Address by Ms Nomantu Nkomo-Ralehoko, Gauteng MEC for Health during Gauteng Department of Health and Wellness 2022/23 annual debate held on the 06 December 2023 at the Gauteng Legislature
Madam Speaker;
Deputy Speaker;
Honourable Premier;
Honourable colleagues in the Executive Council; Honourable Members of this House;
Leaders from Labour, Business and Communities; Ladies and Gentlemen;
People of Gauteng; and Honourable speaker.
Madam Speaker,
I am deeply honoured and humbled to stand before you today in this esteemed assembly. This debate marks not just a routine engagement in our democratic processes, but a critical moment where we reflect on our collective journey towards a healthier, more resilient Gauteng. It is a moment to assess, to acknowledge, and to chart the way forward in our relentless pursuit of health and wellness for all our people.
The last time we gathered in this distinguished hall to present the annual report, we discussed a vision that was both bold and essential. We deliberated on a critical change in our healthcare system, transitioning from a reactive to a more proactive, comprehensive, and enduring model. We acknowledged the obstacles we faced, yet we were reinforced by a firm dedication to the citizens of Gauteng, motivated by the conviction that every individual, regardless of age or gender, is entitled to high-quality healthcare.
Today, we pause to reaffirm our dedication to implementing Primary Health Care, a fundamental component of a sustainable healthcare system aimed at Universal Coverage. We've made notable progress in reaching vulnerable communities by delivering health services directly to homes and connecting them to established facilities. This success is largely due to our 13,700 Ward Based Outreach Teams, consisting of Community Health Workers.
In the past year, these teams have impressively conducted 680,000 initial household visits and over 3.5 million follow-up visits. Their critical role in community health screening and education has been instrumental in our efforts.
Support to Public Schools and Learners
Madam Speaker and distinguished members, as the Department of Health and Wellness, we have been persistent in our commitment to enhancing the learning environment in public schools by addressing health and social barriers to education.
In the past year, we have significantly expanded our integrated school health services, reaching approximately 120,000 learners, a notable increase of 60% from the previous year. These comprehensive services, ranging from deworming and immunization to eye and hearing care, TB referrals, and Td doses, are crucial for early detection and intervention in health-related issues that can impact learning and teaching.
In addition, provision of health services to public schools remained important for early detection of health and social barriers to learning and teaching. The Department provided integrated school health services, from de-worming, immunisation, weight assessments, eye care, hearing problems, TB referrals and Td doses to 119 350 learners during the year under review.
This was an increase of 60% from 74 808 in the 2021/22 financial year. The number of learners given deworming doses increased by 93% from 25 876 in the previous financial year to 49 877 in 2022/23. In addition, a total of 2 683 learners were referred for mental health or psycho-social support.
Post Pandemic Improved Access to Care
In the domain of Primary Health Care (PHC), a significant post-pandemic development has been observed in terms of facility utilization. We have seen an encouraging increase in patient visits at PHC facilities, rising from 18.6 million in the 2021/22 financial year to 19.7 million in the current year under review. This notable rise in patient visits reflects the renewed trust in our healthcare system and underscores the effectiveness of the public health measures we have implemented.
Expansion of Service Platforms to Increase Access to Care
We have demonstrated our commitment to enhancing healthcare accessibility, particularly in underserved regions, by expanding the number of Community Health Centres (CHCs) offering 24-hour services. From 36 in the 2021/22 financial year, we've increased this number to 38 in 2022/23.
This expansion is a significant step in our strategy to provide round-the-clock healthcare access, especially for those in remote or less served areas. These 24-hour CHCs are crucial not only for delivering immediate medical care but also serve as an essential part of our healthcare network, providing both preventive and primary care services.
Improving Quality of Service Platforms
The commitment to improving Primary Health Care Universal Coverage demands that we improve the quality of care. It is for this reason that the Department worked hard in ensuring that the Ideal Clinic Realisation and Maintenance (ICRM) programme, aimed at ensuring access to high-quality universal healthcare is accelerated. In the year under review, 358 out of 368 facilities, or 97.3% of those assessed, achieved the ideal clinic status. This is a 5% increase compared to the previous year, reflecting our ongoing commitment to enhancing the quality of care in our primary health facilities.
The improvement in PHC facility utilization is not just a number; it represents a growing trust in our healthcare system and its ability to meet the needs of our community. The ICRM programme, in particular, has been instrumental in this regard, setting high standards for care and ensuring that facilities meet these benchmarks.
Our initiative to expand the number of Community Health Centres (CHCs) offering 24- hour services is a testament to our commitment to healthcare accessibility. In the 2021/22 financial year, we had 36 CHCs operating around the clock, and we have successfully increased this to 38 in the 2022/23 period. This growth is a strategic move to ensure that healthcare is continuously available, particularly for those in remote or underserved communities.
Reduction of Queues at Hospitals
As we continue to strive for excellence in our healthcare system, it is imperative to focus on enhancing the patient experience through efficient service delivery. A cornerstone of our efforts in this regard is the significant progress made in reducing queues and waiting times at our healthcare facilities. This achievement is not just a matter of convenience but a critical component of providing compassionate and effective healthcare.
Central to these efforts is the innovative implementation of the Centralised Chronic Medicine Dispensing and Distribution (CCMDD) programme. This program has been a game-changer in transforming how patients access their medications, particularly benefiting those with chronic conditions who face health or financial challenges. By reducing the need for these patients to physically visit hospitals for their medication, we have significantly eased the burden on our hospital outpatient departments.
I am proud to report that, as of the end of the 2022/23 financial year, approximately
1.2 million clients were enrolled in the CCMDD programme. This represents a substantial increase, with a 10% rise from the approximately 1.1 million clients enrolled in the previous year. This significant achievement underscores our commitment to improving healthcare accessibility and efficiency. It is a testament to our dedication to ensuring that every citizen receives timely and convenient healthcare services, thereby enhancing the overall patient experience in our healthcare system.
Mental Health
Mental health is an increasingly critical issue in today's world, affecting individuals and communities globally. As the Department of Health and Wellness, we are acutely aware of the challenges posed by mental health conditions and are committed to addressing them through comprehensive strategies and programs.
Recognizing mental health as a global challenge, we have implemented several initiatives at the primary healthcare level to support individuals with mental health conditions. A significant aspect of our approach has been the expansion of mental health services, with a particular emphasis on increasing the availability of mental health beds, a top priority in our agenda.
In the 2022/23 financial year, we have made substantial progress in this area. We allocated 230 beds in District Hospitals and another 230 in Regional Hospitals specifically for mental health services. This allocation marks a 5% increase in Regional Hospitals and a 3% rise in District Hospitals compared to the previous year. Our efforts have been inclusive, offering both generalized and specialized psychiatry services to all community members, encompassing children and the elderly
HIV/AIDS
Madam Speaker, Hounarable Members, and guests, in the wake of a highly successful World AIDS Day celebrated last Friday in Sedibeng, I am proud to report on the strides our Department has made in the ongoing battle against HIV/AIDS. Our approach has been comprehensive and multi-sectoral, focusing on reducing new HIV infections. A significant milestone achieved in the 2022/23 financial year was the administration of over 5.3 million HIV tests.
This marks a 6% increase from the 5 million tests conducted in the previous year, a testament to our unwavering commitment to this cause. Such diligent efforts have been pivotal in advancing towards our ambitious target of ensuring that 90% of our population knows their HIV status.
The success we celebrate today stems from a variety of initiatives and campaigns. These include our robust community testing programs, heightened activities during Condom and STI Awareness Months, the introduction of HIV Self-Service options, and the use of index testing modalities in healthcare facilities and community HIV testing services across all five districts.
Also, our diverse HIV awareness campaigns have significantly contributed to expanding the scope and impact of our work in this crucial health sector. These concerted efforts reflect our dedication to not only combating HIV/AIDS but also to fostering a well-informed and health-conscious community.
Diabetes and Hypertension
In the context of the global challenge posed by non-communicable diseases, our department has placed a strong emphasis on the early detection and management of diabetes and hypertension. These conditions are leading contributors to premature morbidity and mortality worldwide. In the year under review, we screened over 7.2 million clients for diabetes and more than 7.6 million for hypertension.
A significant focus was on the age group of 18 to 44 years, where 64.2% of those screened for diabetes and 70.4% for hypertension fell. Additionally, there was a notable improvement in diabetes management, with a 3.6% increase in clients maintaining a normal HbA1c level (≤8%), rising from 60% to 63.6%. This improvement is largely credited to the diligent adherence to the Diabetes and Adult Primary Care (APC) 101 Guidelines by our healthcare providers.
Maternal and Child Health
Our commitment to maternal and child health remains a key pillar of our public health strategy, emphasizing the reduction of pregnancy complications and the improvement of health outcomes for mothers and children. An essential aspect of this strategy has been the focus on increasing the number of Antenatal Care (ANC) visits within the first 20 weeks of pregnancy. In the reporting period, we recorded 229,000 ANC visits, of which 69.2% were initial visits conducted before 20 weeks.
This represents a 2.4% increase compared to the previous year. Such progress is largely due to the successful implementation of Basic Antenatal Care (BANC) training and the refinement of pregnancy screening and testing protocols across all service points. These measures ensure that expectant mothers receive early and comprehensive care, which is crucial for their health and that of their babies.
Financial Performance
Madam Speaker, our journey towards improving the financial stewardship of the department has been both arduous and fruitful. In the 2022/23 financial year, we have made commendable strides in our financial management, as evidenced by achieving an unqualified audit opinion. This significant milestone is a testament to our dedication to enhancing transparency and accountability in our operations.
The attainment of this unqualified audit opinion is not just a mark of financial health but also a step closer to our ultimate goal of a clean audit. Despite facing challenges such as an increase in medico-legal claims, we have implemented targeted interventions to mitigate these issues in the current financial year.
Our commitment to community development is further demonstrated through our active role in promoting local economic empowerment, particularly in township areas. Of our total expenditure on goods and services, a substantial 33.8% (over R2 billion) was allocated to township enterprises, underscoring our dedication to fostering local economic growth. Moving forward, we plan to expand this initiative, especially in the realm of Occupational Health and Safety Maintenance projects for health facilities.
Madam Speaker,
The significance of our unqualified audit outcome is immense and cannot be overstated. It stands as a testament to the strength and reliability of our department's financial systems and processes. Reflecting on this achievement, the words of Maya Angelou, a well-known African American poet and civil rights activist, come to mind: "Do the best you can until you know better. Then when you know better, do better."
This statement, while simple, encapsulates a powerful ethos that is highly relevant to our work in financial governance. It speaks to the journey of continuous improvement, emphasizing the importance of striving for excellence with the knowledge and resources we have, and then elevating our efforts as we gain more insight and capability.
This achievement in our financial management is crucial for maintaining public trust and confidence in our operations. It ensures that we have a solid foundation for the efficient allocation and utilization of resources, which is essential for the effective delivery of health services. In line with Angelou's wisdom, our approach has been one of constant learning and improvement, ensuring that every decision, every allocation, and every expenditure is made with the best of our current understanding and with a commitment to do even better as we progress.
In conclusion, Madam Speaker, while we celebrate these achievements, we remain acutely aware that our journey does not end here. The health and wellness of our citizens are an ongoing commitment. We pledge to continue this journey with the same vigour and dedication, ensuring that every citizen in Gauteng has access to quality healthcare.
I thank you.
