Decreasing morbidity and mortality rates through strategic interventions

1
Decreasing morbidity and mortality rates through
strategic interventions

• Tackling HIV and AIDS
• An accreditation process to evaluate the
  readiness of the sites was done in February 2004
• Six sites were accredited.
• Two sites Shongwe and Witbank Hospitals have
  rolled out on 1st June 2004

2
Decreasing morbidity and mortality rates through
strategic interventions

• Managing Rehabilitation Services
• 30 electrical wheelchairs and 2471 wheelchairs
  issued
• 3 500 hearing aids issued
• 400 walking frames issued
• 3 400 aluminium crutches issued

3
Decreasing morbidity and mortality rates through
strategic interventions

• Managing Rehabilitation Services
• 350 quadropods issued
• 700 Other mobility assistive devices issued
• The community Based Rehabilitation Counselling
  programme implemented in partnership with
  Disabled People South Africa

4
Decreasing morbidity and mortality rates through
strategic interventions

• The Department has renewed the agreement with
  the Mpumalanga Provincial Council for the blind
• An independence training programme for the blind
  and partially sighted people living in the
  province has been initiated
• The administrative system and communication plan
  for the implementation of free health services to
  people with disabilities living in the province
  has been developed

5
Decreasing morbidity and mortality rates through
strategic interventions

• Improving Mental Health Services
• Identified and established sexual offence
  support rooms at 4 hospitals
• 80 Primary Health Care Nurses Trained in
  Integrated Mental Health Care

6
Decreasing morbidity and mortality rates through
strategic interventions

• Improving Mental Health Services
• A mental Health awareness campaign was
  successfully conducted in Lekwa- Dipaleseng on
  the 15/11/2003 and was attended by 500 school
  going children

7
Decreasing morbidity and mortality rates through
strategic interventions

• Tuberculosis.
• TB is managed according to the Direct Observed
  Treatment Strategy (DOTS). Executed in PHC
  Clinics the DOTS Programme has been effectively
  implemented in the Province

8
Decreasing morbidity and mortality rates through
strategic interventions

• Tuberculosis.
• Patients who cannot be treated on an
  ambulatory basis are admitted in one of the
  SANTA Hospitals or the Provincial TB Hospital.
  TB registers are maintained in each of the
  hospitals for all patients admitted

9
Decreasing morbidity and mortality rates through
strategic interventions

• Tuberculosis.
• TB Management has been identified as a
  National Priority and to that regard a Medium
  Term Strategy was launched

10
Decreasing morbidity and mortality rates through
strategic interventions

• Measles
• A measles outbreak of adults ranging from 18
  22 years broke out at Nkomazi area during
  Sept/Oct 2003
• A measles campaign was carried at Tonga and
  Shongwe and the index case was from Mozambique
• The outbreak was contained to 45 cases at the
  end of October 2003

11
Decreasing morbidity and mortality rates through
strategic interventions

• Managing Chronic Conditions
• Situation Analysis conducted in Ehlanzeni
  District and Gert Sibande
• A Total of 32 Clinics were visited and
  recommendations given to site managers

12
Decreasing morbidity and mortality rates through
strategic interventions

• Eye Care
• 2 000 cataract operations performed in the
  province
• Trained 10 Ophthalmic Nurses to do
  refractions so as to enable them to screen,
  refract and supply spectacles to patients in the
  rural areas

13
Decreasing morbidity and mortality rates through
strategic interventions

• Eye Care
• Screened 20 000 people to detect various eye
  conditions
• On 6 October 2003, the first day of the eye
  care awareness week, which was organised at
  Msogwaba Clinic, Ehlanzeni District, the eye
  care workers screened 604 patients and issued
  156 pairs of spectacles free of charge

14
Decreasing morbidity and mortality rates through
strategic interventions

• Eye Care
• A primary eye care network has been
  established in all hospitals and several
  clinics in the Ehlanzeni district, at
  Embhuleni, Piet Retief and Bethal Hospitals in
  the Gert Sibande, and Witbank, Middelburg and
  Philadelphia in Nkangala

15
Decreasing morbidity and mortality rates through
strategic interventions

• Improving Emergency Medical Services
• 23 response vehicles purchased with the
  appropriate advance life support and immediate
  intervention extrication equipment
• Inter-directorate arrangements were achieved
  with regards to the supply and purchase of
  surgical sundries and medical gases

16
Improving resource mobilisation and the
management of resources without neglecting the
attainment of equity in resource allocation

• Conducted District Health Expenditure Reviews in
  all three districts
• Implemented Patient Administration and Billing
  (PAAB) system in 9 hospitals
• 3 Pilot sites identified for Designated Service
  Provider Network (DSPN)

17
Improving human resource development and
management

• Tuition provided to 425 students on nursing
  education
• 1074 health officials trained on PHC
• 588 learners enrolled on the ABET
• 329 bursaries provided

18
Improving human resource development and
management

• 45 Ambulance Emergency Assistants trained
• 900 officials received generic training
• Performance Management and Development System
  (PMDS) developed and implemented

19
Improving human resource development and
management

• Challenges
• Ensuring compliance with the PMDS requirements
  e.g. Quarterly reports
• Recruitment and retention of appropriately
  skilled staff
• Improve mentoring and coaching to facilitate
  promotion of the staff internally

20
Improving communication and consultation within
the health system and between the health system
and communities we serve

• Community outreach programmes conducted
• Meetings held with external stakeholders e.g.
  NGOs and traditional healers
• Quarterly departmental newsletter issued
• Departmental Website launched
• Patient hotline established and Functional (0800
  20 40 98)

21
Strengthening co-operation with our partners
internationally

• Developed an Action plan on general health
  matters as well as one on HIV and AIDS with the
  Maputo Province in Mozambique
• Participate in the Lebombo Spatial Development
  Initiative to strengthen Malaria management
• Identification of possible areas of cooperation
  with the Italian Corporation

22
Vision

• Our Vision is a caring and humane society in
  which all people in Mpumalanga have access to
  affordable and good quality health services

23
Mission

•   To provide and improve access to quality
  health care within a Primary Health Care approach
  
•   Reduce inequity
•   Strive for excellence at all levels of the
  health care delivery system
•   Work in partnership with other stakeholders

24
Values

• We are a department that will always strive for
• Effectiveness, efficiency, accountability and
  commitment to all the principles enshrined in the
  Batho Pele policy and the Patients Rights
  Charter

25
Key priorities for the next 3 years
26
Reorganisation of support services

• Health Information Systems
• To establish a fully functional and integrated
  health information system linking facilities at
  all levels of care by 2007
• Telemedicine
• Increase the number of PHC telemedicine sites to
  4 sites per districts
• Increase the number of Hospital telemedicine
  sites to 3 sites per districts

27
Reorganisation of support services

• Patient Administration and Billing System (PAAB)
• Fully functional system at all hospitals
  (including ICD 10 coding) by 2006
• Uniform Patient Fee Structure (UPFS)
• Fully implement at all hospitals by 2005

28
Reorganisation of support services

• Integrated nutrition Strategy
• Establish an inter-sectoral plan so as to develop
  an integrated food safety and control system by
  2005
• Increase the capacity of the provincial MDR unit
  by an additional 36 beds by January 2005

29
Reorganisation of support services

• Ensure the take over of the management of
  medico-legal mortuaries from the SAPS by 01 April
  2005
• Establish a specialised provincial hospital for
  chronic psychiatric patients by 2007

30
Reorganisation of support services

• Establish a new provincial pharmaceutical depot
  incorporating a depot facility as well as a pre
  packing unit by June 2006.
• Ensure sufficient provincial capacity to take
  over management of the Pharmaceutical facility at
  the end of the outsourced contract period by
  December 2005

31
Legislative reform

• Enactment of the Provincial Health Bill

32
Improving quality of care

• Motivational intervention with emphasis on Batho
  Pele and Patients Rights Charter
• Monitor and comply with COHSASA programme over
  the next three years

33
Improving quality of care

• Possibly extend COHSASA programme to include PHC
  services
• Facilitate the establishment of governance
  structures linked to health facilities

34
Revitalisation of hospital services

• Ensure the comprehensive revitalisation of 6
  hospitals over the next 3 years. This would
  include physical upgrading, transforming
  management, modernising technology and
  establishing quality assurance programmes. It
  would also include the establishment of
  empowered hospital boards

35
Revitalisation of hospital services

• Establish 4 regional hospitals with at least
  50 capacity in terms of the proposed national
  package of level 2 services
• Also complete planning and initiate
  construction of a new tertiary hospital for the
  province in Nelspruit in line with the
  Modernisation of Tertiary Services (MTS) model