1. NATIONAL DEPARTMENT OF HEALTH’S ANNUAL REPORT FOR 2006/07 PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH 06 NOVEMBER 2007

2. 2 1. FLOW OF PRESENTATION VISION & MISSION LEGISLATIVE MANDATES KEY PRIORITIES OF THE NATIONAL HEALTH SYSTEM (NHS) FOR 2004-2009 SUMMARY OF ACHIEVEMENTS AGAINST THE NHS PRIORITIES FOR 2004-2009 SUMMARY OF ACHIEVEMENTS & CHALLENGES PER BUDGET PROGRAMME, COMPARING PROGRESS BETWEEN 2004/05, 2005/06 AND 2006/07 CONCLUSIONS

3. 3 2. VISION & MISSION VISION  AN ACCESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM. MISSION  TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS & DISEASES AND THROUGH THE PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY.

4. 4 3. LEGISLATIVE MANDATES 51 ACTS MENTIONED IN THE NDOH ANNUAL REPORT 2006/07 INCLUDING:  THE CONSTITUTION OF THE REPUBLIC  NATIONAL HEALTH ACT OF 2003  PUBLIC FINANCE MANAGEMENT ACT OF 1999  NURSING ACT OF 2005  MEDICINES & RELATED SUBSTANCES ACT  MEDICAL SCHEMES ACT OF 1998  TOBACCO PRODUCTS CONTROL AMENDMENT ACT OF 1999

5. 5 4. BUDGET PROGRAMME STRUCTURE OF THE NDOH IN 2006/07 PROGRAMME 1: ADMINISTRATION PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES PROGRAMME 3: HEALTH SERVICE DELIVERY PROGRAMME 4: HUMAN RESOURCES

6. 6 5. KEY NHS PRIORITIES FOR 2004-2009 1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS 2.PROMOTE HEALTHY LIFESTYLES 3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE 4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON- COMMUNICABLE DISEASES 5. STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS 6. STRENGTHEN SUPPORT SERVICES 7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT 8. PLANNING, BUDGETING AND MONITORING & EVALUATION 9. PREPARATION AND IMPLEMENTATION OF LEGISLATION 10. STRENGTHEN INTERNATIONAL RELATIONS

7. 7 6.KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009 NHS PRIRORITIES 2004-2009 ACHIEVEMENTS IN 2006/07 1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS REGULAR MEETINGS OF NATIONAL HEALTH COUNCIL (NHC), TO PROVIDE STEWARDSHIP OVER THE HEALTH SECTOR; CONSOLIDATED BUDGET BID TO NATIONAL TREASURY 2. PROMOTE HEALTHY LIFESTYLES DIVERSITY OF AWARENESS CAMPAIGNS CONDUCTED INCLUDING: BREAST CANCER AND CERVICAL CANCER AWARENESS CAMPAIGN IN IN MPUMALANGA PROVINCE; NUTRITION AWARENESS WEEK IN THE NORTH WEST; WORLD HEART DAY CELEBRATION IN THE FREE STATE; AND MENTAL HEALTH DAY AND SADC MALARIA DAY, BOTH HELD IN LIMPOPO PROVINCE 3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE CLOSE TO 40% OF COMPLAINTS FROM USERS ADDRESSED WITHIN 25 DAYS 60% OF REVITALISATION HOSPITALS CONDUCTED CLINICAL AUDITS QUALITY ASSURANCE TRAINING FRAMEWORK COMPLETED AND SENT TO HWSETA FOR APPROVAL 4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON- COMMUNICABLE DISEASES 84% OF SOUTH AFRICAN CHILDREN UNDER 1 YEAR IMMUNIZED BY MARCH 2007, AN INCREASE FROM 78% IN 2005; SOUTH AFRICA DECLARED POLIO FREE BY THE AFRICA REGIONAL CERTIFICATION COMMISSION; SADHS 2003 REFLECTS UNDER-5 MORTALITY AS 57.6/1000 LIVE BIRTHS, SLIGHTLY LOWER THAN THE 60/1000 REPORTED IN THE COUNTRY MDG REPORT OF 2005;

8. 8 6. KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009 NHS PRIRORITIES 2004-2009 ACHIEVEMENTS IN 2006/07 5. IMPROVE MANAGEMENT OF COMMUNICABLE & NON- COMMUNICABLE DISEASES (CONT.) 2006 ANTENATAL HIV SURVEY SHOWS A STATISTICALLY SIGNIFICANT DECREASE IN HIV PREVALENCE AMONGST PREGNANT WOMEN, FROM 30.2% IN 2005 TO 29.1% IN 2006; VCT AND PMTCT PROVIDED IN 90% OF PUBLIC HEALTH FACILITIES OVER 282 200 PATIENTS INITIATED ON ANTIRETROVIRAL TREATMENT ACROSS THE COUNTRY IN 2006/07 (BY MAY 2007, OVER 300 000 PATIENTS WERE ON TREATMENT); NUTRITION PACKAGES DISTRIBUTED TO PEOPLE LIVING WITH HIV AND AIDS, TB AND OTHER DEBILITATING CONDITIONS; NATIONAL STRATEGIC PLAN FOR HIV&AIDS 2007-2011 LAUNCHED NO. OF MALARIA CASES DECLINED CONSISTENTLY FROM 51 444 CASES IN 1999 TO 12 098 CASES IN 2006; 84% REDUCTION IN MALARIA CASES ACHIEVED FROM 2005 TO 2006, MAINLY DUE TO INDOOR RESIDUAL SPRAYING AND SUCCESSFUL COLLABORATION AMONGST AFRICAN COUNTRIES IN IMPROVING THE EFFECTIVENESS OF MALARIA CONTROL PROGRAMME, ESPECIALLY BETWEEN RSA, MOZAMBIQUE AND SWAZILAND. WORLD DIABETES CONGRESS HELD IN CAPE TOWN IN DEC 2006

9. 9 6.KEY ACHIEVEMENTS IN 2006/07 AGAINST NHS PRIORITIES FOR 2004-2009 NHS PRIRORITIES 2004-2009 ACHIEVEMENTS IN 2006/07 6. STRENGTHEN SUPPORT SERVICES TRANSFER OF FORENSIC SERVICES FROM SAPS TO DOH COMPLETED 5O% OF EXISTING MORTUARIES REFURBISHED 20% OF PLANNED MORTUARIES BUILT 7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT REMUNERATION DISPENSATION FOR ALL CATEGORIES OF NURSES AGREED TO WITH NATIONAL TREASURY AND DPSA, AS PART OF OCCUPATION SPECIFIC DISPENSATION 4 PROVINCES PRODUCED DRAFT HR PLANS (EC, LP, MP & NW) 8. PLANNING, BUDGETING AND MONITORING & EVALUATION NATIONAL DOH REVIEWD ALL 9 PROVINCIAL ANNUAL PERFORMANCE PLANS FOR 2007/08 AND PROVIDED FEEDBACK TO PROVINCES 48/52 DISTRICTS PRODUCED DISTRICT HEALTH PLANS FIRST ANNUAL NATIONAL HEALTH PLAN PRODUCED IN MAY 2006, IN TERMS OF THE NATIONAL HEALTH ACT OF 2003 MONITORING OF IMPLEMENTATION OF PLANS BY NATIONAL & PROVINCIAL DOHs STRENGTHENED, WITH 4 QUARTERLY REPORTS COMPILED DURING 2006/07 9. PREPARATION AND IMPLEMENTATION OF LEGISLATION TWO PIECES OF LEGISLATION PROCESSED: TOBACCO PRODUCTS CONTROL AMENDMENT BILL & HEALTH PROFESSIONS AMENDMENT BILL 10. STRENGTHEN INTERNATIONAL RELATIONS DIVERSE MULTILATERAL SUMMITS & CONFERENCES CO-ORDINATED INCLUDING 3 RD CONFERENCE OF AFRICAN HEALTH MINISTES (CAMH 3) AND SADC HEALTH MINISTERS

10. 10 7. SUMMARY OF ACHIEVEMENTS IN 2006/07 PER BUDGET PROGRAMME 7.1. PROGRAMME 1: ADMINISTRATION NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 DEVELOPMENT OF HEALTH LEGISLATION 8 BILLS PROCESSED DURING 2004/05 NATIONAL HEALTH ACT OF 2003 ALSO SIGNED INTO LAW 5 BILLS PROCESSED DURING 2005/06 2 BILLS PROCESSED DURING 2006/07 (TOBACCO PRODUCTS CONTROL AMENDMENT BILL AND HEALTH PROFESSIONS AMENDMENT BILL) STRENGTHENING COMMUNI-CATION WITH PROVINCIAL & NATIONAL STAKEHOLDERS NATIONAL CONSULTATIVE HEALTH FORUM (NCHF) HOSTED IN DECEMBER 2005 NCHF HOSTED IN MAY 2006 18 MINISTERIAL IZIMBIZO HELD NCHF HOSTED IN JULY 2007, FOCUSING ON PROGRESS TOWARDS MDG TARGETS HEALTH EXHIBITION HELD AT THE WORLD DIABETES CONGRESS IN CAPE TOWN FROM THE 03 RD -07 TH DECEMBER 2007

11. 11 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 STRENGTHENING COMMUNICATION WITH PROVINCIAL & NATIONAL STAKEHOLDERS RANGE OF PUBLICATIONS PRODUCED HEALTH RELATED ARTICLES PUBLISHED IN THE PAN AFRICAN HEALTH MAGAZINE CHILD CARE OPEN DAY HELD IN MPUMALANGA ON THE 10TH NOVEMBER 2006, FOLLOWED BY A TB BLITZ IN THE SAME PROVINCE ON 19-21ST NOVEMBER 2006 PROGRAMME 1: ADMINISTRATION (Cont.)

12. 12 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 STRENGTHENING HEALTH SECTOR PLANNING PROVINCIAL ANNUAL PERFORMANCE PLANS (APPs) FOR 2005/06 REVIEWED ANNUAL REPORTS FOR 2004/05 REVIEWED APPs FOR 2006/07 AND ANNUAL REPORTS FOR 2005/06 REVIEWED 8/9 PROVINCES PRODUCED SERVICE TRANSFORMATION PLANS (STPs) FOR 2007/08 APPs FOR 2007/08 AND ANNUAL REPORTS REVIEWED 8/9 PROVINCES UPDATED THEIR SERVICE TRANSFORMATION PLANS (STPs) FOR 2007/08, WITH SUPPORT FROM NATIONAL DOH FIRST ANNUAL NATIONAL HEALTH PLAN (ANHP) PRODUCED IN MAY 2006 NATIONAL HEALTH PRIORITIES IN THE ANHP 2006 USED TO INFORM BUDGET BIDS TO TREASURY PROGRAMME 1: ADMINISTRATION (Cont.)

13. 13 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 STRENGTHENING HEALTH SECTOR PLANNING DISTRICT HEALTH PLANNING (DHP) GUIDELINES REVISED BY MARCH 2005 DHP GUIDELINES PUBLISHED BY JULY 2005 AND USED BY 53 DISTRICTS TO DEVELOP DISTRICT PLANS FOR 2006/07 DESPITE GOOD PROGRESS, QUALITY OF MOST DHPs NEEDS FURTHER STRENGTHENING 4 SUMMARY REPORTS ON THE PERFORMANCE OF THE NATIONAL DEPARTMENT OF HEALTH ON ITS STRATEGIC PLAN FOR 2006/07-2008/09 PRODUCED, FOCUSING ON 2006/07 4 REPORTS ON THE ON THE PERFORMANCE OF THE 9 PROVINCE ON THEIR ANNUAL PERFORMANCE PLANS FOR 2006/07-2008/09 PRODUCED, FOCUSING ON 2006/07 3 POLICY BRIEFS PRODUCED, COVERING A RANGE OF ISSUES SUCH AS THE DEVELOPMENT, IMPLEMENTATION AND ANALYSIS OF HEALTH POLICIES, AND ASSESSING EQUITY IN THE PROVISION OF HEALTH CARE PROGRAMME 1: ADMINISTRATION (Cont.)

14. 14 7. SUMMARY OF ACHIEVEMENTS 7.2. PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 EXPANSION OF THE IMPLEMENTATION OF INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES (IMCI) STRATEGY ALL 53 DISTRICTS IMPLEMENTING IMCI IMCI CASCADED TO 136 OF 284 LOCAL (47.8%) MUNICIPALITIES (EXPANDED TO SUB-DISTRICTS) 72% OF DISTRICTS IMPLEMENTING THE SECOND COMPONENT OF IMCI, THE HOUSEHOLD AND COMMUNITY COMPONENT (HHCC) TRAINING OF HEALTH WORKERS IN THE IMCI STRATEGY 64% OF HEALTH WORKERS PROVIDING SERVICES TO CHILDREN TRAINED IN IMCI 60% OF THOSE WHO PROVIDE SERVICES TO CHILDREN TRAINED IN IMCI 71% OF THOSE WHO PROVIDE SERVICES TO CHILDREN TRAINED IN IMCI

15. 15 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 IMPROVING IMMUNISATION COVERAGE NATIONAL IMMUNISATION COVERAGE OF 82% ATTAINED NATIONAL IMMUNISATION COVERAGE OF 84% ATTAINED 37/53 DISTRICTS (69%) OF DISTRICTS HAVE MORE THAN 80% IMMUNISATION COVERAGE 12/53 DISTRICTS (23%) OF DISTRICTS HAVE MORE THAN 90% IMMUNISATION COVERAGE 19/52 DISTRICTS (37%) OF DISTRICTS HAVE MORE THAN 90% IMMUNISATION COVERAGE ACHIEVE POLIO FREE CERTIFICATION SOUTH AFRICA’S POLIO ERADICATION STATUS REPORT WAS ACCEPTED BY THE AFRICAN REGIONAL CERTIFICATION COMMITTEE (ARCC) OF THE GLOBAL CERTIFICATION COMMITTEE PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

16. 16 NATIONAL DOH ACHIEVEMENTS OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 EXPANSION OF SCHOOL HEALTH SERVICES 30% OF PROVINCES WITH 100% OF DISTRICTS PROVIDING PHASE 1 OF SCHOOL SERVICES 72% OF DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES 94% OF DISTRICTS PROVIDE PHASE 1 OF SCHOOL HEALTH SERVICES IMPROVING WOMEN’S ACCESS TO CHOICE ON TERMINATION OF PREGNANCY (CTOP) SERVICES 55% OF APPROVED FACILITIES PROVIDED CTOP 60% OF APPROVED FACILITIES PROVIDED CTOP CTOP CASCADED FROM HOSPITALS TO COMMUNITY HEALTH CENTRES (CHCs) 25% OF CHCs PROVIDED CTOP PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

17. 17 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 STRENGTHENING PREVENTION OF HIV AND STIs 347 MILLION MALE CONDOMS AND OVER 1 MILLION FEMALE CONDOMS DISTRIBUTED 413 MILLION MALE CONDOMS & OVER 2 MILLION FEMALE CONDOMS DISTRIBUTED 453 MILLION MALE CONDOMS & OVER 3, 392 MILLION FEMALE CONDOMS DISTRIBUTED EXPANSION OF VOLUNTARY COUNSELLING AND TESTING (VCT) AND PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES 80% OF PUBLIC HEALTH FACILITIES OFFERED VCT 88% OF FACILITIES OFFERED VCT 91% OF FACILITIES OFFERED VCT 60% OFFERED PMTCT 87% OFFERED PMTCT 90% OF FACILITIES OFFERED PMTCT EXPANDING THE COMPREHENSIVE PLAN FOR HIV &AIDS CARE, TREATMENT AND MANAGEMENT (CCMT) 139 CCMT SITES ESTABLISHED 210 CCMT SITES ESTABLISHED 245 CCMT SITES ESTABLISHED 65% OF ELIGIBLE PEOPLE LIVING WITH HIV&AIDS, TB AND OTHER DEBILITATING CONDITIONS PROVIDED WITH NUTRITIONAL SUPPORT 81.8% OF ELIGIBLE PEOPLE LIVING WITH HIV&AIDS, TB AND OTHER DEBILITATING CONDITIONS PROVIDED WITH NUTRITIONAL SUPPORT PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

18. 18 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 200320042005 STRENGTHENING TB CONTROL AND MANAGEMENT SUCCESSFUL TREATMENT COMPLETION 62.9% 65.5% 71.1% CURE RATE 50.1% 50.8% 57.7% DEAFAULTER RATE 10.1% 10.3% 10.4% PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

19. 19 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 EXPANDING INTERNATIONAL HEALTH RELATIONS DIVERSE BILATERAL AND TRILATERAL AGREEMENTS WERE SIGNED INCLUDING THOSE WITH IRAN, RWANDA, MALI, INDIA AND BRAZIL DIVERSE BILATERAL AND TRILATERAL AGREEMENTS WERE SIGNED INCLUDING: PROGRAMME OF ACTION WITH DRC AND NIGERIA ON TRADITIONAL MEDICINE; 24 CONTRACTS FOR RECRUITMENT OF IRANIAN DOCTORS; THROUGH DFID, UK GOVERNMENT PROVIDED R90 MILLION FOR THE COMPREHENSIVE PLAN FOR HIV AND AIDS; SA- CHINA MOU; ETC. DIVERSE MULTILATERAL SUMMITS & CONFERENCES CO-ORDINATED INCLUDING: 3 RD CONFERENCE OF AFRICAN HEALTH MINISTERS (CAMH 3) AND SADC HEALTH MINISTERS IN MARCH 2007; CONSULTATIVE MEETING OF AFRICAN HEALTH MINISTERS ON INJURY PREVENTION AND SAFETY PROMOTION PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

20. 20 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 IMPROVING ACCESS TO SAFE AND AFFORDABLE MEDICINES APPROPRIATE DISPENSING FEE PUBLISHED BUT UNDER CHALLENGE MEDICINE PRICING REGULATIONS REVIEWED MEDICINE PRICING REGULATIONS PUBLISHED BUT UNDER CHALLENGE DRAFT INTERNATIONAL BENCHMARKING METHODOLOGY GAZETTED IN DECEMBER 2006; 100% OF NEW PHARMACIES LICENSED IN LINE WITH THE NEW PHARMACY ACT INSPECTION OF AUTHORISED PRESCRIBERS LAGGED BEHIND DUE TO DIFFICULTYIN RECRUITING PHARMACISTS PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.)

21. 21 PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES (Cont.) NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 REDUCING MALARIA MORBIDITY AND MORTALITY BY 10% EACH YEAR ALL 3 MALARIA AFFECTED PROVINCES (KWAZULU-NATAL, LIMPOPO & MPUMALANGA) IMPLEMENTED RECOMMENDATIONS FROM THE ROLL BACK MALARIA STRATEGY ALL MALARIA AFFECTED PROVINCES PROVIDING REGULAR REPORTS ON THE IMPLMENTATION OF THE RECOMMENDATIONS FROM THE ROLL BACK MALARIA STRATEGY APPROX 84% REDUCTION IN MALARIA CASES COMPARED TO 2005/06 MALARIA CASE FATALITY RATE (CFR) OF 0.5% ATTAINED IN 2006/07

22. 22 7. SUMMARY OF ACHIEVEMENTS 7.3. PROGRAMME 3: HEALTH SERVICE DELIVERY NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 STRENGTHEN THE DELIVERY OF PRIMARY HEALTH CARE SERVICES PHC UTILISATION RATE OF 2.1. VISITS PHC UTILISATION RATE OF 2.2 VISITS PHC UTILISATION RATE OF 2.11 VISITS 35/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES 48/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES 53/53 DISTRICTS PROVIDE A FULL BASKET OF PHC SERVICES PHC HEADCOUNT OF 97, 993, 394 ATTAINED IN 2004/05 PHC HEADCOUNT OF 101,758,377 ATTAINED IN 2005/6 PHC HEADCOUNT OF 101,644, 080 ATTAINED IN 2006/07 PHC SUPERVISION RATE OF 60% ATTAINED PHC SUPERVISION RATE OF 48% ATTAINED

23. 23 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/052005/062006/07 EXPANSION OF THE HOSPITAL REVITALISATION PROGRAMME 3 HOSPITALS COMPLETED NAMELY: CALVINIA & COLESBURG IN THE NORTHERN CAPE; PIET RETIEF IN MPUMALANGA) 5 HOSPITALS COMPLETED NAMELY: LEBOWAKGOMO & JANE FURSE IN LIMPOPO; MARY THERESA IN THE EASTERN CAPE; GEORGE HOSPITAL IN WESTERN CAPE & SWARTRUGGENS IN THE NORTH WEST) 9/9 PROVINCES SUBMITTED 2007/08 PROJECT IMPLEMENTATION PLANS. 2 HOSPITALS OPENED: LEBOWAKGOMO (LIMPOPO) AND MARY THERESA (MADIKANA KA ZULU) IN THE EASTERN CAPE 11% OF HOSPITALS ARE PART OF THE HOSPITAL REVIT. PROGRAMME 12% OF HOSPITALS ARE PART OF THE HOSPITAL REVITALISATION PROGRAMME (I.E. 46 HOSPITALS) 63 ADDITIONAL BUSINESS CASES ACCEPTED BY NDOH SEVERAL PROJECTS TEMPORARILY STOPPED DUE TO FUNDING SHORTAGES DELEGATION OF AUTHORITY TO HOSPITAL MANAGERS ALL 9 PROVINCES DELEGATED AUTHORITY TO HOSPITAL CEOs 75% OF HOSPITAL CEOs RECEIVED WRITTEN DELEGATIONS PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)

24. 24 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/05 2005/062006/07 EXPANDING ACCESS TO TELEMEDICINE 12% OF HOSPITALS HAVE TELEMEDICINE FACILITIES ADDITIONAL TELEMEDICINE SITES ESTABLISHED IN EC & MP IMPLEMENTATION OF THE FIRST 6 OF THE 18 EASTERN CAPE TELEMEDICINE SITES COMPLETED TRANSFER OF FORENSIC LABORATORIES AND MORTUARIES TO PROVINCIAL DOHs 8 PROVINCIAL BUSINESS PLANS DEVELOPED FOR THE TRANSFER OF FORENSIC LABS AND MORTUARIES FROM SAPS TO DOHs TRANSFER OF FORENSIC LABS AND MORTUARIES TO DOHs COMPLETED TRANSFER OF FORENSIC SERVICES FROM SAPS TO DOH COMPLETED 5O% OF EXISTING MORTUARIES REFURBISHED 20% OF PLANNED NEW MORTUARIES BUILT PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)

25. 25 NATIONAL DOH OBJECTIVES AND INTERVENTIONS ACHIEVEMENTS 2004/05 2005/062006/07 EXPANSION OF THE CATARACT SURGERY PROJECT CATARACT SURGERY RATE OF 1039 OPERATIONS PER MILLION PEOPLE ATTAINED (TARGET 950 PER MILLION) CATARACT SURGERY RATE OF 1030 OPERATIONS PER MILLION PEOPLE ATTAINED (TARGET 1000 PER MILLION) CATARACT SURGERY RATE OF 1146 OPERATIONS PER MILLION PEOPLE ACHIEVED PROGRAMME 3: HEALTH SERVICE DELIVERY (Cont.)

26. 26 7. SUMMARY OF ACHIEVEMENTS 7.4. PROGRAMME 4: HUMAN RESOURCES MANAGEMENT NATIONAL DOH OBJECTIVES AND INTERVENTIONS 2004/052005/062006/07 DEVELOPMENT OF A NATIONAL HUMAN RESOURCES (HR) FOR HEALTH PLAN DRAFT HR PLAN DEVELOPED AND CONSULTATION PROCESS COMPLETED HR PLAN LAUNCHED IN APRIL 2006 4 PROVINCES PRODUCED DRAFT HR PLANS (EC, LP, MP & NW) REMUNERATION DISPENSATION FOR ALL CATEGORIES OF NURSES AGREED TO WITH NATIONAL TREASURY AND DPSA, AS PART OF THE OCCUPATION SPECIFIC DISPENSATION (OSD) TRAINING OF HEALTH WORKERS TO IMPLEMENT THE COMPREHENSIVE PLAN FOR HIV &AIDS CARE, TREATMENT AND MANAGEMENT (CCMT) MORE THAN 9 000 HEALTH WORKERS TRAINED TO IMPLEMENT THE CCMT 11 958 HEALTH WORKERS TRAINED IN THE IMPLEMENTATION OF CCMT (TARGET WAS 6 233) 17 054 HEALTH WORKERS TRAINED IN THE IMPLEMENTATION OF CCMT (TARGET WAS 6 233)

27. 27 8. CHALLENGES LACK OF SUFFICIENT & SKILLED HUMAN RESOURCES FOR HEALTH (CLINICAL & MANAGEMENT LEVEL) POOR HEALTH INFRASTRUCTURE POVERTY, UNEMPLOYMENT, LOW EDUCATION LEVELS, POOR TRANSPORT INFRASTRUCTURE, SOCIAL COHESION ISSUES TRIPLE BURDEN OF DISEASE (COMMUNICABLE, NON- COMMUNICABLE, INJURIES AND TRAUMA) INTERSECTORAL COLLABORATION COMMUNITY MOBILISATION & PATIENT ADHERENCE ISSUES

28. 28 ANNUAL FINANCIAL STATEMENTS 2006/07

29. 29 NATIONAL DEPARTMENT OF HEALTH

30. 30 NATIONAL DEPARTMENT OF HEALTH

31. 31 NATIONAL DEPARTMENT OF HEALTH

32. 32 NATIONAL DEPARTMENT OF HEALTH

33. 33 NATIONAL DEPARTMENT OF HEALTH

34. 34 NATIONAL DEPARTMENT OF HEALTH

35. 35 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Qualification Finding:  Reconciliation of fixed asset entries between BAS and Logis System not done Comment:  After the audit it was found that incorrect classifications on the Logis System resulted in inaccurate asset figures being posted in the Asset Register

36. 36 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Matters of Emphasis:  Transfers made to provinces without business plans Comment:  DORA rules that transfers to provinces in respect of Schedule 4 grants cannot be withheld hence the transfers were made

37. 37 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Matters of Emphasis:  Transfer of R 35m to the NGO, LoveLife was made contravening the Departments own NGO Funding Guidelines Comment:  The requirement is that an approved contract be in place between the NDoH and the NGO. In this instance the current contract had expired

38. 38 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Matters of Emphasis:  Amounts in the FPS grant business plans were less than the approved amounts which had been transferred Comment:  The business plans were not adjusted by provinces to match the approved grant allocation but the grant allocation was not exceeded

39. 39 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Other Matters – Lack of Monitoring:  Late submission of Business Plans  Late or non submission of monthly and quarterly reports  Lack of capacity to monitor  Inadequate evaluation of reports  Presence of inconsistencies between monthly and quarterly reports

40. 40 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Comment:  Improvement of monitoring and reporting is continuously being worked at and there is improvement

41. 41 NATIONAL DEPARTMENT OF HEALTH 2006/07 Annual Report - Audit findings Other Matters:  Non compliance with NEMA Comment:  The Department did not present the environmental plan as required by the Act

42. 42 CONCLUSION DESPITE MANY CHALLENGES THE DOH HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2006/07 WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2007/08 TARGETS HOWEVER, CHANGES IN THE SOCIAL CONTEXTS IN WHICH OUR PEOPLE LIVE AND ADEQUATE RESOURCE AVAILABILITY FOR THE HEALTH SYSTEM (HUMAN RESOURCES & FINANCES) ARE KEY TO THE SUCCESSFUL IMPLEMENTATION OF THIS PLAN; INTERSECTORAL COLLABORATION ACROSS GOVERNMENT AND WITH KEY STAKEHOLDERS ARE CRUCIAL.