Submission to the Parliamentary Portfolio Committee on Health on the National Health Bill 19 August 2003 Children

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Submission to the Parliamentary Portfolio
Committee on Health on the National Health
Bill19 August 2003Childrens Institute,
University of Cape Town
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Childrens health rightsOur commitment

• The Convention on the Rights of the Child
• The African Charter on the Rights of the Child
• The South African Constitution
• White Paper on the Transformation of the Health
  System
• Previous drafts of Health Bill

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Childrens issues to be mainstreamed in
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Why do we need to mainstream children in the NHB

• International and national commitment
• Domestic precedents in other sectors
• Single comprehensive child health legislation
• NHB a framework for responsive, appropriate,
  health system

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..continued

• Childrens vulnerability
• Childrens current health status
• 59/1000 die before 1st birthday
• Further 36 die before 5th birthday
• High prevalence of preventable conditions
• Child-specific health needs

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(No Transcript)
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Specific recommendations(1)

• Legislate minimum level of free health care for
  children under 6, pregnant and lactating women
  with free medical services
• All persons at the primary level who are not on
  an medical aid scheme
• Section 4 (1) a

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Specific recommendations(2)

• Entrench current structures in the interest of
  children by
• Including child health representatives in all
  national , provincial and district structures
• Ring-fencing funding allocation to child health
  priorities
• ALL national plans and programmes to demonstrate
  due consideration of child health issues

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Specific recommendations(3)

• Legislate for the statutory establishment of the
  Maternal, Child and Womens health directorate at
  all levels
• Defined structure and ring-fenced budget
  (particularly for the Child Health Unit within
  this directorate)
• (Chapters 3, 4 and 5)

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Specific recommendations(4)

• Consent (Chapter 2, clause 7)
• Right to information and participation (Chapter
  2, clause 8)
• Confidentiality (Chapter 2, clause 14)
• Recommend that the exact clauses currently in the
  Childrens Bill be re-echoed in this Bill, as
  this Bill is specifically governs the activities
  of the health sector
• Attendance without adult caregivers (to be
  inserted into Chapter 2)

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Childrens experiences

• Children under the age of 16 years who arrive
  alone are not admitted
• to the clinic unless they require immediate
  treatment, such as for
• malaria.. But the community doesnt listen,
  children keep coming alone and being sent away.
• Clinic manager, Ingwavuma
• "When you are ill and you go to the clinic
  without an adult person,
• nurses do not want to attend to you. Sometimes
  even when you are very
• sick and you arrive at the clinic, the nurses
  ignore you."
• 15 year old Nosifiso (Umzimkulu) who has to walk
  2 hours to the nearest clinic.

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Specific recommendations(5)

• Specify specific child health services to be
  rendered in Chapter 3, 4 and particularly 5 for
  the National, Provincial and district level
• For example at districts level services must
  include preventive, acute curative,chronic,
  emergency, rehabilitative, palliative and
  home-based care as a minimum set of services
• Regulate a set of norms and standards

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Conclusion

• Let us follow through on our commitment to
  children and create a responsive and
  comprehensive National Health Act