Building for the future

Aaron Motsoaledi, the Minister of Health, presented his oversight feedback report to the Parliament Portfolio of Health committee on 26 February 2014.

He referred to the WHO’s six building blocks of a health care system and pointed out that the one which is most commonly neglected is health systems financing.

He also reminded his audience that NHI is just one of the points in South Africa’s 10 point plan. Vision 2030 is supported by what is in the National Development plan (NDP) which also supports NHI.

A national health insurance system (NHI) needs to be implemented in phases, complemented by a reduction in the relative cost of private medical care and supported by better human capacity and systems in the public health sector.

The Minister add that part of the pilot project work was based on The WHO service availability and readiness assessment methodology that measures and provides a standard health facility assessment questionnaire to assess, map and monitor service availability and readiness. This tool covers the following areas:

  • The key topic areas and core functional capacities of a facility census of service availability and readiness
  • Identification, location and managing authority of health facility (public and private)
  • Facility infrastructure and amenities, such as availability of water supply, telecommunications and electricity
  • Basic medical equipment, such as weighing scales, thermometer and stethoscope
  • Availability of health workforce (e.g. cadre of human resources, staff training and guidelines)
  • Drugs and commodities-availability of general medicines
  • Diagnostic facilities-availability of laboratory tests (e.g. HIV, malaria, tuberculosis (TB), others)
  • Standard precautions on prevention of infections-availability of general injection and sterilisation, disposal and hygiene practices
  • Specialised services, such as family planning, maternal and new-born care, child health, HIV/AIDS, tuberculosis, malaria, and chronic diseases
  • Facility censuses also serve as an independent source for numbers of health workers

The Minister reminded the Portfolio Committee that the focus in the NHI 11 Pilots would cover the 5 points listed below.

  • Infrastructure Development and Maintenance
  • HR: Planning, Development and Management
  • Quality of Health Services: Six Core Standards, namely:
    • Cleanliness
    • Safety and security of staff and patients
    • Attitude of staff
    • Infection control
    • Long queues
    • Drug stock-outs
  • Re-engineering of the Primary Healthcare System: Three streams: School Health Programme, Municipal Ward-base Primary Healthcare Agents and District Specialist Health teams
  • Contracting of GPs to work in public clinics

The Minister’s honest feedback to the portfolio committee detailed outcomes from the full facility audit undertaken within all the 11 pilot areas which was completed over 18 month’s period.

He also announced that from August 2014, three full hospitals and eight clinics will be built or refurbished in OR Tambo in Eastern Cape. In the audit on all pilots this area reported the worst outcomes.

Finally the Minister presented the concept of what is required in an ideal clinic. He then went on to share with the Portfolio the plan of new clinic structures.

Progress to date:

Key Current Activities Number of clinics
Total number of clinics 102
Number of clinics with Earthworks completed 92
Number of Slabs completed 74
Number of clinics with super structure delivered 83
Number of clinics with superstructure installed 69
Number of clinics with roof installed 38
Clinics with finishes completed 17
Equipment and furniture installed 8

The above will greatly improve access to patient in these pilot areas.

So you can see that our Minister of Health is truly making a difference by him and his team working tirelessly in the background quietly but achieve great strides in understanding the issues on the ground and then taking corrective action. This will bear awesome result for the most vulnerable of our societies and that is good for everyone.

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