1. Presentation to the Select Committee on Social Services
Annual Performance Plan 2018/19 – 2020/21
Presentation to the Select Committee on Social Services
15 May 2018

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 Goal 3
2018/19 – 2020/21 MTEF PRIORITIES
The priorities for the MTEF commencing 2018/19 year are derived from:
Sustainable Development Goal 3

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.
Public Finance Management Act, 1999
Treasury Regulations – Chapter 5 of 2007
Framework for Strategic Plans and Annual Performance Plans, 2010

5. Impact Indicator Baseline (2009)
Outcome 2 : A long and Healthy lives for all South Africans Impact Indicators: Targets
Impact
Indicator
Baseline
(2009)
Current Performance1
Targets
(2019)
(2030)
Life expectancy at birth: Total
56.5 years
63.8 years
64.2 years
70 years (NDP)
Life expectancy at birth: Male
54.0 years
60.8 years
61.5 years
Life expectancy at birth: Female
59.0 years
66.9 years
67 years
Under-5 Mortality Rate
56 Under 5 deaths per 1,000 live-births
34 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
12 neonatal deaths per 1000 live births
8 neonate deaths per 1000 live births
Infant Mortality Rate (IMR)
39 per 1,000
live-births
25 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
152 / live births (2015)
<100 maternal deaths per 100,000live-births
Rapid Mortality Surveillance (RMS) Report 2016, (Published by MRC during March 2018)

6. 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

7. Performance Indicator Estimated performance
Programme 1
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Ensure effective financial management and accountability by improving audit outcomes
Audit opinion from
Auditor General
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
Clean Audit Opinion for the NDOH for 2019/20
Number of Provincial DoH that demonstrate improvements in Audit Outcomes or Opinions
4 Provincial DoH that demonstrate improvements in Audit with no significant matters for 2016/17
5 Provincial DoH that demonstrate improvements in Audit with no significant matters for 2017/18
5 Provincial DoH that demonstrate improvements in Audit with no significant matters for 2018/19
6 Provincial DoH that demonstrate improvements in Audit with no significant matters for 2019/20

8. Programme 1: Administration
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
197,170 6
209,195
Goods and Services
308,819
328,136
Transfers
2,252 9
2,455
Capital
4,597
139
11,006
TOTAL
512,838 7
550,792 8

9. DISCRIPTION: EARMARKED
Programme 1: Administration
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EAR-MARKED
GRANTS
Ministry
31,840
31,217
Management
19,646
25,666
Corporate Services
232,421
239,998
Medico-legal Committees -
5,000
Office Accommodation
165,179
174,912
Financial Management
63,752
65,999
SAICA programme
8,000
Total Programme 1
512,838
537,792
13,000
Total per financial year
550,792 9

10. 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.

11. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Achieve Universal Health Coverage through the phased implementation of National Health Insurance
Legislation for NHI
Draft NHI Bill gazetted for public comments
Draft NHI Bill published for comments
NHI Bill approved by the National Assembly and National Council of Provinces.
NHI Bill assented to by the President
Private Health providers contracted to expand coverage of care
New Indicator
Private health providers contracted to provide health services on behalf of population
Additional Private health providers contracted to provide health services on behalf of population
Implement eHealth Strategy of South Africa through the development of patient information systems
eHealth Strategy published
eHealth Strategy implementation reviewed
eHealth Strategy 2019 – 2023 implantation commenced, and monitored
eHealth Strategy 2019 – 2023 implementation monitored

12. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Develop and implement a system for the creation of a NHI Beneficiary Registry
Number of health facilities implementing health patient registration system (HPRS)
3000 PHC Facilities implementing the health patient registration system (HPRS)
3000 PHC Facilities maintained; Additional 470 PHC facilities and 22 Hospitals implementing the health patient registration system (HPRS)
3470 PHC facilities and 22 Hospitals maintained; Additional 38 hospitals implementing the health patient registration system (HPRS)
3470 PHC facilities and 60 Hospitals maintained; Additional 260 hospitals implementing the health patient registration system (HPRS)
Number of individuals from the population registered on the NHI Patient Beneficiary Registry
15 million
35 million
50 million
57 million

13. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Establish a national stock management surveillance centre to improve medicine availability
Total number of health facilities reporting stock availability at national surveillance centre
3450 of health facilities reporting stock availability at national surveillance centre (cumulative)
3625 of health facilities reporting stock availability at national surveillance centre (cumulative)
3800 of health facilities reporting stock availability at national surveillance centre (cumulative)
3942 health facilities reporting stock availability at national surveillance centre (cumulative)
Improve contracting and supply of medicines through innovative service delivery models
Number of patients enrolled for receiving medicines through the centralised chronic medicine dispensing & distribution (CCMDD) programme
1,900,000 patients enrolled for receiving medicines through the CCMDD programme (cumulative)
2,500, 000 patients enrolled for receiving medicines through the CCMDD programme (cumulative)
2,800,000 patients enrolled for receiving medicines through the CCMDD programme (cumulative)
3,000,000 patients enrolled for receiving medicines through the CCMDD programme (cumulative)

14. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve the use of antibiotics in South Africa by implementing the Antimicrobial Resistance Strategy
Surveillance system implemented for monitoring resistance
Surveillance system for monitoring resistance developed.
Surveillance system for monitoring resistance accessible to 3 provincial DoH
Surveillance system for monitoring resistance accessible to 6 provincial DoH
Surveillance system for monitoring resistance accessible to 9 provincial DoH
Regulate Traditional Health Practitioners in South Africa
Traditional Health Practitioners Amendment Bill drafted and published for comment
Traditional Health Practitioners Amendment Bill drafted
Traditional Health Practitioners Amendment Bill published for comment
Amendment Bill promulgated NA

15. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Regulation of the price on medicines through the transparent pricing system
Single Exit Price Adjustments Published and Implemented Annually
2017/18 Annual Price Adjustments gazetted and published
2018/19 Annual Price Adjustments gazetted and implemented
2019/20 Annual Price Adjustments gazetted and implemented
2020/21 Annual Price Adjustments gazetted and implemented
Improve the acceptability, quality and safety of health services by increasing user and community feedback and involvement
Number of PHC health facilities conducting Patient Experience of Care Survey
9 Provincial Health Departments trained on use of PEC Guideline
1500 PHC facilities conducting Patient Experience of care surveys annually
2000 PHC facilities conducting Patient Experience of care surveys
3000 PHC facilities conducting Patient Experience of care surveys

16. Performance Indicator Estimated performance
Programme 2
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Implement an integrated monitoring and evaluation plan aligned to health outcomes and outputs contained in the Health Sector Strategy
NHI Phase 1 Evaluation Conducted
NHI Phase 1 evaluation conducted
NHI Phase 1 evaluation report published
NHI Phase 1 evaluation report disseminated and used to inform further planning for NHI
Comprehensive NHI indicator list developed

17. Programme 2: National Health Insurance, Health Planning and System Enablement
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
114,740 2
116,693
Goods and Services
585,328
130
1,347,334
Transfers
28,401 6
30,048
Capital
6,618
2,582
177,478
TOTAL
735,087
127
1,671,553 17

18. DISCRIPTION: EARMARKED
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Chief Operating Officer
3,752
4,649
Technical Policy & Planning
21,961
21,377
PHC Integrated Patient Information System In-kind grant -
76,000
Health Information Management, Monitoring & Evaluation .
39,132
32,000
Health System Trust
15,019
15,890
Health Information System Programme
13,382
14,158
Sector-wide Procurement
39,445
36,279
Electronic Medicine Stock Management System
10,000
National Medicine Stock Surveillance System In-kind grant
90,000 18

19. DISCRIPTION: EARMARKED
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Health Financing & National Health Insurance .
11,497
24,693
Health Professionals Contracting In-kind grant -
318,053
DRG Project
17,159
NHI in-kind: Non-personal services
700,000
NHI in-kind: Personal services
712,500
NHI Interim Fund Management & Administration
5,000
NHI Ministerial advisory committees
2,000
Health Technology Assessment
7,000
International Health & Development
79,687
86,007
Total Programme 2
195,474
55,560
484,053
205,005
47,048
1,419,500
Total per financial year
735,087
1,671,553 19

20. Programme 2- Growth 17/18 to 18/19
Additional R700 million for the NHI. NHI allocations were restructured, by centralizing the budgets previously allocated under Responsibilities (such as Technical Policy and Planning and Sector-Wide Procurement) under Health Financing and NHI;
NHI in-kind grant is allocated to both Goods and Services as well as Capital;
Conversion of DRG allocation under Goods and Services and Capital to a Conditional Grant for Western Cape under Transfers and Subsidies;
Programmes allocated Capital Budgets were reduced to allocate funds to Information Communication Technology to maintain current systems;
Compensation of Employees budget was realigned in accordance with the filling of priority posts. 20

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
2017/18
2018/19
2019/20
2020/21
To implement combination of prevention and treatment interventions to reduce burden of HIV, STI and TB infections
Total number of clients remaining on ART (TROA)
Number of people reached in the National Health Screening and Testing campaign annually
New Indicator
Medical Male Circumcisions performed
Number of undiagnosed TB infected persons (new cases) found
80 000

23. Performance Indicator Estimated performance
Programme 3
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
To reduce under 5 mortality rate to less than 33 per live births
EPI coverage survey conducted
EPI coverage survey protocol developed.
Survey protocol developed and field work completed
Survey report completed and used to strengthen EPI programme
Targeted Interventions identified and implemented to strengthen EPI Programme
EPI surveillance and coverage external review recommendations implemented
New Indicator
Implementation plans developed in partnership with Provincial DoH; and Three (3) pro-vincial trainings conducted
Six (6) provincial trainings conducted
Implementation plans monitored

24. Programme 3: HIV and AIDS, TB, Maternal and Child Health
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
79,420 6
84,413
Goods and Services
454,561
(27)
332,742
Transfers
17,728,096 15
20,301,535
Capital
16,267
(98)
367
TOTAL
18,278,344 13
20,719,057 24

25. DISCRIPTION: EARMARKED
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Office of DDG: Programme 3
6,458
5,409
HIV & AIDS
276,481
333,626
Condoms
94,116
119,099
Communication campaign
50,000
Higher Education & Training AIDS
8,500 -
Comprehensive HIV, AIDS & TB conditional grant
17,557,903
18,645,071
Comprehensive HIV, AIDS, TB & community health worker conditional grant
1,276,626
SANAC
17,547
17,108
Tuberculosis Management
26,498
27,240
Women's, Maternal & Reproductive Health .
18,390
19,907
Child, Youth & School Health
22,451
24,971
Human Papilloma Virus Vaccines in-kind grant
200,000
Human Papilloma Virus Vaccines conditional Grant
Total Programme 3
73,797
446,644
17,757,903
77,527
719,833
19,921,697
Total per financial year
18,278,344
20,719,057 25

26. Programme 3 - Growth 17/18 to 18/19
Transfer budget for Public Universities of South Africa was shifted to Department of Higher Education;
Conversion of Human Papilloma Virus Vaccination In-Kind grant under Goods and Services and Capital a Direct Conditional grant under Transfers and Subsidies;
Inclusion of Community Heath Workers into Comprehensive HIV and AIDS and TB Conditional Grant (ringfenced);
Programmes allocated Capital Budgets were reduced to allocate funds to Information Communication Technology to maintain current systems; 26

27. 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.

28. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Eliminate Malaria in South Africa
The National Malaria elimination Strategic Plan for South Africa Published
New Indicator
Malaria Elimination Strategic Plan for South Africa published
M&E report produced on the key indicators for Malaria Elimination
Implement the International Health Regulations Joint External Evaluation recommendations
Joint External Evaluation (JEE) Recommendations implemented
Joint External Evaluation on International Health Regulations conducted
Work plan for JEE recommendations developed
JEE recommendation implemented
All JEE recommendation implemented

29. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Strengthen district governance and improve management and leadership of the district health system
Number of Districts compliant with the minimum requirements of the District Health Management Office structure guidelines
National Guidelines for District Health Management Structures approved
Plans developed for 10 districts structures to meet the minimum requirements of the guidelines
Plans developed for 30 districts structures to meet the minimum requirements of the guidelines
Plans developed for 52 districts structures to meet the minimum requirements of the guidelines
Number of PHC facility committees assessed to determine functionality
3400 PHC facility committees assessed to determine its functionality
3400 PHC facility committees assessed to determine its functionality; Report on findings with recommendations completed

30. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve quality of services at primary health care facilities through the Ideal Clinic Initiative
Number of primary health Care facilities in the 52 districts that qualify as Ideal Clinics
1000 primary health Care facilities in the 52 districts qualify as Ideal Clinics
1400 primary health Care facilities in the 52 districts qualify as Ideal Clinics
1800 primary health care facilities in the 52 districts qualify as Ideal Clinics
2500 primary health care facilities in the 52 districts qualify as Ideal Clinics
Improve accessibility of Primary Health Services to people with disabilities
Proportion of PHC facilities accessible to people with disabilities
34% of PHC facilities accessible to people with disabilities
40% of 3400 PHC facilities accessible to people with disabilities
50% of of PHC facilities accessible to people with disabilities
60% of 3400 of PHC facilities accessible to people with disabilities

31. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve quality of services at District Hospitals through the Ideal District Hospitals Programme
Ideal District Hospital Framework implemented
Ideal District hospital framework drafted and presented to NDHSC
Status of all district hospitals determined against the Ideal District hospital framework version 1
80% of district hospitals score at least 60% against the Ideal District hospital framework
80% of district hospitals score at least 70% against the Ideal District hospital framework
Improve environmental health services in all 52 districts and metropolitan municipalities in the country
Number of public health facilities assessed for adherence to Health Care Risk Waste (HCRW) Norms and Standards
50 public health facilities assessed for adherence to Health Care Risk Waste (HCRW) Norms and Standards
78 Major Health Care Risk Waste (HCRW) generating public health facilities (hospitals that generate more than 25kg per day) assessed for adherence to HCRW Norms and Standards

32. Performance Indicator Estimated performance
Programme 4
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
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
20 municipalities are randomly selected and audited against environmental health norms and standards in executing their environmental health functions
21 municipalities randomly selected and audited against environmental health norms and standards
Municipalities that achieved less than 65% compliance during 2018/19 audited against environmental health norms and standards
Municipalities that achieved less than 65% compliance during 2020/21 audited against environmental health norms and standards
Strengthen district mental health services
Number of Districts with Mental Health Teams established
10 District mental health teams established
15 District mental health teams established
20 District mental health teams established
25 District mental health teams established
Expand provision of rehabilitation services, and accessibility of Primary Health Services to people with physical disabilities
Number of multi-disciplinary rehabilitation teams (physiotherapist, optometrist, audiologist, occupational therapist) established
Survey conducted to determine the number of Districts with an multi-disciplinary rehabilitation team
2 multi-disciplinary rehabilitation teams established
5 multi-disciplinary rehabilitation teams established
9 multi-disciplinary rehabilitation teams established

33. Programme 4: Primary Health Care Services
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
185,583 13
209,054
Goods and Services
70,501 27
89,332
Transfers
2,960 6
3,131
Capital
5,255
(96)
219
TOTAL
264,299 14
301,736 33

34. DISCRIPTION: EARMARKED
11/30/2018
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Office of DDG: Programme 4
3,136
3,976
District Health Services
16,266
10,606
Ideal Clinic in-kind grant
30,000 -
Communicable Diseases
21,923
22,727
Non-Communicable Diseases
22,491
24,183
NDC Prevention and health promotion
50,000
Health Promotion & Nutrition
26,456
24,682
Environmental Health & Port Health Services .
144,027
165,562
Total programme 4
234,299
251,736
Total per financial year
264,299
301,736 34

35. Programme 4 - Growth 17/18 to 18/19
Additional allocations for Chronic Disease Prevention and Health Promotion;
Programmes allocated Capital Budgets were reduced to allocate funds to Information Communication Technology to maintain current systems; 35

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
2017/18
2018/19
2019/20
2020/21
Strengthen local decision making and accountability of central hospitals to facilitate semi-autonomy
Number of central hospital organisational structures aligned with Guidelines on Organisational Structures for Central Hospitals
Draft Guidelines on Organisational Structures for Central Hospitals Developed
Guidelines on Organisational Structures for Central Hospitals approved by TechNHC
Costed implementation plans for improvement of 10 Central hospitals organisational structures completed
Implementation plans monitored
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 assessed
43 Hospitals (8 Central, 15 Tertiary, 20Regional Hospitals)
10 Central Hospitals achieved an overall performance 75% (or more) compliance with the National Core Standards assessed
50% of Hospitals assessed, and achieved an overall performance of 75% (or more) compliance with NCS
70% of Hospitals assessed, and achieved an overall performance of 75% (or more) compliance with NCS
Oncology services improvement plan developed
New Indicator
Oncology service improvement plan developed for public hospitals
Implementation monitored

38. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Ensure quality health Care by improving compliance with National Core Standards at all Central, Tertiary, Regional and Specialised Hospitals
Obstetric services improvement plans developed
New Indicator
Obstetric service improvement plan developed for public hospitals
Implementation monitored
Ensure access to and efficient effective delivery of quality Emergency Medical Services (EMS)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
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 for compliance with the EMS regulations using the approved checklist 9 x EMS Improvement plans developed
9 provincial DoH monitored for compliance with the EMS regulations using the approved checklist annually and 9 x EMS Improvement plans revised accordingly
9 provincial DoH monitored for compliance with the EMS regulations using the approved checklist 9 x EMS Improvement plans revised accordingly

39. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
 To build new and improve quality of existing health infrastructure in South Africa
Number of facilities that comply with gazetted infrastructure Norms & Standards.
Specifications of 50 facilities compliant with Infrastructure norms and standards
400 facilities compliant with Infrastructure norms and standards
800 facilities compliant with Infrastructure norms and standards
1500 facilities compliant with Infrastructure norms and standards
Number of clinics and Community Health Centres constructed or revitalised
20 clinics and Community Health Centres constructed or revitalised
Number of hospitals constructed or revitalised
1 hospitals constructed or revitalised
2 hospitals constructed or revitalised
Number of facilities maintained, repaired and/or refurbished in NHI Districts
150 facilities, 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
Not Applicable1
1. By the end of 2019/20, all health facilities in national health insurance pilot districts will have been maintained, repaired and/or refurbished)

40. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve management of PERSAL data to track implementation of staffing norms and facilitate HRH planning
Number of facilities maintained, repaired and/or refurbished outside NHI Districts
100 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
100 facilities maintained, repaired and/or refurbished outside NHI pilot Districts
HR Regulations developed and promulgated to ensure WISN based HRH planning in PHC facilities
New Indicator
Draft HR Regulations submitted to NHC for consideration
Draft HR Regulations for WISN implementation promulgated
Monitor implementation and compliance with HR Regulations for WISN implementation

41. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve the Human resource planning by strengthening the placement process for medical interns and community service personel
Percentage South African Medical Interns and Community service personel allocated in health facilities that studied at South African universities
98% (1510/1529) Medical Interns Placed and 91% (6878/7527) Community service personnel placed
100 % of South African Medical Interns and Community service personnel who studied at SA Universities allocated for placement by October for annual and April for asynchronous allocations respectively

42. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Develop and support implementation of health workforce staffing norms and standards
National Human Resources for Health (HRH) Strategy drafted
A review of the HRH strategic plan 2012/ /2017 conducted
HRH Strategic plan drafted
HRH Strategic plan published and implementation commenced
HRH Strategic plan monitored
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
Number of medical students returning to South Africa from the expanded Nelson Mandela Fidel Castro Medical Programme placed in local medical schools
Expanded academic integration programme finalized for final year training in South Africa
All students returning from Cuba during 2018/19 placed for final clinical training in the local medical schools
All students returning from Cuba placed for final clinical training in the local medical schools
All students returning from Cuba placed for final clinical training in the local medical schools

43. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Improve management of health facilities at all levels of are through the Health Leadership and Management Academy
Number of managers accessing the knowledge hub information system for coaching and mentoring
100 Hospital Managers and 300 PHC Managers accessing the knowledge hub information system for coaching and mentoring
150 Hospital and PHC Managers accessing the knowledge hub information system for coaching and mentoring
250 Hospital and PHC Managers accessing the knowledge hub information system for coaching and mentoring
All hospital and PHC managers accessing the knowledge hub information system for coaching and mentoring

44. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
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 finalised  8 colleges with customised draft curricula
9/17 remaining colleges have customised curricula for the new 3yr Diploma in General Nursing New courses commenced in 2019 academic year
New basic nursing qualification programmes implemented and monitored at all 17 public nursing colleges
Progress reports produced on the implementation of the new basic nursing qualification programmes at all 17 public nursing colleges 
Norms and standards for clinical training platform developed
Norms and standards for clinical training platform drafted and consultations held
Norms and standards for clinical training platform approved
Provinces supported in the development of implementation plans of the Norms and Standards for Clinical Training Platforms
Provinces supported in the development of improvement plans of the norms and standards for clinical training platforms

45. Performance Indicator Estimated performance
Programme 5
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Eliminate the backlog of blood alcohol tests by 2018/19 and toxicology tests by 2020/21
Percentage backlog eliminated for blood alcohol tests
Backlog of blood alcohol tests eliminated (0% backlog) in Durban, Cape Town, and Pretoria Laboratories
100% backlog eliminated for blood alcohol tests in Johannesburg laboratory
Not applicable
Percentage backlog eliminated for toxicology tests
40% backlog eliminated for toxicology tests (cumulative target)
60% backlog eliminated for toxicology tests
70%backlog eliminated for toxicology tests
95% backlog eliminated for toxicology tests 

46. Programme 5: Hospitals, Tertiary Health Services and HR Development
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
130,750 11
145,181
Goods and Services
189,878
(29)
134,161
Transfers
19,962,489 6
21,100,893
Capital
830,177 2
843,947
TOTAL
21,113,294 5
22,224,182 46

47. DISCRIPTION: EARMARKED
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Office of DDG: Programme 5
3,692
3,271
Health Facilities Infrastructure Management .
IUSS, infrastructure management
20,191
33,532
Health Facility Revitalization In-kind grant
948,984
891,359
Health Facility Revitalization conditional grant -
5,654,495
5,815,694
Tertiary Health Care Planning & Policy
4,618
4,384
Nelson Mandela Children's Memorial Hospital
150,000
200,000
National Tertiary Services conditional grant
11,526,145
12,194,661
National Tertiary Services: DRG Western Cape conditional grant
6,042
Hospital Management
5,155
6,498
Human Resources for Health
21,939
20,867
Health Professions Training & Development conditional grant
2,631,849
2,784,496
Nursing services
6,562
9,077
Forensic Chemistry Laboratories
127,405
145,804
Violence, Trauma & EMS
7,149
8,497
Total Programme 5
49,115
147,596
20,911,473
52,594
179,336
21,892,252
Total per financial year
21,108,184
22,124,182 47

48. Programme 5 - Growth 17/18 to 18/19
Increase in Capital Asset and Goods and Services budgets for Forensic Chemistry Laboratories to address backlogs and improve turnaround times;
Programmes allocated Capital Budgets were reduced to allocate funds to Information Communication Technology to maintain current systems; 48

49. 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. .

50. Performance Indicator Estimated performance
Programme 6
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
To establish the National Public Health Institutes of South Africa (NAPHISA) for coordinated and integrated disease and injury surveillance.
Legal framework to establish National Public Health Institutes of South Africa (NAPHISA)
NAPHISA Bill tabled for consideration to the Parliamentary Portfolio Committee of Health
NAPHISA Act Promulgated into law.
NAPHISA established as a public entity, and NAPHISA board appointed
NAPHISA fully operational and functional
Improve oversight and Corporate Governance practices by establishing effective governance structures, policies and tools.
Governance monitoring system implemented to strengthen oversight and corporate governance
Bi-annual governance progress reports produced of all health entities and councils
Biannual governance progress reports produced of all health entities and councils

51. Performance Indicator Estimated performance
Programme 6
Strategic Objective
Performance Indicator
Estimated performance
Medium-term targets
2017/18
2018/19
2019/20
2020/21
Ensure integrated and coordinated governance and management oversight of public entities and statutory professional councils
Handbook for Board members serving on public health entities and statutory professional councils developed.
New Indicator
Handbook for departmental representatives serving on Entities Boards developed.
Handbook for departmental representatives serving on Entities Boards implemented
Handbook for departmental representatives serving on Entities Boards evaluated and reviewed

52. Programme 6: Health Regulation and Compliance Management
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
52,369 23
64,278
Goods and Services
36,795
(19)
29,866
Transfers
1,629,998 3
1,678,961
Capital
2,699
(10)
2,441
TOTAL
1,721,861
1,775,546 52

53. DISCRIPTION: EARMARKED
11/30/2018
SUBPROGRAMME
DISCRIPTION: EARMARKED
2017/18
2018/19
R'000
VOTED
EARMARKED
GRANTS
Office of DDG; Programme 6
4,532
6,021
Food Control
11,728
10,571
Radiation Control
18,956
14,218
Public Entities Management
9,298
9,617
NHLS
746,464
789,759
MRC
614,961
624,829
SAHPRA
133,648
125,189
OHSC
125,711
129,678
CCOD & Occupational Health
57,955
61,828
Compensation Fund
3,718
3,836
Total Programme 6
44,514
1,682,457 -
40,427
1,735,119
Total per financial year
1,726,971
1,775,546
Total for NDoH
1,110,037
2,332,257
39,183,429
1,165,081
2,744,336
43,233,449
Total FOR NDoH per financial year
42,625,723
47,142,866 53

54. Programme 6 - Growth 17/18 to 18/19
Most of the general allocations to Departmental Agencies, namely Council for Medical Schemes, Office of Health Standards Compliance, South African Health Product Regulatory Authority and Compensation Commissioner were reduced;
Programmes allocated Capital Budgets were reduced to allocate funds to Information Communication Technology to maintain current systems; 54

55. TRANSFERS TO PUBLIC ENTITIES, TRADING ACCOUNTS AND TRUSTS
11/30/2018
TRANSFERS TO PUBLIC ENTITIES, TRADING ACCOUNTS AND TRUSTS
Type
Name
2017/18
R’000
2018/19
Public Entities
NHLS
MRC
SAHPRA
OHSC
CMS
5 496
5 670
Trading Accounts
Compensation Fund (CCOD)
3 718
3 836
Trusts
South African National AIDS Council
17 547
17 108 55

56. NDOH BUDGET ALLOCATION

57. Summary per Programme
11/30/2018 57

58. Economic Classification
Summary per
Economic Classification
11/30/2018
Subprogramme
2017/18
% Growth from 2017/18 to 2018/19
2018/19
R'000 %
Compensation of Employees
760,032 9
828,814
Goods and Services
1,645,882 37
2,261,571
Transfers
39,354,196 10
43,117,023
Capital
865,613 20
1,035,458
TOTAL
42,625,723 11
47,242,866 58

59. NDOH - Growth 17/18 to 18/19
Establishment of Medico-legal Committees and expansion of SAICA financial management support programmes in Provinces;
Additional Goods and Services funds of R700 million for the NHI, and the centralizing of the NHI In-Kind Grants under one Programme;
Additional allocations for Chronic Disease Prevention and Health Promotion, Health Technology Assessment, the Management and Administration of the interim NHI, and the NHI Ministerial Advisory Committees;
Increase in budget for Forensic Chemistry Laboratories to acquire specialized laboratory equipment to address backlogs and improve turnaround times;
Inclusion of Community Health Workers transfer of R 1,27 billion into Comprehensive HIV and AIDS and TB Conditional Grant;
Allocation to upgrade Civitas Building security systems. 59

60. Conditional Grants Direct Allocations
11/30/2018
Conditional Grants Direct Allocations 60

61. Conditional Grants Indirect Allocations
11/30/2018
Conditional Grants Indirect Allocations 61

62. CONCLUSION
National DoH Annual Performance Plan 2018/ /21 is founded on government’s 2030 vision outlined in the National Development Plan 2030.
The Department will continue to work towards improving equity, quality and access to healthcare through the implementation of the National Health Insurance policy of South Africa, which commences during 2018/19 financial year.