Transcript Document 7125744

PORTFOLIO REPORT
2002/3
DEPARTMENT OF HEALTH
NORTH WEST PROVINCE
TEAM
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Dr Hugh Gosnell : HOD(DDG)
Ms Rebecca Hlabatau: CF0
Mr O Mongale : CD Corporate Services
Dr M Saasa-Modise : CD Strategic
Health Programs
Mr Molefi Mosenogi : Director Policy and
Planning
Mr. F P Netshipale: Director: CD
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OUTLINE
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Provincial Health Services
Overview/Background
Health Services Performances(Strategic Plans)
Budgetary Allocations
Capital Projects including Revitilisation
Projects
Responses to Portfolio Committee Questions
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POPULATION :3.4 MILLION
DISTRICTS:4
SUB-DISTRICTS:22
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STRATEGIC OVERVIEW(CONT..)
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2 provincial (level 2) hospital complexes
(2 provide specialist psychiatric services
as well) and 1 provincial hospital
20 district hospitals
12 community hospitals
327 fixed clinics and health centres
77 mobile clinics.
5
FIXED PUBLIC PRIMARY HEALTH CARE FACILITIES
PHC facilities
Number
Average
population
per facility
Province wide
327
11,009
Bophirima (least served health district in
terms of access)
81
8,000
Bojanala (best served health district in
terms of access)
134
12,375
Southern
34
19,058
Central (best served in terms of both
access and average population per
facility)
78
9,231
6
PUBLIC HOSPITALS
Hospital type
Number
Number of beds
(Authorised)
Beds per
1000 people
Beds per
1000
uninsured
people (80%
of population)
District and community[1]
27
3 613
1.1
1.4
General (regional)
4
2 244
0.7
0.9
Central
0
0
0
0
Sub-total acute hospitals
31
5 857
1.75
2.2
Tuberculoses
0
0
0
0
Psychiatric [2]
2
1 520
0.5
0.6
0
0
2.19
2.8
Chronic
medical
specialised
Total
and
other
31
7 377
7
STAFF ESTABLISHMENT 2002/3
AFRICANS
MALES
INDIANS
COLOUREDS
WHITES
TOTAL
3498
29
53
308
3888
25%
FEMALES
10224
19
246
878
11367
75%
TOTAL
13722
48
299
1186
15255
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Vision
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Optimum health for all individuals and
communities in the North West Province.
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Mission
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To ensure access to affordable,
equitable, quality, caring health services
for all in the North West Province
through:
• Community involvement and partnerships;
• Batho Pele Principles and the Patients’ Rights
•
•
Charter;
Innovation driven performance; and
By valuing our people and their diversity.
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Strategic Goals
1.
2.
3.
4.
Providing quality health care
Providing accessible, equitable and
affordable comprehensive primary
health care services
Well functioning and competitive
hospital services
Improving the health status of
communities through implementation of
integrated health programmes
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Strategic Goals
5.
6.
7.
8.
Well managed and effective District
Health System
Competent, empowered and
performance focused employees
Appropriate and effective
organisational systems
Effective management of the
Department’s finance and assets
12
Demographic Indicators
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< 15 years – 1.2 million
> 49 years – 430,000
15 – 49 years – 54% of total population
non-urban areas – 65% of population
only 36 people / sq. km. (Gauteng 468)
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Socio-economic Indicators
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GDP per capita – 2/3 of country average
Official unemployment rate : 30.7%
Piped water inside houses: 21.7% of
households
Using electricity for cooking : 33.8%
Infant mortality rate : 36/1000 Below
national 45/1000
Life expectancy at birth : 52.7 years
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NUTRITION
Nutrition Indicators:
Nutrition Indicators
Obesity (%):
1998 Men
1998 Women
Stunting (%):
1994 Age 6-71 months
1999 Age 1-9 years
Wasting (%):
1994 Age 6-71 months
1999 Age 1-9 years
Vitamin A deficiency (%)
(1994 Vitamin A survey)
North West
South Africa
5.4
18.8
9.1
29.4
11.6
24.9
22.9
21.6
4.5
5.7
32.0
2.6
3.7
33.0
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HIV/AIDS/STI
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Male urethral discharge incidence
decrease from 3/1000 to 2.8/1000
Syphilis prevalence rate remained at 4%
(77% reduction from 1998 figure of 17%)
HIV prevalence rate among antenatal
clinic at tenders increases from 22.9%in
2000 to 25.2% in 2001
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HIV/AIDS/STI(CONT..)
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322 VCT sites established & are functional
1310 Nurses were trained in Rapid testing
664 Nurses trained in counselling
PMTCT rollout district approach adopted
PMTCT sites increased from 2 to 89
392 HCW Prof nurses trained in PMTCT
400 lay counselors appointed through NGO
Approach
Out of eighty two(82) children tested for HIV
at nine months(9), only 9 tested HIV positive
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HIV/AIDS/STI(CONT..)
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R2.6 million was spent to fund 24 HBC NGO’s.
Assisted 51 other NGO’s with Home Based Care
kits (refilled quarterly by Department)
HBC beneficiaries increased from 6,458 to
11,473
NGO’s have conducted 28,366 visits as
compared to 22,880 in 2001.
More than 1333 care givers were trained in HBC
Department adopted 36 affected children in
circles of support/care
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PMTCT PERFORMANCE JULY 2001 –DEC RUSTENB
2002
G
ZEERUST
TOTAL
# First Antenatal (booking) visits
2970
2855
5825
# Pregnant women who accepted HIV
testing
1196
1828
3024
# Antenatal clients testing positive for HIV
462
319
781
# Deliveries to women with HIV
162
165
327
# HIV positive women given Nevirapine
162
162
324
# New born babies of HIV positive mothers
on PMTCT
160
166
326
26
56
82
2
6
8
51
81
132
101
85
186
40%
64%
52%
38.6%
17.5%
25.8%
# Infants tested for HIV at 9 months
# Infants tested HIV positive at 9 months
# Exclusive breastfeeding
# Exclusive formula feeding
% VCT/ PMTCT uptake
% HIV positive ( As a % of those who
accepted VCT)
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HIV/AIDS/STI(CONT..)
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24 private doctors were trained in the
syndromic management of STI, as well
as 320 traditional healers.
2,080 condom distribution points.
22,208,331 male condoms and 210 837
female condoms were distributed during
2002(feb 2003).
Assisted in training 8,700 youth as Peer
Educators in five sub-districts.
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NORTH WEST PROVINCE: 1990 to 2001
HIV PREVALENCE AMONG ANTENATAL CLINIC ATTENDERS
30
North West
25.1
25.2
25
23.1
HIV PREVALENCE (%)
21.3
22.9
20
18.1
15
10
6.7
6.5
8.3
5
0.9
1.1
0
1990
1991
1992
2.2
1993
1994
1995
1996
1997
1998
1999
2000
YEAR
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2001
ANNUAL VCT PERFORMANCE 2002/3
300000
241619
250000
200000
150000
100000
50000
19704
17119
5904
11260
339
2749
1520
8825
1019
0
No. Client s
No. pre-t est
No. accept ing t o
No. t est ing
No. t est ing
No. of
No. ret urning f or
No. ref erred
No. of
inf ormed about
counseled
be t est ed
posit ive
negat ive
discordant
f ollow up
elsewhere
dependent s
service
result s
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No. of part ners
VCT INDICATION FOR BURDEN OF CARE 2002/3
10000
8825
9000
No. returning for
follow up
No. referred
elsew here
No. of dependents
8000
7000
6000
No. of partners
5000
3582
4000
2749
3000
2245
1811
2000
1187
1083
1000
99
53
154175
48
1520
1045
1015
497
201
737
1019
181
0
QRTR 1
QRTR 2
QRTR 3
QRTR 4
TOTAL
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No. of AFP cases by region and year
15
16
12
10
10
10
8
6
13
12
10
3 33
2
2
4
33
1
2
2002
2
Ta
rg
et
ta
l
To
op
hi
r im
a
B
th
er
n
So
u
C
en
t
ra
l
0
oj
an
al
a
2000
2001
5
4
4
B
No. of cases
14
24
NUMBER OF SUSPECTED AND TRUE MEASLES CASES
BY REGION AND YEAR: 2000-2002
Year
Bojana
la
Centr
al
Southern
Bophiri
ma
Provin
ce
True
measles
cases.
2000
37 (6 )
4
56 (3)
13
110
9
2001
41
3
11
29
84
0
2002
31
3
1
13
48
0
25
NUMBER OF NEONATAL TETANUS CASES
REPORTED: 2000-2002
YEAR
BOJA
NALA
CENT
RAL
SOUTHE
RN
BOPHI
RIMA
PROV
INCE
RATE
2000
1
1
0
0
2
<1/1000
2001
0
1
0
0
1
<1/1000
2002
0
0
0
0
0
0
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No. of cases of diseases with potential outbreak:
2000-2002
14
12
No. of cases
12
13
10
2000
8
6
6
2001
2002
4
2
0
0
Cholera
0
2
Meningococcal
meningitis
1 1
0
Congo fever
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TB
INDICATOR
2001
2002
CURE RATE
52
47
% OF TREAMENT COMPLETION WITH NO
SPUTUM COLLECTION
16%
26%
DOTS COVERAGE
93%
93%
STT < 48HRS
75%
80%
INTERUPTION RATE
12%
11%
MDR RATE
0.4%
0.5%
TB INCEDENCE RATE
402/1000
409/1000
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PSYCHIATRIC COMMUNITY SERVICES
20000
18416
18000
16000
15963
14503
14149
14610
14000
12000
11354
9618
10000
9900
8000
6063
6000
4531
4000
3806
3149
Register
2000
Visits
0
1st Qtr
2nd Qtr
3rd Qtr
2001/02
Defaut
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PSYCHIATRIC HOSPITAL SERVICES
900
800
851
779
700
600
492
500
404
400
375
300 283
200
100
0
32 0
1st Qtr
49
9
2nd Qtr
Att suicide
Acute psy
Detox
45 14
3rd Qtr
Rehab
30
MCWH
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Antenatal visits per client increased from3.8 to 4.1
(higher than national norm of 3)
Caesarean section rate remained 14% for last 3
years
Decreased teenage pregnancy rate to 9% in 2002
from 11% in 2001
Increased TOP by 64% from 2000 in 2001 to 3300
in 2002
IMCI implementation – 85% of sub-districts
Implementation of CIC
35% Maternal deaths due to HIV
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NUMBER OF MATERNAL DEATHS AND ESTIMATED
RATE PER 100,000 WOMEN
Number reported
Year
1998
34
1999
54
2000
115
2001
62
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CERVICAL SCREENING PERFORMED 2002/3
SERVICE PROVIDER
PERIOD
NUMBER OF CERVICAL
SCREENING DONE
Operation Blanket:
Mafikeng district
2002/2003
8,274
Klerksdorp
2002/2003
9,224
Potchefstroom
2002/2003
1,500
Moses Kotane
Cancer Association
Moretele
2002/2003
151
2002/2003
1,963
Schweizer-Reneke
2002/2003
233
Lichtenburg
2002/2003
840
Odi
2002/2003
1,491
Total 2002/2003
23 676
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NUMBER OF ASSISTIVE DEVICES ISSUED
Assistive device
Backlog
Provided by
Department Nov
2000 – December
2002
Walking Aids
91
679
Wheelchairs
1350
1127
Hearing Aids
563
385
Spectacles and
IOL
1350
1034
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NUMBER OF CATARACT OPERATIONS PER YEAR SINCE1996
Year
1996
Number cataract
operations done
1185
Estimated percentage
increase
1997
1580
25%increase
1998
1975
25% increase
1999
1518
23% decrease
2000
1675
11% increase
2001
2208
32,5% increase
2002
1854
16% decrease
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PSNP
Complete Decentralized PSNP
Programme implemented
 In 2002 85% of targeted children as
opposed to 58% of 2001( out of 312 000,
263 693 were fed)
 More than 660 women groups benefited
from the initiative
 This ensured income for 5000 women
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ORAL HEALTH SERVICES
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20 new fully equipped surgeries with state of
the art equipments were opened between
2000 and 2002. 80% of them in rural areas.
Number of out reach clinic visits increased by
30 %Preventive services has increased by
35%
Conservative dentistry services by 30 %
Curative in other areas has increased by 100
% where we had no services before as new
more clinics where opened.
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CAPITAL PROJECTS ACHIEVEMENTS
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HR&R Projects
•
•
•
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Doctors Residences in 3 district hospital i.e
Schweizer Reneke, Ventersdorp and Jubilee
Medical/psychiatric Unit in Taung & maternity Units in
Mafikeng Complex
Laundry /kitchen and boilers
HOSPITAL REVITILISATION
•
Business Cases completed for 4 hospitals
5/19/2016
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CAPITAL PROJECTS ACHIEVEMENTS
(CONTINUE…)
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Clinics Projects Completed
•
10 clinic/CHC’s (R25Million)
Clinics to be completed (R14million)
•
16 clinics
Madibogo CHC completed in partnership with
IDT(R13million).
Other 3 CHC’s to be built this year also by
partnership with IDT worth R17Million.
5/19/2016
39
SOME CAPITAL PROJECTS PLANS 2003/4
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Differential amenities for 12 hospitals (total
costs R18 million)
Revitilisation projects started
•
•
•
•
Swartruggens Hospital building started(R32m)
Vryburg and Moses Kotane Hospitals to be built
Ongoing projects in Mafikeng SPDU, Taung hospital
Pharmacy, Laundry linen bank (R13Million)
Business Cases for Moretele and Brits to be
developed
5/19/2016
40
QUALITY ASSURANCE ACHIEVEMENTS
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Clinical Investigation Committee work
•
Investigates cases of neglect/clinical mismanagement
and litigation matters
Cohsasa Programmes started in 21 hospitals
Clinic Supervision Tools work shopped and
implemented
Mortality and Morbidity Meetings monthly
QA Unit established and functional
41
Drug availability at various centres:
District Hospitals
Central
96.49%
q
Southern
90.36%
Bojanala
87%
Community Health Centers and Clinics
Central
85.125%
q
Bophirima
93.6%
Bophirima
86.6%
Southern
89.6%
Bojanala
80%
Provincial Hospitals
Average = 92.25%
42
EXPENDITURE ON PHARMACEUTICALS &
SURGICALS
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2001/2002 = R137,457,949,00
2002 /2003 = R170,589,542,00
Projected exp 2003/04
R204,707,450 (20% increase)
43
Percentage Allocation of 2002/03 Budget by Programme
27%
2%
3%
Provincial Administration
District health services
Provincial hospitals
7%
4%
Health sciences
Health care support services
Health facilities development
57%
44
BUDGET AND EXPENDITURE PER CONDITIONAL GRANTS 2002/3
Conditional Grant
Budget
Expenditure
%Expenditure
Primary School Nutrition Programme
43,964
43,964
100%
National Tertiary Services
34,750
36,446
105%
Professional Training and Development
32,898
32,898
100%
Hospital Rehabilitation/Revitalization
64,293
52,824
82%
Infrastructure
20,113
13,318
66%
HIV/AIDS
20,419
21,245
104%
8,334
6,395
77%
224,771
207,149
92%
Hospital
Management
Enhancement
TOTAL
and
Quality
45
BUDGET ALLOCATION & EXPENDITURE PER
PROGRAMME
PROGRAMME
Budget
Est Actual
Variance
R'000
R'000
R'000
83,888
-655
Administration
83,233
District Health Services
1,252,569
1,282,716
-10,147
Provincial Hospital Services
537,071
550,117
-23,046
Health Sciences
46,069
47,036
-967
Health Care Support Services
55,017
56,416
-3,399
Total
1,973,959
2,012,173
-38,214
46
FLAGSHIP PROGRAMME
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
FARM CHILD/COMMUNITY
NUTRITION/FOOD SECURITY
SOCIAL GRANT
ELCD
FAMILY/SEXUAL/OTHER VIOLENCE
SUBSTANCE ABUSE
47
PRIORITY PROJECTS
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
HIV/AIDS &TB
EMS
QUALITY IMPROVEMENT -CLINIC
SUPERVISION & HOSPITAL ACCREDITATION
ATTRACTING & RETAINING STAFF
HOSPITAL REVITALISATION &
DIFFERENTIATED AMENITIES
DEVOLUTION OF PHC SERVICES
COMMUNITY DEVELOPMENT WORKERS
48
NEXT
RESPONSES
49