The good, the bad, and the ugly of the NDoH Annual Report 2015

When it comes to Annual Reports and audits, not every department in our country has as good a track record as the National Department of Health (NDoH). Sadly, however, the provincial departments don’t always fare as well.

The National department of Health presented its NDoH 2014-15 Annual Report and Annual Performance Plan (APP) recently. Ms Precious Matsoso, Director General, Department of Health, said the APP is designed to deliver on specific commitments such as improving the quality of health care, reducing health care costs, improving health management and leadership and implementing the re-engineering of primary health care.

For the past four years the NDoH has obtained an unqualified audit opinion from the Auditor General (AG) and three out of nine provinces obtained an unqualified audit for their 2014/2015 financial year compared to two provincial Departments for the 2013/2014 year.

Key milestones were achieved during the financial year 2014/2015, in relation to the objectives and targets set by the National Department of Health. 63% of the targets for the year were fully achieved while 31% were partially achieved. Some of the challenges which the Department experienced would be addressed in the Department’s APP for 2015/2016.

Programme 1: Administration

The vacancy rate was 6%, which was below the 10% target performance of Department of Public Service (DPSA). The turnaround time for recruitment process was within six months, which is within the 6 months benchmark of the DPSA.

To ensure efficient and responsive human resources services the Department’s target was to develop and implement an employee wellness programme that complied with the Public Service Regulation and Employee Health and Wellness (EHW) Strategic Framework. This target was achieved as all four new EHW pillars improved the well-being and productivity of the employees.

Programme 2: National Health Insurance, Health Planning and Systems Enablement

The health sector continued to implement strategies linked to the National Health Insurance (NHI) pilot sites. The country was still within the first phase of the implementation of the NHI, which was planned to take five years. The process of developing and testing Diagnosis-Related Groups (DRG) as an alternative reimbursement tool for hospitals was in place. Phase 1 of the process involved developing a base DRG tool for the ten central hospitals across the country

The draft White Paper for the NHI Bill had been revised and prepared for submission to Cabinet.

To improve the management and control of pharmaceutical services the Department wanted to review 20% hospital level paediatric Essential Medicines List (EML). It managed to review 24% of the paediatric EMLs and this review was also published for the public.

The Council for Scientific and Industrial Research (CSIR) was commissioned to assess the level of Primary Health Care Patient Information Systems implemented in the country against the published National Health Standards Framework.

Programme 3: HIV/AIDS, Tuberculosis and Maternal and Child Health

The Ward-based Primary Health Care Outreach Teams were now following up new mothers within six days of giving birth. At the end of 2014/2015, 73% of mothers received a post-natal visit. The Human Papilloma Virus (HOV) immunisation campaign was largely successful, with 91.8% of the target number of girls reached for the first dose HPV immunisation.

DoH wanted to increase the number of HIV positive people who were being managed so that they did not contract opportunistic infections, especially tuberculosis. The planned target of 64% was exceeded, with 73.7% reached. The number of hospitals assessed according to the Multi Drug Resistant TB treatment criteria was targeted at 50, but only 43 hospitals were reached.

Programme 4: Primary Health Care

The Ideal Clinic initiative was launched in July 2013 and culminated in the Operation Phakisa Ideal Clinic Laboratory from 12 October to 21 November 2014. In addressing the management of Ebola disease outbreak in Northern Africa, an Emergency Operations Centre was established at the National Institute for Communicable Disease (NICD).

To improve district governance and strengthen management and leadership of the district health system the Department targeted to implement approved plans and monitoring and evaluation (M&E) system.

Programme 5: Hospitality, Tertiary Health Services and Human Resource Development

A process was started to assist public nursing colleges to be ready to offer nursing qualifications aligned to the National Qualifications Framework and an assessment was done of the state of readiness of selected nursing colleges to offer such qualifications.

To improve the quality of nursing training and practice by ensuring that all nursing colleges were accredited to offer the new nursing qualifications, the Department targeted having five public nursing colleges accredited to offer the new nursing qualification. The target was still being achieved as the Minister of Higher Education, Mr Blade Nzimande, and the Minister of Health, Mr Aaron Motsoaledi, had agreed to re-direct nursing colleges.

Programme 6: Health Regulation and Compliance Management

A definition for complementary medicine and guidelines on vitamins and minerals and ten Care Management Systems applications were under review.

Guidelines for medical devices and in vitro diagnostics were published and proposed legislation was introduced in November 2014 for stakeholders to comment.

The Medicines and Related Substances Amendment Bill was developed in order to improve the efficiency of the regulation through restructuring by establishing South African Health Product Regulation Authority (SAHPRA) as a public entity.

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