1. SUGGESTIONS FOR NAPHISA BILLBy
Prof Welile Shasha
Public Health Specialist
Household Surveys Foundation
Pretoria

2. Aim of Presentation
To make 3 suggestions for legislation that can enable an integrated people- centred approach for disease control, using eradication of TB as an example.

3. Deaths from TB 2015 TOTAL 54 956 900 460 910 32 952 7.2 PROVINCE
POPULATION
ALL DEATHS 2015
DUE TB %
NORTHERN CAPE
13 725
1 061
7.7
FREE STATE
31 891
2 098
6.6
EASTERN CAPE
68 303
5 874
8.6
NORTH WEST
33 343
2 738
8.2
LIMPOPO
50 448
3 071
6.1
WESTERN CAPE
50 068
2 663
5.3
MPUMALANGA
34 111
2 704
7.9
GAUTENG
97 982
5 401
5.5
KWAZULU NATAL
81 039
7 342
9.1
TOTAL
32 952
7.2

4. WHY SO MANY DEATHS? When TB is easily identified?
When TB is eminently Curable?
When TB is Preventable?
When South Africa has got the resources to Eradicate TB in 10 years?

5. Weak Health System Community Dependence on Gov Poverty & Unemployment
Three Main Reasons
Weak Health System
Community Dependence on Gov
Poverty & Unemployment

6. Integrated People Centred Approach
100% Hosehold Survey in Municipal Ward
Assistance of persons with Disease & Poverty – CHW/Community Care Givers
Enabling Community Participation
Enabling InterDepartmental Cooperation

7. 100% Household Survey Motivation of Mayor & Ward Community;
Recruitment & Training of Fieldworkers;
Data Download, Analysis & Lists of Persons for TB, HIV, etc; and Social Grants, and Jobs;
Assistance of Persons by Gov. Departments
Community & Gov to own the Data

8. List of Persons with TB, Diabetes, Hypertension
Village
Head of Household
Person
Gender
Age 1
Maya
William Vaphi
Nomsa
Female 35 2
Khulu Mfanto
Simon
Male 39 3
Noma Mavuso
Vuyiswa 32 4
John Booi
Phumzile 49 5
Ntlakwefolo
Novamna Zibi
No amen 46 6
Tyuka Shange
Sipho 7
Nonesi Vilani
Siphenathi 52 8
Mkhukhwini
Nowanisi Kalima
Nozibongo 38
The lists are for action by the Department of Health; &
WBOT’s will visit each household, and persons assisted

9. Distribution of disease in the households
Maps open the way for collaboration in research & health promotion

10. Enabling Community Partnership
Communities to pay R10.00 per Household (Local Gov to support)
Legislation for Ward Health Committee
Fund-Raising for Clinic Committees
Oversight of Community Care Givers
Negotiate with Doctors to work in Clinic

11. Please Legislate To Enable
Eradication of TB, to ensure NHI
Ward Health Committee, for Effective Community Participation
InterDepartmental Cooperation
People Centred Integration

12. Example: Cost of TB Eradication Process in Eastern Cape
District
Wards
TB Deaths
Perm_Jobs
Temp_Jobs
ESTIMATED COST
Alfred Nzo
101
290
808
5 050 R
Amathole
120
1 203
960
6 000 R
Buffalo City 50
854
400
2 500 R
Cacadu 73
421
584
3 650 R
Chris Hani
111
701
888
5 550 R
Joe Gqabi 45
264
360
2 250 R
Nelson Mandela 60
885
480
3 000 R
O R Tambo
146
1 256
1 168
7 300 R
TOTAL
706
5 874
6 816
35 300 R
Source: Statistics South Africa 2015
R per Municipal Ward

13. Thank You!