Functional coordinating structures of Primary Health Care (PHC) re-engineering are in place at Districts and Sub-Districts. The North West PHC re-engineering costed plan has been developed to implement the three streams, i.e. School Health services, Specialist team, and Ward based outreach teams. Training has been standardised by National and phase one which is orientation and basic foundation, is provided by a contracted service provider and funded through conditional grants.
Speaking during his budget speech, MEC Magome Masike said that PHC Re-engineering communication strategy is already in place.
“We have started marketing the programme through community dialogues where 18 sub-districts participated. We will further strengthen social mobilisation through community dialogues, ward and cluster meetings, the media and other marketing initiatives” said MEC Masike.
Piloting of two monitoring and evaluation system is nearing an end with participating sub-districts including Tlokwe and Greater Taung. Data from households has been integrated into the District Health Information System (DHIS) and household registration in pilot wards has been completed. However some households could not be reached due to various reasons like working occupants during office hours.
As President Jacob Zuma indicated in the State of the Nation Address, the Department of Health will accelerate and intensify progress in the pilot districts.
“Our efforts in strengthening implementation of the NHI pilot in 2013/2014 include improved supply chain management systems and processes to support efficient and effective health services provision within the pilot district. We will also enhance the pilot District capacity in the areas of District Health Planning and Monitoring and Evaluation as well as strengthening referral system based on a re-engineered primary health care platform with a particular focus in rural and previously disadvantaged areas” stressed the MEC.
Appropriate communication equipment will be made available at all levels of the referral system to equip Outreach Teams, PHC facilities and Hospitals to provide appropriate care at all levels. There will be a full scale roll out of Integrated Chronic Disease Management (ICDM), Community Health Worker (CHW) equipment for chronic disease screening throughout the pilot district. Twenty two pharmacists’ assistants will be trained in Post Basic and 35 nurses will be trained on drug supply management.
The specialist teams will use own transport for official duties until the department approves subsidised transport or pool vehicle for them.
“We have realised that the district specialist teams need to have a community psychiatrist on the team to support peripheral facilities as there is manifold increase in drug and substance abuse. There is no budget for this post but the National Department of Health will be approached to support this” said the MEC.
The department undertakes to improve access and infection control in the referral chain through maintenance of Infrastructure; hand washing facilities; signage; colour coded cleaning trolleys, fast queues and electronic queue management system.
“We will focus on improving IT equipment, software, networks and connectivity for improved support from referral hospitals” lamented Masike. The pilot sites will also have the Electronic Patient’s Record, Life tracking and bio-metrics system to strengthen the referral system by improved access to patient records.
“We will provide all the necessary support to the Community Health Workers and Outreach teams with uniforms and identification tags. Some of the resources to be made available to them include pepper spray, whistles, name tag, branded clothing, SMS phones, etc.” said MEC Masike.
The department intends to embark on full expansion of Ward Based Primary Health Care Outreach Teams (WBPHCOT) at the pilot district with small scale expansion at other three districts as it fast-tracks implementation of the PHC Re-engineering Programme in 2013/14. Recruitment of more nurses and other allied health professionals to support roll out is needed and the department will explore alternative staffing models for short term solutions.
“There is a need to align budget and procure school mobile units as well as vehicles for WBPHCOT. We have progressively started registering CHWs into the PERSAL system and we want to complete this process within 2013/14 financial year” concluded MEC Masike.
