Victoria PEPFAR Partner meeting Nov 2011 1

Report
KWAZULU NATAL DOH PRIORITIES
DR V MUBAIWA
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2
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POVERTY SCORE : 2007
(Source PGDS)
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COMPOSITE SOCIAL NEEDS
(Source PGDS)
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PROVINCIAL GROWTH AND
DEVELOPMENT STRATEGY –
KZN VISION
KwaZulu-Natal, a prosperous Province
with a healthy, secure and skilled
population, acting as a gateway to
Africa and the World.
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» MISSION
» To develop and deliver a sustainable, coordinated,
integrated and comprehensive health system at all
levels of care based on the Primary Health Care
Approach
Paradigm Shift for staff and clients
“NONE BUT OURSELVES”
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1. Overhaul Provincial Health
Services.
2. Improve the efficiency and
quality of health services.
• An efficient and well functioning health care
system with the potential to respond to the
burden of disease and health needs in the
Province.
• Improved compliance with legislative/ policy
requirements and Core Standards for quality
service delivery in order to improve clinical/
health outcomes.
3. Reduce morbidity and
• Reduction of preventable/ modifiable causes
mortality due to
of morbidity and mortality at community and
communicable diseases and
facility level contributing to a reduction in
non-communicable conditions morbidity and mortality rates.
and illnesses.
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» Output 1: Increasing Life Expectancy
» Output 2: Decreasing Maternal and Child mortality
» Output 3: Combating HIV and AIDS and decreasing the burden
of diseases from Tuberculosis
» Output 4: Strengthening Health System Effectiveness
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Reduce noncommunicable
diseases
Prevent intentional/
unintentional injuries
Maintain strategies
to prevent malaria &
cholera
Health care financing &
management
Human resources for
health
Quality & accreditation of
health facilities
Reduce Child
morbidity & mortality
NSDA Priority 1:
Increase life
expectancy
All MDG's
NSDA Priority 4:
Strengthen
health system
effectiveness
NSDA Priority 2:
Decrease child &
maternal
mortality
Reduce neonatal
and maternal
morbidity & mortality
Improve women’s
health
MDG 4 and 5
NSDA Priority 3:
Combat HIV, AIDS,
STI & burden of
disease from TB
MDG 6
Reduce HIV
incidence
Manage HIV
prevalence
Health infrastructure
Scale up integration
of HIV and TB
IT and Health Information
systems
Improve TB
outcomes
Revitalisation of PHC
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Strategic Goal
1. Overhaul Provincial Health
Services.
2. Improve the efficiency and
quality of health services.
3. Reduce morbidity and
mortality due to communicable
diseases and non-communicable
conditions and illnesses.
Rationale
An efficient and well functioning health
care system with the potential to
respond to the burden of disease and
health needs in the Province.
Improved compliance with legislative/
policy requirements and Core Standards
for quality service delivery in order to
improve clinical/ health outcomes.
Reduction of preventable/ modifiable
causes of morbidity and mortality at
community and facility level
contributing to a reduction in morbidity
and mortality rates.
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rational criteria include:
» the extent of the disease burden;
» the availability of interventions to alleviate this
burden;
» the potential to reduce or alleviate poverty;
» the cost (affordability) and cost-effectiveness
(value-for money) of available interventions;
» the social, economic and political consequences of
failing to implement the interventions.
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Indicators
Current Status
Provincial Target for
2014/15
Life expectancy
Male: 47.3 years
Female: 51.0 years
70 years
70 years
Statistical Release P0302 Mid-Year Population
Estimates 2009
(National)
Maternal Mortality Ratio
(MMR
210 per 100,000 live births
National Confidential Enquiries into Maternal –
2008, Deaths 2004-2007 (KZN Data)
135 (or less) per 100,000
live births
Under-5 mortality rates
87.7 deaths per 1,000 (ASSA,
37 deaths per 1,000
2010) AIDS Committee of Actuarial Society of
South Africa
Infant Mortality Rate
55,8/1 000 live births
18 per 1,000 (NSDA)
The TB cure rate
62.9%
85%
Access to antiretroviral
treatment.
74% (2010/11)
New HIV infections
National = 52 000 annually
1 450 per day
(output for 08/09 cases)
90% of eligible people
APP 2011/12
Reduced by 50%.
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1. Improve clinical governance
2. Respond appropriately to the burden of disease and
consequent health needs
3. Manage HIV prevalence & decrease HIV incidence
4. Strengthen HIV/TB integration
5. Reduce and improve the management of non-communicable
diseases;
6. Reduce and manage intentional & unintentional injuries;
7. Reduce maternal and child mortality and morbidity
8. Reduce TB incidence and Improve TB outcomes
1. Reduce the incidence of cervical cancer
2. Maintain preventative strategies for malaria control e.g.
malaria spraying coverage
3. Prevention of illness and promotion of health
4. Accelerate implementation of the integrated School Health
and Health Promoting Schools Programme.
5. Strengthen Mental Health, Disability & Rehabilitative Care
and address substance abuse & violence
6. Engage in Behavioural Change Campaigns for staff and
communities
7. Enhance capacity within the Youth Ambassador Programme
for improved promotive and preventive activities
1.
2.
3.
4.
5.
6.
7.
Social mobilization, civil society and engagement in Sukuma Sakhe
(flagship programme ) to improve early booking, reduce teenage
pregnancy (through the Contraceptive Strategy and youth programmes),
improve low risk pregnancies and reduce morbidity and mortality
Increase access to safe delivery through establishment of basic
emergency obstetric care (BEOC or MOUs) in key strategic areas
Improve the referral and transport by introducing dedicated or
specialized ambulances for maternity and paediatric care
Scaling up Highly Active Anti-Retroviral Therapy (HAART) access for
pregnant women by increasing capacity of PN to initiate ARV
Improving staff competency and skills and improving quality of clinical
care through the introduction of mentorship teams including district
obstetrician and paediatrician
Establishing waiting mothers lodges in all district hospitals
Strengthen Mortality Reviews at Hospitals
1. Implement community based Maternal & Child Health
Framework
2. Integrate Sukuma Sakhe activities into Primary Health Care
3. Back to the basics of GOBI-FFF through Sukuma Sakhe
(Growth monitoring; Oral rehydration therapy; Breastfeeding; Immunization; Family Spacing (planning); Female
Education; Food Supplementation)
4. Establish a neonatal experiential learning sites and outreach
programme per Area
5. Strengthen Mortality Reviews at Hospitals
1. Implement community based Maternal & Child Health
Framework
2. Integrate Sukuma Sakhe activities into Primary Health Care
3. Back to the basics of GOBI-FFF through Sukuma Sakhe
(Growth monitoring; Oral rehydration therapy; Breastfeeding; Immunization; Family Spacing (planning); Female
Education; Food Supplementation)
4. Establish a neonatal experiential learning sites and outreach
programme per Area
5. Strengthen Mortality Reviews at Hospitals
1. Improve neonatal facilities and care at all hospitals
2. Scale up interventions for early detection of under nutrition
3. Monitor implementation of the IYCF Policy adopted-focusing
on breastfeeding promotion (Infant and Young Child
Feeding)
4. Scale up implementation of Integrate Management of
Childhood illness
5. Improve immunisation coverage
6. Reduce trends in morbidity affecting children
1. Inter-sector collaboration for interventions in High Transmission
Areas
2. Accelerate implementation of the National Strategic Plan (NSP)
for HIV and AIDS – including new policy changes
3. Intensify the Voluntary Male Medical Circumcision Campaign
4. Extend the HIV Counselling and Testing Campaign
5. Scale up implementation of the Accelerated Plan for PMTCT
including early booking strategy for ANC.
1. Continue to implement the TB Crisis Plan
2. Expand the Community management of MDR TB
3. Strengthen TB ACSM (advocacy, communication & social
mobilization) to increase awareness in communities about TB
4. Integrate TB DOTS support, surveillance for early detection of
TB, and follow up of defaulters into the activities of Sukuma
Sakhe
1. Implementation of the Community Based Model
2. Signed Negotiated Service Delivery Agreements
3. Align Provincial macro plans (within funding envelope) with the
NHS and MTEF priorities
4. To finalise and implement the 2010-2020 Service
Transformation Plan
5. Strengthen Governance Structures
6. Implementation of National Core Standards towards
accreditation of health facilities in preparation for National
Health Insurance
7. Revitalisation of PHC services as per STP Implementation Plan
(including Provincialisation of Local Govt clinics)
1. To continue with the Finance & SCM Turn-Around Strategy
2. Review Performance Management Systems and outdated
Policies
3. Improved Human Resource Management Services including
reconfiguration of organizational structure
4. Decentralize appropriate delegations, controls and
accountability
5. Develop and implement a Management Training Strategy
including succession training, mentoring and team building
programmes
6. Strengthen collaboration with public, private and civil society
entities, including Labour
1. Promulgation of the KZN Health Act (1 of 2009) Regulations
2. Increase investment in Information, Communication and
Technology
3. To deliver new clinical infrastructure in line with the STP and
approved Infrastructure Programme Implementation Plan (IPIP)
as well as address Infrastructure backlogs
4. Revitalisation of EMS services
5. Strengthen Pharmaceutical Services
6. Revitalise the Health Technology Services with a focus on
Telemedicine
7. Regular engagement by MEC with District Managers
» National consultation processes for critical
Policy areas.
» Strengthen dedicated capacity for critical
functions.
» Develop focus on policy-making and resource
allocation
» Decentralize operational functions within the
context of clear National Policy Framework
» Keeping the collective healthy is complex
» Involvement of all stakeholders is crucial , to improve overall
health outcomes of our people
» Members of our community have to take charge of their own
health as “NONE BUT OURSELVES” are responsible
» Collective strategic leadership at all levels of service delivery is
necessary
» Mechanisms will be in place to monitor the performance of
Department to ensure accountability with appropriate incentives
and sanctions instituted.
» The specific strategies for the four outcomes are comprehensive
and ambitious but there is Political and Administrative will &
commitment to realise Government’s expected outcome of “A
Long and Healthy Life for All South Africans”

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