Gauteng Health ensuring a long and healthy life for all
When we began this fourth session of the democratic government in 2009, Gauteng was faced with a declining life expectancy. The average life expectancy was 53.7 years for males and 58.1 for females.
The province was facing a burden of disease that was exacerbated by the impact of the HIV and AIDS epidemic and TB, and also by injuries resulting from violence and trauma.
As a response and informed by the work that had been done in the first 15 years of democracy, we decided to focus on five priority areas to turn this situation around and ensure a long and healthy life for all communities.
These priorities were:
- increasing in life expectancy
- decreasing maternal and child mortality rates
- combating HIV infections and manage AIDS prevalence
- reducing the burden of disease from TB as well as
- improving health system effectiveness and promotion of Primary Health Care.
As we come to the end of the term we can report that we have seen improvements and we concur with the Premier that Gauteng is now a better place to live in. Life expectancy has increased to 57.7 for males 60.8 years for females and there has been a substantial reduction in AIDS-related deaths.
TB cure rates are improving, and the new initiatives on primary health care re-engineering have been rolled out. There has been an increase in health infrastructure investment (hospitals and clinics, refurbishments, maintenance and rehabilitation) to the tune of R6.9 billion from 2009/10 to 2012/13.
The increase in life expectancy can be attributed to the roll out of antiretroviral therapy in the province. Currently there are 378 facilities providing antiretroviral therapy services and a total of 693136 adults and 41 172 children were on treatment at the end of the 2012/13 financial year.
The number of HIV positive pregnant women on antiretroviral treatment has also increased from 60.2% in 2010/11 to 80.5% in March 2013. This resulted in the reduction of the Transmission of HIV from Mother to Child from 4.1% in 2010/11 to 2.4% in 2012/13.
During the 2012/13 financial year, a total of 50 461 TB cases were diagnosed in Gauteng and affected individuals were immediately put on treatment. New cases of multi-drug resistant TB (MDR-TB) totalled 794 which is 1.6% of the number of people diagnosed.
Positive development in improving TB diagnosis and MDR detection included the introduction of Gene Expert machines in hospitals and to date the province has 18 hospitals with these machines. Improvements in TB treatment outcomes include a TB Cure rate improvement from 79% in 2009/10 financial year to 83.4% in the second quarter of 2013/2014 financial year.
The department is also moving in the right direction in achieving the goal of reducing infant and maternal mortality rates.
As a result of amongst other initiatives, the provision of antiretroviral to pregnant women with CD4 count of less than 350 and the provision of a dedicated obstetric ambulance service in all districts, the ratio of maternal death decreased from 167 to 117 per 100 000 live births between 2005 and 2013.
The ratio of deaths amongst children under the age of five has also decreased from 43% in 2005 to 75% in 2013 and this can be attributed to successful strategies of combating HIV epidemic; the promotion of breastfeeding; the implementation of Kangaroo Mother Care which is available at all hospitals with maternity services as well as increased immunisation efforts.
The department has further strengthened the immunisation programme which is aimed at reducing deaths of children due to vaccine preventable diseases through the introduction of the Rotavirus and Pneumococcal vaccines.
Immunisation coverage has been kept above 90% coverage for all vaccines. Recently the department was commended by the National Health Department for being the only province which had attained 100% immunisation coverage with the recent immunisation campaigns.
In the early days of a democratic government, the free healthcare policy was implemented and it ensured that free medical care was provided to children under six, people with disabilities and improved maternity care for women. The free healthcare policy was subsequently extended to include children under 14 years, pensioners, people receiving social grants and TB services.
To improve the quality and efficiency of primary health care services, facilities have professional nurses who have specialised in primary health care and are responsible for delivery of comprehensive primary health care package. All facilities have the support of medical officers to whom they refer patients where necessary.
Community Health Centres and district hospitals offer investigative radiology and pathology services as well as a wider range of medicines than clinics. Family medicine specialists are also placed at these facilities to help improve the quality of clinical care.
Today, as result of investments we made in building clinics, the residents of Gauteng do not have to travel more than 5km anymore to access primary healthcare services. Currently, the department offers 24-hour services at 26 of 35.
A total of at 112 of its 317 fixed clinics and operate on extended hours during the week and have weekend services (Instead of closing at 16h00, they now close at 18h00 during the week and they open on Saturdays between 07h30 – 13h00). These initiatives have improved access to health care and over 23 million visits at the end of March 2013 compared to 20 million in 2010.
The introduction of ward-based primary healthcare outreach teams, as part of the re-engineering of primary health care, has assisted in further improving access to health care. The number of these teams increased from 19 in 2010 to 126 teams by the end of December 2013. They are now providing services to the 133 municipal wards.
The department has also created 61 School Health Teams each consisting of a professional nurse, a staff nurse and a health promoter. These teams aim to promote optimal health and development of learners and to address barriers to learning.
Last year these teams screened 57 095 primary school learners for barriers to learning. A total of 6 347 of these learners were referred to local clinics and hospitals for specialist care and further investigations. Prevalent cases that were identified were oral health, eye care, hearing difficulties, speech and suspected TB.
These teams will be going out to schools this year from Monday March 10 to Friday April 11 to administer the human papillomavirus (HPV) vaccine to young girls as part of our new campaign against cervical cancer. The campaigning will be undertaken in two phases starting with first phase next month and there will be another phase later on in the year.
The campaign is targeting all Grade 4 girls of age nine and above in all public schools from Quintile 1 - 5 non-quintile and special schools. The department is targeting to vaccinate about 80 000 girls during this campaign.
All girls will receive the parents’ information pack with consent forms that must be signed and returned to the school before the start of the campaign. Today, we are at our ambulance base in Midrand to showcase ambulances that were procured in the current financial year. The department procured 120 ambulances and 20 of whom are obstetric ambulances. These are equipped to deal with emergencies during pregnancy.
These ambulances were deployed in December and they responded to 1001 motor vehicle accidents over the festive season. They transported 9820 trauma patients were to different health facilities. Many of these patients, 2415, were victims of assault and had gunshot wounds or other injuries inflicted with weapons. Not a single mother died while being transported by our ambulances this festive season.
We are however concern about the high number of calls for minor injuries where people could easily have walked to the clinic. Minor injuries accounted for more than half of the trauma cases transported.
I am appealing to communities to work with us and call ambulances for major injuries not minor cuts and bruises. This will assist us in ensuring that our ambulances are always available to attend to people with life-threatening emergency situations on time all the time.
In our efforts to ensure a long and healthy life for the residents of Gauteng will in the next financial year, 2014/15 continue to offer services that focus on promotion of healthy living and prevention of disease, treatment, care and support as well as rehabilitation of people especially most vulnerable to illness and injury.
I thank you!
