1. Presentation to the Portfolio Committee on Health 17 April 2015 Annual Performance Plan 2015/16 to 2017/18

2. Alignment between NDP 2030 – MTSF 2014-2019 NDoH Strategic Plan and Annual Performance Plan 2

3. Annual Performance Plan 2015/16 3 VISION Outcome 2: Long and healthy life for all South Africans MISSION 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.

4. Programme 1 - Administration Strategic Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Ensure effective financial management and accountability by improving audit outcomes Audit opinion from Auditor General Unqualified Audit opinion Audit opinion from Auditor for Provincial Departments of Health 3 Unqualified audit opinions 4 Unqualified audit opinions Number of provinces that submit reports against defined set of non-negotiable items on a monthly basis 9 999 Fully implement the Departmental Information Communication Technology (ICT) Service Continuity Plan by the 31st of March 2018 Establish ability to access domain services outside the NDoH premises Ability to recover all Email Data of NDoH in the event of a Disaster Ensure all Senior Managers of NDoH are able to access Domain services at DR site. Ability to recover all Email Data of NDoH in the event of a Disaster Ability to access all domain services at the DR site in event of a Disaster ICT Service continuity plan fully implemented

5. Programme 1 - Administration Strategic Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Provide support for effective communication by developing an integrated communication strategy and implementation plan Develop an integrated communication strategy and implementation plan Integrated communication Strategy and implementation Plan developed Communication Toolkit developed to integrate messages Provincial Communication Strategies aligned to National Integrated Communication Strategy Measure the impact of the Integrated Communication Strategy and Implementation Plan and review the Strategy and Plan Ensure efficient and responsive Human Resource Services through the implementation of efficient recruitment processes and responsive Human Resource support programmes Average Turnaround times for recruitment processes Average recruitment process turnaround time will be 5 months Average recruitment process turnaround time will be 4 months Average recruitment process turnaround time will be 3 months Develop and Implement Employee Health and wellness programme that comply with Public Service Regulations (PSR) and Employee Health and Wellness Strategic Framework (EHWSF) NoneEHW induction programme to Port Health Employees Implementation of EHW pillars Monitoring and evaluation of the EHW programme

6. Programme 1 - Administration Strategic Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Ensure efficient and responsive Human Resource Services through the implementation of efficient recruitment processes and responsive Human Resource support programmes NDoH vacancy rate5.08%5 % Percentage of Senior Managers that have entered into Performance agreements with their supervisors 98% 99 %100% A National Health Litigation Strategy developed and fully implemented Develop National Health Litigation Strategy The Medico -Legal Workshop and summit held with Provincial Departments of Health, State Attorney and other relevant stakeholders The National Litigation Strategy developed, and approved Implement the National litigation strategy Review the National litigation strategy

7. Programme 1 - Administration Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % MINISTRY31 0462.8131 9171.5932 4254.2733 810 MANAGEMENT16 38719.8619 6412.7320 1774.3221 048 CORPORATE SERVICES184 64715.61213 467-4.19204 5146.62218 046 OFFICE ACCOMMODATION105 82518.88125 8109.33137 54712.00154 053 FINANCIAL MANAGEMENT51 74528.0266 243-7.4761 2956.2065 095 TOTAL389 65017.30457 078-0.25455 9587.92492 052

8. Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees156 13113.44177 1154.98185 9334.99195 207 Goods and Services226 33019.45270 360-2.57263 41810.08289 979 Transfers1 39740.941 9695.382 0755.012 179 Capital5 79231.807 634-40.634 5323.424 687 TOTAL389 65017.30457 078-0.25455 9587.92492 052 Programme 1 - Administration

9. PROGRAMME 1: ADMINISTRATION 1.Job grading and backpay of Assistant and Deputy Directors during current financial year. Will have a carry thru over the MTEF; 2.Maintenance and repairs of security systems in Civitas and information systems will run over two years (2014/15 and 2015/16); 3.Backlog in payments of office accommodation to be addressed during 2015/16. This could amount to about R50 million; 4.AG fees also grow with about 10% per annum

10. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Purpose Improve access to quality health services through the development and implementation of policies to achieve universal coverage, health financing reform, integrated health systems planning, reporting, monitoring and evaluation and research.

11. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2014/152015/162016/17 Achieve Universal Health Coverage through the phased implementation of the National Health Insurance(NHI) White Paper on NHI Draft White Paper on NHI Finalise and publish White Paper on NHI Legislation for NHI Draft White Paper on NHI Publication of legislation and regulations Establishment of the National Health Insurance Fund Draft conceptual document prepared Funding Modality for the National Health Insurance Fund including budget reallocation for the district primary health care NHI fund created and arrangements for the contracting and purchasing of defined services initiated NHI fund purchasing services and the scope of services purchased expanded

12. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Establish A national stock management surveillance centre to improve medicine availability Implement an Electronic system for the early detection of stock outs of medicines at hospitals Electronic system developed Electronic stock management system implemented and functional at 10 central hospitals. and 17 Tertiary hospitals and 25 regional hospitals. Electronic stock management system implemented and functional at 21 regional hospitals and 50 district hospitals Electronic stock management system implemented and Functional at 100 District Hospitals Implement an Electronic system for the early detection of stock outs of medicines at PHC Facilities Electronic stock management system functional in 600 PHC facilities Electronic stock management system functional in 1200 PHC facilities. Electronic stock management system functional in 1800 PHC facilities. Electronic stock management system functional in 2400 PHC facilities Establish a national surveillance centre to monitor medicine availability Business plan for the a national surveillance centre developed National surveillance centre functional and reporting stock availability at 10 central hospitals, and 1200 PHC facilities. National surveillance centre functional and reporting stock availability at 10 Central,17 Tertiary hospitals and 46 regional hospitals., and 1800 PHC facilities.. National surveillance centre functional and reporting stock availability at 10 Central,17 Tertiary, 46 regional and 100 District hospitals., and 2400 PHC facilities.. Programme 2 - National Health Insurance, Health Planning and Systems Enablement

13. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Improve contracting and supply of medicines Establish Provincial Control Towers for the management of direct delivery of medicines Control towers have been established in Limpopo and Gauteng. Control towers implemented in Free State and Eastern Cape DoH Control towers implemented in North-West and KZN DoH. Control towers implemented in Mpumalanga DoH Number of patients receiving medicines through the centralised chronic medicine dispensing & distribution system 200,000 patients500,000 patients750,000 patients 1,000.000 patients Contracts are available at least 8 weeks prior to expiration of outgoing tender ARV Tender awarded 3 months prior to expiry 100% pharmaceutical tenders awarded at least 8 weeks prior to expiration of outgoing tender 100% pharmaceutical and medical related tenders awarded at least 8 weeks prior to expiration of outgoing tender 100% pharmaceutical tenders and medical related tenders are awarded at least 8 weeks prior to expiration of outgoing tender Establish Provincial Control Towers for the management of direct delivery of medicines Control towers have been established in Limpopo and Gauteng. Control towers implemented in Free State and Eastern Cape DoH Control towers implemented in North-West and KZN DoH. Control towers implemented in Mpumalanga DoH Programme 2 - National Health Insurance, Health Planning and Systems Enablement

14. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Implement the Strategy to address antimicrobial resistance (AMR) Implement the National AMR strategy Approved National AMR Strategy Appointment of the MAC Implementation plan for AMR strategy developed Antimicrobial stewardship Policy identified in AMR strategy developed and implemented Surveillance system monitoring resistance developed Regulate African Traditional Practitioners Establish Council for Traditional Practitioners Interim Council for Traditional Practitioners established and meets quarterly Council for Traditional Practitioners and Registrar appointed Staff for Council for Traditional Practitioners appointed Not Applicable Strengthen Revenue collection by incentivising hospitals to maximise revenue generation. Develop and implement a Revenue Retention Model (RRM) at central hospitals Identified two provinces (WC and FS) that have existing Revenue Retention Models. A discussion paper on revenue retention models developed and presented to NHC, and Financial and Fiscal Committee (FFC) Implement RRM at 4 central hospitals Implement the RRM at 7 Central Hospitals Programme 2 - National Health Insurance, Health Planning and Systems Enablement

15. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Implement eHealth Strategy of South Africa through the development of the system design of patient information systems and implantation Develop a complete System design for a National Integrated Patient based information system Basic Health Information Exchange architecture conceptualised Basic Health Information Exchange developed to conduct a reference implementation of eHealth interoperability norms and standards System, Technology and Data architecture developed and incorporated into the Health Information Exchange for integrating Patient Based Information Systems System, Technology, and Data architectures integrated for a National Integrated Patient Based Information System developed Number of PHC health facilities with required IT Hardware for the reference implementation eHealth project 698 PHC Facilities received required IT Hardware for the reference implementation of the eHealth Programme Additional 1400 PHC Facilities received required IT Hardware for the reference implementation of the eHealth Programme -

16. Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Implement eHealth Strategy of South Africa through the development of the system design of patient information systems and implantation Number of health facilities implementing improved patient administration and web based information systems 50 PHC Facilities implementing improved patient administration and web based information systems Additional 700 Facilities implementing improved patient administration and web based information systems Additional 1400 PHC Facilities implementing improved patient administration and web based information systems Programme 2 - National Health Insurance, Health Planning and Systems Enablement

17. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Develop and implement a national research strategic plan National health research plan developed and implemented Draft national research plan developed National Health Research strategic plan approved Costed National Health Research implementation plan implemented National Health Research priority research evidence generated 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 implemented Monitoring and evaluation plan for health developed Fully defined comprehensive list of indicators and data elements approved At least one national evaluation conducted Data collections systems established for revised indicators list At least one national evaluation conducted Monitoring & Evaluation system strengthened At least two national evaluations conducted (on health programme and health systems) Programme 2 - National Health Insurance, Health Planning and Systems Enablement

18. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Domestication of international treaties and Implementation of multilateral cooperation on areas of mutual and measurable benefit number of International treaties and multilateral frameworks implemented International treaties and multilateral frameworks implemented Three International treaties and multilateral frameworks implemented Four International treaties and multilateral frameworks implemented Implementation of bilateral cooperation on areas of mutual and measurable benefit Number of Bilateral projects implemented Two strategic bilateral projects implemented Five strategic bilateral projects implemented Seven strategic bilateral projects implemented Eight strategic bilateral projects implemented Programme 2 - National Health Insurance, Health Planning and Systems Enablement

19. Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Review Annual dispensing fee. Systematic survey for the dispensing fee completed for 2015/16 cycle Review of the 2015/16 dispensing fee in determining the 2016/17 maximum dispensing fee Review of the 2016/17 dispensing fee in determining the 2017/2018 maximum dispensing fee Review of the 2017/18 dispensing fee in determining the 2018/2019 maximum dispensing fee Publish and Implement Single Exit Price Adjustments Annually Implementation of the gazette 2014/15 Annual Price Adjustment Implementation of the gazette 2015/16 Annual Price Adjustment Implementation of the gazette 2016/17 Annual Price Adjustment Implementation of the gazette 2017/18 Annual Price Adjustment Review Criteria for the approval of Pharmacy Licences Criteria for the approval of Pharmacy Licences drafted Criteria for the approval of Pharmacy licences are finalised, and published for implementation Criteria for the approval of Pharmacy licenses Implemented Not Applicable Develop Regulations pertaining to Uniform Patient Fee Schedule (UPFS) UPFS regulations drafted UPFS regulations gazetted and implemented UPFS regulations implemented

20. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Develop a Central Repository for the funded and unfunded patients Develop the specifications of the Central Repository in collaboration with CMS. A repository containing funded patients established by Council for Medical Schemes A repository containing funded patients integrated with Health Patient Registration System A repository containing funded and unfunded patients operational Percentage of the review process of the PHC Essential Medicines List (EML) and Standard treatment Guidelines (STGs) completed 100%20%50%100% Percentage of the review process of the Hospital Level Paediatric Essential Medicines List (EML) and Standard treatment Guidelines (STGs) completed 20%50%100%20% Percentage of the review process of the Hospital Level Adult Essential Medicines List (EML) and Standard treatment Guidelines (STGs) completed 50%100%20%50% Number of medicines reviews conducted for the Tertiary and Quaternary EML 12 reviews

21. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Number of Provincial Annual Performance Plans (APPs) aligned to the National Health System Priorities 9 Provincial APPs reviewed and feedback provided 9 Provincial APPs reviewed and feedback provided to ensure APPs and DHPs sector plans are aligned to the National Health System (NHS) Priorities 9 Provincial APPs reviewed and feedback provided to ensure health sector plans are aligned to the National Health System (NHS) Priorities Implement Patient Quality of care survey tool Patient Quality of care survey protocol and tool developed Patient Quality of care survey tool tested and piloted Patient Quality of care survey tool fully implemented Patient Quality of care survey tool reviewed Conduct a National Survey to measure Patient Quality of Care New IndicatorA national survey conducted to measure patient quality of care at all PHC Facilities A national survey conducted to measure patient quality of care at all Hospitals A evaluation of Patient Quality of Care conducted

22. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % OFFICE OF THE DDG2 9891.043 0205.533 1874.963 345 TECHNICAL POLICY & PLANNING22 929-13.3519 86927.3625 3066.9727 071 HEALTH INFORMATION MANAGEMENT, MONITORING & EVALUATION55 7252.7957 2803.4159 23311.4366 003 SECTOR-WIDE PROCUREMENT22 98729.3329 7292.2630 4015.3832 036 HEALTH FINANCING & NATIONAL HEALTH INSURANCE487 210-14.95414 388-5.88390 01723.78482 762 INTERNATIONAL HEALTH & DEVELOPMENT52 25721.5663 5217.7868 4643.6070 928 TOTAL644 097-8.74587 807-1.91576 60818.30682 145

23. Programme 2 - National Health Insurance, Health Planning and Systems Enablement Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees79 13221.4196 0775.50101 3605.06106 484 Goods and Services485 348-19.22392 080-5.20371 71025.54466 649 Transfers77 00026.0597 0623.85100 7975.27106 105 Capital2 617-1.112 5885.912 7416.062 907 TOTAL644 097-8.74587 807-1.91576 60818.30682 145

24. Programme 2: NHI, Health Planning and System Enablement 1.Budget cut on National Health Insurance Grant (Indirect Grant) of about R115 million. 2.Set up of Health Attachè’s Office in Cuba as well as increase in exchange rate for annual contribution to the World Health Organisation during 2014 and 2015. 3.Additional funds to Sector-Wide Procurement for Research. 4.Funds were received for the Demographic Health Survey of about R30 million whilst the need is in excess of R80 million.

25. Programme 3: HIV / AIDS, TB and Maternal and Child Health Purpose To decrease the burden of disease related to the HIV and TB epidemics; to minimise maternal and child mortality and morbidity; and to optimise good health for children, adolescents and women. This is done through the three overarching strategies of setting policies, guidelines, norms, standards and targets; supporting the implementation of these; and monitoring and evaluating the outcomes and impact of this implementation.

26. Programme 3: HIV / AIDS, TB and Maternal and Child Health Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 To reduce the maternal mortality ratio to under 100 per 100 000 live births Antenatal 1 st visit before 20 weeks rate Ind 55.5%60%65%70% N 235 811661 752716 898772 044 D 454 2311 102 920 Mother postnatal visit within 6 days rate Ind 77.3%85%90%95% N 301 448803 274850 525897 777 D 405 613945 028 Maternal mortality in facility ratio (annualised) Ind 134.5120115110 N 5351 1261 0791 032 D 397748938 073 To reduce the neonatal mortality rate to under 6 per 1000 live births Inpatient Neonatal death rate (annualized) Ind 12.41098 N 4653637 57433 81730 060 D 37483283 757 448 To improve access to sexual and reproductive health services by expanding the availability of contraceptives Couple year protection rateInd 55% 60%65%70% N 2 322 3008 832 7279 568 78710 304 848 D 14 870 10814 721 211 Cervical cancer screening coverage Ind 54.9%60%64%68% N 281 804871 679929 791987 903 D 6 166 42014 527 991

27. Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 Expand the PMTCT coverage to pregnant women by ensuring all HIV positive Antenatal clients are placed on ARVs and reducing the positivity rate to below 1% Antenatal client initiated on ART rate Ind 85.22%88%90%92% N 74 238204 220208 861213 503 D 87 111232 068 Infant 1st PCR test positive around 6 weeks rate Ind 2.0%1.50%1.40%1.20% N 1 6303 7143 4662 971 D 107 237247 578 Programme 3: HIV / AIDS, TB and Maternal and Child Health

28. Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 To reduce under-five mortality rate to less than 23 per 1,000 live births by promoting early childhood development Child under 5 years diarrhoea case fatality rate Ind 3.6%3.20%3.00%2.70% N 7191 2801 2001 080 D 20 09240 000 Child under 5 years pneumonia case fatality rate Ind 3.2% 3%2.75%2.50% N 762120011001 000 D 23 64140 000 Child under 5 years severe acute malnutrition case fatality rate Ind 11.0%10%9%8% N 9001 5001 3501 200 D 7 93115 000 Confirmed measles case incidence per million total population Ind < 4/ 1,000,000< 3/1,000,000 < 2/1,000,000 < 1/1,000,000 Programme 3: HIV / AIDS, TB and Maternal and Child Health

29. Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 To reduce under-five mortality rate to less than 23 per 1,000 live births by promoting early childhood development Immunisation coverage under 1 year (Annualised) Ind 86.39% 90%92%93% N 381 443970 919992 4951 003 283 D 1 059 6601 078 799 DTaP-IPV/Hib 3 - Measles 1st dose drop- out rate Ind 7% 6% 5% N 21 36860 146 50 122 D 422 6361 002 438 Measles 2nd dose coverage Ind 79%83%86%88% N 1 056 563885 228917 224938 555 D 5 282 8151 066 540 Infant exclusively breastfed at HepB 3rd dose rate Ind 44.5%≥50%60%65% Programme 3: HIV / AIDS, TB and Maternal and Child Health

30. Strategic objective Performance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 To protect girl learners against cervical cancer HPV 1st dose coverage Ind 92% 80%87%88% N 429 840365 821397 831402 403 D 457 276 HPV 2nd dose coverage Ind 94% 80%87%88% N 429 840365 821397 831402 403 D 457 276 Undertake a massive TB screening campaign TB client 5 years and older screened at health facilities for TB symptoms rate Ind 15%50%75%85% Improve Access to treatment TB client 5 years and older initiated on treatment rate Ind New Indicator85%90%95% TB Rifampicin Resistant clients treatment initiation rate Ind New Indicator80%85%90% Programme 3: HIV / AIDS, TB and Maternal and Child Health

31. Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 Strengthen patient retention in treatment and care TB Client loss to follow up rate Ind 6% 5%4%3% N 17 69614 15810 618 D 353928 TB Client death rate Ind 7% 6%5%4% N 21 23617 69714 158 D 353,928 TB MDR client loss to follow up rate Ind 18% 16%14%12% N 1 044913783 D 6 523 TB new client treatment success rate Ind79%83%84%85% Programme 3: HIV / AIDS, TB and Maternal and Child Health

32. Strategic objectivePerformance Indicator Estimated Performance Medium-term targets 2014/15 2015/162016/17 2017/18 Strengthen patient retention in treatment and care TB MDR client death rate Ind 18% 15%12%9% N 978783587 D 6 523 TB MDR treatment success rate Ind 50% 55%60%65% N 3 5883 9144 240 D 6 523 TB/HIV co-infected client on ART rate Ind 70%75%80%85% Programme 3: HIV / AIDS, TB and Maternal and Child Health

33. Strategic Objective Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 To scale up combination of prevention interventions to reduce new infections including HCT, male medical circumcision and condom distribution Number of client 15 Years and older tested for HIV 8 million10 million14 million17 million Number of medical male circumcisions conducted 550 0001 600 000800 000650 000 Male Condoms Distributed 600m700m800m Female Condoms Distributed 15.2m16.5m17.5m18.5m Increase the numbers of HIV positive people on ARVs Total clients remaining on ART (TROA) at the end of the month 3.0 million3.8 million4.8 million6.0 million

34. Programme 3: HIV / AIDS, TB and Maternal and Child Health Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Monitor implementation of Maternal, Neonatal and Woman’s health programmes using the standardised dashboard reports 2 reports produced and implementation feedback provided to all provincial DoH Quarterly performance reports produced with feedback provided to each provincial DoH Develop Training manual for the implantation of Contraception and Fertility Planning (CFP) Policy CFP Policy training manual drafted CFP policy training manual finalized disseminated, and training commenced Implementation of the training plan monitored with 9 provincial reports Develop Pharmacovigilance system for adverse events for contraceptive implants New Indicator Pharmacovigilance information system for adverse events developed and implemented in All Provincial DoH Quarterly reports on functionality of pharmacovigilance information system for each province drafted Adverse events monitored in each province with quarterly reports Develop cervical cancer control Policy New IndicatorCervical cancer control policy guidelines finalised and disseminated to facilities Monitoring of the implementation of policy guidelines in all provinces through quarterly M&E processes Monitoring of the implementation of revised/updated policy guidelines in all provinces through quarterly M&E processes

35. Programme 3: HIV / AIDS, TB and Maternal and Child Health Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Develop breast cancer Policy New Indicator Breast cancer policy guidelines Developed and disseminated to facilities Monitoring of the implementation of the new breast cancer policy guidelines in all provinces through quarterly M&E processes Developprovincial reports to track progress on the eliminations of mother-to-child transmission of HIV New Indicator 9 Provincial visits conducted and reports with recommendations produced Develop and implement the HIV Counselling and Testing (HCT) policy New Indicator HCT policy finalised and approved Implement and monitoring of policy Monitor implementation of the HIV and AIDS Programme New indicatorQuarterly reports produced

36. Programme 3: HIV / AIDS, TB and Maternal and Child Health Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Develop and implement HIV prevention strategy New indicator Strategy Developed and Approved and produce 9 provincial reports on its implementation Monitor Implementation of the HIV prevention strategy and produce 9 provincial reports Monitor Implementation of HIV prevention strategy and produce 9 provincial reports Develop and implement adherence guidelines for health programmes New indicator Guidelines developed and approved and produce 9 provincial reports on its implementation Monitor the Implementation of adherence guidelines and produce 9 provincial reports on its implementation Facilitate development of district plans to support NDoH male and female condom distribution strategy New indicator 52 district distribution plans for male and female condoms developed and implemented with 9 provincial progress reports Monitor implementation of the district plans and produce 9 provincial reports Monitor the implementation of the HIV and AIDS Conditional grant New indicator4 x Quarterly HIV conditional grant reports within the required timeframe produced Annual HIV Conditional Grant Report produced 4 x Quarterly HIV conditional grant reports within the required timeframe produced Annual HIV Conditional Grant Report produced 4 x Quarterly HIV conditional grant reports within the required timeframe produced Annual HIV Conditional Grant Report produced

37. Programme 3: HIV / AIDS, TB and Maternal and Child Health Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Develop and Distribute EPI Disease Surveillance Manual New indicator EPI Disease Surveillance Manual developed, printed distributed and implemented with 9 provincial progress reports produced Orientate and capacitate province on diseases surveillance guidelines for implementation with 9 provincial progress reports produced Monitoring and Mentoring with 9 provincial progress reports produced Develop and Distribute EPI Cold Chain Manual New indicator EPI Cold Chain Manual developed, printed and distributed to 9 Provincial DoH with 9 province progress reports produced Orientate and capacitate provinces on Cold Chain Guidelines for implementation with 9 province progress reports produced Monitoring and Mentoring with 9 province progress reports produced Convene quarterly meetings of Ministers Polio Committees New indicator One Ministerial Polio committee meeting convened per quarter, and Annual Report produced One Ministerial Polio committee meeting convened per quarter, and Annual Report produced One Ministerial Polio committee meeting convened per quarter, and Annual Report produced Develop and Distribute Guidelines for the management of common childhood illness in district hospitals printed and disseminated New indicatorGuidelines printed and disseminated to all district hospitals Implementation of guidelines monitored and 9 provincial reports produced

38. Programme 3: HIV / AIDS, TB and Maternal and Child Health Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Convene Morbidity and Mortality in Children under 5 years (COMMiC) Committee quarterly meetings New indicator 4 x Quarterly CoMMiC meetings convened CoMMiC Interim Report produced 4 x Quarterly CoMMiC meetings convened CoMMiC Interim Report produced 4 x Quarterly CoMMiC meetings convened Triennial CoMMiC report drafted Develop Adolescent and Youth health policy and implementation guidelines New indicator Adolescent and Youth health policy and guidelines finalised, printed and distributed Adolescent and Youth health policy implementation in all provinces Adolescent and Youth health policy implementation in all districts Monitor implementation of child health programmes using the standerdised dashboard reports New indicator Quarterly report developed and implementation feedback provided Reports sent to provinces each quarter Percentage of inmates screened for TB annually 50%75%80%85% Percentage of mines providing routine TB screening 30%60%75%85% Number of community members in 6 Peri mining districts screened for TB 134,400462,000

39. Programme 3: HIV / AIDS, TB and Maternal and Child Health Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % OFFICE OF THE DDG3 6091.193 6525.533 8544.964 045 HIV & AIDS12 784 41810.8414 170 75312.4215 930 87412.3417 896 977 TUBERCULOSIS26 4425.0327 771-0.3227 6834.2628 862 WOMEN'S MATERNAL & REPODUCTIVE HEALTH17 05810.0818 778-0.1118 7589.4320 527 CHILD, YOUTH & SCHOOL HEALTH218 3961.28221 190-90.2821 5064.7422 526 TOTAL13 049 92310.6714 442 14410.8116 002 67512.3117 972 937

40. Programme 3: HIV / AIDS, TB and Maternal and Child Health Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees64 4047.0468 9375.5072 7275.0076 365 Goods and Services468 7120.49471 006-35.73302 719-7.24280 811 Transfers12 515 08011.0713 900 39912.4115 625 46712.7317 613 994 Capital1 7274.341 802-2.221 7620.281 767 TOTAL13 049 92310.6714 442 14410.8116 002 67512.3117 972 937

41. Programme 3: HIV and AIDS, TB, Maternal and Child Health 1.Increase in transfer for HIV and AIDS conditional grant over the MTEF. 2.Funds for Human Papiloma Virus Vaccination are available for only 2014/15 and 2015/16. The grant will revert back to the Provinces for 2016/17.

42. Programme 4 – Primary Health Care Purpose Develop and oversee implementation of legislation, policies, systems, and norms and standards for a uniform district health system, environmental health, communicable and non-communicable diseases, health promotion, and nutrition.

43. Programme 4 – Primary Health Care Strategic Objective Performance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Improve district governance and strengthen management and leadership of the district health system Number of Districts with uniform management structures Uniform management structures for Districts 15 Districts with uniform management structures 40 Districts with uniform management structures 52 Districts with uniform management structures Number of primary health care facilities with functional clinic committees Implementation plan approved and Monitoring and evaluation system developed 1000 health care facilities with functional clinic committees 2000 health care facilities with functional clinic committees 2800 health care facilities with functional clinic committees Improve access to community based PHC services Number of functional WBPHCOTs 1500 functional WBPHCOTs 2000 functional WBPHCOTs 2500 functional WBPHCOTs 3000 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 New Indicator500 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

44. Programme 4 – Primary Health Care Strategic ObjectivePerformance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Improve environmental health services in all 52 districts and metropolitan municipalities in the country Number of municipalities that meet environmental health norms and standards in executing their environmental health functions Environmental Health strategy developed 20 municipalities meet environmental health norms and standards in executing their environmental health functions 35 municipalities meet environmental health norms and standards in executing their environmental health functions 45municipalities meet environmental health norms and standards in executing their environmental health functions Hand hygiene campaign rolled out in all 9 (nine) provinces Hand hygiene campaign launched A national Hand hygiene strategy developed 3 provinces implementing hand hygiene campaign targeting commuters, early childhood development centres and schools 6 provinces implementing hand hygiene campaign targeting commuters, early childhood development centres and schools Health Care Risk Waste Regulations Developed Regulations developed and published in the government gazette for public comment Health care risk waste regulations finalised and tools for audit implementation developed 50 public health facilities audited 150 health facilities audited

45. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performanc e 2014/15 Medium-term targets 2015/162016/172017/18 Establish a National Health Commission to address the social determinants of health National Health Commission established New Indicator Operating framework for National Health Commission developed Operating framework for National Health Commission approved and resourced National Health Commission established Reduce risk factors and improve management for Non Communicable Diseases (NCDs) by implementing the Strategic Plan for NCDs 2012-2017 Number of National government Departments oriented on the National guide for healthy meal provision in the workplace New Indicator 20 National Departments 30 National Departments All National Departments Regulations relating to Labelling and packaging of tobacco products and smoking in indoor and outdoor public places Developed New indicator Tobacco Act amended Regulations relating to labelling and packaging of tobacco products (plain packaging) published Regulations relating to smoking in indoor and outdoor public places

46. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Reduce risk factors and improve management for Non Communicable Diseases (NCDs) by implementing the Strategic Plan for NCDs 2012- 2017 Number of people screened for high blood pressure as part of comprehensive health screening 500 000 people screened for high blood pressure 8 million people screened for high blood pressure Number of people screened for raised blood glucose levels as part of comprehensive health screening 500 000 people screened for raised blood glucose levels 8 Million people screened for raised blood glucose levels 8 million people screened for raised blood glucose levels Awareness on risk factors relating to excessive salt intake, excessive sugar intake, physical inactivity and, alcohol related harm created New Indicator Content of campaign finalised and ready for implementation Visible media campaign conducted Random Monitoring of salt content in foodstuffs conducted. New IndicatorRandom samples from each of 13 regulated food category tested, reported on and corrective action taken

47. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Improve access to and quality of mental health services in South Africa Percentage people screened for mental disorders Information system and baseline established 28 % of 16.5% (prevalence) people screened for mental disorders 30 % of 16.5% (prevalence) people screened for mental disorders Percentage of people treated for mental disorders Information system and baseline established 28 % of 16.5% (prevalence) people treated for mental disorders 30 % of 16.5% (prevalence) people treated for mental disorders Percentage of mental health inpatient units attached to designated district and regional hospitals 14.2% (39/274) of mental health inpatient units attached to designated district and regional hospitals 16% of mental health inpatient units attached to designated district and regional hospitals 18% of mental health inpatient units attached to designated district and regional hospitals 20% of mental health inpatient units attached to designated district and regional hospitals Mental health teams established in each district ZeroStrategy for establishment of specialist mental health teams approved by the TechNHC 5 specialist mental health teams established 20 specialist mental health teams established

48. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Improve access to disability and rehabilitation services through the implementation of the framework and model for rehabilitation and disability services Number of Districts implementing the framework and model for rehabilitation services Draft Framework and Model approved and costed Resources allocated for the approved Framework and Model 5 Districts implementing the framework and model for rehabilitation services 15Districts implementing the framework and model for rehabilitation services Prevent avoidable blindness Cataract Surgery Rate 1 500 operations per million un- insured population Eliminate Malaria by 2018, so that there is zero local cases of malaria in South Africa Malaria Incidence per 1000 population at risk 0.3 malaria cases per 1000 population at risk 0.2 malaria cases per 1000 population at risk Number of districts targeted for malaria elimination reporting malaria cases within 24 hours of diagnosis 3 malaria targeted districts reporting malaria cases within 24 hours of diagnosis 5 malaria targeted districts reporting malaria cases within 24 hours of diagnosis 7 malaria targeted districts reporting malaria cases within 24 hours of diagnosis [1] Targeted districts: Pre-elimination: Vhembe District Elimination: Mopani, Waterberg, Capricorn, Sekhukhune, Ehlanzeni, Nkangala, UMkhanyakude, Zululand, uThungulu

49. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Strengthen preparedness and core response capacities for public health emergencies in line with International Health Regulations Number of Provincial Outbreak Response Teams capacitated to respond to zoonotic, infectious and food- borne diseases outbreaks New indicator 9 Provincial Outbreak Response Teams capacitated to respond to zoonotic disease outbreaks 9 Provincial Outbreak Response Teams capacitated to respond to food- borne disease outbreaks 9 Provincial Outbreak Response Teams capacitated to respond to infectious disease outbreaks Improve South Africa’s response with regard to Influenza prevention and control Number of high risk population covered by the seasonal influenza vaccination 750 000 high risk individuals covered with seasonal influenza vaccination 800 000 high risk individuals covered with seasonal influenza vaccination 1 000 000 high risk individuals covered with seasonal influenza vaccination

50. Programme 4 – Primary Health Care Strategic Objective Performance IndicatorEstimated Performance 2014/15 Medium-term targets 2015/162016/172017/18 Establish a coordinated disease surveillance system for Notifiable Medical conditions (NMC) A strategy and plan for the integration of disease surveillance systems for NMC Developed and Implemented Draft strategy for the integration of disease surveillance systems for NMC developed Strategy for the integration of disease surveillance systems for NMC approved and implementation plans developed First Phase implementation commenced Second Phase implementation commenced Conduct Annual National HIV Antenatal Prevalence Survey Annual National HIV Antenatal Prevalence Survey conducted 2014 National Antenatal Sentinal HIV and Herpes Simplex Type 2 prevalence Report produced 2015 National Antenatal HIV prevalence Report produced 2016 National Antenatal HIV prevalence Report produced 2017 National Antenatal HIV prevalence Report produced

51. Programme 4 – Primary Health Care Services Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % OFFICE OF THE DDG3 0072.933 0955.533 2664.963 428 DISTRICT HEALTH SERVICES23 7623.0324 48131.6832 237-1.3131 814 ENVIRONMENTAL AND PORT HEALTH SERVICES - 130 0953.93135 2137.08144 789 COMMUNICABLE DISEASES13 55322.1116 5501.0416 7224.4317 462 NON-COMMUNICABLE DISEASES25 7189.8828 2593.2329 1711.1629 510 HEALTH PROMOTION & NUTRITION21 7683.4822 5250.5922 6589.4124 790 TOTAL87 808156.25225 0056.34239 2675.24251 793

52. Programme 4 – Primary Health Care Services Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees48 909260.90176 5115.50186 2225.00195 531 Goods and Services35 11623.2143 26811.2348 1285.4250 737 Transfers2 43818.992 9014.653 0364.413 170 Capital1 34572.862 325-19.101 88125.202 355 TOTAL87 808156.25225 0056.34239 2675.24251 793

53. Programme 4: Primary Health Care Services 1.Transfer of Port Health Services from Provincial Health Departments amounting to R118 million. 2.Some subprogrammes were underfunded in Compensation of Employees during previous budget cycle, which are now addressed.

54. Programme 5: Hospital, Tertiary Health Services and Human Resource Development PURPOSE to develop policies, delivery models and clinical protocols for hospitals and emergency medical services. Ensure alignment of academic medical centres with health workforce programmes, training of health professionals and to ensure the planning of health infrastructure to meet the health needs of the country.

55. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Increase capacity of central hospitals to strengthen local decision making and accountability to facilitate semi- autonomy of 10 central hospitals Number of central hospitals with full delegated authority. 0 10 central hospitals with full delegated authority 6 Central Hospitals with reformed management and governance structures implement decentralised accounting systems 10 Central Hospitals with reformed management and governance structures implement decentralised accounting systems Ensure equitable access to tertiary service through implementation of the National Tertiary services plan Number of gazetted Tertiary hospitals providing the full package of Tertiary1 Services 5 gazetted tertiary hospitals providing the full package of Tertiary 1 services 4 additional tertiary hospitals (Pietersburg, Frere, Kimberly and Ngwelezana) providing the full package of Tertiary 1 services 4 additional gazetted tertiary hospitals (Mankweng, Rob Ferreira, Kalafong, Kerksdorp / Tshepong complex) providing the full package of Tertiary 1 services 4 additional gazetted tertiary hospitals (Witbank, Port Elizabeth, Pelonmi, JST), providing the full package of Tertiary 1 services Programme 5: Hospital, Tertiary Health Services and Human Resource Development

56. Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium-term targets 2015/162016/17 2017/18 Ensure quality health care by improving compliance with National Core Standards at all Central, Tertiary, Regional and Specialised Hospitals Number of Hospitals that comply fully with the National Core Standards. Varying degrees of compliance with the National Core Standards in 5 Central Hospitals Full compliance with the National Core Standards in 8 Central hospitals and 5 Tertiary Hospitals Full compliance with the National Core Standards in 10 Central, 17 Tertiary, 25 Regional Hospitals Full compliance with the National Core Standards in 10 Central, 17 Tertiary, 40 Regional Hospitals Develop health workforce staffing norms and standards. Develop guidelines for HRH norms and standards using the WISN methodology Determine norms for PHC. Orientate District Hospital managers Guidelines for HRH Norms for District and specialised hospitals developed. Tertiary, Regional and Central Hospital managers oriented on WISN tool and methodology Guidelines for HRH Norms for District and specialised hospitals approved. Guidelines for HRH Norms for Regional, Tertiary and Central Hospitals developed Guidelines for HRH Norms for Regional, Tertiary and Central Hospitals approved Number of facilities benchmarked against PHC staffing normative guides New indicator100024003507

57. Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Professionalise Nursing Training and Practice through implementation of the objectives of the Nursing Strategy. Public Nursing colleges offering new Nursing programmes (inline with National Qualifications Framework) A scope of requirements for the implementation of the nursing strategy developed A national policy for nursing education developed in the context of bedside training 3 Public Nursing Colleges piloting new nursing programmes 10 Public Nursing Colleges offering new nursing Programmes Develop a Nursing and midwifery educators’ training and development programme Audit of capacity of nurse educators completed a Nursing and midwifery educators’ training and development programme developed a Nursing and midwifery educators’ training and development programme piloted (at 3 Public Nursing colleges) and approved a Nursing and midwifery educators’ training and development programme piloted at 10 Public Nursing colleges Develop a standerdised Nursing leadership structure for Provincial DoH A national nursing services leadership structure established A provincial Nursing structures to give authority over nursing and midwifery services tabled at NHC Provincial nursing structures established and Functional Not Applicable Programme 5: Hospital, Tertiary Health Services and Human Resource Development

58. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 To improve quality of health infrastructure in South Africa Number of facilities maintained, repaired and/or refurbished in NHI Districts 94 maintenance projects for health facilities in NHI Districts 198 facilities192 facilities 212 facilities Number of facilities maintained, repaired and/or refurbished outside NHI pilot Districts 249 maintenance projects for health facilities outside NHI pilot Districts 310 facilities320 facilities 335 facilities Number of clinics and Community Health Centres constructed or revitalised 72 clinics and community health centres constructed 354642 Number of hospitals constructed or revitalised 7 hospitals constructed or revitalised 288 Number of new facilities that comply with gazetted infrastructure Norms & Standards. 100% from date of gazetting 37 new facilities 54 new facilities 50 new facilities Strengthen Monitoring of Infrastructure projects Develop a Infrastructure Monitoring System New IndicatorInfrastructur e Monitoring System fully developed and tabled at NHC Infrastructur e Monitoring System approved by NHC and implemented Not Applicable Programme 5: Hospital, Tertiary Health Services and Human Resource Development

59. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Ensure access to and efficient effective delivery of quality Emergency Medical Services (EMS) Number of provinces that are compliant with the EMS regulations Draft EMS Regulations developed EMS Regulations and compliance checklist gazetted for implementation 3 provinces (WC, GP and LP) compliant with EMS Regulations 3 provinces (FS, NW, NC) compliant with EMS Regulations To eliminate the backlog of blood alcohol and toxicology tests by 2016 Number of Blood Alcohol reports produced 7500 reports per lab per quarter ( 4 FCLs) 120 000 Backlogs Eliminated, and 120 000 blood alcohol reports issued Backlogs Eliminated, and 120 000 blood alcohol reports issued Number of Toxicology reports produced 375 reports per lab( 3 FCLs) 4 500 Backlogs Eliminated, and 4 500 toxicology reports issued Backlogs Eliminated, and 4 500 toxicology reports issued To provide food analysis services Number of food tests performed 500 per lab per quarter( 2 FCLs) 4 000 Programme 5: Hospital, Tertiary Health Services and Human Resource Development

60. Objective Statement Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Improve management of health facilities at all levels of care through the Health Leadership and Management Acadamy. Establish a coaching mentoring and training programme for health managers New indicator Coaching mentoring and training programme developed and piloted 20% of Hospital CEOs and PHC Facility Managers benefiting from the coaching and mentoring programme. 40% of Hospital CEOs and PHC Facility Managers benefiting from the coaching and mentoring programme. Develop a knowledge hub which includes a web based interactive information system New IndicatorFramework for knowledge hub developed and approved 60% of Hospital CEOs and PHC Facility managers benefitting from the knowledge hub. 100% of Hospital CEOs and PHC Facility managers benefitting from the knowledge hub Programme 5: Hospital, Tertiary Health Services and Human Resource Development

61. Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Publish Policy on education and training of EMS Personnel published for implementation Policy on education and training of EMS Personnel drafted Policy on education and training of EMS Personnel published 3 EMS Colleges implementing the policy on education and training of EMS Personnel published Additional 3 EMS Colleges implementing the policy on education and training of EMS Personnel published Develop regulations for Emergency Care Centres None Regulations on Emergency Care Centres Drafted Publish Regulation on Emergency Care Centres for public comment and implementation Regulations implemented by 9 Provinces Publish Regulations for EMS in Mass Gatherings Regulations on EMS in mass gatherings developed EMS in mass gatherings published for public comment and implementation Regulations implemented by 9 Provinces 9 Provinces compliant with regulations Develop a monitoring system to effectively measure turnaround time of tests conducted at Forensic Chemistry Laboratories New IndicatorA standardised workflow and monitoring system developed for all 3 tests and implemented at 4 forensic chemistry laboratories Baselines established using the new monitoring system Not Applicable Programme 5: Hospital, Tertiary Health Services and Human Resource Development

62. Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Regulations for the Rendering of Forensic Pathology Services promulgated New indicator Regulations on for the Rendering of Forensic Pathology Services reviewed and Published for public comment Publish Regulation on for the rendering of Forensic Pathology Services for implementation Not Applicable Publish Scope of Practice Guidelines for the rendering of Forensic Pathology Services New indicator Review and Finalise the Scope of Practice Guidelines for the rendering of Forensic Pathology Services and Publish for Implementation Implement the scope of practice guidelines in 9 provinces 9 provinces compliant with the scope of practice guidelines Number of Health Facilities that are designated to render services for the management of sexual and related offences 40 additional facilities were designated 60 additional facilities designated 80 additional facilities designated 200 additional facilities designated Number of Regional Training Centre established 3 RTCs established5 RTCs established9 RTCs established9 RTCs established Programme 5: Hospital, Tertiary Health Services and Human Resource Development

63. Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % OFFICE OF THE DDG3 5701.373 6195.553 8204.954 009 HEALTH FACILITIES INFRA-STRUCTURE MANAGEMENT6 275 300-0.696 231 7393.826 469 5216.516 890 866 TERTIARY HEALTH CARE PLANNING & POLICY10 171 4052.2610 401 0674.3210 850 1566.2611 529 705 HOSPITAL MANAGEMENT5 426-4.875 1623.745 3556.165 685 HUMAN RESOURCES FOR HEALTH2 344 6522.292 398 3854.302 501 5916.262 658 129 NURSING SERVICES2 53195.224 941-37.223 1025.003 257 FORENSIC CHEMISTRY LABORATORIES122 896-12.92107 01912.52120 4210.00120 419 VIOLENCE, TRAUMA & EMS3 70792.427 1333.767 4016.477 880 TOTAL18 929 4871.2119 159 0654.1919 961 3676.3121 219 950

64. Programme 5: Hospital, Tertiary Health Services and Human Resource Development Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees106 3809.08116 0375.50122 4245.00128 544 Goods and Services83 144314.31344 4775.28362 6694.71379 744 Transfers17 730 0041.8018 048 5194.1418 796 1836.2719 975 005 Capital1 009 959-35.64650 0324.62680 0918.32736 657 TOTAL18 929 4871.2119 159 0654.1919 961 3676.3121 219 950

65. Programme 5: Hospitals, Tertiary Health Services & HR Development 1.Some subprogrammes were underfunded in Compensation of Employees during previous budget cycle, which are now addressed. 2.Shifting some of the capital budget to goods and services and budget cut regarding the indirect Health Facility Revitalization grant of about R107,8 million. 3.Set up of Chief Nursing Services Office in 2015.

66. Programme 6: Health Regulation and Compliance Management PURPOSE Regulate the procurement of medicines and pharmaceutical supplies, including food control, and the trade in health products and health technology. Promote accountability and compliance by regulatory bodies and public entities for effective governance and quality of health care.

67. Programme 6: Health Regulation and Compliance Management Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Establish the South African Health Product Regulatory Authority (SAHPRA) Establish SAHPRA as a public entity National Portfolio Committee on Health deliberates over the bill SAHPRA Act (Bill 6 of 2014) Promulgated, and transitional plan from MCC to SAHPRA developed  SAHPRA established  Board, CEO and Committees Appointed SAHPRA Operational and functional Establish Institute of Regulatory Science (IRS) Institute of Regulatory Science (IRS) providing training New Indicator Project Team appointed with Business Plan drafted and approved Incorporate virtual university within SAHPRA IRS functional with training provided To develop the policy and legislative framework for occupational health and compensation Review occupational health legislative framework 1 consultative meeting on amendments to the Occupational Diseases in Mines and Works Act, 1973 Draft amendments to the Occupational Diseases in Mines and Works Act, 1973 gazetted Gazette legislation on amendments to the Occupational Diseases in Mines and Works Act, 1973 Implementation of legislative amendments to the Occupational Diseases in Mines and Works Act, 1973

68. Programme 6: Health Regulation and Compliance Management Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 To establish an occupational health cluster occupational health cluster established and functional Discussion document on integration of the governance and management of the occupational health units (NIOH, CCOD and MBOD) Consultation on discussion document and approval of structure, organogram and activities of the occupational health cluster by NHC Reorganisation of occupational health cluster and middle management structures New structure for occupational health cluster implemented To provide occupational health and compensation services through the development of One Stop Service centres in provinces Number of provinces with One Stop Service Centres to deliver occupational health and compensation services One Stop Service Centre for occupational health and compensation services in one health facility in Eastern Cape and Gauteng province established One Stop Service Centre for occupational health and compensation services in one health facility in Northern Cape and Limpopo Established One Stop Service Centre for occupational health and compensation services in one health facility in North West and Free State Established One Stop Service Centre for occupational health and compensation services in one health facility in Mpumalanga and KZN established To establish the National Public Health Institutes of South Africa (NAPHISA) for disease and injury surveillance Develop legal framework to establish National Public Health Institutes of South Africa (NAPHISA) Report on conceptual framework and business case for NAPHISA Gazetted legislation on NAPHISA Assessment of other business units within the National Department of Health that are transferred to NAPHISA Consolidation of other business units into NAPHISA

69. Programme 6: Health Regulation and Compliance Management Objective StatementPerformance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Improve oversight and Corporate Governance practices by establishing effective governance structures, policies and tools Number of Health entities’ and Statutory Health professional Councils with fully functional and compliant to good Governance practices (structures, Finance, HR, Supply Chain Management policies) and also respond to health sector priorities 2 health entities fully functional 4 health Entities’ and 6 statutory health professional councils Develop and implement a performance management system for board members Non standardised performance management system A standardised performance management system for board members developed and piloted A standardised performance management system for board members fully implemented

70. Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Regulate Medical devices, IVDs, cosmetics and expand on regulation of Complementary medicines (CAMS) New indicator  Develop draft regulations and guidelines for Medical devices and IVDs  Call up specific high risk categories of CAMS for registration purposes  Promulgate Regulations for Medical Devices and IVDs and call up high risk Medical Devices and IVDs  Call up additional categories of CAMS  Call up additional Medical Devices and IVDs  Call up additional categories of CAMS Improve registration turnaround times of ARV’s, TB, oncology and vaccines to treat and prevent high burden of diseases New indicator 50 % of priority medicine registered NCE = 22 months Generics = 18 months 55 % of priority medicine registered NCE = 36 months; Generics = 28 months 60 % priority medicine registered NCE = 36 months; Generics = 28 months Establish a MOU with Department of Agriculture, Fisheries and Forestry’s (DAFF)` 40 additional facilities were designated Draft MOUMOU Signed between DoH and DAFF DAFF Laboratories testing Food Samples Programme 6: Health Regulation and Compliance Management

71. Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Develop Regulations for Cosmetic products Draft Regulations produced Regulations gazetted for public comments comments reviewed and final regulations gazette Regulations fully implemented Number of applications certified at MBOD as compensable disease claims 700080001000012000 Number of compensable disease claims paid by CCOD other than pensioners 2700300033006000 Number of newly appointed boards inducted and trained 1 new public entity board (Council for Medical Schemes) with 10 members appointed inducted and trained 3 new boards appointed, inducted and trained (Health Professions Council of South Africa; National Health Laboratory Service and the Interim Traditional Health Practitioners Council of South Africa) 3 new boards appointed, inducted and trained (MRC; OO H SC and AHPCSA) 1 new board appointed, inducted and trained (Council for Medical Schemes Inducted Programme 6: Health Regulation and Compliance Management

72. Performance Indicator Estimated Performance 2014/15 Medium Term Targets 2015/162016/17 2017/18 Develop and implement Dashboard to monitor entities performance and compliance to legislative prescripts New Indicator 10 Dashboards developed and piloted (1 per entity or statutory council) 10 Dashboards fully implemented (1 per entity or statutory council) Develop a reporting template to enable feedback to the executive authority. No standardised Feedback mechanism available for Departmental representatives serving on boards Standardised reporting template developed and implemented for Departmental representatives serving on boards Programme 6: Health Regulation and Compliance Management

73. Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % OFFICE OF THE DDG4 127-11.073 6705.563 8744.934 065 FOOD CONTROL7 51230.439 7983.8110 1714.1910 597 PHARMACEUTICAL TRADE & PRODUCT REGULATION120 3403.72124 8168.05134 8624.02140 281 PUBLIC ENTITIES MANAGEMENT666 619110.011 399 9915.511 477 1221.441 498 355 COMPENSATION COMMISSIONER FOR OCCUPATIONAL DISEASES & OCCUPATIONAL HEALTH55 9124.8958 6445.1161 6435.5565 064 TOTAL854 51086.881 596 9195.681 687 6721.821 718 362

74. Programme 6: Health Regulation and Compliance Management Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees102 98533.43137 4115.60145 1115.15152 588 Goods and Services87 004-33.0358 2689.1963 6242.8765 449 Transfers660 926111.471 397 6435.551 475 1501.441 496 350 Capital3 5950.063 5975.283 7874.963 975 TOTAL854 51086.881 596 9195.681 687 6721.821 718 362

75. Programme 6: Health Regulation and Compliance Management 1.Conversion of Office of Health Standards Compliance to a transfer payment during 2015.

76. Programme 6: Health Regulation and Compliance Management SUMMARY FOR DEPARTMENT Subprogramme 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % ADMINISTRATION389 65017.30457 078-0.25455 9587.92492 052 NATIONAL HEALTH INSURANCE, HEALTH PLANNING & SYSTEM ENABLEMENT644 097-8.74587 807-1.91576 60818.30682 145 HIV & AIDS, TB, MATERNAL & CHILD HEALTH13 049 92310.6714 442 14410.8116 002 67512.3117 972 937 PRIMARY HEALTH CARE SERVICES SERVICES87 808156.25225 0056.34239 2675.24251 793 HOSPITALS, TERTIARY HEALTH SERVICES & HUMAN RESOURCE DEVELOPMENT18 929 4871.2119 159 0654.1919 961 3676.3121 219 950 HEALTH REGULATION & COMPLIANCE MANAGEMENT854 51086.881 596 9195.681 687 6721.821 718 362 TOTAL33 955 4757.4036 468 0186.7338 923 5478.7742 337 239

77. SUMMARY FOR DEPARTMENT Economic Classification 2014/15 % Growth from 2014/15 to 2015/16 2015/16 % Growth from 2015/16 to 2016/17 2016/17 % Growth from 2016/17 to 2017/18 2017/18 R'000 % % % Compensation of Employees557 94138.38772 0885.40813 7775.03854 719 Goods and Services1 385 65413.991 579 459-10.591 412 2688.571 533 369 Transfers30 986 8457.9433 448 4937.6436 002 7088.8739 196 803 Capital1 025 035-34.83667 9784.01694 7948.28752 348 TOTAL33 955 4757.4036 468 0186.7338 923 5478.7742 337 239

78. Budget Pressures Additional budget cut in goods & services of R70.4 million for 2015/16 to 2016/17. Office Accommodation - ± R20 million. Audit fees - ± R6 million. Maintenance and repair of security systems. SA Demographic Health Survey – R50 million. Port Health Services – insufficient Goods and Services budget. Intake of MbChb students at Universities KZN Forensic Chemistry lab. No funds received for carry-through cost for MCC.

79. Conditional Grants Schedules Conditional Grants Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Schedule 4AHealth Professions Training & Development Grant2 374 7222 476 7252 631 850 National Tertiary Services Grant10 398 03510 846 77811 526 145 Schedule 5AComprehensive HIV/AIDS Grant13 737 31215 466 60317 440 333 Health Facility Revitalisation Grant5 275 7625 472 6805 817 010 National Health Insurance Grant72 04275 43380 157 Schedule 6ANational Health Grant National Health Insurance Component298 100268 000348 564 Health Facility Revitalisation Component273 953285 913308 748 Human Pappiloma Virus Component200 00000 Conditional Grants transferred to provinces S4 & S5 Conditional Grants kept at National Health Total Sector Conditional Grants32 629 92634 892 13238 152 807

80. Health Professions Training Grant Health Professions Training & Development Grant Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Eastern Cape204 431213 231 156 Free State149 757156 190169 335 Gauteng829 607865 241938 059 KwaZulu Natal299 514312 379338 669 Limpopo118 856123 961134 394 Mpumalanga97 461101 647110 202 Northern Cape78 44681 81688 701 North West106 971111 566120 955 Western Cape489 679510 711553 699 Total2 374 7222 476 7242 685 170

81. National Tertiary Services Grant Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Eastern Cape803 771838 459909 025 Free State918 388958 0221 038 651 Gauteng3 572 8533 727 0444 040 719 KwaZulu Natal1 530 2471 596 2871 730 633 Limpopo330 463344 724373 736 Mpumalanga99 312103 598112 316 Northern Cape305 478318 662345 480 North West242 626253 097274 398 Western Cape2 594 8972 706 8852 934 706 Total10 398 03510 846 77811 759 664

82. Comprehensive HIV/AIDS Grant Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Eastern Cape1 577 0651 775 5902 029 876 Free State911 9461 026 7451 173 787 Gauteng2 928 3003 296 9243 769 082 KwaZulu Natal3 813 0944 293 0964 907 918 Limpopo1 056 9751 190 0311 360 457 Mpumalanga927 2141 043 9341 193 437 Northern Cape371 253417 987477 847 North West1 012 9841 140 5011 303 834 Western Cape1 138 4811 281 7951 465 364 Total13 737 31215 466 60317 681 602

83. Health Facility Revitalisation Grant Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Eastern Cape442 930 Free State554 950 Gauteng303 630 KwaZulu Natal1 090 431 Limpopo184 255 Mpumalanga277 942 Northern Cape446 407 North West558 721 Western Cape645 200 Unallocated771 2965 472 6805 934 894 Total5 275 7625 472 6805 934 894

84. National Health Insurance Grant Budget Allocation - 2015/16 Budget Allocation - 2016/17 Budget Allocation - 2017/18 R'000 Eastern Cape 7 2047 5448 178 Free State 7 2057 5448 178 Gauteng 7 2047 5448 178 KwaZulu Natal 14 40815 08316 356 Limpopo 7 2057 5448 178 Mpumalanga 7 2047 5448178 Northern Cape 7 2037 5438 179 North West 7 2057 5448 178 Western Cape 7 2047 5438 179 Total 72 04275 43381 872

85. CONCLUSION  National DoH Annual Performance Plan 2015/16 to 2017/18 is aligned to the National DoH Strategic Plan 2015/16-2019/20, which is founded on government’s 2030 vision outlined in the National Development Plan 2030.  National DoH Annual Performance Plan 2015/16 to 2017/18 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. 85