1. Revitalisation of hospital services
Ensure an appropriate inter facility referral system supported by an adequate and appropriate transport system
Empowerment and support of hospital management

2. Speeding up delivery of an essential package of services through the district health system
Gradually increasing the budget to primary health care facilities as cost centres for human and material resources to improve service delivery
Enforcing the implementation of Primary Health Care package at all the clinics and mobile services

3. Commissioning 24 hour facilities to function as intended
Speeding up delivery of an essential package of services through the district health system
Commissioning 24 hour facilities to function as intended
Increase number of PHC facilities by 2% per annum
Ensure outreach service by medical officers to all PHC facilities at least once a week by 2007

4. Speeding up delivery of an essential package of services through the district health system
Comprehensively trained PHC nurses available in 50% of the total PHC facilities by 2007
Establishing a Provincial training school for PHC nursing by April 2005

5. Emergency Medical Services
Decreasing morbidity and mortality rates through strategic interventions
Emergency Medical Services
Ensure the improvement of EMS resources (vehicles, human resources and equipment) from a current level of 30% of national norms to 80% over the next 3 years
Establish a fully accredited provincial EMS College providing basic, intermediate, advanced life support and rescue courses

6. Continue Acute Flaccid Paralysis (AFP) surveillance
Decreasing morbidity and mortality rates through strategic interventions
Continue Acute Flaccid Paralysis (AFP) surveillance
90% immunisation coverage for children under one year
Sustain and increase IMCI implementation to all Health facilities
Strengthen the cervical cancer screening programme

7. Develop a Provincial Specialised Rehabilitation Centre by 2006
Decreasing morbidity and mortality rates through strategic interventions
Develop a Provincial Specialised Rehabilitation Centre by 2006
80% of hospitals rendering rehabilitation services in line with National norms and standards by 2007
Outreach rehabilitation services available at all CHC’s by 2007

8. Decreasing morbidity and mortality rates through strategic interventions
To implement integrated malnutrition intervention in 50% of the PHC facilities by March 2007

9. Establish three Mental Health Review Boards by March 2005
Decreasing morbidity and mortality rates through strategic interventions
Ensure fully functional Psychiatric units in the three districts by December 2005
Establish three Mental Health Review Boards by March 2005
To ensure that 80% of PHC facilities are rendering integrated Mental Health services by December 2006

10. To ensure a Malaria case fatality rate less than 0,5%
Decreasing morbidity and mortality rates through strategic interventions
To ensure a Malaria case fatality rate less than 0,5%
To reduce the Malaria case incidence to less than 1,5% by December 2007
To achieve a spray coverage of 80% in the Malaria high risk area

11. Decreasing morbidity and mortality rates through strategic interventions
To strengthen capacity for health promotion in 17 health promotion units to effect community outreach programmes in respect of preventive and promotive aspects in diseases of lifestyle by March 2007
To improve the health status of the child by launching 30 health promoting schools by March 2007

12. Decreasing morbidity and mortality rates through strategic interventions
To implement the community component of the IMCI in 13 sites by March 2007
To implement clinical guidelines for the management of Diabetes and Hypertension in all health facilities in the province by March 2007

13. Decreasing morbidity and mortality rates through strategic interventions
To put monitoring mechanisms in place to identify index Cholera cases towards the early prevention of Cholera outbreaks by October 2004
To strengthen and maintain a fully functional Epidemic Preparedness and Response(EPR) system by March 2007

14. Decreasing morbidity and mortality rates through strategic interventions
Increase awareness on the benefits of Voluntary Counseling and Testing (VCT)
To continuously strengthen social mobilization using the Abstain, Be faithful and Condomise strategy
Increase awareness on the Prevention of Mother To Child Transmission programme

15. Implementation of a HIV and AIDS workplace policy by October 2004
Decreasing morbidity and mortality rates through strategic interventions
Implementation of a HIV and AIDS workplace policy by October 2004
Increase the utilization of community based health workers including Home Based Care workers to extend community outreach programmes
Reduce the incidence of STI’s using the syndromic approach for management of all STI cases

16. Decreasing morbidity and mortality rates through strategic interventions
Implementation of the Comprehensive, management and treatment of HIV and AIDS patients at all hospitals and some PHC facilities by March 2007
Reduce the Multiple Drug Resistance (MDR) to TB drugs to less than 1% by March 2007
Expand the Directly Observed Treatment Programme to all districts by March 2007

17. Optimally utilise information to equitably allocate resources
Improving resource mobilisation and the management of resources without neglecting the attainment of equity in resource allocation
Establish assessment teams to evaluate Certificate of Need applications in conjunction with National Department of Health
Optimally utilise information to equitably allocate resources

18. Improve revenue generation at all hospitals
Improving resource mobilisation and the management of resources without neglecting the attainment of equity in resource allocation
Improve revenue generation at all hospitals
Finalise and implement PPP framework
Develop and implement Donor funding policy using National guidelines

19. Improving human resource development and management
Strengthen and expand the tele-tuition project in the province
Train 30 additional PHC qualified nurses per annum
Train 100 Pharmacist assistants per annum
Empower health managers in Labour Relations management

20. Improving human resource development and management
Strengthen cooperation for training of various health workers by the University of Pretoria, Limpopo, Free State and MEDUNSA
Strengthen the implementation of the Personnel Management and Development System (PMDS)

21. Improving human resource development and management
Improve personnel and administrative filing system as well as developing an electronic filing system
Continuous update of the PERSAL information

22. Improving communication and consultation within the health system and between the health system and communities we serve
Enhance community interaction through IZIMBIZO’s
Produce internal newsletter for the department
Increase the effectiveness of the Departmental Website
Schedule stakeholders meetings/summits with Medical Practitioners, Allied Health Professionals, Traditional Healers and NGO’s

23. Strengthening co-operation with our partners internationally
Implement plans of action with the Maputo Province in Mozambique
Jointly manage Health Information System development and GIS plotting projects with the Italian Corporation
Strengthen the Lebombo Spatial Development Initiative towards eradication of Malaria in the region

24. Brief description of the Budget with Trends 2000/01 – 2006/07

25. Department of Health
Expenditure
R’000
Medium Term Estimates
Sources of revenue
2000/2001
2001/ 2002
2002/2003
2003/2004
2004/ 2005
2005/ 2006
2006/ 2007
Equitable share
Conditional Grants
Own Revenue
10 370
10 540
46 000
Total Revenue

26. Expenditure as % allocation
Department of Health
Budget
2003/2004
R’000
Expenditure
Savings
(Excess)
Expenditure as % allocation
Equitable share
66 753
96%
Conditional Grants
78 940
75%
Total
93%

27. Department of Health Expenditure R’000 Medium Term Estimates
Programmes
2000/2001
2001/ 2002
2002/2003
2003/2004
2004/ 2005
2005/ 2006
2006/ 2007
1. Administration
97 152
2. District Health Services
3. Emergency Medical Services
70 031
84 549
95 908
4. Provincial Hospital Services
91 339
6. Health Sciences and Training
25 816
32 638
39 328
48 225
55 619
58 937
62 473
7. Health care Support services
9 847
12 664
24 696
27 793
31 501
34 629
36 707
8. Health Facilities Management
6 876
63 763
72 401
Total Revenue

28. Department of Health
Expenditure
R’000
Medium Term Estimates
Conditional Grant
2002/2003
2003/2004
2004/ 2005
2005/ 2006
2006/ 2007
Health Financial Management Grant
2 844
Provincial Infrastructure Grant
16 655
29 171
35 724
39 975
44 323
Flood Infrastructure Grant
10 000
11 016
National Tertiary Services Grant
39 044
41 796
41 427
42 224
44 757
Health Professional Training and Development Grant
31 147
46 575
41 808
54 363
Hospital Revitalisation Grant
48 000
65 944
68 292
71 025
92 662
Hospital Management and Quality Improvement Grant
8 333
20 273
12 833
12 340
13 081
Integrated Nutrition Programme Grant
39 728
67 183
8 713
9 581
HIV and AIDS Grant
20 867
34 550
53 840
81 392
Medico Legal Services
1 000
Total

29. Department of Health
Budget 2003/2004
R’000
Expenditure 2003/2004
Savings(Excess)
Health Financial Management Grant
2 844
836
2 008
Provincial Infrastructure Grant
29 171
24 342
4 829
Flood Infrastructure Grant
11 016
4 339
6 677
National Tertiary Services Grant
41 796
34 696
7 100
Health Professional Training and Development Grant
46 575
Hospital Revitalisation Grant
65 944
45 813
20 131
Hospital Management and Quality Improvement Grant
20 273
4 116
16 157
Integrated Nutrition Programme Grant
67 183
60 843
6 340
HIV and AIDS Grant
34 550
22 729
11 821
Medico Legal Services
1 000
Total
76 063

30. Budgetary Trends
The Mpumalanga Province had a budget of R1,456 billion for the 2001/2 financial year. For 2002/3 the budget was R1,688 billion and for 2003/4 the budget was R2,152 billion
The department provides in addition to the population of the province, health care services to patients from neighboring countries of Swaziland and Mozambique

31. Budgetary Trends
Mpumalanga Province, is the third lowest in terms of per capita spending at R770
The Head count per capita for the visits to PHC facilities (2001/2) indicates an average of 1,5 visits as opposed to the 3-3,5 national norm
Expenditure has increased by 19% in 2003/4