NDoH Response to Rural-Proofing Guidelines

Report
Launch: Rural Proofing Guidelines
Response from NDoH
Jeanette R Hunter
29 January 2015
Problem Statement
• Policy limitations and rural realities – Vuyokazi Gonyela
• The difficulty with policy implementation in a rural province
- Andrew Robinson
Problem Statement
• Problem statement
– Policy formulated to address
statement
– Implementation preparation
– Implementation
Applying a systematic approach
on a system
Result
Hit and miss mostly miss
Why ?????
Problem Statement
MISS in Hit and
Miss
• Policy limitations and rural realities –
Vuyokazi Gonyela
– Out of stock medicines
– Long queues, resulting in impossible waiting
times
– Functionality of CHEs
– Problems to information systems
– Social Determinants of Health
– Systems inability to cope with the demand (CD4
of <500)
• The difficulty with policy implementation
in a rural province - Andrew Robinson
– A facilitator of services to communities feeling
let down by the system, (peers and principals)
Rural Proofing guidelines
• Daygan: “The Guidelines are not going to
propose solutions, its going to enable us to
THINK RURAL”
• Thus on its own it will not improve the REAL
SITUATION on the ground for communities
• Development MUST be supported where people live
• Health System activities MUST support development
WHY the MISS in Implementation
• No blanket answer that will suffice for the entire health
service environment
• In spite of good policies there are very specific
problems from setting to setting
– Issue of funding is a good example of this
• Ian’s point about Equity – act in terms of specific need
HOW
Ideal Clinic (rural/urban)
Ideal Community Services
Ideal DHMT
Ideal Provincial Management
Ideal National Health Management
Ideal Political Leadership in Health
Adequate
Health
Services
Vhembe District Ideal Clinic Status
• Total of 120 clinics and CHCs in Vhembe health district
• Of these 61 have determined their Ideal Clinic status between April and
October 2014
• The remaining 59 will be done by end January 2015
• The status determination is done by the Permanent Perfect Team for Ideal
Clinic Realisation and Maintenance (PPTICRM) with the help of a PEPFAR
funded implementation partner
• The corrective interventions are done by the PPTICRM under guidance of
the acting district manager and the team member from the NDoH who is
responsible for Vhembe
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Beaconsfield
Wayeni
Muledane
Helderwater
Makhado
Mphephu
Madombidzha
Ntlhaveni D
Tshiombo
Tshiungani
Mavambe
Makonde Clinic
Olifantshoek
Malamulele Clinic
Vhufuli Tshitereke
80%
74%
68%
66%
65%
63%
61%
60%
60%
60%
59%
58%
57%
56%
55%
Facililities
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Tshixwadza
Waterval
Folovhodwe
Sterkstroom
Masisi
Shayandima Clinic
Madala
Marseilles
Levubu
Shingwedzi
Manavhela
Khakhu
Mulenzhe
Tshimbupfe
Mbilwi
SCORE %
SCORE %
Facililities
45%
45%
44%
44%
44%
43%
43%
43%
42%
42%
42%
42%
41%
40%
40%
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Gondeni
Pfanani
Mhinga Clinic
Rumani
Mphambo
Shigalo
Mukula
Matsheka
Makuleke
Guyuni
Ha-mutsha
Tiyani CHC
Makahlule
Ntlhaveni C
Tswinga
Matiyani
54%
53%
52%
52%
49%
49%
48%
48%
47%
47%
46%
46%
46%
46%
46%
46%
Facililities
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
Davhana
Magwedzha Clinic
Damani
Mashau
Shikundu
Lwamondo Clinic
Tshisaulu
Mtititi
Peninghotsa
Tshikundamalema
Thengwe
Ntlhaveni E
Nghezimani
Masakona
Nkhensani Clinic
SCORE %
SCORE %
Facililities
38%
38%
38%
37%
37%
36%
34%
29%
28%
28%
27%
27%
26%
25%
22%
The following slides contain the
summarised and aggregated results for
the 61 clinics and CHCs in Vhembe
Additional Consultation rooms have been completed for the clinics below
1
Matsheka
The additional doctors rooms for these clinics
2
Nghezimane
have been completed. Waiting for Municipality to
3
Xhikundu
sign off the occupation certificate before it can be
4
Duvhuledza
practically handed over for use
5
Tshifudi
6
Mukula
7
Phiphidi
8
Murangoni
9
Thondo Tshivhase
10
Sambandou
11
Mutale
12
Manenzhe
13
Makhado
14
Nkhensani
15
Muila
Social Determinants of Health
– Political Commitment
– Pressure from leadership
• Premier in KZN now to be followed by premiers in other provinces steered
by the deputy president
• Service delivery committee chaired by Minister Gorhan, Task team chaired
by DG Coperative governance with a very specific and practical approach
• Minister of Health – Operation Phakisa
• NDoH using a population indicator approach (diarrhoea in children under 5)
Value of Rural-Proofing Guidelines
• Thank you
• Keeping Rural In mind
– Educational
– Instructive (Identify rural clinics as part if IC Process)
– Facilitate improvement
• But only if we keep our eye on, plan for and make specific
interventions
THANK YOU FOR YOUR
ATTENTION!
www.doh.gov.za

similar documents