EASTERN CAPE DEPARTMENT OF HEALTH STRATEGIC PLAN 2003/4 15 April 2003.

EASTERN CAPE DEPARTMENT OF HEALTH

STRATEGIC PLAN 2003/4

15 April 2003

2

OVERVIEW

The Department’s Strategic Plan: Aims to improve the health status of the Eastern

Cape population through 8 programs with specific objectives, targets and indicators

Is informed by the: Epidemiological profile of the EC population Demand & utilisation of health services Existing backlogs in service delivery

Is aligned with the Ten Point Plan, Batho Pele, EC Provincial Growth and Development Strategic Plan and the Strategic Position Statement of the province

3

VISION

A health service to the people in the Eastern Cape Province promoting a better quality of life for all.

4

MISION

To provide and ensure accessible comprehensive integrated services in the Eastern Cape emphasizing the primary health care approach utilizing and developing all resources to enable all its present and future generation to enjoy health and quality of life.

5

VALUES

The Department formulated a policy to ensure that all its residents have access to essential health services. The policy encapsulated the following VALUES:

Equity of both distribution and quality of services Service excellence including customer satisfaction Fair labour practices Good work ethic and a high degree of accountability Transparency demonstrated through consultations

with all stakeholders in the health industry/field

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Strategic goals and objectives of the Department of Health

Strategic Goal 1: Ensuring equitable access by all communities to essential package of services through DHS.

Strategic Goal 2: Health services in the province meet quality standards.

Strategic Goal 3: Communities throughout the province become active, responsible partners in health issues which affect them.

Strategic Goal 4: Build capacity in the Department to support improved implementation of its goals.

Strategic Goal 5: Effective utilization of the Department’s finance and assets to achieve effective service delivery.

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SECTORAL SITUATION ANALYSIS Size of the province 169,580 sq kms and is 13,9% of the

country’s land surface

Table A-1: Land area distribution by Province in SA

Province

EC FS GP KZN MP NC LP NW WC SA

KM2 169580

129480

17010

92100

79490

361830

123910

116320

129370

1 219 090

% 13.9 10.6 1.4 7.6 6.5 29.7 10.2 9.5 10.6 100

Source: Pop census 1996

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SECTORAL SITUATION ANALYSIS

Urban /Rural distribution

Table A-4: % Urban/Non-urban population distribution by province (1996 census)

Province

EC FS GP KZN MP NC LP NW WC SA

Urban 36.6 68.8 97 43.1 39.1 70.1 11 34.9 88.9 53.7

Non-urban

63.4 31.4 3 56.9 60.9 29.9 89 65.1 11.1 46.3

Source: Pop census 1996

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SECTORAL SITUATION ANALYSIS

District Health Services facilities by health district

Health District

Facility type No. Average population per facility

Alfred Nzo Clinics and CHCs 57 10789

Amatole Clinics and CHCs 255 7363

Cacadu Clinics and CHCs 98 4275

Chris Hani Clinics and CHCs 159 5846

N Mandela Clinics and CHCs 68 16136

O R Tambo Clinics and CHCs 163 11169

Ukhahlamba Clinics and CHCs 56 6636

Province Clinics and CHCs 856 8330

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POPULATION PYRAMID COMPARING WESTERN AND EASTERN REGIONS OF THE EC

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Population by health district

HEALTHDISTRICT

NUMBER % SQ KM % DENSITY

Alfred Nzo 614,973 8.6 8138.20 4.79 78.14

Amatole 1,877,565 26.3 23577.10 13.9 79.64

Cacadu 418,950 5.9 58244.00 34.3 7.19

Chris Hani 929,514 13 36963.70 21.8 25.15

N Mandela 1,097,248 15.4 1952.20 1.2 562.05

O R Tambo 1,820,547 25.5 15946 9.4 114.16

Ukhahlamba 371,616 5.2 26401.20 15.6 14.63

EC 7,130,480 100 169,580 100 41.95

Source: Stats SA Mid-Year Population Estimates 2002

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EPIDEMIOLOGY CHILD HEALTH

MORBIDITY AND MORTALITYThe IMR of 61.2 per 1000 live births is the highest in the country

with the National figure of 45.2(SADHS 1998). The following conditions accounted for the high morbidity and

mortality rates

Diarrhoea HIV/AIDS Communicable diseases Malnutrition Tuberculosis Injuries and burns

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WOMEN’S AND MATERNAL HEALTH (epidemiology cont)

The provincial hospital maternal death rate was calculated at 133 maternal deaths per 100 000 hospital deliveries.

In 2000 108 deaths were reported and 53% of these were from the Eastern regions. These occurred in the public hospitals only.

32% of reported maternal deaths were primigravidas.

The recent review of maternal deaths identified AIDS as the most common cause of maternal deaths at all levels of care in SA.

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EPIDEMIOLOGY CONT MEDICAL CONDITIONS

1. TB Prevalence in the Eastern Cape There has been a dramatic rise in TB cases from

mid-1980s and this rise is directly associated with HIV and improved case-finding.

TB cases reported

2000 2001

28428 30010 TB patients accounted for 10.2% of all medical

admissions This can be attributes to improved case finding

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ACHIEVEMENTS

Significant improvement in the hospital revitalization and rehabilitation programme

From 1994 to date the following health facilities have been constructed:

Completion of Nelson Mandela and its readiness to admit

patients by the 1st of September 2003.Clinics 130

Community Health Centres 5

Hospital OPDs 16

Academic Health Resource Centres 3

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ACHIEVEMENTS CONT

An increase in the utilization of primary health care services of 2,287,069 between 1998 an1999. this is increasing yearly.

Management and Administration of the Department has been significantly improved through filling of critical posts, recruitment and appointment of suitable qualified personnel in all fields.

Leave gratuities 90% of backlog cleared.

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ACHIEVEMENTS CONT

Ante-natal care (ANC) has been offered five days a week in 80% of clinics in 1999, a remarkable increase from the baseline survey when only half of all clinics were providing the service for the five working days.

The utilization of the 9 HIV/AIDS National Policy Guidelines

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ACHIEVEMENTS CONT

Appointment of CEOs in all the Provincial/Regional Hospitals

Formation of a Provincial Hospitals Coordinating Committee

Implementation of the deinstitutionalization programme in mental health.

PFMA Implementation with ECDOH moving to the third position in the Province in terms of the PFMA compliance matrix applied by Provincial Treasury

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ACHIEVEMENTS CONT

Budget Review Process

Quarterly budget reviews with all institutions are held by the ECDOH. This has improved the monitoring process.

Policy for nursing education (Nursing Education Bill) to assist with the rationalization of nursing education has been formulated and submitted to the legislature.

Continuous research is taking place with yearly conferences to share results

Nursing Education Bill with the Legislature

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BUDGETTable 1: Trends in provincial public health expenditure by budget programme in current prices (R million)

Programme 2001/02 (actual)2002/03

(estimate)2003/04

(budget2)

2004/05 (MTEF

projection)

2005/06 (MTEF projection)

Administration 168,947 532,443

273,426

288,692

310,006

District Health Services 2,124,751 2,155,833

2,252,759

2,523,756

2,725,766

Emergency Medical Services 87,314 119,488

364,774

385,110

412,861

Provincial Hospital Services 1,237,958 1,171,894

1,736,779

2,053,528

2,306,945

Health Sciences and Training 76,756 15,531

63,690

67,053

72,561

Health Care Support Services 6,765 7,642

15,197

15,992

17,130

Health Facilities Management 189,962 349,370

411,261

377,026

469,046

Total DOH 3,892,453 4,352,201

5,117,886

5,711,157

6,314,315

Municipal own expenditure 4 4

4

5

5

Department of Public Works 27 28

30

31

33

Total (R million) 3,892,484 4,352,233

5,117,920

5,711,193

6,314,352

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RESPONSES TO QUESTIONS POSED BY THE NATIONAL ASSEMBLY PORTFOLIO COMMITTEE ON HEALTHPROVINCIAL QUESTIONS

1.Please indicate the total health allocation in 2002/03

R'000

Original Budget 2002/03 3,916,824

Roll-over from 2001/02 298,425

Additional funds allocated in Adjustments Budget

345,677

Total Allocation for 2002/03

4,560,926

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2. What was the percentage real increase between 02/03 and 03/04?

Original Budget Adjusted Rands

R'000 R'000

Budget 2002/03 3,916,824 3,916,824

Budget 2003/04 5,117,886 4,804,376

Difference 1,201,062 887,552

% increase 30.66% 22.66%

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3. What was the total overspending, if any, specify reasons. No over-expenditure was incurred.4. What was the total underspending, if any, specify reasons.

Please note that the above figures are provisional as the books were not closed at the time the figures were prepared however, it is likely that there will no under-expenditure .

R'000

Total Allocation for 2002/03 4,560,926

This is the total represents the net effect of the total under spent by the department of which the main underspending is in infrastructure.

Total 62,800

% under spent 1.38%

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5.Provide variance by programme between budgeted allocation and actual expenditure for 2002/03

Adjusted Budget

Est Actual

Variance

R'000 R'000 R'000

Health Administration242,451

242,451 0,00

District Health Services 2,391,815 2,363,455 -28,360

Provincial Hospital Services 1,405,410 1,405,410 0,00

Academic Health Services 88,756 95,139 -6,383

Health Sciences 48,688 50,136 -1,448

Health Care Support Services 9,231 9,168 63

Health Facilities Development and Maintenance

402,935 302,443 100,492

Total 4,560,926 4,498,126 62,800

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6. Which health programme has received the highest budget increase within 02/03? Provide the reason for this.

Programme 1 Health Administration received the highest budget increase in the 2002/03 financial year.

The reason : the Personnel Budget for Critical posts was managed under this programme; Management contract to be outsourced and managed in

this programme [Increase R46,137m or 23.69%]

7. Which programme has received the least increase, please indicate why?

Programme 6 Health Care Support Services: received the least budget increase in the 2002/03 financial year:

The reason: [Increase R70,000 or 0.75%] is insufficient budget.

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8.Indicate the proportion of the budget that is spent on personnel.

2002/03R’000

2003/04R'000

Budget (excluding transfers)

3,947,148

4,307,850

Personnel budget

2,538,045 2,928,542

Portion of budget

64% 68%

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9.What proportion of your 02/03 budget was transferred to Local Government

3.06 % or R143m - proportion of the 2002/03 budget was transferred to Local Government

10. What was the total amount received in Donor funding, and provide a breakdown of how the money was disbursed and

spent and the criteria used for making the allocations.

This department did not receive any direct or Cash donor funding for the 2002/03 financial year, however the Equity Project, which is

funded by USAID, has provided technical support, training, equipment and donated 22 vehicles with a total value of R24m

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11. Give proportion of budget spending on personnelThe proportion of personnel spending is R2,537,368 or 54.74% of the adjusted budget for 2002/3

12. Give proportion of budget spent on district health services

The proportion of the budget spent on district health services is R2,391,815or 52.44% of the adjusted budget for 2002/3

13. Give proportion spent on Community Health Services and primary health services

The proportion of the budget spent on community health services and primary health services is R1,053,338m or 44,56% of the adjusted budget for 2002/3.

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14. How does the budget accommodate the provision of free care to the Disabled as announced by the President on 14 February 2003

The Department is currently assessing the budgetary implications of the policy

15. What proportion of the Provincial Budget does health account for?

The Eastern Cape Department of Health Budget was 17.49% for the 2002/03 and 18.32% for the 2003/04 financial year of the Eastern Cape Provincial Budget

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16. Based on the 2003/04 budget allocation what is your per capita budget allocation

Expenditure per capita for the Eastern Cape Department of Health 2003/04

Population 7,130,480[1]

Per capita (total Budget)

R717,75 Per Capita (Excluding Conditional Grants

R634,71

In terms of the Inter Governmental Fiscal Review (IGFR) 2003 this province at R769.00 received the third lowest per capita allocation in South Africa.

1 Source: STATS SA Mid Year Population Estimates 2002

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CONDITIONAL GRANTS

17.Give the overall HIV/Aids budget allocations for 2003/04 and the percentage increase from 2002/03

The overall HIV/AIDS budget for 2003/04 is R71,934m which is a 17.46 % increase from 2002/03

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18. Provide variance for 2002/03 between allocated budget and actual expenditure

Conditional Grant Total Allocation (Including Roll-overs) R’000

Estimated Actual Expenditure

R’000

Variance R’000

Central hospitals

National tertiary services 145,506 133,187 12,319

Health Profession’s training & research 88,917 89,188 -271

HIV/AIDS 28,253 24,758 3,495

Hospital rehabilitation 109,586 130,828 -21,242

Integrated Nutrition Programme 168,063 135,463 32,600

Hospital Management Improvement 9,333 5,916 3,417

Total 549,658 519,340 30,318

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19. The Eastern Cape Province breakdown of HIV budget is: (R’000)

Health GrantEducation Grant

Social Development Grant

Eastern Cape 38,934 22,288 6,658

The Health HIV/AIDS grant is for the following programmatic interventions:VCTHBCPMTCTStep-down careProvincial ManagementNon-occupational post-exposure prophylaxisCommercial sex workersCentre of Excellence

The Education Grant is for life skills education and the Social Development Grant for HBC

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20. The following initiatives from the National Department of Health will assist with provincial implementation and improve the capacity to spend:•Appointment of coordinators and administrative staff in the key programmes VCT, HBC and PMTCT.

•Training of master trainers for VCT, Home Based care to fast track training

•Appropriate VCT guidelines were developed and distributed.

•Decentralization of funds to Districts and Hospitals

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21. Areas that have experienced under spending in the last financial year and the reasons therefore

•Infrastructure: Procurement of equipment Maintenance and intervention funds and roll-overs were only received in August 2002. Lack of trained artisans in institutions.

•Personnel: An additional amount of R41,288 for critical post was not able to attract external applicants

•Grants: the under spending occurred mainly on the Integrated Nutrition Programme grant owing to changes in the implementation structure and a roll over amount of R36m from the previous financial year.

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22. An allocation was made for the provision of step-down facilities, please provide a progress report also indication how much of the allocation was spent

The Eastern Cape Department of Health spent R1,314,077 on the provision of step-down facilities.

37


29. Inter provincial inequity remains a major area of concern- how is the Department addressing thisThe department address this by interacting with the NDoH who engages the National Treasury; and through the Provincial Budget Committee this is being addressed

30. Intra- provincial inequity still persist how is the Department working to ensure a more equitable distribution of funds especially at district and sub-district level.The allocation of budget is based on the HTP (that took equity into consideration)

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31. Areas of the budget and the budget process, where the Department might require assistance / advocacy of theCommittee in facilitating the necessary changes.It may be necessary in addressing the inequity in per capitaallocation especially because of the historical circumstances andgeographic nature (mostly rural with poor infrastructure).

32. Provide the number of district management posts and howmany are filled – provide reasons for vacanciesThere are 25 District Management posts of which 20 are filled. Thereason for the vacancies is that the department restructured thenumber of districts from 21 to 25 and had to change and loadthe new structure.

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33. What guides your district and sub-district budgetallocation e.g. formula etc.

The allocation for district and sub-district is based onthe results of the Hospital Transformation Projectrecommended establishments (based on equity considerations).

34. What steps have been put in place to facilitateimplementation of the rural incentive scheme?

The department has identified the areas and commenced withpayments to the nursing staff only.

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MAJOR HEALTH CHALLENGES

Escalating HIV/AIDS Escalating TB prevalence Brain drain of health professionals especially doctors

and nurses to countries like UK and Saudi Arabia. Presently the doctor patient ratio is 1 per 3000.

Low immunization coverage Legislative reforms influenced by cultural factors e.g.

circumcision, and recognition of alternative medicine including traditional healing

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MAJOR HEALTH CHALLENGES CONT

Escalating crime calling for more security for staff working in primary health care facilities, establishment of crisis centers and counseling facilities for victims of abuse as well as calling for more collaborative endeavors with other sectors

The impact of increased motor vehicle accidents on Emergency Medical services and other services

Backlog in health facilities development High Infant and Maternal mortality

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PRIORITIES FOR 2003/4

To manage and improve health outcomes for HIV/AIDS, STDs and TB

To reduce infant and child mortality To control communicable diseases To develop the district health system and the delivery

of the PHC Package To improve emergency and patient transport To improve logistical and other support To implement the hospital revitalization programme To improve capacity and access to regional and

tertiary services in the province To develop human resources for quality management

and service delivery

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SERVICE DELIVERY PROGRAMMES

The core services of the department is driven through PROGRAMMES 2 DISTRICT HEALTH and 4 PROVINCIAL HOSPITAL SERVICES with the remainder of the departments programmes offering the necessary support.

There is an overlap between programmes in the provision of services which means that some interventions will not have specific budgets as they cut across the board

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SERVICE DELIVERY PROGRAMMES CONT

1. PROGRAMME 2 AIM: TO DEVELOP AND SUPPORT DISTRICT HEALTH SERVICES BUDGET (000) 2003/4 2004/5 2005/6 R2,252,759 R2,523,756 R2,725,766

SUBPROGRAMMES District management Community Health Clinic Services Community Health Centers Community Based services Other Community Services HIV/AIDS Nutrition District Hospitals

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SERVICE DELIVERY PROGRAMMES CONT

2.PROGRAMME 4

AIM : To provide cost effective, good quality, high level specialized services to the people of the Eastern Cape in collaboration with the Health Sciences Faculties

BUDGET (000) 2003/4 2004/5 2005/6 R1,736,779 R2,053,528 R2,306,945

SUBPROGRAMMES General Hospitals: T.B. Hospitals: Psychiatric/Mental Hospitals

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HIV/AIDS BUDGET (000) 2003/4 2004/5 2005/6 R70,947 R92,988 114,111

IMPROVED MANAGEMENT OF HIV/AIDS EPIDEMIC IMPROVE ACCESS TO VCT BY INCREASING

NUMBER OF TESTING SITES BY 30% IMPLEMENT POST EXPOSURE PROPHYLAXIS

FOR RAPE SURVIVORS EXPAND PMTCT PROGRAMME IMPROVE CARE AND SUPPORT FOR PEOPLE

INFECTED WITH AND AFFECTED BY AIDS/HIV

47

HIV/AIDSCONT

COMMUNITY INVOLVEMENT IN HIV & AIDS MANAGEMENT THROUGH AIDS COUNCILS

PROVIDE SERVICES TO VULNERABLE GROUPS(CSW)

PROVIDE CONTINUUM OF QUALITY CARE THROUGH PROVISION OF STEP DOWN CARE IN DESIGNATED HOSPITALS

SET UP CENTRE OF EXCELLENCE IN PARTNERSHIP WITH A MEDICAL SCHOOL TO PROVIDE MODELS OF PREVENTION TREATMENT AND RESEARCH

48

TB PROGRAMME

REDUCE THE MORTALITY AND MORBIDITY OF TB INCREASE TB CURE RATE BY

IMPROVING AND MONITORING DRUG SUPPLY INCREASE CASE DETECTION BY SMEAR MICROSCOPY

AMONG ALL TB SUSPECTS TO 80% IMPROVE MDR PROGRAMME DECREASE TREATMENT INTERRUPTION EXPAND DIRECT OBSERVED TREATMENT SHORT

COURSE FINALIZE TB ADVOCACY PLAN FOR EASTERN CAPE

49

REDUCE INFANT MORTALITY

DECREASE IMR FROM 61,5 TO 40 PER 1000 LIVE BIRTHS IN 2006

INTERVENTIONS PLANNED IMPROVE IMMUNISATION COVERAGE TO 85% IN 2005/6 IMPROVE ACCESS TO PRIMARY HEALTH CARE FACILITIES PREVENTION OF MOTHER TO CHILD TRANSMISSION OF

HIV/AIDS MANAGEMENT AND FOLLOW UP OF CHILDREN WITH

HIV/AIDS IMPLEMENTATION OF INTEGRATED MANAGEMENT OF

CHILDHOOD ILLNESSES

50

INTEGRATED NUTRITION PROGRAM BUDGET(000) 2003/4 2004/5 2005/6 R172,465 R202,698 R222,133

DECREASE MORBIDITY AND MORTALITY THROUGH STRATEGIC INTERVENTIONS TO PREVENT AND MANAGE MALNUTRITION.

INTERVENTIONS INTENSIFY IMPLEMENTATION OF INP AS GUIDED BY THE

UNICEF CONCEPTUAL FRAMEWORK AND THE TRIPLE A APPROACH. PROMOTE COMMUNITY BASED GROWTH MONITORING. STRENGTHEN NUTRITION INTERVENTIONS AT HEALTH

FACILITY AND COMMUNITY LEVELS, AND REHABILITATE MALNOURISHED CHILDREN.

TO WORK WITH OTHER SECTORS IN TACKLING THE ROOT CAUSES OF MALNUTRITION AND POVERTY.

FACILITATE TRANSFER OF PSNP TO THE DEPARTMENT OF EDUCATION

51

PROFESSIONAL HR RETENTION STRATEGY

ENSURE ATTRACTION AND RETENTION OF

PROFFESSIONAL STAFF DEVELOPMENT OF INCENTIVES: PROVISION OF ACCOMMODATION FOR DOCTORS INDUCTION PROGRAMMES FOR COMMUNITY SERVICE

STAFF AND INTERNS CREATION OF SENIOR POSTS PROMOTION OF DOCTORS

TO HIGHER POSTS FILLING OF CRITICAL POSTS UTILISATION OF THE GRANT TO ATTRACT AND RETAIN

STAFF INTENSIVE MARKETING OF THE PROVINCE

52

LEGISLATIVE REFORM

BUDGET(000)

2003/4 2004/5 2005/6

R282 PRORITY FOR 2003/4 F/Y IS THENURSING

EDUCATION ACT WHICH IS GOING TO GOVERN RATIONALISATION OF NURSING EDUCATION

53

REDUCE MATERNAL MORBIDITY AND MORTALITY

BUDGET : BOTH IN PROGRAMME 2,4 AND HPTD GRANT

ENSURE THAT THE MMR FOR F/Y 2003/4 IS REDUCED FROM 133 TO 110 DEATHS PER 100 000.

INTERVENTIONS INCREASE LEVEL OF REPORTING AND SURVELLIANCE ON

MATERNAL DEATHS IMPLEMENTATION OF MATERNAL HEALTH GUIDELINES INCREASE ACCESS TO MATERNAL SERVICES EXPAND TOP SERVICES

54

DISTRICT HEALTH SERVICES

DELEGATION OF PRIMARY HEALTH CARE SERVICES TO THE DISTRICT MUNICIPALITIES.

DEVELOPMENT AND IMPLEMENTATION OF INTEGRATED PLANNING IN THE DISTRICT

CLUSTERING OF DISTRICT HOSPITALS DEVELOPMENT OF CLINICAL PROGRAM TO

SUPPORT THE DISTRICT HOSPITALS (WITH SPECIALISTS SUPPORT FROM THE COMPLEXES AND THE FLYING DOCTORS PROGRAM)

55

PRIMARY HEALTH CARE SERVICE DELIVERY PLAN IMPROVE ACCESS TO PRIMARY HEALTH CARE SERVICES INTERVENTIONS

INCREASE UTILIZATION RATE BY INCREASING NUMBER OF FACILIITIES

MONITOR POPULATION SERVED PER FIXED CLINIC TO ENSURE THAT IT FITS IT WITH THE NORMS AND PUT IN REMEDIAL ACTION AS NEEDED

ENSURE INCREAS IN NUMBER OF NURSES PER PUBLIC PHC PER 1000 PEOPLE

MONITOR DHS EXPENDITURE PER PERSON INCREASE PERCENTAGE OF FIXED PHC FACILITIES WITH

FUNCTIONING COMMUNITY PARTICIPATION STRUCTURES

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IMPROVEMENT OF EMERGENCY SERVICE DELIVERY

BUDGET(000) 2003/4 2004/5 2005/6 R364,774 R385,110 R412,861 IMPROVE ACCESS TO EMERGENCY CARE

INTERVENTIONS FILLING OF VACANT POSTS WHICH WILL ENABLE THE SERVICE

TO PROVIDE TWO MEN AMBULANCE CREWS WHICH ARE MORE EFFICIENT

REDUCE RESPONSE TIME BY INCREASING CREW NUMBERS AND VEHICLES HENCE REDUCING MORBIDITY AND MORTALITY

IMPLEMENT AEROMEDICAL EVACUATION PROGRAM TO OVERCOME THE PROBLEM OF INACCESSIBILITY IN CERTAIN RURAL AREAS.

INCREASE THE NUMBER OF STAFF TRAINED IN ADVANCED LIFE SUPPORT

57

PROVINCIAL HOSPITALS

BUDGET(000) 2003/4 2004/5 2005/6 R1,373,953 R1,636,737 R1,798,376

TO PROVIDE COST EFFECTIVE, GOOD QUALITY, HIGH LEVEL SPECIALISED SERVICES

INTERVENTIONS OPEN NELSON MANDELA ACADEMIC HOSPITAL ON 1ST OF

SEPTEMBER STRENGTHEN HOSPITAL MANAGEMENT AND ORGANISATIONAL

DEVELOPMENT IMPLEMENT RATIONALIZATION PROPOSAL IMPROVE IMPLEMENTATION OF REVITALISATION OF HOSPITAL

SERVICES PROGRAMME UTILISATION OF THE HPTD GRANT TO TRAIN DOCTORS IN

SPECIALISED SERVICES.

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PSYCHIATRIC/MENTAL HOSPITALS

BUDGET(000) 2003/4 2004/5 2005/6 R268,114 R316,869 R402,652 TO PROVIDE COST EFFECTIVE, INTEGRATED AND HIGH

QUALITY SPECIALIZED SERVICES TO THE PEOPLE OF THE EASTERN CAPE

INTERVENTIONS IMPLEMENT LEGISLATIVE FRAMEWORK RATIONALISE PSYCHIATRIC SERVICES DEINSTITUTIONALIZE OF MENTAL HEALTH PATIENTS IMPROVE ACCESS TO MENTAL HEALTH SERVICES

ESPECIALLY IN RURAL AREAS ESTABLISH MENTAL HEALTH REVIEW BOARDS

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PHARMACEUTICAL SERVICES

Facilitate the training of Pharmacist's Assistants such that all Pharmacies are manned by this mid-level health worker.

Recruitment and retention of Community Service Pharmacists to areas of greatest need.

Monitoring of drug availability on a regular basis. Monitor drug expenditure at all levels. Implement a Public Private Partnership (PPP) for

management support and Distribution of pharmaceutical and surgical supplies.

60

MANAGEMENT AND DEVELOPMENT OF INFRASTRUCTURE

BUDGET(000) 2003/4 2004/5 2005/6 R411,261 R377,026 R469,046

TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY PROVIDING NEW HEALTH FACILITIES, UPGRADING AND MAINTAINING EXISTING FACILITIES.

INTERVENTIONS COMPLETION OF 26 CLINICS ADVANCE PLANNING IN CAPEX PROGRAMMES. IMPLEMENTATION OF PROJECT MANAGEMENT TO IMPROVE

MAINTENANCE OF FACILITIES

EASTERN CAPE DEPARTMENT OF HEALTH STRATEGIC PLAN 2003/4 15 April 2003.

Documents

health industryfield

province slide

health issues

health status

essential health services

ec slide

following health facilities

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