1. DEPARTMENT OF HEALTH Presentation to JMC Programmes for Persons with Disabilities 14 September 2007

2. INTRODUCTION Focus of the Sub-Directorate: Disabilities is to: increase accessibility of health services to persons with disabilities improve, promote and maintain accessibility to quality rehabilitation services through implementation and integration of rehabilitation models and policies into the PHC system following a Community Based Rehabilitation approach.

3. UNDERLYING PRINCIPLES Health Act National Rehabilitation Policy UN Convention on the Rights of Persons with Disabilities Same range, quality & standard of care Early identification, intervention No discrimination Local service delivery

4. NDOH CONTEXT Strategic Plan Improve access to health care for persons with disabilities Monitoring implementation of Free Health Care, using national guidelines Improve access to assistive devices Improve accessibility to health care facilities.

5. FREE HEALTH CARE Full health service package at hospital level. Application of national protocol and assessment criteria. Includes persons on disability grants. Varying degrees of success in provinces Crucially dependent on awareness by management and admin staff.

6. ACCESS TO ASSISTIVE DEVICES NDOH eradication of backlog Up to 30 000 wheelchairs & buggies 16 000 hearing aids Intention for Districts to develop sustainable budgeting process not always successful Observed backlog on some provinces Significant backlog in N Cape Wheelchair repair Project Access to service delivery Socio-economic development in disability sector.

7. ACCESSIBILITY OF HEALTH FACILITIES Initiated nationally, implemented at a district level involving teams including the disability sector. Addresses ALL levels of access including communication. Levels of accessibility acknowledged in terms of Bronze, Silver & Gold awards

8. ORIENTATION & MOBILITY SERVICES FOR THE BLIND Previously, significantly ignored area of rehabilitation. Primary service provider presently the NGO sector. Consultation with all key stakeholders Document now complied on the options for service delivery NB : SERVICES INTEGRATED INTO THE HEALTH SYSTEM

9. TRAINING OF HEALTH WORKERS ON SIGN LANGUAGE Need to facilitate access to health services by Deaf persons DOH initiated training for health workers in provinces on sign language with focus on “health” related vocabulary. Provinces now exploring initiatives to roll-out training to health workers. Definite projects in KZN & Free State involving NGO partnerships.

10. CHALLENGES HUMAN RESOURCES Community Services – significant access to services especially in rural areas HOWEVER – very poor recruitment & retention of rehabilitation personnel Remuneration Conditions of service Career development

11. CHALLENGES (contd) BUDGET No dedicated budget for service, development, assistive devices Funding allocation fails to reflect services at different levels of care Linked to lack of priority of the programme, generally Poor budgeting results in services which are not sustainable

12. CONCLUSION Significant progress in one or more aspect in all provinces. Access has been created to services for the first time. Sustainable service delivery can only be facilitated through: Enhanced priority and budgeting at provincial and district levels Link to key programmes incl HIV and AIDS and MCWH Specified recruitment and retention policies Alignment to national rehabilitation & related policy, UN Convention on the Rights of Persons with Disabilities