THE MILLENNIUM DEVELOPMENT GOALS: OVERVIEW OF ACHIEVEMENTS AND CHALLENGES MS NTHARI MATSAU NCHF: 19

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THE MILLENNIUM DEVELOPMENT GOALS OVERVIEW OF
ACHIEVEMENTS AND CHALLENGESMS NTHARI
MATSAUNCHF 19 - 20 JULY 2007
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1. THE CONTEXT

• Health and development are intricately linked.
  Ill health and poverty and are also intertwined
• The social determinants of health must be taken
  into cognisance in reviewing (and accelerating)
  progress towards the MDGs
• South Africa is facing a triple burden of
  diseases associated with its epidemiological
  transition namely communicable diseases (e.g.
  TB, malaria, sexually transmitted infections
  including HIV and AIDS) non-communicable
  diseases, and trauma and violence
• South Africas population has increased from 36
  million in 1996 to 47.5 million in 2007

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2. OVERVIEW OF PROGRESS TOWARDS MDGs
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2. OVERVIEW OF PROGRESS TOWARDS MDGs (CONT.)
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2. OVERVIEW OF PROGRESS TOWARDS MDGs (CONT.)
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2. OVERVIEW OF PROGRESS TOWARDS MDGs (CONT.)
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2. OVERVIEW OF PROGRESS TOWARDS MDGs (CONT.)
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2. OVERVIEW OF PROGRESS TOWARDS MDGs (CONT.)
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3. NON-COMMUNICABLE DISEASE (NCD) CONTROL

• PROGRESS
• Vuka South Africa move for your health campaign
  (increased physical activity)
• Healthy lifestyles campaigns focusing on
  nutrition
• Guidelines prepared distributed on a range of
  NCDs (implementation being monitored)
• Significant progress made with sight restoration,
  with a cataract surgery rate of 1030 per million
  people achieved during 2005/06, and 1146 per
  million people during 2006/07
• Anti-tobacco use legislation campaings

• CHALLENGES
• Increased contribution of NCDs to the Burden of
  Disease as reported in the 2003 SADHS
• Increase in deaths due to diabetes in the three
  year period 2002-2004 (StatSA)

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4. INJURIES TRAUMA

• Progress
• Increased collaboration co-operation amongst
  government departments
• National Strategy to reduce non-natural causes of
  deaths
• Finalisation of alcohol labelling

• Challenges
• High levels of interpersonal violence
• Reckless behaviour, including large number of
  MVAs
• Inadequate social cohesion in communities

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5. MDGs SOME CONTINUING CHALLENGES

• Lack of 1990 baseline data of good quality
• Lack of consensus amongst the scientific
  community about Child, Infant, Maternal Mortality
  rates in South Africa
• Good quality data on child mortality is an urgent
  need
• South Africas maternal mortality rates remain
  relatively too high for a developing country
• TB indicators unsatisfactory (high incidence, low
  cure rates, high defaulter rate), coupled with
  emergence of XDR and MRD TB
• Lack of focus on Non-communicable Diseases
  violence and trauma in the MDGs
• Need for a systematic assessment of the
  contribution of Non-Communicable Diseases as well
  as injuries and trauma to the national Burden of
  Diseases.

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6. HEALTH SECTOR INTERVENTIONS TO STRENGTHEN
PROGRESS TOWARDS MDGs

• National Health Systems priorities 2007/08
• Development of Service Transformation Plans
• Strengthening provision of Human Resources
• Improving Quality of Care
• Strengthening Infrastructure
• Strengthening Strategic Health Programme

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7. SOCIAL DETERMINANTS OF HEALTH

• Despite good progress reported earlier on,
  backlogs still exist which is the focus of the
  Social Cluster
• 1.3 million people in the Free State (35 of the
  population) have no access to basic sanitation
• 34 urban schools and 464 rural schools in the
  Free State (11 of schools) have no sanitation
  facilities
• 22 of households in Limpopo do not have access
  to piped water
• 23 of households in Limpopo do not have access
  to proper sanitation
• 8 of the population of Mpumalanga older than 20
  years have no formal education.

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8. CONCLUSIONS

• Progress has been made but challenges still exist
• More robust monitoring systems are required to
  track our progress towards the MDGs, and to
  generate consensus about areas of progress and
  areas of difficulty. This must be one of the key
  priorities going forward.
• The mandate of this workshop is to identify a key
  set of turnkey interventions to be implemented
  between 2007 and 2015
• Best wishes for all your deliberations.