The overarching outcome that South Africa seeks to achieve is a long and healthy life for all South Africans, with the NDP envisioning an accessible health system that works for everyone and produces positive health outcomes.
Health MEC Benny Malakoane said that the province is making inroads and independent 2015 statistics indicate that the provincial life expectancy for males has increased from 43.1 in 2001 to 53 years in 2011 and 46.5 to 54.7 years for women in the same period.
“Since 2001, the outpatient departments of the [province’s] 31 hospitals have treated 4 875 574 patients and the clinics and community health centres 22 286 671 patients, with 61 872 assistive devices provided through the different health facilities,” said Malakoane. “The specialist centres in Bloemfontein, Bethlehem and Welkom have issued a further 41 033 patients with orthotic and prosthetic devices and 7 721 cataract operations were performed in our efforts to scale up the prevention of blindness.
“It is important to acknowledge the role of traditional healing and a traditional practices unit has been established to realise the Traditional Health Practictioners Act and begin the process of accommodating traditional practices within the Western medical model.
“All of the 20 local areas have implemented the school health services programme and school health programmes extend across all five districts.”
Decreasing maternal and child mortality is another key objective, and Malakoane said that a new specialist unit focussed on this has been established with an obstetrician, paediatrician, advanced midwife, paediatric nurse and PHC nurse co-ordinating the department’s efforts in this area. District clinical specialist teams were also appointed in each district.
The training of 1 525 doctors, medical interns and midwives in different health facilities in the Essential Steps in the Management of Obstetric Emergencies has taken place since the programme’s implementation in 2009.
The policy guidelines on preventing mother-to-child transmission of HIV are implemented in all maternity facilities and all pregnant mothers found to be HIV-positive are placed on Nevirapine, with the coverage at 100 %, which has played a significant role in reducing transmission from 2.96% to 1.3% in 2015.
Basic antenatal care was accelerated to improve the care for pregnant mothers and coverage has increased to 89.6%, with antenatal first visits before 20 weeks also improving to 58.6%.
“Infant immunisation programmes have improved to 90.1% and the department is now providing the Human Papilloma Virus vaccine to grade four learners in our effort to reduce the risk of young girls developing cervical cancer, with 85% of these girls vaccinated in 2014/15,” said Malakoane.
Contraception
“Contraception and contraception services are available in regional hospitals and the academic complex, and emergency contraception is available at all 24-hour facilities.
We strive to make these services youth-friendly to encourage contraception and reduce teenage pregnancies. Also, our condom distribution programme has grown substantially.”
Monitoring tools
Combatting HIV and Aids has gone hand-in-hand with the antenatal programme, now that more women are tested earlier and the uptake of Nevirapine has reached 100%.
“The management of TB continues to improve and the Direct Observed Treatment Strategy’s coverage stands at 85%, with a TB cure rate of 75% achieved. The electronic TB register was successfully expanded to include TB case-finding information from hospitals and all 31 hospitals reported on this system. The monitoring tools now include both TB and HIV data elements.
“The department has also implemented a male circumcision programme, with 223 176 circumcisions performed as of the end of August 2015.
“An audit of our primary health care system outreach teams resulted in these teams being increased from 11 to 46 and family physicians have already been appointed in four districts. Across the districts and metros, 36 mobile clinics have been allocated. We are also continually monitoring and applying quality improvement plans aimed at improving patient care and satisfaction.”
New hospitals
This department has made considerable efforts to upgrade its emergency management services; it has invested heavily in new vehicles and increased its staff complement.
It has also completed a number of infrastructure projects since 2009, including upgrades to Boitumelo Regional Hospital, the completion of two new hospitals in Ladybrand and Trompsburg, four new community health centres and three new clinics. Seven hospitals and 13 clinics have been upgraded and there are now two new forensic mortuaries.