I am pleased to present to you detailed plans in regards to what was stated in the State of the Province Address by the Premier. In 2011/12, we will continue to provide quality service, guided by our goal of achieving ‘A long and healthy life for all South Africans’.
Child and neonatal mortality has been a major focus for government during 2010 and we intend to rapidly upscale this programme in 2011/12.
In 2010, we had around 203,000 deliveries in our health institutions. We took steps to strengthen neonatal services in our hospitals. We have already upgraded neonatal Intensive Care Units (ICU) in a number of our hospitals. At Charlotte Maxeke Johannesburg Academic Hospital, a new ward has been built and fully commissioned as a high care area for neonates, which has ended the overcrowding in the ICU. This ward is now fully operational with 20 beds and 24 staff members.
At Natalspruit Hospital, the ICU has been expanded through the creation of an additional ward and this is fully functional. Additional neonatal ICU beds have been added to Dr George Mukhari Hospital and Chris Hani Baragwanath Hospital. The upgrading of neonatal ICUs for all other hospitals will be prioritised for this year.
Two provincial committees have been established to advice the department on methods and interventions to reduce maternal, neonatal, infant and child morbidity and mortality. These committees are: A Maternal Morbidity and Mortality Committee and a Neonatal, Infant and Child Committee. These teams continue to ensure rigours monitoring and analysis of maternal and infant mortality in 2011/12.
We have prioritised instilling an attitude among our health professionals that the death of a mother, a child or any person in our hospitals should not be regarded merely as a statistic! All deaths are now being investigated, causes identified and intervention measures put in place.
Where negligence is found, people will be held accountable. There will be no exceptions. This instruction has gone out to all clinics, hospitals managers and health professionals.
Another important measure to reduce child and infant mortality is to ensure that staff is trained in the Integrated Management of Childhood Illnesses (IMCI). The department is conducting an audit to identify clinics that need to be strengthened in this area, and in 2011/12 will ensure that every clinic has more than one IMCI-trained nurse, and that nurses are also trained in Oral Rehydration Therapy – a simple yet critical step in preventing babies from dying from dehydration linked to diarrhoea.
As the Premier said, the introduction of multi-dose therapy to Prevent Mother to Child Transmission of HIV has resulted in a marked decrease in children born with HIV. In the Soweto and Coronation catchment areas for example the transmission rate has dropped from 8% to below 3%. Our target is to reduce the transmission rate of HIV to less than 5% across the province in 2011, and the Soweto-Bara model will be expanded to Ekurhuleni and Sedibeng in 2011/12.
By the end of November 2010, we had registered more than 358 000 people on Anti-Retroviral Treatment. This we achieved through extending this service to Primary Health Care facilities.
Last year alone we increased the number of public health facilities providing this treatment to 206. By the end of April next year, approximately 520 000 people will access this treatment, from 366 public health facilities.
Since the launch of the HIV Counselling and Treatment Campaign by the State President in April last year, more than 1 million people have been tested. We will continue to encourage the people of Gauteng to know their HIV status and to take appropriate measures depending on their status. We will also strongly focus on male circumcision because we know that it assists in reducing transmission of HIV.
We have seen encouraging progress in our efforts to fight TB. The cure rate is around 80%. This year our focus will be on reducing the defaulter rate from 6.1% to 5%. Next month on World TB Day we will launch a door-to-door campaign to find defaulters and to encourage their next of kin to also get tested.
TB is curable – even in the presence of HIV infection - and I want to urge those who are on treatment to stay on the course and complete treatment. Further I would like to appeal to everyone who may have symptoms to seek treatment before it is too late.
Health services in Gauteng are under a great deal of pressure with high levels of demand. In the 2009/10 financial year, a total of 24.5 million visits were made to our out-patient facilities.
As part of improving Primary Health Care (PHC) and improving community based services, the Department has begun to establish ‘health posts’. In the current financial year, eight health posts were established in Sedibeng. In the 2011/12 financial year, 15 health posts will be established in Orlando, Zola, Thokoza (at Phendula and Andries Raditsela), Atteridgeville, Boipatong, Mamello, Sharpeville, Bophelong, Bekkersdal, Kokosi, Kekana Gardens and Ekangala.
Each health post team will service a defined number of households; the teams will consist of a Doctor, Professional nurse, Social worker, Health promoter, an enrolled nurse or nursing assistant, and counsellor.
As the programme is expanded, priority will be given to the 20 priority townships and rolled out to the 50 poorest wards, and other needy areas as identified by the districts.
Additional interventions to strengthen PHC will be a renewed role for doctors, family physicians and general practitioners at PHC level. Already, all 35 Community Health Centres (CHCs) have resident doctors, and 248 out of 307 fixed clinics are supported by a doctor at least once a week. The department has been utilising private General Practitioners on a sessional basis to support clinics where there are no doctors which has contributed to this achievement.
In order to improve access to PHC facilities, the department will continue to extend the hours of operation of PHC facilities, and by the end of 2011/12 30 out of the 35 CHCs will be operational for 24 hours, and hours of operation will be extended in an additional 18 clinics, taking the number of clinics with extended hours from 82 to 100 (out of the 318 clinics).
More nurses were recruited last year in order to further strengthen the public health system in the province. In January 2010 there were 1 560 new nursing recruits who started the four year nursing programme. In addition, 408 new recruits started the two year enrolled nurse programme in June 2010. In total 1 968 new nurses have been recruited. This is an increase from 2009 where 1 633 nurses were recruited.
Also in 2011/12, the Department will also pay attention to the following areas: school health, infection control and strengthen of management in hospitals.
Through school health services, school health nurses visited 1 435 primary schools and screened more than 300,000 children in Grade R to 7 for obstacles to learning. In 2011/12 we will expand this programme to include high schools, and the programme will be expanded to promote healthy lifestyles, alcohol and substance abuse awareness, teenage pregnancy, HIV and AIDS and teenage suicides education. I am pleased to announce that the department working together with the Smile Foundation will provide life changing surgery to correct facial disfigurement to 19 children. All the operation will be done at Dr George Mukhari hospital.
We will strengthen our infection control measures including the clean hands campaign and this will be strictly monitored through the Office of Standards Compliance.
A number of functions that are being handled by the Gauteng Shared Services Centre will be delegated back to the department and hospital Chief Executive Officer’s (CEOs). The two departments are working closely together to ensure there is a smooth transition of these functions and to ensure that capacity exists at the institutional capacity to receive these full delegations.
These delegations include procurement and Human Resources processes. The department will also ensure that there are tight monitoring and evaluation processes to ensure that CEOs are held accountable, that resources are used appropriately, that proper procedures are followed and that there is alignment between budget and expenditure. The process of delegations will start with some of the bigger hospitals and we will phase it in through building capacity in some of the smaller institutions.
The Department plans to fund 1 160 Early Childhood Development (ECD) centres with a focus on those in historically disadvantaged communities.
In addressing the problem of unregistered ECDs, the Department will introduce a toll free number to assist with the registration of ECDs.
The department will continue to strengthen alternative programmes such as mobile toy libraries and play groups in addressing the problem of closure of unregistered centres.
As part of the War on Poverty 10 000 poorest households will be identified this year and provided with access to a basket of services such as food parcels and school uniforms for school going children. We started this programme in Heidelberg last year and we plan to take to the most economically depressed areas of Rethabiseng, Refiloe, Zithobeni, Hammankraal and Diepsloot.
In addition, 1 000 young women who receive child support grant will be trained through various skills development programmes and provided with opportunities to earn a decent living rather than depend on the state. Together with the Gauteng City Region Academy we train them as auxiliary social workers, shop fitters, aircon technicians and lift technicians.
In 2010/11 we will extend the drug abuse out-patient treatment programme to reach 6 500 beneficiaries. Furthermore 7 in-patient treatment centres will provide services to 1820 clients.
We also plan to establish 15 cooperatives in previously disadvantaged areas to do cleaning, gardening and washing of linen for our facilities.
Financial management will continue to receive priority attention in the coming financial year. We will ensure that budget allocations are based on provincial priorities and based on the annual performance plan. This will ensure that we spend within our budget and we move away from the over-expenditure that we experienced in the recent past.
Enquiries:
Simon Zwane
Cell: 082 551 9892
