We are presenting to you detail plans and or reports in regards to what was stated in the State of the Province address by the premier. As you all know by now that the health sector is focusing on the outcome: A long and healthy lifestyle for all South Africans!
This outcome will be achieved by focusing on the following outputs:
* reducing mortality rates (women, children and infants)
* addressing HIV and AIDS
* reducing the burden of tuberculosis (TB) and
* improving the effectiveness of the health system.
Output number one: reducing mortality rates
To increase the chances of survival for new born babies and children into adulthood, we will step up our immunisation campaign. This year we will undertake two rounds of polio and measles campaigns (in April and in August) to reach 95 percent of children in all districts.
Immunisation is important to eliminate vaccine preventable illnesses such as pneumonia, diarrhoea and measles among children. And parents must understand that they have an obligation to ensure that their children have received all the necessary immunisation.
Hypertension and bleeding after delivery (post partum haemorrhage) have been shown to be among major factors leading to the death of mothers in our province. To reduce this, pregnant mothers must attend their antenatal care classes regularly and make hospital bookings for delivery in good time. For its part the department will ensure that all facilities with maternity services conduct clinical reviews to identify avoidable factors to reduce maternal deaths. The availability of blood and skilling of doctors and nurse will be undertaken to reduce incidents of wrong diagnosis and incorrect treatment.
Output number two: addressing HIV and AIDS
Providing antiretroviral therapy to pregnant mothers with a CD4 count of 350 or with AIDS defining symptoms regardless of CD4 count will also help to decrease the number of deaths among mothers. I urge mothers who are in the 14th week of pregnancy and are HIV positive to present themselves to our clinics to start their antiretroviral treatment. This will make them and their babies less vulnerable to complications of HIV and AIDS.
Prevention remains the key pillar of our HIV and AIDS management, treatment and care strategy. This year we will undertake a mass education campaign including door to door visits in municipal wards to encourage people to know their status, avoid infection and change attitude towards unprotected sex. A total of 132 million male condoms and 1,3 million female condoms will be distributed from April 2010 to March 2011.
In line with the call by South African National AIDS Council (SANAC) led by Deputy President Kgalema Motlanthe and King Goodwill Zwelithini Zulu we will work with Chief Kekana and Chief Mahlangu as well as izinduna in hostels to promote circumcision among men. We will take this message to hostels, taxi ranks, informal settlement and townships. Remember circumcision does not prevent infection but does reduce or minimize chances of infection. In encouraging men to circumcise we are calling South Africans who live Gauteng to take responsibility of the sexual conduct amongst others they follow what we have always said: abstain, be faithful and condomise (ABC).
In order to strengthen our capacity to deliver on this crucial task of increasing number of sites where people can get access to antiretroviral treatment these will increase from 73 to 113. The total number of patients to be targeted in the new financial year is 130 000 which take us to reach out to 400 000 by the end of March 2011. All patients co-infected with TB will be initiated on antiretroviral treatment irrespective of CD4 count.
Output number three: reduce the burden of TB
We have seen encouraging progress in our efforts to fight TB. The cure rate is expected to reach 80 percent in this financial year increasing to 82 percent in the 2010/11 financial year. The defaulter rate has also decreased from 6.4 percent to four percent. TB is curable, even in the presence of HIV infection and I want to urge those who are treatment to stay the course and complete treatment.
Further I would like to appeal to everyone may have symptoms to seek treatment before it is too late. If you have had a persistent cough for two weeks accompanied by night sweating and loss of weight, please consult your nearest clinic.
This year Gauteng will host the national day to commemorate World TB Day on 26 March. To mark this day we will launch a public awareness campaign called Kick TB 2010 targeting learners between the ages of five and 13 years. Schools will be visited as part of this campaign to convey TB awareness messages in a way that will strengthen our efforts to combat this disease.
Output number four: effectiveness of the healthcare system
The building of an effective health system is critical to the attainment of our vision of a long and healthy life for our people. Last year, through Operation Kuyasheshwa-la, we worked hard to improve the quality of service, to change the attitudes of our staff towards patient and reduce queues. Much still needs to be done.
The premier yesterday we must take the following concrete steps:
* setting up help desk at the entrance of hospitals to direct patients to appropriate departments or section
* retrieve patient files from patient records a day before the appointment date
* SMS system to remind patients of appointment date and time
* clerks at patient affairs to be available from 7h00 until 15h30
* decentralisation of patient registration to the different clinics
* dedicated queue marshals at all queues within an institution
* automated payment system.
All four central hospitals, Chris Hani, Steve Biko, Charlotte Maxeke and Dr George Mukhari have functional help desks. We have to strengthen this service are regional hospitals. We have identified some challenges and we busy addressing them and some of them are: retrieval of patients file the night before is being implanted at Steve Biko and Charlotte Maxeke.
Other facilities will introduce the system from April. In the next three months we will introduce an SMS system to remind patients of their appointment dates. We will start at Steve Biko, Natalspruit and Edendale hospitals and extend it to other facilities from 1 April. However, this will work if patients collaborate with us by presenting themselves to hospitals on the dates they are scheduled to see a doctor. Failure to present on appointment dates causes delays as a file has to be retrieved again while other patients are already on the queue. Queue marshals have been recruited and trained to assist patients and direct patients to healthcare points in all facilities. More will be recruited in 2010/11.
This year we will focus strongly on strengthening the primary health system by establishing health posts in each district. Our aim is to introduce this system in 50 poorest wards in 20 priority townships. Family doctors will be employed in the voting districts and integrated in working teams with community health workers and primary healthcare nurses to take health services into communities.
This programme is based on the Cuban model of primary healthcare and it will enable clinics to understand the burden of disease in the catchment areas they serve, improve follow up of patients and ensure community and stakeholder participation as well optimal use of our limited resources.
Each community health worker will be required to service around 200 households and they will assist in delivering medicines to chronic patients, referring appropriate health facilities, health education and promotion as well as in directly observed treatment.
We will continue to recruit retired nurses to help with massive high impact and visible campaigns on immunisation, health education and awareness and to promote women’s reproductive health rights.
As part of our effort of building an effective health system, ambulances will be stationed at clinics and hospitals rather than far away depots. This will enable them to respond quickly to emergencies and improve communication with accident and trauma units.
For instances ambulances are already stationed at the following facilities; Bekkersdal clinic, Yusuf Dadoo hospital, Leratong hospital in the West Rand, Odi hospital, Jubilee hospital, Soshanguve clinic in Tshwane. In Ekurhuleni they are stationed at Daveyton Main Clinic, Germiston hospital, Natalspruit hospital, Pholosong hospital and J Dumane CHC. In Johannesburg they are at Hillbrow clinic, Charlotte Maxeke hospital and Mofolo clinic.
We will strengthen partnership with the private sector to extend services to more communities. We are grateful to the all the partners who have supported this year and those who have indicated a willingness to help in future. Through this support we will be able to build new clinics in Diepsloot north of Johannesburg and Finetown in the south in the 2010/11 financial year.
Partnership have also enabled us to employ sub-specialists who rotate to regional hospitals ensuring that patients with complicated ailments closer to home and not be transferred to central hospitals which may be a distance away. Much needed renovations in neonatal units of Chris Hani and Charlotte Maxeke hospital have been done by our private sector partners.
In the coming financial year, we will extend hours of service in 20 of our 34 community health centres. This will improve access to health services for our people and to visitors for the World Cup for minor illnesses. The following community health centres will be operated on a 24 hour basis from the April: Lilian Ngoyi, KwaThema, Phillip Moyo, Ramokonopi, Mohlakeng, Bekkersdal West, Khutsong, Thusanang, Eersterus and Johann Heyns.
The following clinics will increase their hours of service from eight hours to 12 hours five days a week: Vosloorus poly clinic, Kathlehong north, Thembisa Main, Thembisa Healthcare clinic, Khutsong East, Khutsong extension three, Yarona, Odirileng, Dr Ramirez Martinez, and Simunye clinic east.
We have instituted a monitoring system, based on weekly reporting on the availability of drugs and consumables in all healthcare facilities in the province. Challenges have identified relating to delays by suppliers to supply on time and inadequate stock management system. This is being addressed through visits by regional pharmacists to clinics to advise on stock management and closer liaison with suppliers to exchange information. We have also increased the number of items pre-packed at the medical depot as a back up to respond to stock-outs.
Social development
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.
We will also establish food banks to address the basic needs of poorest households. We have already launched one food bank in Krugersdorp on the West Rand and we are finalising more establishments in each of the following four regions: Ekurhuleni, Johannesburg, Tshwane and Sedibeng.
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, air conditioner technicians and lift technicians. 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. We will establish a contract management division to negotiate favourable contracts and prices. This will ensure that we spend within our budget and we move away from the situation we experienced this year.
We will continue to fight fraud and corruption and theft of food or linen will not be tolerated. We will make sure that every institution has designated people to manage the cleaning and counting of linen. Let’s embark on Operation Buyisa to recover items stolen from health facilities. Let all stolen items be returned to healthcare facilities.
May I take this opportunity to appeal to all employees to stop stealing from the poor because shortage of essentials equipment especially linen is partly due to theft!
Enquiries:
Mandla Sidu
Cell: 082 773 9013
Issued by: Department of Health and Social Development, Gauteng Provincial Government
23 February 2010
