National Health Council media statement by Health Minister, Dr Joe Phaahla and Provincial Health MECs in Eco Park, Centurion
Introduction of new vaccines
South Africa continues to experience outbreaks of vaccine- preventable diseases, this is in despite of a strong childhood vaccination programme, There is an ongoing need to improve coverage of existing vaccines and add new vaccines to the Expanded Program on Immunization schedule. As part of efforts to improve, the department will introduce new vaccines to be included in the routine Expanded Program on Immunization to the value of R3,5 billion. We are introducing a better packaged/derived vaccine that will prevent a whooping cough, tetanus and Diphtheria. This new derivate will reduce the chances of resurfacing of the above conditions within the communities. We are also introducing a combination vaccine of measles and rubella that will protect young girls rubella, particularly during the pregnancy which may lead to birth defects. All these changes will be implemented with effect from Jan 2024. The changes were recommended by the Ministerial appointed National Advisory Group on Immunization (NAGI) with effect from January 2024.
Integration of Covid-19 vaccination into PHC services
The uptake of COVID-19 vaccines is very low around the country and globally due to a number of reasons including the level of severity and transmissibility, as such the department has decided to make a number of changes related vaccination which including transitioning from a mass vaccination campaign to integrate vaccination into routine primary health care services, in line with WHO recommendations.
The current available vaccine stock purchased as part of the COVID National Vaccination roll-out will expire at the end of October 2023 (Pfizer vaccine), while Janssen (J&J) vaccines doses will expire end of February 2024. The EVDS will continue to record all COVID-19 vaccinations until 29 February 2024, thereafter vaccinees will receive a paper-record of vaccination, but vaccinees will still be able to download vaccination certificates as long as they have at least one vaccination code. The department plans to procure vaccines for administration in the public sector and will continue to work with the private sector to facilitate availability of vaccines. All restrictions limiting procurement of vaccines by private sector providers will be lifted. Investigation and causality assessment of COVID-19 vaccination related Adverse Events Following Immunisation (AEFIs) will continue, and mechanisms for processing No Fault Compensation Scheme claims will be retained.
Expansion of online birth registrations in health facilities
As parts of collaborative efforts between the Departments of Health and Home Affairs to ensure that all births are registered on time through Online Birth Registration system which has been rolled in 161 health facilities with ability to issue birth certificates on the spot, the Department of Home Affairs has made budget provision for the set-up and operational costs for the expansion of Online Registration System by an additional ninety-one (91) health facilities during 2023/24 financial year. These facilities will be allocated full-time Home Affairs officials to provide birth registration service during office hours. The establishment of the system in these new facilities will commence by the end of October 2023. This initiative will go a long way in providing early birth registration
Cost containment measures
National Treasury communicated budget reduction in the region of R1.645 billion of which R205 million will come from the National Department voted funds, R1 billion from HIV and AIDS grant and R440 million from Health Facility Revitalization grant. The meeting deliberated on how the health sector will navigate through the Cost Containment Measures announced by the National Treasury because there is no doubt that the new measures will affect our future planning, programmes and the overall healthcare service delivery efforts we are making. While we will need to find creative and cost-effective ways to do more with less, there are continuous discussions between the health sector and National Treasury to find means to cushion the effects of the budget cuts.
Audit outcomes and performance against targets
In terms of the performance of the health sector against the targets for the last financial year, there is notable great improvement. Although, more work still needs to be done to enhance the provision of quality healthcare to improve the lives of our people. I am pleased to indicate that the National Health Department has received an unqualified audit for the financial year 2022/23. KwaZulu-Natal has received an unqualified audit after more than 10 years of qualifications. Mpumalanga, North West and Gauteng have sustained unqualified audit, Western Cape sustained the clean audit. As the sector we are all working towards a clean audit. In my meeting with the Auditor General, they raised concerns on the three provinces, namely Eastern Cape, Northern Cape and Free State, more especially FS as they have regressed in the past two financial years. I have asked the CFO to extend the hand of support to these provinces. By identifying where gaps exist or capacity is limited, we are better able to target our support and interventions.
Medico-legal issues
Medico-legal crisis continue to pose a challenge to many of the provincial departments as it impacts on the overall budgets and crippling healthcare provisions. We need a long-lasting solution to this; however, we continue to make progress in this regard. In the last meeting it was agreed on the workshop, which took place and there are several recommendations that will be presented here which we will need to implement whilst we await the South African Law Commission to finalize its report and present final recommendations to government. There is an urgent need to consider the implementation of the Medico-Legal Declaration Action Plan which entails both Patient Safety and Administration to enforce a culture of patient safety and medical accountability by the Heads of the institutions.
There must be reliable, complete and accurate record-keeping at all health facilities including Electronic record keeping. The Solicitor General has indicated that the State Attorney will establish specialized Medico-Legal Units, the 15th Layer of State Attorneys, in each province. This will be through the co-opting of legal officers from Provinces to work in the offices of the State Attorneys in their respective Province.
Risk of avian influenza infection on human
The department has been inundated with public enquiries on the level of risk of Avian bird Influenza on human beings since the outbreak of the disease in which affected several poultry farms around the country. According to our scientists at the NICD, poultry products, including commercially available eggs and fresh and frozen chickens, are safe for human consumption. Any persons with known or suspected close contact with dead or sick birds from avian flu and who presents with upper or lower respiratory tract symptoms or conjunctivitis should seek medical attention. All individuals exposed to avian flu should be monitored for 14 days for respiratory symptoms and encouraged to seek care as soon as possible after the onset of symptoms. Handwashing with disinfectant soap after contact with poultry or birds is essential. Clinicians who suspect avian influenza infection in their patients should contact the National Institute for Communicable Diseases (NICD) doctor on call (0800 212 552) to discuss the case before a sample is collected.
Nurses uniform and allowance
The issue of nurses` uniform continues to be misinterpreted to punish people from certain religious groups, especially Muslim women to whom it is customary to have their heads covered. While it is customary for women of the Muslim faith to have their heads covered, not all Muslim women cover their heads. The dress code for nurses has always served as an administrative instrument to give effect to all these service obligations that are imposed by the profession on their members. This is also aligned to the prescripts and regulatory framework of the nursing profession as reflected in the SA Nursing Council regulations. The regulations stipulate that the wearing of the uniform should enable all nurses to display the devices which distinguish a nurse providing care in line with her professional qualifications from others. With regards to nurses` uniform allowance, according to Resolution 1 of 2023 as signed by majority parties in the Public Health and Social Development Sector Bargaining Council at the beginning of this month, a once-off uniform allowance amount of R3153 should be paid to nurses by 30 November 2023.
