1. DEPARTMENT OF HEALTH NORTH WEST PROVINCE
PORTFOLIO REPORT 2002/3
DEPARTMENT OF HEALTH
NORTH WEST PROVINCE

2. TEAM Dr Hugh Gosnell : HOD(DDG) Ms Rebecca Hlabatau: CF0
Mr O Mongale : CD Corporate Services
Dr M Saasa-Modise : CD Strategic Health Programs
Mr Molefi Mosenogi : Director Policy and Planning
Mr. F P Netshipale: Director: CD

3. OUTLINE Provincial Health Services Overview/Background
Health Services Performances(Strategic Plans)
Budgetary Allocations
Capital Projects including Revitilisation Projects
Responses to Portfolio Committee Questions

4. POPULATION :3.4 MILLION
DISTRICTS:4
SUB-DISTRICTS:22

5. STRATEGIC OVERVIEW(CONT..)
2 provincial (level 2) hospital complexes (2 provide specialist psychiatric services as well) and 1 provincial hospital
20 district hospitals
12 community hospitals
327 fixed clinics and health centres
77 mobile clinics.

6. FIXED PUBLIC PRIMARY HEALTH CARE FACILITIES
PHC facilities
Number
Average population per facility
Province wide
327
11,009
Bophirima (least served health district in terms of access) 81
8,000
Bojanala (best served health district in terms of access)
134
12,375
Southern 34
19,058
Central (best served in terms of both access and average population per facility) 78
9,231

7. Beds per 1000 uninsured people (80% of population)
PUBLIC HOSPITALS
Hospital type
Number
Number of beds
(Authorised)
Beds per people
Beds per uninsured people (80% of population)
District and community[1] 27
3 613
1.1
1.4
General (regional) 4
2 244
0.7
0.9
Central
Sub-total acute hospitals 31
5 857
1.75
2.2
Tuberculoses
Psychiatric [2] 2
1 520
0.5
0.6
Chronic medical and other specialised
Total
7 377
2.19
2.8

8. STAFF ESTABLISHMENT 2002/3 15255 MALES 3498 29 53 308 3888 25% FEMALES
AFRICANS
INDIANS
COLOUREDS
WHITES
TOTAL
MALES
3498 29 53
308
3888
25%
FEMALES
10224 19
246
878
11367
75%
13722 48
299
1186
15255

9. Vision
Optimum health for all individuals and communities in the North West Province.

10. Mission
To ensure access to affordable, equitable, quality, caring health services for all in the North West Province through:
Community involvement and partnerships;
Batho Pele Principles and the Patients’ Rights Charter;
Innovation driven performance; and
By valuing our people and their diversity.

11. Strategic Goals Providing quality health care
Providing accessible, equitable and affordable comprehensive primary health care services
Well functioning and competitive hospital services
Improving the health status of communities through implementation of integrated health programmes

12. Strategic Goals Well managed and effective District Health System
Competent, empowered and performance focused employees
Appropriate and effective organisational systems
Effective management of the Department’s finance and assets

13. Demographic Indicators
< 15 years – 1.2 million
> 49 years – 430,000
15 – 49 years – 54% of total population
non-urban areas – 65% of population
only 36 people / sq. km. (Gauteng 468)

14. Socio-economic Indicators
GDP per capita – 2/3 of country average
Official unemployment rate : 30.7%
Piped water inside houses: 21.7% of households
Using electricity for cooking : 33.8%
Infant mortality rate : 36/1000 Below national 45/1000
Life expectancy at birth : 52.7 years

15. NUTRITION

16. HIV/AIDS/STI
Male urethral discharge incidence decrease from 3/1000 to 2.8/1000
Syphilis prevalence rate remained at 4% (77% reduction from 1998 figure of 17%)
HIV prevalence rate among antenatal clinic at tenders increases from 22.9%in 2000 to 25.2% in 2001

17. HIV/AIDS/STI(CONT..) 322 VCT sites established & are functional
1310 Nurses were trained in Rapid testing
664 Nurses trained in counselling
PMTCT rollout district approach adopted
PMTCT sites increased from 2 to 89
392 HCW Prof nurses trained in PMTCT
400 lay counselors appointed through NGO Approach
Out of eighty two(82) children tested for HIV at nine months(9), only 9 tested HIV positive

18. HIV/AIDS/STI(CONT..) R2.6 million was spent to fund 24 HBC NGO’s.
Assisted 51 other NGO’s with Home Based Care kits (refilled quarterly by Department)
HBC beneficiaries increased from 6,458 to 11,473
NGO’s have conducted 28,366 visits as compared to 22,880 in 2001.
More than 1333 care givers were trained in HBC
Department adopted 36 affected children in circles of support/care

19. 25.8% PMTCT PERFORMANCE JULY 2001 –DEC 2002 RUSTENBG ZEERUST TOTAL
# First Antenatal (booking) visits
2970
2855
5825
# Pregnant women who accepted HIV testing
1196
1828
3024
# Antenatal clients testing positive for HIV
462
319
781
# Deliveries to women with HIV
162
165
327
# HIV positive women given Nevirapine
324
# New born babies of HIV positive mothers on PMTCT
160
166
326
# Infants tested for HIV at 9 months 26 56 82
# Infants tested HIV positive at 9 months 2 6 8
# Exclusive breastfeeding 51 81
132
# Exclusive formula feeding
101 85
186
% VCT/ PMTCT uptake
40%
64%
52%
% HIV positive ( As a % of those who accepted VCT)
38.6%
17.5%
25.8%

20. HIV/AIDS/STI(CONT..)
24 private doctors were trained in the syndromic management of STI, as well as 320 traditional healers.
2,080 condom distribution points.
22,208,331 male condoms and female condoms were distributed during 2002(feb 2003).
Assisted in training 8,700 youth as Peer Educators in five sub‑districts.

25. NUMBER OF SUSPECTED AND TRUE MEASLES CASES BY REGION AND YEAR: 2000-2002
Bojanala
Central
Southern
Bophirima
Province
True measles cases.
2000
37 (6 ) 4
56 (3) 13
110 9
2001 41 3 11 29 84
2002 31 1 48

26. NUMBER OF NEONATAL TETANUS CASES REPORTED: 2000-2002
YEAR
BOJANALA
CENTRAL
SOUTHERN
BOPHIRIMA
PROVINCE
RATE
2000 1 2
<1/1000
2001
2002

28. TB
INDICATOR
2001
2002
CURE RATE 52 47
% OF TREAMENT COMPLETION WITH NO SPUTUM COLLECTION
16%
26%
DOTS COVERAGE
93%
STT < 48HRS
75%
80%
INTERUPTION RATE
12%
11%
MDR RATE
0.4%
0.5%
TB INCEDENCE RATE
402/1000
409/1000

29. PSYCHIATRIC COMMUNITY SERVICES
2001/02 Register:
Visits:
Default: 3806
2002/03
1st Q Register:
Visits:
Default: 3 149
2nd Q Register:
Visits:
Default: 4 531
3rd Q Register:
Visits:
Default: 6 063

30. PSYCHIATRIC HOSPITAL SERVICES
1st Quarter: Attempted suicide 283
Acute psychiatry 779
Detox 32
Rehab 0
2nd Quarter Attempted suicide 404
Acute psychiatry 851
Detox 49
Rehab 9
3rd Quarter Attempted suicide 375
Acute psychiatry 492
Detox 45
Rehab 14

31. MCWH
Antenatal visits per client increased from3.8 to 4.1 (higher than national norm of 3)
Caesarean section rate remained 14% for last 3 years
Decreased teenage pregnancy rate to 9% in 2002 from 11% in 2001
Increased TOP by 64% from 2000 in 2001 to 3300 in 2002
IMCI implementation – 85% of sub-districts
Implementation of CIC
35% Maternal deaths due to HIV

32. NUMBER OF MATERNAL DEATHS AND ESTIMATED RATE PER 100,000 WOMEN
Year
Number reported
1998 34
1999 54
2000
115
2001 62

33. CERVICAL SCREENING PERFORMED 2002/3
SERVICE PROVIDER
PERIOD
NUMBER OF CERVICAL SCREENING DONE
Operation Blanket:
Mafikeng district
2002/2003
8,274
Klerksdorp
9,224
Potchefstroom
1,500
Moses Kotane Cancer Association
151
Moretele
1,963
Schweizer-Reneke
233
Lichtenburg
840
Odi
1,491
Total 2002/2003
23 676

34. NUMBER OF ASSISTIVE DEVICES ISSUED
Backlog
Provided by Department Nov 2000 – December 2002
Walking Aids 91
679
Wheelchairs
1350
1127
Hearing Aids
563
385
Spectacles and IOL
1034

35. NUMBER OF CATARACT OPERATIONS PER YEAR SINCE1996
Number cataract operations done
Estimated percentage increase
1996
1185
1997
1580
25%increase
1998
1975
25% increase
1999
1518
23% decrease
2000
1675
11% increase
2001
2208
32,5% increase
2002
1854
16% decrease

36. Complete Decentralized PSNP Programme implemented
In % of targeted children as opposed to 58% of 2001( out of , were fed)
More than 660 women groups benefited from the initiative
This ensured income for 5000 women

37. ORAL HEALTH SERVICES
20 new fully equipped surgeries with state of the art equipments were opened between 2000 and % of them in rural areas.
Number of out reach clinic visits increased by 30 %Preventive services has increased by 35%
Conservative dentistry services by 30 %
Curative in other areas has increased by 100 % where we had no services before as new more clinics where opened.

38. CAPITAL PROJECTS ACHIEVEMENTS
HR&R Projects
Doctors Residences in 3 district hospital i.e Schweizer Reneke, Ventersdorp and Jubilee
Medical/psychiatric Unit in Taung & maternity Units in Mafikeng Complex
Laundry /kitchen and boilers
HOSPITAL REVITILISATION
Business Cases completed for 4 hospitals
11/14/2018

39. CAPITAL PROJECTS ACHIEVEMENTS (CONTINUE…)
Clinics Projects Completed
10 clinic/CHC’s (R25Million)
Clinics to be completed (R14million)
16 clinics
Madibogo CHC completed in partnership with IDT(R13million).
Other 3 CHC’s to be built this year also by partnership with IDT worth R17Million.
11/14/2018

40. SOME CAPITAL PROJECTS PLANS 2003/4
Differential amenities for 12 hospitals (total costs R18 million)
Revitilisation projects started
Swartruggens Hospital building started(R32m)
Vryburg and Moses Kotane Hospitals to be built
Ongoing projects in Mafikeng SPDU, Taung hospital Pharmacy, Laundry linen bank (R13Million)
Business Cases for Moretele and Brits to be developed
11/14/2018

41. QUALITY ASSURANCE ACHIEVEMENTS
Clinical Investigation Committee work
Investigates cases of neglect/clinical mismanagement and litigation matters
Cohsasa Programmes started in 21 hospitals
Clinic Supervision Tools work shopped and implemented
Mortality and Morbidity Meetings monthly
QA Unit established and functional

42. Drug availability at various centres: District Hospitals
Central %
Bophirima 93.6%
Southern 90.36%
Bojanala 87%
q       Community Health Centers and Clinics
Central
85.125%
Bophirima 86.6%
Southern 89.6%
Bojanala 80%
q       Provincial Hospitals
Average = 92.25%

43. EXPENDITURE ON PHARMACEUTICALS & SURGICALS
Projected exp 2003/04
R204,707,450 (20% increase)

45. TOTAL Conditional Grant Budget Expenditure %Expenditure
BUDGET AND EXPENDITURE PER CONDITIONAL GRANTS 2002/3
Conditional Grant
Budget
Expenditure
%Expenditure
Primary School Nutrition Programme
43,964
100%
National Tertiary Services
34,750
36,446
105%
Professional Training and Development
32,898
Hospital Rehabilitation/Revitalization
64,293
52,824
82%
Infrastructure
20,113
13,318
66%
HIV/AIDS
20,419
21,245
104%
Hospital Management and Quality Enhancement
8,334
6,395
77%
TOTAL
224,771
207,149
92%

46. BUDGET ALLOCATION & EXPENDITURE PER PROGRAMME
Est Actual
Variance
R'000
Administration
83,233
83,888
-655
District Health Services
1,252,569
1,282,716
-10,147
Provincial Hospital Services
537,071
550,117
-23,046
Health Sciences
46,069
47,036
-967
Health Care Support Services
55,017
56,416
-3,399
Total
1,973,959
2,012,173
-38,214

47. FLAGSHIP PROGRAMME FARM CHILD/COMMUNITY NUTRITION/FOOD SECURITY
SOCIAL GRANT
ELCD
FAMILY/SEXUAL/OTHER VIOLENCE
SUBSTANCE ABUSE

48. PRIORITY PROJECTS HIV/AIDS &TB EMS
QUALITY IMPROVEMENT -CLINIC SUPERVISION & HOSPITAL ACCREDITATION
ATTRACTING & RETAINING STAFF
HOSPITAL REVITALISATION & DIFFERENTIATED AMENITIES
DEVOLUTION OF PHC SERVICES
COMMUNITY DEVELOPMENT WORKERS

49. NEXT
RESPONSES