1. Limpopo Health Challenges: Select Committee on Social Services
Dr Sipho Kabane
26th May 2015

2. Contents Vision and Mission Key Mandates and Priorities
Major Challenges
What has improved
What still needs to be improved
Vision 2030

3. Strategic Priority 5: Improve the health profile of all South Africans
Manifesto, MTSF, Outcomes & Mandated Outputs - The focus – 2010 to 2015
Manifesto
MTSF
Strategic Priority 5: Improve the health profile of all South Africans
Outcomes
A Long and Healthy Life for All South Africans
Mandated Outputs
Output 1: Increasing Life Expectancy
Output 2: Decreasing Maternal and Child mortality
Output 3: Combating HIV and AIDS and decreasing the burden of disease from
Tuberculosis
Output 4: Strengthening Health System Effectiveness

4. What are the Major Challenges?

5. Major Challenges: Service Delivery
Poor quality of health care services
Lack of essentials[ food, medicines, security etc]
High number of reported and unreported adverse events
High litigation costs due to medico-legal claims
Poor access and long waiting times
Rude, uncaring, unethical and unprofessional staff attitudes
High perinatal deaths in many facilities
Slow response times by our ambulances

6. Major Challenges: Workforce
Shortage of key clinical and clinical support personnel
Shortage of specialist and academic personnel
High personnel turnover
Ageing personnel
Inequitable distribution of personnel
Poor staff attitudes, Culture of entitlement, Lack of professionalism and corruption

7. Major Challenges: Leadership and Governance
Key posts occupied by unqualified, incompetent and unskilled officials
Ageing, unproductive, uncommitted and obstructive officials in key posts
Appointment of Governance structures not in line with National Health Act
Role confusion between management, labour and governance structures
High leadership turnover and vacancies in key executive posts; numerous acting officers

8. Major Challenges: Infrastructure, ICT
Ageing and poorly maintained infrastructure
Unfunded infrastructure backlogs
Dysfunctional laundries, generators, autclaves etc
Poorly planned and constructed infrastructure
High cost, High maintenance and low value add ICT systems
Ageing and poorly maintained ICT infrastructure
Lack of ICT hardware, connectivity and telecommunications systems on the coalface

9. Major Challenges: Information Management
Key vacancies at provincial and district level
Inappropriately skilled personnel in key posts
Shortage of data capturers
Inability to capture, secure, analyse, report and use data for planning and decision-making
Lack of credible information management systems between facilities and levels of care
Lack of storage and security for key information used in administration and patient care
Repeated exceptions from the AG on organisational performance vs targets

10. Major challenges: Medicines, Technology and Equipment
Sporadic medicine and consumable stock-outs
Long lead times between ordering and delivery of key items
Backlogs of key clinical and non clinical equipment
Lack of basic equipment at PHC facilities
Poor planning and maintenance of equipment
Obsolete, non-compliant and dysfunctional equipment

11. Major Challenges: Financial Management
Budgetary shortfalls vs Increased demand
Three disclaimers in a row previous audits
Poor compliance with SCM prescripts
Poor revenue collection and management
Irregular, Unauthorised, Fruitless and Wasteful expenditure
Fraudulent, unethical and corrupt practices
Poor asset and records management

12. What Has Improved?

15. What has improved? Maternal and under 5 mortality rates have improved
Life expectancy for both males and females has increased
HIV, AIDS,TB and Malaria disease burden has decreased
Complaints management at hospital level has improved
Patient Satisfaction rates have also improved

16. What has improved? Medicine availability improved from 45 to >80%
Consumable availability improved to 75%
Increased number of clinical and clinical support staff appointed
Increased number of key posts filled at hospital level including CEO’s
Increased number of completed infrastructure projects
Increased number of clinics supplied with computers and connectivity

17. What has improved? Increased number of clinical equipment procured
Improved audit outcome from a series of disclaimers
Improved financial management and accountability for assets
Improved supply chain processes
Response times are improving as a result of the procurement of 50 ambulances

18. What still needs to be improved?

19. What still needs to be improved?
Accelerated implementation of programmes that will lead to the realisation of Universal Coverage through the NHI
Focus on maintenance of infrastructure in the short to medium term
Accelerated delivery of health infrastructure in the long term
Improve Life Expectancy and reduce burden of disease from HIV, AIDS, TB, Malaria and non-communicable diseases

20. What still needs to be Improved?
Provincial Health Information system to be fully revitalised
Implement electronic patient records
Implement systems that will improve data collection, security, analysis, usage and storage
Maintain high levels of medicine and consumable availability at all facilities including the depot all the time
Maintain and improve on the audit outcomes

21. What still needs to be improved?
Increase the number of operational ambulance through significant investments
Set up systems for the efficient deployment of EMS vehicles
Restructure, capacitate and reopen the Ambulance College
New health sector generic structure to be implemented based on an extensive scientific skills audit recommendations

22. What still needs to be improved?
Improve the compliance with the National core quality standards by all our facilities
Reduce litigation costs through safer health care systems and effective management of claims
Improvement of health outcomes through accelerated reduction of burden of disease
Increased focus on non-communicable disease burden
Improve leadership and management of all facilities through mentoring and coaching

23. What still needs to be improved?
Accelerate the recruitment, appointment and retention of specialists to sustain tertiary services and the new medical school
Accelerate the appointment of key clinical and clinical support personnel in line with resources
Equitable redistribution of clinical personnel
Streamline bursary awards with the skills requirements and availability of funded posts

24. National Development Plans The nine health pillars
Manifesto, MTSF, Outcomes & Mandated Outputs - The focus – 2010 to 2015
Manifesto
National Development Plans
The nine health pillars
1. Average male and female life expectancy increased to 70 years; 2. Tuberculosis prevention and cure rates progressively improved; 3. Maternal and child mortality rates reduced; 4. Prevalence of chronic Non-Communicable Diseases reduced by 28%; 5. Injury, accidents and violence reduced by 50% from 2010 levels; 6. Health systems reforms completed. 7. Primary Health Care teams deployed to provide care to families and communities; 8. Universal Health Coverage achieved; 9. Posts filled with skilled, committed and competent individuals.

25. Vision 2030 Increased Life expectancy
Reduction of burden of TB, HIV and AIDS
Reduction of burden of non-communicable disease
Reduction of maternal and child deaths
Accelerated health infrastructure delivery
Improved quality of health care services
Implementation of quality information systems
Universal coverage

26. The End!! Thank You!!