1. Presentation to the Select Committee on Social Services
Annual Performance Plan 2017/18 – 2019/20
Presentation to the Select Committee on Social Services
30 May 2017

2. VISION MISSION Outcome 2: Long and healthy life for all South Africans
To improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.

3. Sustainable Development Goals
2017/18 – 2019/20 MTEF PRIORITIES
The priorities for the MTEF commencing 2017/18 year are derived from:
Sustainable Development Goals

4. Legislation and Prescripts that regulate Health Sector planning
National Health Act, 2003
Section 21(4) - “the national health plans must comply with national health policy.
Section 21(5) - “The Director-General must integrate the health plans of the national department and provincial departments annually and submit the integrated health plans to the National Health Council”.
Section 33(1) - “Each district and metropolitan health manager must within the national budget cycle develop … a district health plan drawn up in accordance with national guidelines issued by the Director-General…”
Section 23(2) - “The National Health Council may determine the time frames, guidelines and the format for the preparation of national and provincial health plans.
Pubic Finance Management Act, 1999
Treasury Regulations – Chapter 5 of 2007
Framework for Strategic Plans and Annual Performance Plans, 2010

5. Alignment between National <-> Provincial <-> District Plans
National Health Act 2003, Section 23(2) - The National Health Council may determine the time frames, guidelines and the format for the preparation of national and provincial health plans
National Health Act 2003, Section 33(1) - “Each district and metropolitan health manager must within the national budget cycle develop … a district health plan drawn up in accordance with national guidelines issued by the Director-General…”

6. Outcome 2 : A long and Healthy lives for all South Africans Gains 2009-2014
An increase in overall life expectancy from 57.1 years in 2009 to 63.3 years in 2015.
A decrease in the Under-5 mortality rate (U5MR) from 56 deaths per live births in 2009, to 37 deaths per live births in 2015.
A decrease in the Infant Mortality Rate (IMR) from 39 deaths per live births in 2009, to 27 deaths per live births in 2015.
A decrease in mother-to-child transmission (MTCT) of HIV from 8.5% in 2008, to 3.5% in 2010 and to 1.5% in 2015.
An increase in the number of people initiated on antiretroviral therapy (ART) has increased nearly threefold (1.4m in to 3.7m in 2016) in the past 5 years
A decrease in the total number of people dying from AIDS. Percentage of AIDS deaths reduced from 41.9% (2009) to 27.9% (2016).
TB Treatment Success Rate increased from 74% in 2009 to 84% in 2015.

7. Impact Indicator Baseline (2009)
Outcome 2 : A long and Healthy lives for all South Africans Impact Indicators: Baselines and Targets
Impact
Indicator
Baseline
(2009)
Current Performance1
Targets
(2019)
(2030)
Life expectancy at birth: Total
56.5 years
63.3 years
65 years
70 years (NDP)
Life expectancy at birth: Male
54.0 years
60.0 years
61.5 years
Life expectancy at birth: Female
59.0 years
65.8 years
67 years
Under-5 Mortality Rate
56 Under 5 deaths per 1,000 live-births
37 Under 5 deaths per 1,000 live-births
33 Under 5 deaths per 1,000 live-births
30 Under 5 deaths per 1,000 live-births (NDP)
Neonatal Mortality Rate
14 neonatal deaths per 1000 live births
11 neonatal deaths per 1000 live births
8 neonate deaths per 1000 live births
Infant Mortality Rate (IMR)
39 per 1,000
live-births
27 infant deaths per 1,000 live-births
23 infant deaths per 1000 live births
(15% decrease)
20 infant deaths
per thousand live births (NDP)
Maternal Mortality Ratio
304 per 100,000 live-births
154 / live births (2014)
<100 maternal deaths per 100,000live-births
Rapid Mortality Surveillance (RMS) Report 2015, (Published by MRC during December 2016)

8. PROGRAMME 1 - ADMINISTRATION
The purpose of the Administration Programme is to provide support services to the National Department of Health. These include: Human Resources Development and Management, Labour Relations Services, Information Communication Technology Services, Property Management Services, Security Services, Legal Services, Supply Chain Management and Financial Management Services

9. Performance Indicator Estimated performance
Programme 1
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Ensure effective financial management and accountability by improving audit outcomes
Audit opinion from
Auditor General
Unqualified Audit opinion
Unqualified audit opinion with no significant matters for 2016/17
Clean Audit opinion for the NDOH for 2017/18
Clean Audit Opinion for the NDOH for 2018/19
Number of Provincial DoH that demonstrate improvements in Audit Outcomes or Opinions
4 Provincial DoH that demonstrate improvements in Audit
5 Provincial DoH that demonstrate improvements in Audit
7 Provincial DoH that demonstrate improvements in Audit
9 Provincial DoH that demonstrate improvements in Audit
Ensure efficient and responsive Human Resource Services to the National Department of
Health
Percentage of Employees accessing the Health and wellness programmes
30% of NDoH employees
35% (of 1504 NDoH employees)
40% (of 1520 NDoH employees)
45% of National DoH employees

10. Performance Indicator Estimated performance
Programme 1
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Coordinate the development and implementation of the Departmental Business Continuity Plan by the 31st of March 2020
Departmental Business Continuity Plan (BCP) developed.
Phase 1 of the BCP developed and disseminated
Self-assessment as per ISO conducted, and short term corrective action plan implemented
Pre-certification assessment as per ISO conducted, and medium term corrective actions implemented
Certified and compliant with ISO 22300
Provide support for effective communication by developing an integrated communication strategy and implementation plan
Number of communication interventions implemented
52 Communication interventions implemented
56 Communication interventions implemented
60 Communication interventions implemented
62 Communication interventions implemented

11. Performance Indicator Estimated performance
Programme 1
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
NDoH vacancy rate
<10 %
10 %
10%
Percentage of Senior Managers that have entered into Performance agreements with their supervisors
98%
100 %
100%

12. PROGRAMME 2 - NATIONAL HEALTH INSURANCE, HEALTH PLANNING AND SYSTEMS ENABLEMENT
The purpose of National Health Insurance, Health Planning And Systems Enablement Programme is to improve access to quality health services through the development and implementation of policies to achieve universal health coverage, health financing reform, integrated health systems planning, monitoring and evaluation, and research.

13. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Achieve Universal Health Coverage through the phased implementation of the National Health Insurance(NHI)
White Paper on NHI
Review public comments and revise and publish final White Paper on NHI
Final White Paper on NHI finalised and gazetted as a policy document.
Not Applicable
Legislation for NHI
NHI Bill conceptualised
Draft NHI Bill gazetted for public comments
Revised NHI Bill submitted to Parliament
NHI Bill approved by the National Assembly and National Council of Provinces.
Establishment of the National Health Insurance Fund
Funding Modality for the National Health Insurance Fund including budget reallocation for the primary health care updated
Funding Modality for the budget allocation to the primary health care (PHC) facilities developed
Service providers accreditation and contracting mechanisms developed
Functional NHI fund –purchasing services on behalf of the population from accredited and contracted providers
Establish a national stock management surveillance centre to improve medicine availability
Total number of health facilities reporting stock availability at national surveillance centre
3200 of health facilities reporting stock availability at national surveillance centre
3300 of health facilities reporting stock availability at national surveillance centre
3400 of health facilities reporting stock availability at national surveillance centre
3450 of health facilities reporting stock availability at national surveillance centre

14. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Improve contracting and supply of medicines
Number of Provincial Medicine Procurement Unit (PMPU) for the management of direct delivery of medicines established
2 PMPUs established (North-West and KZN DoH).
2 x PMPUs established (Mpumalanga and Northern Cape DoH)
All PMPUs monitored
Control towers have been implemented in 8 Provincial DoH
Number of patients enrolled for receiving medicines through the centralised chronic medicine dispensing & distribution (CCMDD) system
1,100,000 patients enrolled for receiving medicines through the CCMDD system
1,500,000 patients enrolled for receiving medicines through the CCMDD system
1,700, 000 patients enrolled for receiving medicines through the CCMDD system
2,000,000 patients enrolled for receiving medicines through the CCMDD system
Implement the Strategy to address antimicrobial resistance (AMR)
National antimicrobial resistance(AMR) strategy Implemented
Antimicrobial stewardship guideline as identified in the antimicrobial resistance strategy developed
Surveillance system for monitoring resistance developed
Surveillance system monitoring resistance developed and piloted for implementation
Surveillance system monitoring resistance implemented

15. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Regulate Traditional Health Practice in South Africa
Traditional Health Practitioners (THP) Act
New Indicator
Amendment Bill of the Traditional Health Practitioners (THP) Act drafted
Traditional Health Practitioners Act gazetted for public comments
Traditional Health Practitioners Act Promulgated and Implemented
Strengthen Revenue collection by incentivising hospitals to maximise revenue generation.
A Revenue Retention Model (RRM) developed and implemented
A discussion paper on revenue retention models developed and approved
Discussion paper on revenue retention models presented at the Health sector’s 10x10 with Treasury
All 9 Provinces implementing the Revenue Retention Model
Revenue retention model evaluated for effectiveness
Implement eHealth Strategy of South Africa through the development of the system design of patient information systems
A complete System design for a National Integrated Patient based information system
Health Normative Standards Framework (HNSF) Implementation protocol developed for Basic Health Information Exchange (HIE) for piloting integration with sub national systems
Integrated System architecture for a National Integrated Patient Based Information System developed
Phase 1 of System Technology, and Data architectures integrated for a National Integrated Patient Based Information System implemented
System Architecture fully developed and patient registry implemented through the development of
Health Information Exchange,
Number of PHC health facilities implementing improved patient administration and web based information systems
1 450 PHC Facilities implementing the web based health Patient Registration System
2 450 PHC Facilities implementing the web based health Patient Registration System
3000 PHC Facilities implementing the web based health Patient Registration System
3656 PHC Facilities implementing the web based health Patient Registration System

16. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Develop and Implement a national research strategic plan
National health research plan implemented
Costed National Health Research implementation plan approved;
Priority Health Research study trends monitored and report produced
Priority Health Research knowledge generated to inform future research and interventions
National Health Research priorities funded
South African Demographic and Health Survey (SADHS) 2016 conducted
2016 SADHS data collection completed
SADHS 2016 key indicator report published
2016 SADHS detailed report published and disseminated to inform planning and interventions
None
Develop and
implement an integrated
monitoring and
evaluation plan aligned
to health outcomes and outputs contained in the Health Sector Strategy
Integrated Monitoring and Evaluation plan developed
Draft Monitoring framework for NHI developed
NHI Phase 1 evaluation conducted
Evidence available to inform expansion in NHI implementation
Integrated monitoring and evaluation system providing evidence for planning and performance management.

17. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Domestication of international Treaties and Implementation of multilateral cooperation on areas of mutual and measurable benefit
Number of International Treaties and Conventions implemented
Three International Treaties implemented
An audit on the progress of ratification of a treaty completed
Three International Treaties and Conventions implemented
And an audit on the progress of ratification of a treaty completed by 2016/17
Number of multilateral Frameworks and Strategies implemented
Three Multilateral Frameworks implemented and reviewed
Three Multilateral Frameworks and Strategies implemented
Three Multilateral Frameworks and strategies implemented
Implementation of bilateral cooperation on areas of mutual and measurable benefit
Number of Bilateral frameworks and projects implemented
Six strategic bilateral frameworks and projects implemented
Review of all signed bilateral agreements completed and progress reports produced
Six strategic bilateral projects implemented

18. Performance Indicator Estimated performance
Programme 2
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Single Exit Price Adjustments Published and Implemented Annually
2016/17 Annual Price Adjustments gazetted and published
2017/18 Annual Price Adjustments gazetted and published
2018/19 Annual Price Adjustments gazetted and published
2019/20 Annual Price Adjustments gazetted and published
Central Repository for the funded and unfunded patients
A repository containing information related to medical scheme members developed.
Electronic interface piloted at 3 central hospitals to facilitate exchange of records
Electronic Data Interchange (EDI) Switch operational
A functional central Repository containing personal and demographic information of medical scheme members
A national electronic system to monitor supplier performance developed
Performance reports of all contracted pharmaceutical suppliers produced on a quarterly basis
4 x Quarterly Performance reports of all contracted pharmaceutical suppliers produced
A forum to promote transparency and multi-stakeholder engagement regarding medicine availability
Forum established;
Terms of Reference developed;
Forum members appointed;
One quarterly stakeholder meeting convened
4 x Quarterly meetings of the forum held
Quarterly meetings of the stakeholders held

19. Performance Indicator Estimated performance
Programme 2
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Number of Provincial Annual Performance Plans (APPs) aligned to the National Health System Priorities
9 Provincial APPs reviewed and aligned to the National Health System Priorities
9 Provincial APPs reviewed aligned to the National Health System Priorities
Integrated Planning Framework for National Health System
Integrated Planning Framework for National Health System developed and presented to NHC
Integrated Planning Framework approved by Tech NHC and piloted in 1 provincial DoH to compile 2018/19 Plans
Integrated Planning Framework for National Health System implemented in all 9 Provincial DoH
Integrated Planning Framework for National Health System revised and implemented

20. Performance Indicator Estimated performance
Programme 2
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Patient Experience of care survey guideline
Patient Experience of care survey guidelines developed
9 Provincial Health Department trained on PEC Guideline
6 Provincial Health Departments implementing the PEC guideline
All 9 Provincial Health Departments implementing the PEC guideline
National Survey to measure Patient Experience of Care
A national survey to measure patient experience of care commenced
National PEC Survey completed and report produced
Implementation of recommendations from patient experience of care survey report monitored
Not Applicable
National Guideline to manage Complaints, Compliments and Suggestions for the Public Health Sector of South Africa
Guideline to manage Complaints, Compliments and Suggestions for the Public Health Sector of developed and approved
9 Provincial Health Departments trained on Guideline to manage Complaints, Compliments and Suggestions
6 Provincial Health Departments implementing the Guideline to manage Complaints, Compliments and Suggestions
All 9 Provincial Health Departments implementing the Guideline to manage Complaints, Compliments and Suggestions
National Guideline to manage Patient Safety Incidents in the Public Health Sector of South Africa
Guideline to manage Patient Safety Incidents in the Public Health Sector of South Africa developed and approved
9 Provincial Health Department trained on Guideline to manage Patient Safety Incidents
6 Provincial Health Departments implementing the Guideline to manage Patient Safety Incidents
All 9 Provincial Health Departments implementing the Guideline to manage Patient Safety Incidents

21. PROGRAMME 3 - HIV / AIDS, TB AND MATERNAL AND CHILD HEALTH
The purpose of HIV / AIDS, TB and Maternal And Child Health Programme is to develop and monitor implementation of national policies, guidelines, norms and standards, and targets for the national responses needed to decrease the burden of disease associated with burden of HIV and TB epidemics; to minimise maternal and child mortality and morbidity; and to optimise good health for children, adolescents and women; and monitor and evaluate the outcomes and impact of these.

22. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
To reduce maternal and neonatal morbidity and mortality
Maternal, Neonatal and Woman’s health programmes monitored using the standardised dashboard reports
4 x National Quarterly reports produced with recommendations
Eliminate Mother To Child Transmission (EMTCT) in South Africa
Remedial Elimination of Mother To Child Transmission (EMTCT) plans developed and monitored of selected Districts
Remedial plans developed with all Districts that have MTCT rates > 2%
Remedial plans developed and monitored of all Districts that have MTCT rates > 1.5%
Remedial plans developed and monitored of Districts that have MTCT rates > 1.25%
Remedial plans developed and monitored of Districts that have MTCT rates > 1%
To improve access to Cervical and Breast Cancer treatment in South Africa
Cervical Cancer control Policy
Cervical Cancer control Policy developed
Guidelines for the Cervical Cancer Policy produced and 9 Provincial DoH supported to develop Implementations plans
9 provincial DOH monitored against provincial plans and National Reports produced with recommendations
Cervical Cancer control Policy reviewed
Breast Cancer Policy
Breast cancer policy developed
Guidelines for Breast Cancer Policy produced and 9 Provincial DoH supported to develop Implementations plans
9 provincial DOH monitored against provincial plans and National Reports produced with recommendations
Breast Cancer Policy and Guidelines reviewed

23. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Reduce under 5 mortality rate
Monitor implementation of child health programmes using the standardised dashboard reports
4 x National Quarterly Monitoring dashboard reports produced with recommendations
Number of Provincial DoH with Remedial plans to reduce severe acute malnutrition.
Two (Mpumalanga DoH and Free State DoH)
Two (Eastern Cape and North West DoH)
All Nine Provincial DoH
Nine Provincial DoH remedial plans reviewed
Maternal, Newborn, Child, Adolescent , Women’s Health (MNCAWH) and Nutrition Strategy 2017/ /22
New Indicator
MNCAWH and Nutrition Strategy 2017/ /22 approved
Monitor implementation of the MNCAWH and Nutrition Strategy 2017/ /22
Midterm review of the MNCAWH and Nutrition Strategy 2017/ /22 conducted
Road to Health Booklet (RTHB) revised
RTHB revised and Distributed to 52 District Offices and head offices of 9 Provincial DoH for implementation
RTHB Implemented at all Public health facilities;
RTHB reviewed

24. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Reduce under 5 mortality rate
Surveillance system for Polio, Measles and Neonatal Tetanus reviewed
New Indicator
Situational analysis conducted on the implementation of the current surveillance system in 9 provinces and Provincial Reports produced
Revised surveillance system drafted and presented to TechNHC for approval
9 Provincial implementation plans developed for implementing the approved surveillance system, and Provincial DoH monitored against the implementation plans.
Evaluation conducted of the revised surveillance system.
EPI Coverage Survey conducted
EPI Coverage Survey conducted in 9 Provinces
EPI Coverage Survey report produced and Published
Not Applicable

25. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
To improve access to adolescent and youth health services in South Africa
Adolescent and Youth Health Policy (AYHP)
New Indicator
Guidelines for AYHP produced and 9 Provincial DoH supported to develop Implementation Plans.
9 Provincial Implementation Plans monitored
Review of the Adolescent and Youth Health Policy Conducted
To implement combination of prevention and treatment interventions to reduce burden of HIV, STI and TB infections
Number of Districts Implementation plans developed with support from NDoH to reach targets for TB and HIV
52 DIPs developed with health districts for 2017/18
52 DIPs for developed with health districts for 2018/19
52 DIPs for developed with health districts for 2019/20
A national report produced to review progress towards targets for HIV and TB
Number of Districts Implementation plans for 2017/18 monitored to reach targets for TB and HIV
52 Districts Implementation Plans (DIPs) monitored and reports produced
52 Districts Implementation Plans (DIPs) for 2017/18 monitored and feedback reports with recommendations produced
52 Districts Implementation Plans (DIPs) for 2018/19 monitored and feedback reports with recommendations produced
52 Districts Implementation Plans (DIPs) for 2019/20 monitored and feedback reports with recommendations produced

26. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
To implement combination of prevention and treatment interventions to reduce burden of HIV, STI and TB infections
Dashboard reports for Monitoring implementation of the HIV and AIDS and STI Programmes
4 x National Quarterly monitoring dashboard reports produced with recommendations
HIV and AIDS Conditional grant Reports
3x Quarterly HIV and AIDS Conditional grant reports produced
Annual HIV Conditional Grant Report for 2015/16 year produced
Annual HIV Conditional Grant Report for 2016/17 year produced
Annual HIV Conditional Grant Report for 2017/18 year produced
HIV Strategic Plan Developed and monitored
NSP for HIV/AIDS and TB published by SANAC
HIV Strategic Plan outlining key actions and strategies for public health system developed and presented to Tech NHC for approval
HIV Strategic Plan monitored and feedback reports to 9 Provincial DoH produced

27. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Strengthen patient retention in treatment and care for TB
Number of MDR-TB treatment initiation facilities with clinical audits conducted
New indicator
18 MDR-TB treatment initiation facilities
Number of provinces with IPT/3HP sentinel sites
3 provinces with IPT/3HP sentinel sites
6 provinces with IPT/3HP sentinel sites
9 provinces with IPT/3HP sentinel sites
Number of hospitals implementing FAST
15 hospitals implementing FAST
30 hospitals implementing FAST
50 hospitals implementing FAST
Dashboard reports for Monitoring implementation of the TB Programmes
4 x National Quarterly monitoring dashboard reports produced with recommendations
Number of facilities reviewed during provincial supervisory and support visits to track implementation of the TB Quality Improvement Programme
24 facilities reviewed during provincial supervisory and support visits

28. PROGRAMME 4 - PRIMARY HEALTH CARE SERVICES (PHC)
The purpose of Primary Health Care Service Programme is to develop and oversee the implementation of legislation, policies, systems, and norms and standards for a uniform well functioning district health system, environmental health services, communicable disease control, non-communicable disease control as well as health promotion and nutrition programmes.

29. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Improve district governance and strengthen management and leadership of the district health system
Number of Districts with management structures in line with the National Guidelines
Uniform structure for District Health Management approved.
National Guidelines for District Health Management Structures approved
52 Districts audited against the approved guidelines,
Implementation plan in place to arrive at 52 Districts with District Health Management structures in line with the National Guidelines
Number of PHC facility committees assessed to determine functionality
1200 PHC facility committees assessed to determine its functionality
2000 PHC facility committees assessed to determine its functionality
2500 PHC facility committees assessed to determine its functionality
3400 PHC facility committees assessed to determine its functionality
Improve access to community based PHC services
Number of functional WBPHCOTs
2000 functional WBPHCOTs
2000
functional WBPHCOTs
Improve quality of services at primary health Care facilities
Number of primary health Care facilities in the 52 districts that qualify as Ideal Clinics
811 primary health Care facilities in the 52 districts qualify as Ideal Clinics
1000 primary health Care facilities in the 52 districts qualify as Ideal Clinics
1500 primary health Care facilities in the 52 districts qualify as Ideal Clinics
2823 primary health care facilities in the 52 districts qualify as Ideal Clinics

30. Performance Indicator Estimated performance
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Improve accessibility of Primary Health Services to people with physical disabilities
Proportion of PHC facilities accessible to people with physical disabilities
25% of PHC health facilities
35% (of 2823) of PHC facilities accessible to people with physical disabilities
50% (of 2823) of PHC facilities accessible to people with physical disabilities
70% (of 2823) of PHC facilities accessible to people with physical disabilities
Improve quality of services at District Hospitals through the Ideal District Hospitals Programme
Ideal District Hospital Framework
New Indicator
Ideal District hospital framework drafted and presented to NDHSC
Ideal District hospital framework approved by Tech NHC
Ideal District hospital framework Implemented at 25% of District Hospitals
Improve environmental health services in all 52 districts and metropolitan municipalities in the country
Number of municipalities that are randomly selected and audited against environmental health norms and standards in executing their environmental health functions
35 municipalities are randomly selected and audited against environmental health norms and standards in executing their environmental health functions
20 municipalities are randomly selected and audited against environmental health norms and standards
Number of public health facilities assessed for adherence to Health Care Risk Waste (HCRW) Norms and Standards
9 Provincial Implementation Plans developed
50 public health facilities assessed for adherence to Health Care Risk Waste (HCRW) Norms and Standards
Programme 4

31. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Ensure provision of IHR compliant port health services at all 44 commercial points of entry in South Africa
Number of points of entry that provide IHR compliant port health services
All 44 points of entry audited, and report produced
10 commercial points of entry compliant with IHR 2005 core capacity requirements
15 commercial points of entry compliant with IHR 2005 core capacity requirements
20 commercial points of entry compliant with IHR 2005 core capacity requirements
Reduce risk factors and improve management for Non-Communicable Diseases (NCDs) by implementing the Strategic Plan for NCDs
Number of media campaigns creating awareness of risk factors that contribute to NCDs
New Indicator
3 media campaigns creating awareness of risk factors that contribute to NCDs
Number of government Departments oriented on the National guide for healthy meal provision in the workplace
35 (15 additional) National Departments
oriented on the National guide for healthy meal provision in the workplace
3 Government Departments (Education, Social Development and Health) in 9 provinces oriented on the National guide for healthy meal provision in the workplace
Implementation of the National guide for healthy meal provision in the workplace assessed in 50% of the oriented government departments
Implementation of the National guide for healthy meal provision in the workplace assessed in 100% of the oriented government Departments
Guidelines on Nutrition for Early Childhood
Guidelines on Nutrition for Early Childhood consulted widely and approved
Implementation plan developed in collaboration with Department of Social Development
Implementation plan monitored
Implementation Evaluation conducted at ECD Centres and report produced

32. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Reduce risk factors and improve management for Non-Communicable Diseases (NCDs) by implementing the Strategic Plan for NCDs
Regulations relating to
labelling and packaging of tobacco products and
smoking in indoor and outdoor public places developed
Draft Tobacco Product Bill submitted to Cabinet
Consultations led by Cabinet supported and comments incorporated
Tobacco Product Bill enacted
labelling and packaging of tobacco products gazetted; and
smoking in indoor and outdoor public places gazetted
Random Monitoring of salt content in foodstuffs
Random samples from each of 13 regulated food categories tested, reported on and corrective action taken
Establish a National Health Commission to address the social determinants of health
National Health Commission established
Framework for National Health Commission developed
Framework for National Health Commission presented to Cabinet for approval
Framework for National Health Commission approved
Improve access to and quality of mental health services in South Africa
Number of Districts with Mental Health Teams established
5 District mental health teams established
10 districts with mental health teams established
15 district mental health teams established
20 districts with mental health teams established

33. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Expand provision of rehabilitation services in South Africa
Number of Districts with an inter-disciplinary rehabilitation team including physiotherapist, optometrist, speech and hearing/audiologist, occupational therapist, medical orthotist/prosthetist
New Indicator
Survey conducted to determine the number of Districts with an inter-disciplinary rehabilitation team
5% increase on baseline
10% increase on baseline
Eliminate Malaria so that there is zero local cases of malaria in South Africa by 2020
Malaria Incidence per 1000 population at risk
0.2 malaria cases per 1000 population at risk
0.1 malaria cases per 1000 population at risk
Malaria Eliminated, so that there is zero local cases of malaria in South Africa
Number of targeted districts reporting malaria cases within 24 hours of diagnosis
7 of 9 malaria targeted districts reporting malaria cases within 24 hours of diagnosis
9 malaria targeted districts reporting malaria cases within 24 hours of diagnosis
9 districts targeted for malaria elimination reporting malaria cases within 24 hours of diagnosis

34. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Strengthen preparedness and core response capacities for public health emergencies in line with International Health Regulations
Number of Provincial Outbreak Response Teams trained to respond to zoonotic, infectious and food-borne diseases outbreaks
9 Provincial Outbreak Response Teams trained on food borne disease outbreak response
9 Provincial Outbreak Response Teams trained on Infectious disease surveillance and response
Evaluation Report commenced on the capacity of all 9 provinces to respond to zoonotic, infectious and food-borne diseases
Evaluation report on the capacity of all 9 provinces to respond to zoonotic, infectious and food-borne diseases
Improve South Africa’s response with regard to Influenza prevention and control
Number of high risk population covered by the seasonal influenza vaccination
high risk individuals covered with seasonal influenza vaccination
high risk individuals covered with seasonal influenza vaccination
high risk individuals covered with seasonal influenza vaccination
high risk individuals covered with seasonal influenza vaccination annually

35. Performance Indicator Estimated performance
Programme 4
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Regulations on organ transplantation developed
Regulations for organ transplantation drafted
Regulations for organ transplantation published for public comment
Regulations for organ transplantation promulgated
National report compiled to review implementation of organ transplantation
Regulations on dialysis developed
Regulations for dialysis drafted
Regulations for dialysis published for public comment
Regulations for dialysis promulgated
National report compiled to review implementation of dialysis
National Policy Framework and Strategy on Eye Health developed
Draft National Policy Framework and Strategy on Eye Health developed
Policy framework developed and presented to NHC
Policy framework Implemented and Provincial DoH supported to develop Implementation Plans
9 Provincial DoH monitored for implementation
Oral health Policy and strategy
New indicator
Oral health policy and strategy drafted
Oral health policy and strategy costed and approved
Implementation of Oral health policy and strategy monitored and reported on

36. PROGRAMME 5:HOSPITAL, TERTIARY HEALTH SERVICES AND HUMAN RESOURCE DEVELOPMENT
The purpose of the programme is to develop policies, delivery models and clinical protocols for hospitals and emergency medical services. It is also to ensure alignment of academic medical centres with health workforce programmes, training of health professionals and to ensure the planning of health infrastructure meet the health needs of the country. This programme will also assist the government to achieve the population health goals of the country through nursing and midwifery, by the provision of expert policy and technical advice and recommendations on the role of nurses in attainment of desired health outputs.

37. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Ensure quality health Care by improving compliance with National Core Standards at all Central, Tertiary, Regional and Specialised Hospitals
Number of Hospitals that achieved an overall performance 75% (or more) compliance with the National Core Standards assessment.
26 Hospitals
(5 Central10 Tertiary, 11 Regional)
43 Hospitals
(8 Central, 15 Tertiary, 20Regional Hospitals)
72 Hospitals
(10 Central, 17 Tertiary, 30 Regional Hospitals and 15 Specialised Hospitals)
All Hospitals assessed, and achieved an overall performance of 75% (or more) compliance with NC
Increase capacity of central hospitals to strengthen local decision making and accountability to facilitate semi-autonomy of 10 central hospitals
Number of central hospitals benchmarked against standardised organisational structures
Organisational structure for Central Hospitals approved by NHC
3 Central hospitals benchmarked against approved Organisational structure
6 Central hospitals benchmarked against approved Organisational structure
All 10 Central hospitals benchmarked and implementing approved Organisational structure
Develop and Implement health workforce staffing norms and standards.
Guidelines for Human Resources for Health (HRH) norms and standards using the WISN methodology
HRH Norms for District and specialised hospitals developed using WISN methodology
HRH standards for
Regional, Tertiary and Central Hospitals presented at TechNHC
HRH Normative guidelines for Regional, Tertiary and Central Hospitals completed and presented to TechNHC
Guidelines for HR Norms and standards published for all levels of care.
Number of health facilities benchmarked against staffing normative guides
3500 PHC Facilities benchmarked
30 District Hospitals benchmarked
50 Regional and Specialised hospitals benchmarked
All PHC facilities, District Hospitals, Regional and Specialised Hospitals benchmarked

38. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Develop and Implement health workforce staffing norms and standards.
National Human Resources for Health (HRH) Strategy
New indicator
A review of the current HRH strategy
Revised national HRH strategy developed and tabled at TechNHC
6 provincial HRH plans updated in line with the revised national strategy
8 provincial HRH plans updated in line with the revised national strategy
Increase production
of Human
Resources for
Health to strengthen
capacity in the
health system through the implementation of the Nelson Mandela Fidel Castro Medical Programme
Expanded Academic Integration Programme developed and implemented for medical students returning to South African from the expanded Nelson Mandela Fidel Castro Medical Programme
Consultation with key stakeholders and provinces on planning for the returning South African medical students.
Ministerial Task team established and Expanded Academic Integration Programme finalised for their final year training in South Africa
First cohort students placed on the expanded academic programme
second cohort students placed on the expanded academic programme
Strengthen Nursing Education Training and Practice through implementation of the objectives of the Nursing Strategy.
New basic Nursing qualification programmes and draft curricula developed
New basic nursing qualification programmes and
draft curricula developed in line with the national nursing education and training policy
New basic nursing qualification programmes finalised
8 colleges with customised draft curricula
New basic nursing qualification programmes accredited
9 additional colleges with customised curricula
New basic nursing qualification programmes and curricula developed and offered at all 17 public Nursing colleges

39. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Strengthen Nursing Education Training and Practice through implementation of the objectives of the Nursing Strategy.
National Policy for the management of nursing placement agencies developed
New Indicator
National Policy for the management of nursing placement agencies drafted and consulted.
National Policy for the management of nursing placement agencies finalised, consulted and tabled at Tech NHC for approval
National Policy for the management of nursing placement agencies implemented and monitored
Norms and standards for decentralised clinical training platforms developed
Norms and standards for decentralised clinical training platform drafted and consulted.
Norms and standards for decentralised clinical training platform consulted, finzalised, and tabled at TechNHC for approval
Norms and Standards for decentralised Clinical Training Platforms at all levels of care implemented and monitored.
To improve quality of health infrastructure in South Africa
Number of facilities maintained, repaired and/or refurbished in NHI Districts
178 facilities maintained, repaired and/or refurbished in NHI Districts
197 facilities maintained, repaired and/or refurbished in NHI Districts
125 facilities maintained, repaired and/or refurbished in NHI Districts
120 facilities maintained, repaired and/or refurbished in NHI Districts

40. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
To improve quality of health infrastructure in South Africa
Number of facilities maintained, repaired and/or refurbished outside NHI pilot Districts
307 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
321 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
297 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
290 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
Number of clinics and Community Health Centres constructed or revitalised
44 clinics and Community Health Centres constructed or revitalised
42 clinics and Community Health Centres constructed or revitalised
40 clinics and Community Health Centres constructed or revitalised
Number of hospitals constructed or revitalised
8 hospitals constructed or revitalised
6 hospitals constructed or revitalised
Number of new facilities that comply with gazetted infrastructure Norms & Standards.
52 new facilities
Specifications of 50 new facilities compliant with Infrastructure norms and standards
Specifications of 48 new facilities compliant with Infrastructure norms and standards
Specifications of 46 new facilities compliant with Infrastructure norms and standards

41. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Ensure access to and efficient effective delivery of quality Emergency Medical Services (EMS)
Number of provinces that are monitored for compliance with the EMS regulations
EMS Regulations revised, and a compliance checklist drafted and presented to National Committee Emergency Medical services (NCEMS
Compliance checklist finalised and presented to Tech NHC for approval.
9 Provincial DoH baseline assessments conducted and reports produced to determine compliance levels
9 provincial department of health monitored using the approved checklist and 9 x EMS Improvement plans developed
9 provincial DoH monitored using the approved checklist annually
To eliminate the backlog of blood alcohol tests by 2017/18 and toxicology tests by 2019/20
Percentage backlog eliminated for blood alcohol tests
90% Backlog of blood alcohol tests eliminated
Backlog of blood alcohol tests eliminated (0% backlog) in all 4 laboratories
Not applicable
Percentage backlog eliminated for toxicology tests
Review of all the samples with CAS number completed to determine the extent of backlog
40% backlog eliminated for toxicology tests
60% backlog eliminated for toxicology tests
85% backlog eliminated for toxicology tests

42. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Contribute to a comprehensive and inter sectoral response by government to prevent deaths due to violence and injury,
Roadside testing programme implemented to monitor driving under the influence of alcohol
New Indicator
Memorandum of Understanding signed between the NDoH and Department of Transport to implement the roadside testing programme
Mobile laboratory established and piloted in one Province
Mobile laboratory established and implemented in three Provinces
To provide food analysis services
Percentage of food tests completed within normative turnaround time (30 days – perishable, and 60 days non-perishable)
100% of food tests completed within normative turnaround time
Improve management of health facilities at all levels of Care through the Health Leadership and Management Academy.
Number of managers accessing the coaching and mentoring Programme
40 Hospital CEOs and
200 PHC Facility Managers
80 Hospital Managers and
800 Managers responsible for PHC accessing the online Programme
100 of Hospital Managers, and
1200 Managers responsible for PHC
Mentoring and training Programme accessible to all Hospital Managers and PHC Managers
Number of managers using the knowledge hub information system
200 Hospital CEOs and
700 PHC Facility managers.
350 Hospital CEOs and
2100 PHC Facility managers accessing the online Programme
All Hospital CEOs and
All PHC Facility managers
Knowledge hub fully developed and accessible to all Hospital CEOs and PHC Managers

43. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Ensure equitable
access to specialised health care by increasing the training platform for medical specialists
Number of Tertiary Hospitals with approved National Tertiary Service Grant (NTSG) Business Plans
New Indicator
17 Tertiary Hospitals with approved National Tertiary Service Grant (NTSG) Business Plans
Number of Tertiary Hospitals with approved service specifications
17 Tertiary Hospitals with approved service specifications

44. Performance Indicator Estimated performance
Programme 5
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Policy on education and training of EMS Personnel monitored
A checklist for EMS education and training accreditation criteria in line with the Policy developed and approved by NCEMS.
One Monitoring report produced to monitor compliance with Policy on education and training by training providers
4 quarterly monitoring reports produced to determine compliance with Policy on education and training
4 quarterly monitoring reports produced to determine compliance with Policy on education and training by training providers
Regulations for Emergency Care Centres at Hospitals
Regulations for Emergency Care Centres consulted with OHSC
Regulations for Emergency Care Centres published for public comment
Regulations on Emergency Care Centres reviewed and published for implementation
Regulations implemented by 9 Provinces
Regulations for EMS in Mass Gatherings
Regulations for EMS in mass gatherings published for implementation
A monitoring system developed and consulted with TechNHC to measure compliance with Regulation for EMS in Mass Gatherings
Monitor compliance of Regulations for EMS in Mass Gatherings

45. Performance Indicator Estimated performance
Programme 5
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Regulations for the Rendering of Forensic Pathology Services
Regulation on for the rendering of Forensic Pathology Services published for implementation
A monitoring system developed to measure compliance with Regulations for the Rendering of Forensic Pathology Services
Monitor compliance of Regulations for the Rendering of Forensic Pathology Services
Scope of Practice for the rendering of Forensic Pathology Services
Scope of Practice for the rendering of Forensic Pathology Services published for Implementation
A monitoring system developed and implemented to measure compliance with Forensic Pathology Services scope of practice
Monitor compliance of Forensic Pathology Services scope of practice
National report produced to review
Health Facilities that are designated to render services for the management of sexual and related offences monitored
Monitoring system developed and Implemented to monitor facilities which render services for the management of sexual and related offences
Biannual monitoring reports produced on facilities which render services for the management of sexual and related offences
Biannual monitoring reports produced to monitor facilities which render services for the management of sexual and related offences

46. PROGRAMME 6 - HEALTH REGULATION AND COMPLIANCE MANAGEMENT
The purpose of this programme is to regulate the sale of food and to ensure accountability and compliance by public entities and statutory health professional councils in accordance with applicable legislative prescripts. .

47. Performance Indicator Estimated performance
Programme 6
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Establish the South African Health Product Regulatory Authority (SAHPRA)
South African Health Product Regulatory Authority (SAHPRA) established as a public entity
South African Health Product Regulatory Authority Listed as a public entity
Memorandum of Understanding between the Department and South African Health Product Regulatory Authority (SAHPRA) finalised and Implemented
and
CEO, Executive Management, and committees appointed
South African Health Product Regulatory Authority fully functional
South African Health Product Regulatory Authority established by 2016/17 and fully operational and functional by 2019/20
Provide diagnostic health laboratory services with greater efficiency by reforming the NHLS business model
National Health Laboratory Service Amendment Act developed
New Indicator
National Health Laboratory Service Amendment Bill tabled for consideration to the Parliamentary Portfolio Committee of Health
National Health Laboratory Service Amendment Act Promulgated into law
National Health Laboratory Service Amendment Act implemented

48. Performance Indicator Estimated performance
Programme 6
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
To establish the National Public Health Institutes of South Africa (NAPHISA) for disease and injury surveillance
Legal framework to establish National Public Health Institutes of South Africa (NAPHISA)
Comments on draft NAPHISA legislation considered and revised NAPHISA bill submitted to cabinet.
NAPHISA Bill tabled for consideration to the Parliamentary Portfolio Committee of Health
NAPHISA Act promulgated into law.
NAPHISA established and operational as a public entity
Improve oversight and Corporate Governance practices by establishing effective governance structures, policies and tools
Governance monitoring system implemented to strengthen oversight and corporate governance
4 health Entities’ and 6 statutory health professional councils
Governance reports of 4 health Entities’ and 6 statutory health professional councils produced
Governance reports of 4 health Entities’ and 6 statutory health professional councils produced

49. Performance Indicator Estimated performance
Programme 6
Programme
Performance Indicator
Estimated performance
Medium-term targets
2016/17
2017/18
2018/19
2019/20
Number of newly appointed boards inducted and trained
3 new boards appointed, inducted and trained
(South African Medical Research Council; Office of Health Standards Compliance and Allied Health Professions Council of SA)
2 new boards appointed. (South African Health Product Regulatory Authority, Council for Medical Schemes)
4 New boards appointed.
South African Dental Technician Council, South African Nursing Council, South African Pharmacy Council an National Health Laboratory Service
2 new boards appointed. (South African Medical Research Council; Office of Health Standards Compliance)

50. EXPENDITURE AND BUDGETS FOR 2017/18-2019/20

51. % Growth from 2016/17 allocation to 2017/18
2/10/2018
Summary per Programme
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
ADMINISTRATION
463,464
10.65
512,838
6.75
547,470
6.39
582,475
NATIONAL HEALTH INSURANCE, HEALTH PLANNING & SYSTEM ENABLEMENT
559,762
31.32
735,087
35.06
992,822
5.49
1,047,351
HIV & AIDS, TB, MATERNAL & CHILD HEALTH
16,018,568
14.11
18,278,344
13.50
20,745,595
10.43
22,909,431
PRIMARY HEALTH CARE SERVICES SERVICES
257,839
2.51
264,299
10.89
293,089
7.50
315,071
HOSPITALS, TERTIARY HEALTH SERVICES & HUMAN RESOURCE DEVELOPMENT
19,573,498
7.84
21,108,184
5.65
22,301,130
6.01
23,640,756
HEALTH REGULATION & COMPLIANCE MANAGEMENT
1,690,186
2.18
1,726,971
3.47
1,786,866
5.76
1,889,863
TOTAL
38,563,317
10.53
42,625,723
9.48
46,666,972
7.97
50,384,947 51

52. Growth over MTEF
The department’s compensation of employees budget has been reduced by R9.7 million for 2017/18, R10.7 million for 2018/19 and R11.3m for 2019/20 respectively.
The goods & services budget has been reduced with R60.5 million over the MTEF (R17.8m; R19.0m and R23.7m).
The payment for capital assets were reduced with R22.0 million over the MTEF period.
A new component has been added to the national health insurance indirect grant for an integrated patient based information system and an electronic stock management system which include an early warning system for stock-outs of medicine in primary health care facilities. R166 million, R390 million and R411.8 million is allocated over the MTEF period.
R600 million has been reprioritised for the operationalization of the Nelson Mandela Children’s Hospital (R100 million, R200 million and R300 million) 52

53. Programme 1: Administration
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
MINISTRY
31,534
0.97
31,840
7.61
34,264
6.17
36,377
MANAGEMENT
20,069
-2.11
19,646
11.50
21,905
6.23
23,270
CORPORATE SERVICES
206,733
12.43
232,421
6.21
246,854
6.61
263,171
OFFICE ACCOMMODATION
143,695
14.95
165,179
5.89
174,912
6.34
185,995
FINANCIAL MANAGEMENT
61,433
3.77
63,752
9.07
69,535
5.94
73,662
TOTAL
463,464
10.65
512,838
6.75
547,470
6.39
582,475 53

54. % Growth from 2016/17 allocation to 2017/18
Programme 2: National Health Insurance, Health Planning and System Enablement
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
OFFICE OF THE DDG
3,184
17.84
3,752
14.42
4,293
-8.22
3,940
TECHNICAL POLICY & PLANNING
22,011
345.05
97,961
128.16
223,504
5.71
236,263
HEALTH INFORMATION MANAGEMENT, MONITORING & EVALUATION
55,491
21.70
67,533
0.41
67,810
6.03
71,897
SECTOR-WIDE PROCUREMENT
39,550
252.58
139,445
73.77
242,316
5.01
254,453
HEALTH FINANCING & NATIONAL HEALTH INSURANCE
373,528
-7.18
346,709
4.52
362,370
6.01
384,153
INTERNATIONAL HEALTH & DEVELOPMENT
65,998
20.74
79,687
16.12
92,529
4.45
96,645
TOTAL
559,762
31.32
735,087
35.06
992,822
5.49
1,047,351 54

55. Programme 3: HIV and AIDS, TB, Maternal and Child Health
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
OFFICE OF THE DDG
4,736
36.36
6,458
0.81
6,510
-1.97
6,382
HIV & AIDS
15,744,874
14.35
18,004,547
13.66
20,463,809
10.49
22,611,465
TUBERCULOSIS
27,370
-3.19
26,498
12.60
29,837
6.55
31,790
WOMEN'S MATERNAL & REPODUCTIVE HEALTH
18,924
-2.82
18,390
16.01
21,334
6.85
22,796
CHILD, YOUTH & SCHOOL HEALTH
222,664
-0.10
222,451
0.74
224,105
5.75
236,998
TOTAL
16,018,568
14.11
18,278,344
13.50
20,745,595
10.43
22,909,431 55

56. Programme 4: Primary Health Care Services
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
OFFICE OF THE DDG
2,994
4.74
3,136
12.56
3,530
-3.88
3,393
DISTRICT HEALTH SERVICES
26,047
77.63
46,266
45.81
67,462
6.01
71,519
ENVIRONMENTAL AND PORT HEALTH SERVICES
162,916
-11.59
144,027
4.73
150,839
8.65
163,891
COMMUNICABLE DISEASES
21,561
1.68
21,923
4.31
22,867
6.92
24,450
NON-COMMUNICABLE DISEASES
21,598
4.13
22,491
4.87
23,587
7.08
25,256
HEALTH PROMOTION & NUTRITION
22,723
16.43
26,456
-6.24
24,804
7.09
26,562
TOTAL
257,839
2.51
264,299
10.89
293,089
7.50
315,071 56

57. Programme 5: Hospitals, Tertiary Health Services and HR Development
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
OFFICE OF THE DDG
3,713
-0.57
3,692
7.56
3,971
7.23
4,258
HEALTH FACILITIES INFRASTRUCTURE MANAGEMENT
6,078,821
9.79
6,673,670
3.91
6,934,642
5.60
7,323,260
TERTIARY HEALTH CARE PLANNING & POLICY
10,851,438
7.18
11,630,763
6.61
12,399,642
6.32
13,182,903
HOSPITAL MANAGEMENT
5,159
-0.08
5,155
7.45
5,539
7.08
5,931
HUMAN RESOURCES FOR HEALTH
2,500,069
6.15
2,653,788
5.80
2,807,792
5.62
2,965,500
NURSING SERVICES
6,627
-0.98
6,562
7.83
7,076
7.41
7,600
FORENSIC CHEMISTRY LABORATORIES
120,533
5.70
127,405
134,795
143,091
VIOLENCE, TRAUMA & EMS
7,138
0.15
7,149
7.33
7,673
7.04
8,213
TOTAL
19,573,498
7.84
21,108,184
5.65
22,301,130
6.01
23,640,756 57

58. Programme 6: Health Regulation and Compliance Management
2/10/2018
Subprogramme
2016 ENE
% Growth from 2016/17 allocation to 2017/18
2017/18
% Growth from 2017/18 to 2018/19
2018/19
% Growth from 2018/19 to 2019/20
2019/20
R'000 %
OFFICE OF THE DDG
4,062
11.57
4,532
7.37
4,866
7.13
5,213
FOOD CONTROL
9,972
17.61
11,728
-1.92
11,503
7.24
12,336
RADIATION CONTROL AND HEALTH TECHNOLOGY
139,572
-86.42
18,956
3.43
19,606
18.63
23,258
PUBLIC ENTITIES MANAGEMENT
1,474,937
10.52
1,630,082
3.38
1,685,129
5.60
1,779,554
COMPENSATION COMMISSIONER FOR OCCUPATIONAL DISEASES & OCCUPATIONAL HEALTH
61,643
0.05
61,673
6.63
65,762
5.69
69,502
TOTAL
1,690,186
2.18
1,726,971
3.47
1,786,866
5.76
1,889,863 58

59. SPENDING TRENDS 59 ADMINISTRATION 347 342 386 476 438 501 442 876
2/10/2018
SPENDING TRENDS
AUDITED OUTCOME
PRELIMINARY
PROGRAMME
2013/14
2014/15
2015/16
2016/17
R'000
R’000
ADMINISTRATION
NATIONAL HEALTH INSURANCE, HEALTH PLANNING & SYSTEM ENABLEMENT
HIV & AIDS, TB, MATERNAL & CHILD HEALTH
PRIMARY HEALTH CARE SERVICES SERVICES
HOSPITALS, TERTIARY HEALTH SERVICES & HUMAN RESOURCE DEVELOPMENT
HEALTH REGULATION & COMPLIANCE MANAGEMENT
TOTAL
% OF BUDGET EXPENDED
97.7%
97.8%
99.4%
99.7% 59

60. SPENDING TRENDS – CONDITIONAL GRANTS
2/10/2018
SPENDING TRENDS – CONDITIONAL GRANTS
CONDITIONAL GRANTS
Audited outcome
Preliminary
2013/14
2014/15
2015/16
2016/17
R'000
National Tertiary Services
Comprehensive HIV and AIDS
Health Facility Revitalisation
Professional Training and Development
National Health Insurance
50 953
76 956
61 077
94 227
HPV Vaccine (Indirect) -
Health Infrastructure (Indirect) `
Health Professionals Contracting (Indirect)
8 458
82 261
Nursing College and School (Indirect)
75 975
CHAN 2013 (Indirect)
4 561 60

61. Conditional Grant - Budgets
2/10/2018
Covers comparative budget for 2017/18 and 2016/17
Total budget is R37.5bn which is 11% increase compared to last
financial year budget of R33.8bn.
The major contributors to 11% increase is
inflation of 5.5%
5.8% or R2bn increase in HIV/AIDS as a result of scale up on key
prevention interventions on
Male Medical Circumcision(MMC)
Universal Test & Treat (UTT)
0.5% or R150m for Nelson Mandela Childrens Hospital allocation

62. Proportionate Allocation - 2017/18
2/10/2018
It is evident from the chart that HIV/AIDS receives almost 50% of the total grant allocation which is in line with the priorities of the department.
The other 50% is allocated to other three grants with NTSG receiving significant portion (31%).

63. 2/10/2018
Overview - Grants

64. Health Professions Training Grant (01)
2/10/2018
Health Professions Training Grant (01)

65. Health Professions Training Grant (02)
2/10/2018
The grant has 6% increase which represents an inflation increase.
The purpose of the grant is to support provinces to fund service costs
associated with clinical training and supervision of health science trainees
on the public service platform
Allocation to provinces is based on historical allocation and spending
patterns.

66. National Tertiary Services Grant (01)
2/10/2018
National Tertiary Services Grant (01)

67. National Tertiary Services Grant (02)
2/10/2018
An increase of 8% is as a result of Nelson Mandela Children’s Hospital
and general inflationary increase.
Key priorities of the grant is to ensure
provision of tertiary health services for all South African citizens
(including documented foreign nationals)
To compensate tertiary facilities for the additional costs associated
with provision of these services
Grant allocation is based on historical allocation and spending patterns.

68. Comprehensive HIV/AIDS & TB (01)
2/10/2018
Comprehensive HIV/AIDS & TB (01)

69. Comprehensive HIV/AIDS & TB (02)
2/10/2018
An increase of 15% is as result of inflation and scale up of key prevention
interventions – MMC & UTT.
The grant will focus on improving quality of HIV and AIDS and TB
services including access to:
HIV Counseling and Testing (HCT)
TB case finding, screening and diagnosis
Antiretroviral Treatment (ART)
treatment for TB, including drug-resistant TB
adherence monitoring and support
prevention of TB
prevention of mother-to-child-transmission (PMTCT)
medical male circumcision (MMC)
Allocations are based on antenatal HIV prevalence, estimated share of
AIDS cases, populations post-demarcation

70. Health Facility Revitalisation Grant (01)
2/10/2018
Health Facility Revitalisation Grant (01)

71. Health Facility Revitalisation Grant (02)
2/10/2018
Increase of 7% is an inflation increase (5.5%) and accelleration of infrastructure in preparation for NHI (1.5%).
The grant will focus on
accelerating construction, maintenance, upgrading and
rehabilitation of new and existing infrastructure in health
including, health technology, organisational development systems and
quality assurance
To enhance capacity to deliver health infrastructure
More than 50% of the grant will be dedicated on maintenance.
Allocation to provinces is project and performance based.

72. (Schedule 6 – Indirect Grant ) – (01)
2/10/2018
National Health Grant
(Schedule 6 – Indirect Grant ) – (01)

73. National Health Indirect Grant (Schedule 6 – Indirect Grant ) – (02)
2/10/2018
CCMDD was previously focusing on NHI pilot sites however the
programme has extended outside the NHI pilots (since there is no
piloting). This is also due to successes of the programme hence an
increase of 150%.
Ideal Clinic component increased by 200% to accelerate the ideal clinic
programme.
Indirect grants are not allocated to provinces as programmes are
implemented and managed at national level.

74. 2/10/2018
Overview - Provinces

75. CONCLUSION
National DoH Annual Performance Plan 2017/ /20 is founded on government’s 2030 vision outlined in the National Development Plan 2030.
It reflects interventions to improve the health system and health outcomes for all South Africans.
The Department will continue to work towards improving equity, quality and access to healthcare through the introduction of the National Health Insurance, and other Health Sector reforms through various initiatives.