project uses cellphone technology to register pregnant women – all pregnant women in both public and private healthcare. This empowers them to get all the information and instructions necessary for them to ensure a healthy pregnancy and deliver a healthy vibrant baby.

    After delivery, the messages switch over to focus on information on the health needs of a new-born and will continue for up to one year after birth.

    In the space of only 8 months the Department registered 383 354 pregnant women on the system. It is regarded as the largest number in the world. Before we started, Bangladesh was regarded as a world leader after registering 100 000 women in 18 months, while other countries are having only small pilot projects – nothing yet on a massive scale like we have. The aim is to ensure that everyone of the 1, 2 million women who get pregnant annually register on MomConnect.
     

  • To reduce waiting lines at clinics, a new system has been introduced where patients who only want to collect medicines, can register at a collection point where they may collect their medicines, without having to queue or wait. A total of 383 989 patients was on this system at the end of April 2015 and the Department is targeting 0,5 million people.
     
  • Cellphone technology is now used for a system that will give a warning when the stocks of medicines are running low at a particular healthcare centre. The technology is used in 1 160 health facilities in the country, or 25% of our health facilities.

Government on health

Minister of Finance Pravin Gordhan in his 2013/14 budget speech said the initial phase of NHI development will not place new revenue demands on the fiscus. Over the longer term, however, it is anticipated that a tax increase will be needed. The National Treasury is working with the Department of Health to examine the funding arrangements and system reforms required for NHI. A discussion paper inviting public comment on various options will be published this year.

Consolidated spending on health and social protection is R268 billion in 2013/14. Health infrastructure remains a priority. In 2012, a total of 1 967 health facilities and 49 nursing colleges were in different stages of planning, construction and refurbishment.

The National Development Plan 2030, released on 15 August 2012, proposes among others:

  • Broadening coverage of antiretroviral treatment to all HIV-positive people
  • Speeding up training of community specialists  in medicine, surgery including anaesthetics, obstetrics, paediatrics and psychiatry
  • Recruiting, training and deploying between 700 000 and 1.3 million community health workers to implement community-based healthcare
  • Setting minimum qualifications for hospital managers and ensuring that all managers have the necessary qualifications
  • Implementing national health insurance in a phased manner
  • Promoting active lifestyles and balanced diets and controlling alcohol abuse to reduce non-communicable diseases.

Programmes and initiatives supporting health

Government will improve healthcare by:

  • appointing appropriate and qualified heads of department, chief financial officers, hospital chief executive officers, district health officers and clinic managers
  • reviving 105 nursing colleges countrywide, to train more nurses
  • opening a medical faculty at the Limpopo Academic Hospital to train more doctors
  • renovating and upgrading hospitals and clinics
  • providing reproductive health rights and services that include contraception, sexually transmitted infections, teenage pregnancies and sanitary towels for the poor
  • continuing to implement programmes that promote various prevention measures, including medical male circumcision, prevention of mother-to-child transmission and the promotion of HIV testing.
  • The National Nursing Summit were used to critically reflect and discuss key issues affecting nurses and the nursing profession, within the context of South Africa’s disease burden, as well as the national and international health sector.
  • Human Papilloma Virus Vaccination Campaign
  • HIV and AIDS Counselling and Testing (HCT) Campaign.

National Health Insurance

Milestones for National Health Insurance:

It is seen as a 14-year project and the first five years will be a process of building and preparation. Dr Motsoaledi emphases that the cornerstone of the proposed system of NHI is universal coverage

Delivery agreements

Cabinet resolved on 23 November 2011 that all government departments that are signatories to the Negotiated Service Delivery Agreement (NSDA) 2010-2014 continue to work together to address cross-cutting issues such as increasing life expectancy, combating HIV and AIDS and TB and improving maternal and child health. This must also extend to work involving nutrition and measures to reduce the incidence of underweight and stunted growth among children. Accurate measurement of these indicators will assist in tracking the extent to which health and socio-economic interventions are reaching the intended beneficiaries.

The health minister and MECs have signed performance agreements based on Outcome 2: A long and healthy life for all South Africans. These documents list standards against which performance are measured.

>> Delivery agreement for outcome 2: A long and healthy life for all South Africans

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