Transcript Slide 1

Strategic Focus – 2014 to 2019
Presentation to Health Portfolio Committee
02July 2014
Alignment between NDP 2030 MTSF
and NDoH Strategic Plan 2014-2019
NDP Goals 2030
Average male and female life expectancy at birth
increased to 70 years
Tuberculosis (TB) prevention and cure
progressively improved;
Maternal, infant and child mortality reduced
Prevalence of Non-Communicable Diseases
reduced
Injury, accidents and violence reduced by 50%
from 2010 levels
Health systems reforms completed
MTSF Priorites
NDoH Strategic Goals 2014- 2019
HIV & AIDS and Tuberculosis prevented and
successfully managed
Maternal, infant and child mortality reduced
Prevent disease and reduce its burden, and promote health through a
multi stakeholder National Health Commission
Improved health facility planning and infrastructure
delivery
Health care costs reduced
Efficient Health Management Information System for
improved decision making
Improved quality of health care
Primary health care teams deployed to provide
care to families and communities
Re-engineering of Primary Health Care
Universal health coverage achieved
Universal Health coverage achieved through
implementation of National Health Insurance
Posts filled with skilled, committed and
competent individuals
Improved health management and leadership
Improved human resources for health
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Improve health facility planning by implementing norms and
standards;
Improve financial management by improving capacity, contract
management, revenue collection and supply chain management
Develop an efficient health management information system for
improved decision making;
Improve the quality of care by setting and monitoring national norms
and standards, improving systems for user feedback, increasing safety
in health care, and by improving clinical governance
Re-engineer primary healthcare by: increasing the number of ward
based outreach teams, contracting general practitioners, and district
specialist teams; and expanding school health services;
Make progress towards universal health coverage through the
development of the National Health Insurance scheme, and improve
the readiness of health facilities for its implementation;
Improve human resources for health by ensuring appropriate
appointments, adequate training and accountability measures.
National Development Plan 2030
The Health Sector derives its vision and mandate from
NDP 2030. By 2030, South Africa should have:
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Raised the life expectancy of South Africans to at least 70 years;
Progressively improve TB prevention and cure
Reduce maternal, infant and child mortality
Significantly reduce prevalence of non-communicable diseases
Reduce injury, accidents and violence by 50 percent from 2010
levels
Complete Health system reforms
Primary healthcare teams provide care to families and
communities
Universal health coverage
Fill posts with skilled, committed and competent individuals
National Development Plan 2030
The NDP also identifies a set of nine (9) priorities that highlight
the key interventions required to achieve a more effective health
system, which will contribute to the achievement of the desired
outcomes. The priorities are as follows:
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Address the social determinants that affect health and diseases
Strengthen the health system
Improve health information systems
Prevent and reduce the disease burden and promote health
Financing universal healthcare coverage
Improve human resources in the health sector
Review management positions and appointments and
strengthen accountability mechanisms
– Improve quality by using evidence
– Meaningful public-private partnerships
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National DoH Strategic Plan 2014-2019
VISION
Outcome 2: Long and healthy life for all South
Africans
MISSION
To improve health status through the prevention of
illnesses and the promotion of healthy lifestyles and
to consistently improve the health care delivery
system by focusing on access, equity, efficiency,
quality and sustainability.
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National DoH Strategic Plan 2014-2019
The Department’s five year strategic goals are to:
1. Make progress towards universal health coverage through the development of the
National Health Insurance scheme, and improve the readiness of health facilities
for its implementation;
2. Re-engineer primary healthcare by: increasing the number of ward based outreach
teams, contracting general practitioners, and district specialist teams; and
expanding school health services;
3. Improve the quality of care by setting and monitoring national norms and
standards, improving system for user feedback, increasing safety in health care,
and by improving clinical governance;
4. Improve health facility planning by implementing norms and standards;
5. Improve financial management by improving capacity, contract management,
revenue collection and supply chain management reforms;
6. Improve human resources for health by ensuring appropriate appointments,
adequate training and accountability measures.
7. Prevent disease and reduce its burden, and promote health through a multi
stakeholder National Health Commission
8. Develop an efficient health management information system for improved
decision making;
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GOAL 1: Make progress towards universal health coverage through
the development of the National Health Insurance scheme, and
improve the readiness of health facilities for its implementation
NATIONAL HEALTH INSURANCE
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Achieve Universal Health Coverage through the phased implementation of the
National Health Insurance(NHI)
– National Health Insurance law passed by 2015/16
– National Health Insurance Fund created by 2016/17
Regulate health care in the private sector by establishing National Pricing
Commission and legislating methodologies for calculating fees.
– Functional National Pricing Commission to regulate health care in the private
sector established
– Revise and legislate methodology for the determination of the dispensing fee.
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Goal 2: Re-engineer primary healthcare by: increasing the number of ward
based outreach teams, contracting health care providers , and district
specialist teams; and expanding school health services
RE-ENGINEERING OF PHC
• Contribute to health and wellbeing of learners by
screening for health barriers to learning
– Grade 1 learners and Grade 8 learners receiving health screening
• Improve access to community based PHC services and
quality of services at primary health care facilities
– 3500 functional Ward based Primary Health Care Outreach Teams
by 2018/19
• Improve access to disability and rehabilitation services
through the implementation of the framework and model
for rehabilitation and disability services
– 52 Districts implementing the framework and model for rehabilitation
services by 2018/19
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Goal 3: Improve the quality of care by setting and monitoring national
norms and standards, improving system for user feedback, increasing
safety in health care, and by improving clinical governance;
IMPROVE QUALITY OF CARE
• Improve district governance and strengthen management
and leadership of the district health system
– 3760 primary health care facilities with functional clinic
committees/ district hospital boards by 2018/19
• Improve access to quality PHC services
– 2325 (75%) primary health care clinics in the 52 districts
qualify as Ideal Clinics by 2018/19
• Ensure that the Port Health services are rendered in line
with the International Health Regulations
– 75 ports of entry compliant with the International Health
Regulations by 2018/19
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Goal 3: Improve the quality of care by setting and monitoring
national norms and standards, improving system for user feedback,
increasing safety in health care, and by improving clinical
governance;
IMPROVE QUALITY OF CARE
• Ensure quality health care by improving compliance with
National Core Standards at all levels of care
– 100% compliance with the National Core Standards in 10
Central Hospitals
– 100% compliance the National Core Standards in 17
Tertiary, 46 Regional and 63 Specialized Hospitals by
2018/19
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Goal 4: Improve health facility planning by
implementing norms and standards;
ACCELERATE DELIVERY AND IMPROVE QUALITY
OF INFRASTRUCTURE
• Improve quality of health infrastructure in South Africa by
ensuring all new health facilities are compliant with health
facility norms and standards
- Ensure that Provinces comply with Norms & Standards for health
Infrastructure
- Link norms and standards to the Conditional Grant
- 30% budget allocation for the maintenance of existing infrastructure
- Implement health facility planning
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Goal 5: Improve financial management by improving capacity,
contract management, revenue collection and supply chain
management reforms;
Health Care Finances
• Monitor budgets and expenditure of Provinces for NonNegotiable Items
• Develop and implement a Revenue Retention Model to
strengthen revenue collection by incentivizing central hospitals to
increase their revenue collection by 2016/17
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Goal 6: Improve human resources for health by ensuring adequate
training and accountability measures.
IMPROVE HUMAN RESOURCES FOR HEALTH
• Improve Turn around time of recruitment at NDoH
– 3 months by 2018/19
• Develop health workforce staffing norms and standards.
– Guidelines for HR Norms and standards published for all levels of care
by 2018/19
• Improve quality of Nursing training and practice by ensuring that all
Nursing colleges are accredited to offer the new Nursing
qualification
– 220 Public Nursing colleges accredited to offer the new nursing
qualification by 2018/19
• Establish the Health Leadership and Management Academy in order
to
– Develop training programme for Hospital CEOs and District Health
Managers
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Goal 7: Prevent disease and reduce its burden, and
promote health;
Maternal Health
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To reduce the maternal mortality ratio to under 100 per 100 000 live births by
2018/19
To reduce the neonatal mortality rate to under 6 per 1000 live births
To improve access to sexual and reproductive health services
– 55% of women have access to a combination of contraceptives by 2018/19
– Ensure that more than 70% % of females are screened for cancer of the cervix at least
once every 10 years by 2018/19
– Provide Human Papiloma Virus Vaccine to at least 80% of grade 4 girls to protect them
from cancer of the cervix by 2018/19
• In 2015/16 the programme will include Grade 5 Girls
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Expand the PMTCT coverage to pregnant women by ensuring all HIV positive
Antenatal clients are placed on ARVs and reducing the positivity rate to below 1%
by 2018/19
– Ensure 100% of HIV positive pregnant mothers receive ARVs by 2014/15 increasing to
100% by 2018/19.
– Reach a < 1% PCR test positive rate for infant at 6 weeks of age
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Goal 7: Prevent disease and reduce its burden, and
promote health
Child Health
• To reduce under-five mortality rate to less than 23 per 1,000 live births
by promoting early childhood development
– Child under 5 years diarrhoea case fatality rate at 2% in 2018/19
– Child under 5 years severe acute malnutrition case fatality rate of 5%
in 2018/19
– Immunization coverage under 1 year of 93% in 2018/19
– Confirmed measles case incidence per million total population of <1
per 1000 000
– Measles 2nd Dose immunization coverage of 95%
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Goal 7: Prevent disease and reduce its burden,
and promote health;
HIV and AIDS
• To scale up combination of prevention interventions to reduce new
infections
– HIV test conducted among the populations 15 to 49 years targeted at
10 million annually – 50 million over the 5 years
– Targeted 1 Million Medical Male circumcisions conducted annually –
5 million cumulative in 2018/19
– Total number of people remaining on ARVs is targeted at 5.1 million at
the end of 2018/19
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Goal 7: Prevent disease and reduce its burden,
and promote health;
TB
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Improve the effectiveness and efficiency of the routine TB control programme to
increase the identification of TB patients; to ensure that these take and complete their
treatment
– TB new client treatment success rate of 85% by 2018/19
– TB defaulter rate of 5% or less in 2018/19
– TB MDR Treatment success rate improved to 65% in 2018/19
Ensure that all correctional services facilities have appropriate services and that
inmates all have access to TB and HIV Diagnosis and treatments services
– 48 Correctional Services Management Areas that undertake risk assessments for TB
and HIV - by 2018/19
– Percentage of correctional services centers conducting routine TB Screening
targeted at 95% by 2018/19
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Goal 7: Prevent disease and reduce its burden,
and promote health;
TB
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Ensure access for more than 500,000 miners to regular TB
prevention, screening and treatment through:
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Strengthened regulatory framework (review current legislation & close gaps)
Increased capacity to enforce compliance by mines using multi-disciplinary
inspections that comprise officials from Departments of Health, Mineral
Resources & Labour
Effective surveillance & reporting system
Increase TB/HIV awareness in peri-mining in 6 districts with high
concentrations of mines
Increase access to TB/HIV prevention, diagnosis, and treatment in perimining communities in 6 districts with high concentration of mines by
screening, counselling, testing for TB & HIV using mobile units
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Goal 7: Prevent disease and reduce its burden,
and promote health;
Non Communicable Diseases
• Establish the National Health Commission by 2016/17
• Reduce risk factors and improve the management of NCDs
– Reduction in obesity to 55% for women and 21% for men by 2018/19
– Counsel and screen people for high blood pressure – 5 million people cumulative by
2018/19
– Counsel and screen people for raised blood glucose levels – 5 million people
cumulative by 2018/19
• Improve access to and quality of mental health services
– Increase that percentage of people screened for mental disorders
– Increased the percentage of prevalent population access to mental health
treatment from 28% to 35 % over the five year term
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Goal 8 : Develop an efficient health management
information system for improved decision making;
Implementation of eHealth strategy
Systems design for a National Integrated Patient Based Information System
• Appointment of the Ministerial Advisory Committee on E-Health by September 2014
• Implementation of the Health Information Normative Standards Framework
• Health Facility IT Infrastructure – Project First phase 700 PHC facilities in NHI Pilot
Districts , next phase to be extended to other Districts
o Implement Health Patient Registration System
o Implement Patient Administration to improve efficiency and reduce waiting
times
o Implement integrated electronic Health Data Collection System
• Finalization of mHealth Strategy and policy guidelines
o Mom Connect project – mobile messages to pregnant woman
o Mobile Phone Data Collection and Communication for Community Health
Workers
• Implementation of recommendation on PHC Patient Information Systems assessment
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