NationalDoHAPP-2015

Transcription

NationalDoHAPP-2015

ANNUAL PERFORMANCE PLAN
2015/2016 - 2017/2018
A long and healthy life for all South Africans
Annual Performance Plan
2015/16 – 2017/18
Department of Health Annual Performance Plan 2015/16–2017/18
1
STATEMENT BY THE DIRECTOR-GENERAL
FOREWORD BY THE MINISTER MINISTER OF HEALTH .............................................................................................. 4
STATEMENT BY THE DIRECTOR-GENERAL ................................................................................................................. 5
OFFICIAL SIGN OFF ......................................................................................................................................................... 6
PART A
1.
VISION ..................................................................................................................................................................... 11
2.
MISSION .................................................................................................................................................................. 11
3.
LEGISLATIVE AND OTHER MANDATES ............................................................................................................. 11
3.1.Constitutional Mandates ......................................................................................................................................... 11
3.2.National Health Act, 61 of 2003 .............................................................................................................................. 11
3.3.Legislation falling under the Minister of Health’s portfolio....................................................................................... 11
3.4.Other legislation in terms of which the Department operates ................................................................................. 12
3.5.Planned policy initiatives ......................................................................................................................................... 12
4.
SITUATIONAL ANALYSIS ..................................................................................................................................... 15
4.1.Strategic Issues Facing the Department 2010-2014 ............................................................................................. 13
4.2.Demographic Profile ............................................................................................................................................... 13
4.3.Social Determinants of Health ................................................................................................................................ 14
4.4.Epidemiological Profile ........................................................................................................................................... 15
4.4.1.Life Expectancy ................................................................................................................................................... 15
4.5.HIV and AIDS and TB ............................................................................................................................................. 16
4.6.Maternal and Child Health ...................................................................................................................................... 19
4.7.Violence and Injuries .............................................................................................................................................. 20
4.8.Non-Communicable Diseases ................................................................................................................................ 20
4.9.Communicable Diseases ........................................................................................................................................ 21
5.
STRATEGIC FRAMEWORK 2014-2019 ................................................................................................................ 21
5.1.Strategic Approach ................................................................................................................................................. 21
5.2.National Development Plan 2030 vision ................................................................................................................. 21
5.3.Priorities to achieve Vision 2030 ............................................................................................................................. 21
5.4.Alignment between NDP Goals, Priorities and NDoH Strategic Goals ................................................................... 22
5.5. STRATEGIC GOALS OF THE DEPARTMENT ...................................................................................................... 22
6.
ORGANISATIONAL ENVIRONMENT .................................................................................................................... 22
ORGANISATIONAL STRUCTURE ............................................................................................................................... 23
7.
OVERVIEW OF 2015/16 BUDGETS AND MTEF ESTIMATES .............................................................................. 24
8.
PERSONNEL INFORMATION ................................................................................................................................ 27
9.
EXPENDITURE TRENDS ....................................................................................................................................... 28
PART B
PROGRAMME 1: ADMINISTRATION ............................................................................................................................... 32
1.1
STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS ...................................... 32
1.2
PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS ......................................................... 33
QUARTERLY TARGETS FOR 2015/16 ............................................................................................................................ 33
1.3 RECONCILING PERFORMANCE TARGETS WITH THE BUDGETS AND THE MTEF ............................................ 34
Expenditure trends and estimates by subprogramme and economic classification ..................................................... 34
2
Personnel information ................................................................................................................................................... 36
PROGRAMME 2: NATIONAL HEALTH INSURANCE, HEALTH PLANNING AND SYSTEMS ENABLEMENT ............ 37
2.1 PROGRAMME PURPOSE ....................................................................................................................................... 37
2.2 STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS....................................... 39
2.3 PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS.......................................................... 41
2.3 QUARTERLY TARGETS FOR 2015/16 .................................................................................................................. 42
QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS............................................................. 43
QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS............................................................. 44
1.4. RECONCILING PERFORMANCE TARGETS WITH THE BUDGET AND MTEF .................................................. 45
PROGRAMME 3: HIV / AIDS, TB AND MATERNAL AND CHILD HEALTH ................................................................... 48
3.2 CONSOLIDATED PERFORMANCE INDICATORS AND ANNUAL TARGETS ..................................................... 49
3.3 QUARTERLY TARGETS FOR 2015/16 .................................................................................................................. 54
3.4 RECONCILING PERFORMANCE TARGETS WITH THE BUDGETS AND THE MTEF ........................................ 57
PROGRAMME 4: PRIMARY HEALTH CARE SERVICES................................................................................................ 60
4.1
PROGRAMME PURPOSE ...................................................................................................................................... 60
4.2 STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS ....................................... 62
4.3 QUARTERLY TARGETS FOR 2015/16 ................................................................................................................... 66
4.5 RECONCILING THE PERFORMANCE TARGETS FOR THE BUDGET AND MTEF ............................................ 68
PROGRAMME 5:HOSPITAL, TERTIARY HEALTH SERVICES AND HUMAN RESOURCE DEVELOPMENT ............. 72
5.3 PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS.......................................................... 75
5.4 QUARTERLY TARGETS FOR STRATEGIC OBJECTIVE PERFORMANCE INDICATORS 2015/16 ................... 75
5.5 QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS ................................................... 77
5.6 RECONCILING PERFORMANCE TARGETS WITH THE BUDGET AND MTEF ................................................... 78
PROGRAMME 6:HEALTH REGULATION AND COMPLIANCE MANAGEMENT........................................................... 82
PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS.................................................................... 84
6.1 QUARTERLY TARGETS FOR STRATEGIC OBJECTIVES PERFORMANCE INDICATORS 2015/16 ................ 85
6.2 QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE MEASURES FOR 2015/16 .............................. 86
6.3 RECONCILING PERFORMANCE TARGETS WITH THE BUDGET AND MTEF ................................................... 87
PART C :LINKS TO OTHER PLANS
1. CONDITIONAL GRANTS .............................................................................................................................................. 92
2. PUBLIC ENTITIES ......................................................................................................................................................... 94
ANNEXURES ..................................................................................................................................................................... 95
3
FOREWORD BY THE MINISTER OF HEALTH
This Plan is underpinned by a community health approach, which
seeks to promote and protect health and well being, with
particular emphasis on integration and improve access health
services. An immediate priority in the first months of this year will
be the preparation for the enactment of NHI and intensification of
our fight against TB – testing to be targeted at mine workers,
inmates at correctional services and communities peri-urban.
With this Plan we look forward to more focused effort in
addressing the key health concerns of the people; in particular to
reducing the maternal mortality ratio, reducing neonatal and
under five mortality rates, increasing coverage of immunisation
and quality of our primary and hospital services
Building on the learning from the achievements and challenges
of last year will continue to gather momentum during 2015/16
financial year as will our programme of building first class primary
care teams and facilities in communities across the country. By
the end of 2015/16, this programme of development will, I
believe, deliver some of the best primary care structures in the
world.
This Annual Performance Plan outlines the agreed level of health
to be provided by the National Department of Health (NDoH) for
the coming year within the voted allocation. This APP is service,
which, in setting out the planned objectives, actions, and outputs
for 2015/16, it is supported by a comprehensive a performance
monitoring framework that will facilitate its delivery by the
Department.
The overall policy framework, which governs the preparation of
the Plan, is set out in the National Development Plan and the
National Department of Health five year strategic plan 2015 –
2020. The NDP remains the blueprint for the development of the
health care services over the coming decade and beyond. It is
the benchmark against which all elements of the Health Service
Delivery Plans have been and will be constructed. The principles
of equity, people-centredness, quality and accountability are
supported in this plan and each of the actions in the plan is linked
to the Strategic Plan.
The service plan of this nature can only be delivered through the
collective efforts of the health professionals and partners. With
human resource for health constraints our services are now
more than ever dependent on our people to continue to make the
extra effort for our patients and clients. I am enormously
encouraged by the leadership, commitment and goodwill of our
staff in our health services.
_________________
Dr.A. Motsoaledi, MP
Minister of Health
4
STATEMENT BY THE DIRECTOR-GENERAL
are working to improve community health. We should focus on
areas that impact health now and into the future – based on
epidemiological data. We should ensure that best practices are
researched and implemented. Consistently use an equity lens in
all of our work. Consistently incorporate a communications plan
into all programme planning and activities.
The Ebola outbreak in West Africa as taught us one of the most
value lessons: Public health should be part of our nation’s health
system and should be strong enough to ensure our system
focuses on health and not just the provision of care. I believe that
there are two key steps we could take as public health to ensure
the long-term viability of public health within our healthcare
system.
Improving the health of our nation remains a noble societal goal.
In order to implement our strategic objectives this year, we need
to revitalise our efforts to move toward a healthier and an HIV
free generation. The advent of the Strategic Plan 2015 – 2020,
which is strongly aligned to the National Development Plan of
the country, serves as a catalyst for such change by promoting
quality, access to care, and community and health prevention
and promotion. There is a global movement, strongly encouraged
by the World Health Organisation, that says prevention, and
more prevention and promotion of healthy lifestyle is the future of
public health. We should maximise this transformative opportunity
to elevate the health of our society.
Improving access and quality of care, lies at the heart of this
Annual Performance Plan. At this critical time, we should
synthesise lessons learned from the seminal work in quality that
led to the establishment of the Office of Health Standards
Compliance This will require commitment and coordination from
many areas of functionality of our health system and stakeholders
outside of the health sector, an approach requiring “health in all
policies”. It will also require a vision that links promotion of health
and prevention of illness, quality, treatment and access to care.
Public health professionals can help coordinate all these critical
efforts. Strengthening the foundations for strong Primary health
Care will surely help us fulfil our collective mission of ensuring
conditions for a healthy population.
Practically, what does this mean? It means increasing our
leadership role in community engagement for healthy
communities, focusing on health beyond health care services. It
means increasing our partnerships practices organisations that
The first is to start from the beginning. All healthcare professionals
should see prevention of illness and primary health care as part
of their skill set and receive training in it from day one of their
education. Advanced training programmes such as graduate
degrees and post-graduate training should try to bridge the
disciplines, not reinforce professional silos. The second is to
ensure that the goals for our health and healthcare systems
include public and community health measures. There are none
of these right now in our country in any serious way. Focusing on
access to care is an excellent way to ensure that we quality in
public health.
Transforming the primary health care and the public health
system as a whole to improve access and quality is in fact a
primary strategic goal New opportunities abound for building
quality into all levels of public health care in order to assist all
South Africans to live long and healthy.
I believe our vision for public health is to focus on building better
systems to give all people what they need to reach their full
potential for health. This includes empowering with knowledge of
what keeps them healthy. The priority areas presented in this
Plan represent important steps toward fulfilling that vision.
Together, we can give priority to improving access and quality in
the areas identified, raise access and quality and transform
opportunity into actions that make a difference in the lives of the
majority of people who entirely depend on public health for their
health needs.
___________________
Ms MP Matsoso
Director-General: Health
5
OFFICIAL SIGN OFF
Takes into account all the relevant policies, legislation and other mandates for which the National Department is responsible.
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Ms MP Matsoso
Director-General: Health
Dr .A. Motsoaledi, MP
Minister of Health
6
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8
PART A
Strategic Overview
9
10
1. VISION

A long and healthy life for all South Africans
2. MISSION
To improve health status through the prevention of illness, disease
and the promotion of healthy lifestyles, and to consistently
improve the health care delivery system by focusing on access,
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3. LEGISLATIVE AND OTHER MANDATES

The legislative mandate of the Department of Health is derived
from the Constitution, the National Health Act, 61 of 2003, and
several pieces of legislation passed by Parliament.

3.1. Constitutional Mandates
in a common goal to actively promote and improve the
national health system in South Africa;
provide for a system of co-operative governance and
management of health services, within national guidelines,
norms and standards, in which each province, municipality
and health district must address questions of health policy
and delivery of quality health care services;
establish a health system based on decentralised
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governance, internationally recognised standards of
research and a spirit of enquiry and advocacy which
encourage participation;
promote a spirit of co-operation and shared responsibility
among public and private health professionals and
providers and other relevant sectors within the context of
national, provincial and district health plans; and
create the foundation of the health care system, and
understood alongside other laws and policies which relate
to health in South Africa.
In terms of the Constitutional provisions, the Department of
Health is guided by the following sections and schedules, among
others:
3.3. Legislation falling under the Minister of Health’s
portfolio
The Constitution of the Republic of South Africa, 1996, places
obligations on the state to progressively realise socio-economic
rights, including access to health care.
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concurrent national and provincial legislative competence
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Section 9 of the Constitution states that everyone has the right
to equality, including access to health care services. This means
that individuals should not be unfairly excluded in the provision
of health care.
People also have the right to access information that is
held by another person if it is required for the exercise or
protection of a right;
This may arise in relation to accessing one’s own medical
records from a health facility for the purposes of lodging a
complaint or for giving consent for medical treatment; and
This right also enables people to exercise their autonomy
in decisions related to their own health, an important part
of the right to human dignity and bodily integrity in terms of
sections 9 and 12 of the Constitutions respectively
Section 27 of the Constitution states as follows: with regards
to Health care, food, water, and social security:
(1) Everyone has the right to have access to –
a. Health care services, including reproductive health care;
b. 6XI¿FLHQWIRRGDQGZDWHUDQG
c. Social security, including, if they are unable to support
themselves and their dependents, appropriate social
assistance.
(2) The state must take reasonable legislative and other
measures, within its available resources, to achieve the
progressive realisation of each of these rights; and
(3) No one may be refused emergency medical treatment.
Section 28 of the Constitution provides that every child has the
right to ‘basic nutrition, shelter, basic health care services and
social services’.
3.2. National Health Act, 61 of 2003
Provides a framework for a structured health system within the
Republic, taking into account the obligations imposed by the
Constitution and other laws on the national, provincial and local
governments with regard to health services. The objects of the
National Health Act (NHA) are to:
unite the various elements of the national health system
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Medicines and Related Substances Act, 101 of 1965
Provides for the registration of medicines and other medicinal
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provides for transparency in the pricing of medicines.
Foodstuffs, Cosmetics and Disinfectants Act, 54 of 1972
(as amended)
Provides for the regulation of foodstuffs, cosmetics and
disinfectants, in particular quality standards that must be
complied with by manufacturers, as well as the importation
and exportation of these items.
Hazardous Substances Act, 15 of 1973
Provides for the control of hazardous substances, in
particular those emitting radiation.
Occupational Diseases in Mines and Works Act, 78 of
1973
Provides for medical examinations on persons suspected
of having contracted occupational diseases, especially in
mines, and for compensation in respect of those diseases.
Pharmacy Act, 53 of 1974 (as amended)
Provides for the regulation of the pharmacy profession,
including community service by pharmacists
Health Professions Act, 56 of 1974 (as amended)
Provides for the regulation of health professions, in particular
medical practitioners, dentists, psychologists and other
related health professions, including community service by
these professionals.
Dental Technicians Act, 19 of 1979
Provides for the regulation of dental technicians and for the
establishment of a council to regulate the profession.
Allied Health Professions Act, 63 of 1982 (as amended)
Provides for the regulation of health practitioners such as
chiropractors, homeopaths, etc., and for the establishment
of a council to regulate these professions.
Human Tissue Act, 65 of 1983
Provides for the administration of matters pertaining to
human tissue.
National Policy for Health Act, 116 of 1990
Provides for the determination of national health policy to
guide the legislative and operational programmes of the
health portfolio.
SA Medical Research Council Act, 58 of 1991
Provides for the establishment of the South African Medical
Research Council and its role in relation to health Research.
11
related health professions, including community service by these
professionals.
t Dental Technicians Act, 19 of 1979
Provides for the regulation of dental technicians and for the
establishment of a council to regulate the profession.
t Allied Health Professions Act, 63 of 1982 (as amended)
Provides for the regulation of health practitioners such as
chiropractors, homeopaths, etc., and for the establishment
of a council to regulate these professions.
t Human Tissue Act, 65 of 1983
Provides for the administration of matters pertaining to
human tissue.
t National Policy for Health Act, 116 of 1990
Provides for the determination of national health policy to
guide the legislative and operational programmes of the
health portfolio.
t SA Medical Research Council Act, 58 of 1991
Provides for the establishment of the South African Medical
Research Council and its role in relation to health Research.
t Academic Health Centres Act, 86 of 1993
Provides for the establishment, management and operation
of academic health centres.
t Choice on Termination of Pregnancy Act, 92 of 1996 (as
amended)
Provides a legal framework for the termination of pregnancies
based on choice under certain circumstances.
t Sterilisation Act, 44 of 1998
Provides a legal framework for sterilisations, including for
persons with mental health challenges.
t Medical Schemes Act, 131 of 1998
Provides for the regulation of the medical schemes industry
to ensure consonance with national health objectives.
t Tobacco Products Control Amendment Act, 12 of 1999
(as amended)
Provides for the control of tobacco products, the prohibition
of smoking in public places and of advertisements of tobacco
products, as well as the sponsoring of events by the tobacco
industry.
t National Health Laboratory Service Act, 37 of 2000
Provides for a statutory body that offers laboratory services
to the public health sector.
t Council for Medical Schemes Levy Act, 58 of 2000
Provides a legal framework for the Council to charge medical
schemes certain fees.
t Mental Health Care Act, 17 of 2002
Provides a legal framework for mental health in the Republic
and, in particular, the admission and discharge of mental
health patients in mental health institutions, with an emphasis
on human rights for mentally ill patients.
t Nursing Act, of 2005
Provides for the regulation of the nursing profession
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Compensation for Occupational Injuries and Diseases
Act, 130 of 1993
Provides for compensation for disablement caused by
occupational injuries or diseases sustained or contracted by
employees in the course of their employment, and for death
resulting from such injuries or disease.
The National Roads Traf¿c Act, 93 of 1996
Provides for the testing and analysis of drunk drivers.
Constitution of the Republic of South Africa Act, 108 of
1996
Pertinent sections provide for the rights of access to health
care services, including reproductive health and emergency
medical treatment.
Employment Equity Act, 55 of 1998
Provides for the measures that must be put into operation
in the workplace in order to eliminate discrimination and
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State Information Technology Act, 88 of 1998
Provides for the creation and administration of an institution
responsible for the state’s information technology system.
Skills Development Act, 97of 1998
Provides for the measures that employers are required
to take to improve the levels of skills of employees in
workplaces.
Public Finance Management Act, 1 of 1999
Provides for the administration of state funds by functionaries,
their responsibilities and incidental matters.
Promotion of Access to Information Act, 2 of 2000
$PSOL¿HVWKHFRQVWLWXWLRQDOSURYLVLRQSHUWDLQLQJWRDFFHVVLQJ
information under the control of various bodies.
Promotion of Administrative Justice Act, 3 of 2000
$PSOL¿HV WKH FRQVWLWXWLRQDO SURYLVLRQV SHUWDLQLQJ WR
administrative law by codifying it.
Promotion of Equality and the Prevention of Unfair
Discrimination Act, 4 of 2000
3URYLGHV IRU WKH IXUWKHU DPSOL¿FDWLRQ RI WKH FRQVWLWXWLRQDO
principles of equality and elimination of unfair discrimination.
The Division of Revenue Act, 7 of 2003
Provides for the manner in which revenue generated may be
disbursed.
Broad-based Black Economic Empowerment Act, 53 of
2003
Provides for the promotion of black economic empowerment
in the manner that the state awards contracts for services to
be rendered, and incidental matters.
Traditional Health Practitioners Act 2007(Act No 22 of
2007)
Provides for the establishment of the Interim Traditional
Health Practitioners Council, and registration, training and
practices of traditional health practitioners in the Republic
3.5. Planned policy initiatives
3.4. Other legislation applicable to the Department
3.5.1.
t
t
t
Criminal Procedure Act, Act 51 of 1977, Sections 212
4(a) and 212 8(a).
Provides for establishing the cause of non-natural deaths.
Child Care Act, 74 of 1983
Provides for the protection of the rights and well-being of
children.
Occupational Health and Safety Act, 85 of 1993
Provides for the requirements that employers must comply
with in order to create a safe working environment for
employees in the workplace.
Facilitate Implementation of National
Health Insurance (NHI)
6RXWK $IULFD LV DW WKH EULQN RI HIIHFWLQJ VLJQL¿FDQW DQG PXFK
QHHGHG FKDQJHV WR LWV KHDOWK V\VWHP ¿QDQFLQJ PHFKDQLVPV
The changes are based on the principles of ensuring the right to
KHDOWKIRUDOOHQWUHQFKLQJHTXLW\VRFLDOVROLGDULW\DQGHI¿FLHQF\
and effectiveness in the health system in order to realize universal
health coverage. The phased implementation of National Health
,QVXUDQFH1+,LVLQWHQGHGWRHQVXUHLQWHJUDWHGKHDOWK¿QDQFLQJ
mechanisms that draw on the capacity of the public and private
12
The focus areas of these interventions include (i) improving the
management of health facilities; (ii) improving throughput from
training institutions to address key Human resources for Health
requirements; (iii) strengthening infrastructure programme and
procurement of equipment; (iv) health information systems
and technology; (v) rationalising of laboratory services; (vi)
effective and integrated procurement of Health Commodities;
(vii) the implementation of and compliance with National Quality
Standards for Health; (viii) Re-engineering of Primary Health
Care; (ix) the contracting of health practitioners to strategically
enhance the quality of Primary Health Care; (x) restructuring
and improving the provision of Occupational Health, Mental
Health, Disability and Emergency Medical Services as part of the
comprehensive health entitlements that will be covered by the
NHI Fund.
stakeholders on key interventions to ensure achievement of the
set goals, as well as their respective roles in this process. The
NSDA presented four key outputs that the health sector must
endeavor to achieve namely:
t Increasing Life Expectancy;
t Decreasing Maternal and Child Mortality rates;
t Combating HIV and AIDS and Tuberculosis; and
t Strengthening Health Systems Effectiveness.
3.5.2. South Africa Health Products Regulatory
Authority (SAHPRA)
Strengthening the effectiveness of the health system is the
foundation on which successful interventions to improve health
outcomes must be built. International experience points to the
IDFW WKDW RQO\ D VWUHQJWKHQHG KHDOWK V\VWHP IXUWKHU IRUWL¿HG
by effective intersectoral collaboration to address social
determinants of health, can improve health outcomes.
6LJQL¿FDQW PLOHVWRQHV ZHUH DFKLHYHG WKURXJK WKH VWUDWHJLF
interventions implemented by the health sector, in partnerships
with communities across the country. These are outlined in the
(SLGHPLRORJLFDO3UR¿OHVHFWLRQ
The Medicines and Related Substances amendment bill to create
the South African Health Products Regulatory Authority (SAHPRA)
is currently being deliberated by the Portfolio Committee on
Health. The proposal is to bring the medical devices industry,
cosmetics and foodstuffs as well as pharmaceuticals under the
jurisdiction of the SAHPRA. The SAHPRA will be established as
a Section 3A Public Entity and would thus be able to retain funds
from application fees which can be utilised to employ experts to
evaluate applications on a full time basis.
3.5.3. Traditional Medicine
The Traditional Health Practitioners bill for the establishment of
the Traditional Health Practitioners Council. The bill will bring to
an end the existence of the Interim Traditional Health Practitioners
Council established in terms of Act 22 of 2007.
3.5.4. Operation Phakisa and Ideal Clinic Initiative
The Ideal Clinic Realisation and Maintenance process started
in 2013 to systematically build on the work of the Facility
Improvement Teams. An Ideal Clinic is a clinic with good
infrastructure , adequate staff, adequate medicine and supplies,
good administrative processes and adequate bulk supplies that
use applicable clinical policies, protocols, guidelines as well as
partner and stakeholder support, to ensure the provision of quality
health services to the community. An Ideal Clinic will cooperate
with other government departments as well as with the private
sector and non-governmental organizations to address the social
determinants of health. PHC facilities must be maintained to
function optimally and remain in a condition that can be described
as the “Ideal Clinic”. Integrated clinical services management
(ICSM) will be a key focus within an Ideal Clinic. ICSM is a health
system strengthening model that builds on the strengths of the
HIV programme to deliver integrated care to patients with chronic
and/or acute diseases or who came for preventative services by
taking a patient-centric view that encompasses the full value
chain of continuum of care and support.
These outputs were consistent with government’s outcome-based
approach to improving service delivery; enhancing accountability
to the public and enhancing performance management.
An increased life expectancy for all South Africans is the highest
impact that the country seeks to attain. It lies at the summit of the
4 outputs that the health sector seeks to deliver on.
4.2. Demographic Pro¿le
For 2014, Statistics South Africa (StatsSA) estimates the midyear population as 53.7 million. Figure 1 displays the percentage
distribution of the projected provincial share of the total population
according to the 2014 midyear estimates. Gauteng comprises
the largest share of the South African population. Approximately
a quarter of South Africa’s population (12.9 million people)live
in this province. KwaZulu-Natal is the province with the second
largest population, with 10.5 million people (19.7%) living in this
province. With a population of approximately 1.17 million people
(2.2%), Northern Cape remains the province with the smallest
share of the South African population.
In terms of migrating patterns between provinces, there has been
DJUDGXDORXWÀRZRISRSXODWLRQLQSURYLQFHVZLWKSURYLQFHV
that had no change. Gauteng and Western Cape experienced a
VLJQL¿FDQWSRSXODWLRQLQÀX[EHWZHHQDQG
4. SITUATIONAL ANALYSIS
4.1. Strategic Issues Facing the Department 2010-2014
The Health Sector’s Negotiated Service Delivery Agreement
(NSDA) for 2010-2014 served as the strategic framework for
addressing the Burden of Disease (BoD) during previous 5 years.
The NSDA is a charter outlining consensus between different
13
Figure 1: South Africa’s Mid-year Population Estimates for 2014
Source: Mid-year population estimates 2014 (StatsSA, July 2014)
7KHDJHVSHFL¿FSRSXODWLRQHVWLPDWHVIRU6RXWK$IULFDQVLQ
and 2011 are compared in the population pyramids for Census
2001 and Census 2011 in the table above and the graphs below.
The population increased from 44,909,750 in 2001 to 51,770,750
in 2011. There is a noticeable difference in the age groups
younger than 15 years and age groups 20-29 years. In Census
2001, 34.9% (15.6 million) of the population were aged younger
than 15 years compared to Census 2011 where 29.2% (15.1
million) of the population were aged younger than 15 years. In
Census 2001, 19% (8.5 million) of the population were aged 2029 years compared to Census 2011 where 20% (10.4 million) of
the population were aged 20-29 years.
4.3. Social Determinants of Health
Progress is being made towards providing basic services that are
social determinants of health1. These include the following basic
services: no-fee paying schools; social grants; RDP housing;
provision of basic and free services such are reticulated water;
electricity; sanitation and sewerage and free primary health
care. Results towards the social determinants include:
a)
b)
,Q&HQVXVDSSUR[LPDWHO\¿IW\RQHSHUFHQWDSSUR[LPDWHO\
27.16 million) of the population is female and approximately 7.8%
(4.15 million) is 60 years or older.
Figure 2: South Africa’s Population Estimates for 2011
a decline in the proportion of the population living below the
poverty line – based on diverse measures of poverty;
provision of basic services to indigent households as
follows:
Free water
71,6%
Electricity
59,5%
Sewerage and sanitation
57,9%
Solid waste management
54,1%
c)
Source : Census 2011 (StatsSA)
In 2014, about 30,0% of the population is aged younger than
15 years and approximately 8,4% (4,54 million) is 60 years or
older. Of those younger than 15 years, approximately 22,7%
(3,66 million) live in KwaZulu-Natal and 18,8% (3,05 million) live
in Gauteng. The province with the smallest population namely
Northern Cape has 28% of its population aged younger than 15
years, and nearly one tenth of the population aged 60 and older.
Improved availability of data has resulted in better targeting
ZLWKPLOOLRQKRXVHKROGVEHLQJLGHQWL¿HGDVLQGLJHQW
d) Progress has also been made towards achieving universal
primary education2 with
t Adjusted net enrolment ratios in primary education
increased from:
t 96,5% in 2002 to 98,9% in 2013 for males;
t 96,8% in 2002 to 99,2% in 2013 for females;
t Proportion of learners starting Grade 1 who reach last
grade of Primary School increased from:
t 89,2% in 2002 to 93,4% in 2013 for males;
t 90,1% in 2002 to 96,1% in 2013 for females;
t Literacy rate of 15 to 24 year olds increased from:
t 83,3% in 2002 to 90,7% in 2013 for males; and
t 88,4% in 2002 to 94,6% in 2013 for females.
14
4.4 Epidemiological Pro¿le
caused mainly by communicable diseases to a combination
South Africa’s Millennium Development Goals 2013 Country
Report indicates that some key interventions impacted on the
HSLGHPLRORJLFDO SUR¿OH DQG WKDW VRFLDO GHWHUPLQDQWV RI KHDOWK
needs to be addressed to reach the desired future state of health
of South Africans.
of lower fertility rates and changing lifestyles which has led to
an aging population combined with lifestyle related diseases
such as diabetes and hypertension, cancer and other chronic
ailments. South Africa is also in the midst of this transition.
+RZHYHU 6RXWK $IULFDQV DOVR FRQWLQXH WR KDYH D VLJQL¿FDQW
burden of communicable diseases (mainly HIV, AIDS and TB), in
conjunction with chronic diseases.
Most developing countries are facing a transition in their
HSLGHPLRORJLFDOSUR¿OHIURPKLJKIHUWLOLW\UDWHVDQGKLJKPRUWDOLW\
4.4.1.
Life Expectancy
The 2011 Census population estimates (StatsSA 2012) indicated
that the population size was different from what was expected.
The age distribution of the population below 30 years and the
RYHUDOO VL]H RI WKH SRSXODWLRQ ZHUH SDUWLFXODUO\ VLJQL¿FDQW 7KLV
new data was used to determine the mortality indicators in the
Rapid Mortality Surveillance (RMS) Report, 2012 and 2013.
The life expectancy of South Africans for both males and females
KDV VLJQL¿FDQWO\ LPSURYHG EHWZHHQ DQG ZKLOH
premature mortality has decreased for both males and females
during the same period (see Table 1 below).
Table 1: Life Expectancy and Adult Mortality
Baseline
Indicator
Progress
2009
2010
2011
2012
2013
Life expectancy at birth: Total
57.1
58.5
60.5
61.3
62.2
Life expectancy at birth: Male
54.6
56.0
57.8
58.5
59.4
Life expectancy at birth: Female
59.7
61.2
63.2
64.0
65.1
Adult mortality (45q15): Total
46%
43%
40%
38%
36%
Adult mortality (45q15): Male
51%
48%
46%
44%
42%
Adult mortality (45q15): Female
40%
38%
35%
32%
30%
Source: MRC, Rapid Mortality Surveillance Report 2013)
7KHVH¿QGLQJVFRPPHQVXUDWHZHOOZLWK6WDWV6$¶V
midyear population estimates, where the average provincial life
expectancy at birth has increased for both males and females in
all the provinces and has reached 57.7 years and 61.4 years for
males and females respectively in 2013 as illustrated in Table 2
below. Free State province has the lowest life expectancy and
Western Cape the highest amongst the nine provinces.
The Adult Mortality downward trend commensurate with the Life
Expectancy upward trend for the past 5 years. The probability of
population 15 years and older dying before their 60th birthday
(Adult Mortality (45q15)) has declined by 10% from 46% in 2009
to 36% in 2013.
Table 2: Life Expectancy
Province
2001-2006
2006-2011
2011-2016
Male
Female
Male
Female
Male
Female
Eastern Cape
46.7
50.2
48.2
53.6
53.0
59.0
Free State
42.0
45.4
45.4
48.6
50.7
53.6
Gauteng
56.1
60.2
58.7
62.2
62.9
66.4
KwaZulu-Natal
45.7
50.2
49.2
53.8
54.4
59.4
Limpopo
51.5
58.6
55.1
59.8
58.3
62.5
Mpumalanga
49.0
52.5
51.5
55.5
56.9
60.1
North West
46.7
49.0
49.7
53.2
56.6
58.8
Northern Cape
50.4
56.1
51.8
56.9
52.9
57.5
Western Cape
57.9
63.8
61.0
65.7
63.7
67.9
Source: Mid-year population estimates 2013 (StatsSA, July
2014)
15
Table 3 below details the birth rate, life expectancy for People
Living with HIV (PLWHIV), infant mortality, under 5 mortality
and death rate. This table best summarises the country trend in
terms of demography. Life expectancy has continued to steadily
increase, with the crude birth rate (CBR) remaining stable around
22. The infant and under 5 mortality rates have continued to
decrease but not at the targeted rate.
Table 3: Summary of key health outcomes 2002 to 2014
Year
Crude
Life expectancy at birth with HIV
Male
Female
Total
Infant mortality
rate (IMR)
Under 5
mortality rate
Crude death
rate
2002
24.4
51.1
55.7
53.4
57.8
85.2
13.9
2003
24.2
50.5
54.8
52.7
56.2
83.5
14.5
2004
24.0
50.2
54.1
52.2
54.3
80.9
15.0
2005
23.8
50.2
53.9
52.1
52.0
77.4
15.2
2006
23.6
51.0
54.8
53.0
49.4
72.9
14.5
2007
23.4
52.7
56.6
54.7
45.8
67.4
13.4
2008
23.2
53.8
58.1
56.0
45.0
64.7
12.6
2009
23.1
55.1
59.4
57.3
40.9
59.9
11.8
2010
23.0
56.1
60.3
58.2
38.9
53.8
11.4
2011
22.8
56.6
60.6
58.7
37.8
50.4
11.3
2012
22.7
57.3
61.3
59.3
36.8
48.3
11.0
2013
22.6
58.2
62.1
60.2
35.2
45.6
10.7
2014
22.4
59.1
63.1
61.2
34.4
44.1
10.2
Source: Statistics South Africa. Mid-year population estimates,
2014
Years of Life Lost (YLLs) are an estimate of premature mortality
based on the age at death and thus highlight the causes of death
that should be targeted for prevention. The four leading single
causes of YLLs in South Africa are TB, pneumonia, diarrhoea
and heart disease. The 3 main causes of death are all linked
to HIV and this suggests that HIV-related mortality is by far the
leading cause of YLLs in the majority of districts in South Africa.
$SSUR[LPDWHO\ RQH¿IWK RI 6RXWK $IULFDQ ZRPHQ LQ WKHLU
reproductive ages are HIV positive. The country also ranks
third among countries with the highest burden of TB in the
world after India and China (WHO 2012). Levels of HIV and
TB co-infection are very high, with as many as 60% of patients
dually infected. There is also increasing incidence of multidrugresistant (MDR) and extensively drug-resistant (XDR) TB.
4.4.2.
The National Department of Health commissioned a Joint
Review of the HIV, TB and PMTCT Programmes in 2013.
The main purpose was to assess performance of the
programmes and provide options for improvement. It was
an independent review carried out by a multi-disciplinary
team of reviewers from both inside and outside the country.
HIV and AIDS and TB
South Africa is experiencing serious generalised HIV and
TB epidemics. It continues to be home to the world’s largest
number of people living with HIV. The total number of persons
living with HIV in South Africa increased from an estimated 4,09
million in 2002 to 6.4million by 2012. The proportion of South
Africans infected with HIV has increased from 10.6% in 2008
to 12.3% in 2012, according to the Human Sciences Research
Council (HSRC).For 2012 an estimated 12.2.% of the total
population is HIV positive. This is a increase from the 2008
estimate of 10.6%. The estimated national HIV prevalence
among the general adult population (15-49 years old) is 18.8%
in 2012. The evolution of HIV prevalence among women
presenting for antenatal care has been routinely measured since
1990, and has stabilised at approximately 29% since 2004.
The Joint Review found that the country had made impressive
strides in the implementation of HIV, TB and PMTCT programmes
during the period since the previous reviews were conducted in
2009. Most of the key recommendations from the 2009 TB and
HIV reviews appear to have been taken into consideration in ongoing programme development and contributed to rapid scale up
of key interventions. The impact of these efforts is also beginning
to show in declining numbers of new HIV infections, TB infections
and low rates of new infections in children. HIV and TB mortality is
declining, with a corresponding decline in all natural cause mortality.
16
Table 4: HIV mortality, incidence estimates and the number of people living with HIV, 2002-2014
Year
Total number of deaths
Total number of AIDS
related deaths
Percentage AIDS
related deaths
Incidence Adult
15-49
HIV population
(Millions)
2002
631 383
275 444
43.6
1.64
4.09
2003
667 902
313 477
46.9
1.64
4.20
2004
697 473
344 141
49.3
1.69
4.29
2005
716 083
363 910
50.8
1.73
4.38
2006
694 227
343 194
49.4
1.69
4.48
2007
647 827
267 659
45.9
1.59
4.61
2008
617 202
257 504
41.7
1.47
4.75
2009
590 322
228 051
38.6
1.36
4.88
2010
578 953
213 864
36.9
1.29
5.02
2011
580 460
211 839
36.5
1.25
5.14
2012
575 546
203 293
35.3
1.16
5.26
2013
565 310
189 376
33.5
1.14
5.38
2014
551 389
171 733
31.1
1.11
5.51
Source: Statistics South Africa. Mid-year population estimates, 2014
Table 5 Improved Access to ART
Currently on ART
2004
2005
2006
2007
2008
2009
2010
2011
Total
47 500
110 900
235 000
382 000
588 000
912 000
1 287 000
1 793 000*
17 700
37 500
75 000
120 000
183 000
283 000
396 000
551 000
By Gender
Men
Women
25 600
63 600
138 000
228 000
354 000
553 000
777 000
1 090 000
Children (<15)
4 200
9 800
22 000
35 000
51 000
76 000
113 000
152 000
By provider
Public sector
9 600
60 600
163 000
290 000
470 000
748 000
1 073 000
1 525 000
Private sector
34 100
43 800
57 000
68 000
86 000
117 000
154 000
190 000
NGOs
3 900
6 400
15 000
24 000
32 000
47 000
60 000
78 000
Source: Johnson, LF (2012): Access to Antiretroviral Treatment in South Africa, 2004 – 2011, Southern African Journal of HIV
Medicine
There has been rapid scale up of ART services resulting in a fourfold increase in the number of people receiving ART between
2009 and 2012. The number of patients receiving ART in SA has
increased exponentially between 2004 and 2011, with women
and users of the public sector gaining greater access to ART.
$ERYH WDEOHV DUH UHÀHFWLYH RI WKH FORVH UHODWLRQVKLS EHWZHHQ
the scale up of ART services and the reduction in AIDS related
deaths over the past 14 years.
On the HIV prevention front, the HIV incidence has steadily
declining for the past 12 years amongst the most vulnerable
population.
The HIV Counselling and Testing (HCT) campaign resulted in
more than 13 million tests for HIV and over three million people
screened for TB. There is universal coverage of PMTCT services.
TB case detection has increased and the number of sites initiating
MDR-TB treatment has increased from 11 to 45. The Department
of Health (DoH) appears to be on course to meeting its targets
DV GH¿QHG LQ WKH 1DWLRQDO 6WUDWHJLF 3ODQ RQ +,9 67,V DQG7%
(2012-2016).
7XEHUFXORVLV UHPDLQV D VLJQL¿FDQW SXEOLF KHDOWK SUREOHP LQ
the country. The cure rate for new pulmonary smear-positive
TB patients has increased over the last six years from 61.6%
in 2006 to 75.8%% in 2012. This is a 1.6% increase from
2011. Figure 3 shows the TB cure rate (new pulmonary
smear-positive) by province in 2012. Only Gauteng and
Western Cape are achieving the set targets for South Africa.
The lowest cure rate is found in the Eastern Cape Province.
There were just under 300 000 new tuberculosis cases reported
in 2013. This is a decrease from the 2011 numbers reported of
389 000. The 2014 Global WHO TB report indicates that South
Africa’s TB incidence rate has decreased from 993 cases per
100 000 in 2011, to 860 cases per 100 000 in 2013. While there
are still many missed opportunities to identify and treat existing
cases to curb transmission at community level, positively, South
Africa has remained the leading country in providing Isoniasid
Preventive Therapy (IPT) to all HIV positive patients. This has
been shown to decrease TB risk in this vulnerable population.
17
Figure 3: the TB cure rate (new pulmonary smear-positive) by province in 2012.
Source: District Health Barometer 2013/14 (Health Systems Trust)
South Africa’s TB epidemic is worsened by poor adherence as
a result of patients not being initiated on, or lost to treatment.
Resultantly, they expand the pool of infection, and also develop
resistance to “normal” treatment, requiring much more complex
and expensive forms of treatment. In 2012 the estimated cases
of MDR-TB rose to 450 000 globally and XDR-TB was reported in
just under 100 countries, highlighting the threat of drug-resistant
TB to global TB control. South Africa has the second highest
number of reported MDR-TB cases globally, and Figure 4 below
illustrates the rapidly rising numbers of patients with MDR-TB
and more slowly rising numbers of XDR-TB, together with (since
2009) the declining number of TB patients in the country .
Table 6: Key TB Indicators
Period
TB case noti¿cation
Successful treatment rate
Cure rate
Defaulter Rate
2000
151 239
63
54
13
2001
188 695
61
50
11
2002
224 420
63
50
12
2003
255 422
63
51
11
2004
279 260
66
51
10
2005
302 467
71
58
10
2006
341 165
73
62
9
2007
336 328
71
63
8
2008
340 559
71
69
8
2009
406 082
74
67
8
2010
401 048
79
71
7
2011
389 974
79
73
6,1
Figure 4: Reported TB Cases 2004-2012
Source: District Health Barometer 2013/14
18
4.4.3. Maternal and Child Health
In line with MDG targets the South African health system aimed
to reduce its child mortality by two-thirds between 1990 and
2015. “The 1998 South African Demographic and Health Survey
'+6 UHSRUW LQGLFDWHG DQ XQGHU¿YH PRUWDOLW\ UDWH RI SHU
thousand live births during the period 1993–98. Using this as a
benchmark, the implication for South Africa was a reduction of
XQGHU¿YHPRUWDOLW\UDWH805WRSHUWKRXVDQGOLYHELUWKVE\
2015. Similarly, an infant mortality rate (IMR) of 18 per 1000 live
births has been set for the 2015 MDG target for IMR.”
South Africa has made remarkable progress against these 3 very
critical health outcome indicators of maternal, child and infant
mortality. The South African health system delivered against its
Negotiated Service Delivery Agreement 2010-2014 targets for
all 3 indicators. The Rapid Mortality Surveillance Report 2013
UHÀHFWVWKDW
7KH 8QGHU PRUWDOLW\ UDWH 805 KDV VLJQL¿FDQWO\
decreased from 56 deaths per 1,000 live births in 2009, to
41 deaths per 1,000 live births in 2013. This was against the
Negotiated Service Delivery Agreement 2010-2014 target of
50 deaths per 1,000 live births.
The Infant Mortality Rate (IMR) has decreased from 39
deaths per 1,000 live births in 2009, to 29 deaths per 1,000
live births in 2013. This was against the Negotiated Service
Delivery Agreement 2010-2014 target of 35 deaths per
1,000 live births.
The Neonatal Mortality Rate (NMR) has also declined, but
at a much slower pace. It reduced from 14 deaths per 1,000
live births in 2009 to 11 deaths per 1,000 live births in 2013.
It has remained stable at 11 deaths per 1,000 live births for
the past 2 years. This was against the Negotiated Service
Delivery Agreement 2010-2014 target of 12 deaths per
1,000 live births.
The maternal mortality ratio (MMR) reduced from 281
deaths per 100,000 live births in 2008 to 197 deaths per
100,000 live births in 2011. This was against the Negotiated
Service Delivery Agreement 2010-2014 target of 252 deaths
per 100,000 live births.
Table 7: IMR, U5-MR and MMR progression
Health indicator
Source1
Baseline
(2009) 1
NSDA Target (2014) 1
Progress (2013)
Maternal Mortality Ratio
Vital Registration Data Birth estimates
from Actuaries Society of South Africa
(ASSA) 2008
310 per 100 000 live
births (2008)
270 per 100 000 live births
269 3
Infant Mortality Rate
Deaths from the national population
register.
40 per 1000 live
births
29 per 1 000
live births2
Birth estimates from ASSA 2008
56 per 1000 live
births
41 per 1 000
live births2
Deaths from the national population
register.
Population estimates from
ASSA2008
56.5 years
54 years for males
59 years for
females
58.5 years
56 years for males
61 years for females
59.6 years2
56.9 years for
Males2
62.4
years
for females2
8QGHU¿YH0RUWDOLW\
Rate
Life expectancy
: Source: Health Data Advisory and Co-ordination committee report (Published: February 2012)
: Source: Rapid Mortality Surveillance Report 2013 (Published: 2014)
3
: Source : Causes of Death s data from Civil Registration and Vital Statistics System (CRVS)
1
2
,QVWLWXWLRQDO0DWHUQDO0RUWDOLW\5DWLR005UHÀHFWVDGRZQZDUGWUHQGEHWZHHQDQGQDWLRQDOO\DQGVSHFL¿FDOO\LQVHYHQ
of the Provinces (see Table 8).
Table 8: Institutional Maternal Mortality Ratio
Province
2008
2009
2010
2011
2012
Eastern Cape
180.4
215.2
197.0
158.26
146.44
Free State
267.0
350.9
263.5
240.0
124.54
Gauteng
136.0
160.2
159.2
121.45
142.52
KZN
183.8
194.2
208.7
186.74
160.33
Limpopo
176.6
160.4
166.7
195.5
185.8
Mpumalanga
179.8
159.4
218.6
190.13
173.76
North West
161.7
279.5
256.1
153.75
127.76
Northern Cape
274.4
251.8
267.4
191.10
149.33
Western Cape
61.8
113.1
88.0
64.81
78.64
South Africa
164.8
188.9
186.2
159.14
146.71
Source: 1ational Committee of Con¿dential (nTuiry into Maternal Deaths
19
4.4.4. Violence and Injuries
4.4.5. Non-Communicable Diseases (NCDs)
Violence and injuries forms one of the four components of the
quadruple burden of disease that South Africa faces. SA has an
injury death rate of 158 per 100 000, which is twice the global
average of 86,9 per 100 000 population and higher than the
African average of 139,5 per 100 000 . Key drivers of the injury
death rates are:
intentional injuries due to interpersonal violence (46% of all
injury deaths);
URDGWUDI¿FLQMXULHV
suicide (9%);
¿UHV
drowning (2%),
falls (2%) and
poisoning (1%).
Increased prevalence of NCDs globally and in South Africa, is
contributing at least 33% to the burden of diseases. Common risk
factors for NCDs include tobacco use; physical inactivity; unhealthy
diets, and excessive use of alcohol. South African National Health
and Nutrition Examination Survey (SANHANES)-1 published by
WKH +65& LQ UHÀHFWV WKDW JRYHUQPHQW¶V WREDFFR FRQWURO
policy has succeeded in reducing adult smoking by half, from
32% in 1993 to 16,4% in 2012s. However, SANHANES-1 also
UHÀHFWVWKDW
29% of adults were exposed to ‘environmental tobacco
smoke’ i.e. non-smokers who inhaled other people’s
cigarette smoke;
High prevalence of pre-hypertension as well as hypertension
amongst survey participants; and
/RZ OHYHOV RI SK\VLFDO DFWLYLW\ RU DHURELF ¿WQHVV DPRQJVW
the population aged 18-40 years, with 45,2% of females and
RIPDOHVIRXQGWREHXQ¿W
A need exists to implement a comprehensive and intersectoral
UHVSRQVHWRFRPEDWYLROHQFHDQGLQMXU\DQGVLJQL¿FDQWO\UHGXFH
the country’s injury death rate.
Research evidence also shows that there is a high prevalence of
mental disorders linked to social determinants such as poverty,
unemployment, violence, substance abuse and other adversities
that increase vulnerability of South Africans to mental disorders;
high co-morbidity between mental and other diseases; and that
there is a substantial gap between demand and supply of mental
health services.
20
The National Mental Health Policy Framework and Strategic Plan
2013-2020 that was adopted in July 2013 sets out key objectives
and milestones that must be realised to transform mental health
services in this country and in the main the priorities are (i)
improving detection rates and management of mental disorders
especially in primary health care setting; (ii) improving mental
health infrastructure capacity especially at community level;
and (iii) improving the supply of and access to mental health
professionals. To achieve mental well being also requires that
multidimensional interventions be implemented with other sectors
to address the socio-economic determinants of mental disorders.
4.4.6. Communicable Diseases
6HDVRQDO ]RRQRWLF DQG SDQGHPLF LQÀXHQ]D LV D PDMRU SXEOLF
KHDOWKWKUHDWWKURXJKRXWWKHZRUOG6HDVRQDOLQÀXHQ]DLVDKLJKO\
communicable respiratory tract infection causing an estimated
250,000 to 500,000 deaths in persons of all ages annually. In
South Africa, it is estimated that from 5,000 to 10,000 deaths and
IURPWRKRVSLWDOLVDWLRQVDUHGXHWRLQÀXHQVDHDFK
year. The primary effective prevention strategy is vaccination
EHIRUH WKH LQÀXHQ]D VHDVRQ VHWV LQ 7KH SURJUDPPH ZLOO
continue vaccinating high risk individuals to mitigate the impact
of the disease. South Africa is also endemic to neglected tropical
diseases with geographical distribution overlapping with areas
endemic to malaria. South Africa is also pone to infectious disease
such as rabies, cholera and hemorrhagic fevers. Strengthening
the core capacities for surveillance and response in line with
the International Health Regulations (2005) will mitigate the
morbidity and mortality associated with the outbreaks, epidemics
and pandemics.
Malaria transmission in South Africa occurs mainly along the lowlying areas of the country bordering: Mozambique, Swaziland and
Zimbabwe. Approximately 10% of the population in South Africa
live in the malaria endemic areas and are at risk of contracting
malaria. Malaria transmission in South Africa follows a seasonal
pattern, where transmission increases from September and
wanes towards May, the following year. South Africa has set the
goal of eliminating the disease (zero local transmission) by the
year 2018. The aggregated malaria incidence per 1000 population
at risk for the 2014/15 malaria season is approximately 0.3 per
1000 population at risk. The key strategies for elimination of the
disease will be to strengthen surveillance, health promotion,
case management and vector control. South Africa will also be
working closely with its neighbouring countries: Mozambique,
Swaziland and Zimbabwe in regional malaria initiatives as this
will contribute the elimination agenda of the country.
WHO perspective.
The implementation of the strategic priorities for steering the
health sector towards Vision 2030, would continue to be managed
by the Implementation Forum for Outcome 2: “A long and healthy
life for all South Africans”, which is the National Health Council
(NHC). This Implementation Forum consists of the Minister of
Health and the 9 Provincial Members of the Executive Council
(MECs) for Health. The Technical Advisory Committee of the
NHC (Tech-NHC) functions as the Technical Implementation
Forum. The Tech NHC consists of the Director-General of the
National Department of Health (DoH) and the Provincial Heads
of Department (HoDs) of Health in the 9 Provinces, and National
DoH Deputy Director-Generals.1
5.2. National Development Plan 2030 vision
The National Development Plan (NDP) sets out nine (9) longterm health goals for South Africa. Five of these goals relate to
improving the health and well-being of the population, and the
other four deals with aspects of health systems strengthening.
By 2030, South Africa should have:
1. Raised the life expectancy of South Africans to at least
70 years;
2. Progressively improve TB prevention and cure
3. Reduce maternal, infant and child mortality
4. 6LJQL¿FDQWO\ UHGXFH SUHYDOHQFH RI QRQFRPPXQLFDEOH
diseases
5. Reduce injury, accidents and violence by 50 percent from
2010 levels
6. Complete Health system reforms
7. Primary healthcare teams provide care to families and
communities
8. Universal health care coverage
9. Fill posts with skilled, committed and competent
individuals
5.3. Priorities to achieve Vision 2030
7KH1'3VWDWHVH[SOLFLWO\WKDWWKHUHDUHQRTXLFN¿[HVIRU
DFKLHYLQJWKHQLQHJRDOVRXWOLQHGDERYH7KH1'3DOVRLGHQWL¿HV
a set of nine (9) priorities that highlight the key interventions
required to achieve a more effective health system, which will
contribute to the achievement of the desired outcomes. The
priorities are as follows:
a.
5. STRATEGIC FRAMEWORK 2014-2019
5.1. Strategic Approach
b.
c.
d.
Despite efforts to transform the health system into an integrated,
FRPSUHKHQVLYH QDWLRQDO KHDOWK V\VWHP DQG VLJQL¿FDQW
investment and expenditure, the South African health sector has
largely been beset by key challenges including:
e.
f.
g.
a.
b.
c.
d.
h.
i.
a complex, quadruple burden of diseases;
serious concerns about the quality of public health care;
DQLQHIIHFWLYHDQGLQHI¿FLHQWKHDOWKV\VWHPDQG
spiralling private health care costs.
Both the National Development Plan (NDP) 2030 and the World
Health Organisation (WHO) converge around the fact that a wellfunctioning and effective health system is the bedrock for the
attainment of the health outcomes envisaged in the NDP 2030.
The trajectory for the 2030 vision, therefore, commences with
VWUHQJWKHQLQJRIWKHKHDOWKV\VWHPWRHQVXUHWKDWLWLVHI¿FLHQW
DQG UHVSRQVLYH DQG RIIHUV ¿QDQFLDO ULVN SURWHFWLRQ7KH FULWLFDO
focus areas proposed by the NDP 2030 are consistent with the
1
Address the social determinants that affect health and
diseases
Strengthen the health system
Improve health information systems
Prevent and reduce the disease burden and promote
health
Financing universal healthcare coverage
Improve human resources in the health sector
Review management positions and appointments and
strengthen accountability mechanisms
Improve quality by using evidence
Meaningful public-private partnerships
Medium Term Strategic Framework 2014-2019
21
5.4. Alignment between NDP Goals, Priorities and NDoH Strategic Goals
NDP Goals 2030
NDP Priorities 2030
NDoH Strategic Goals 2014- 2019
Average male and female life expectancy at
birth increased to 70 years
a. Address the social determinants that affect
health and diseases
d. Prevent and reduce the disease burden and
promote health
Prevent disease and reduce its burden, and
promote health through a multi stakeholder
National Health Commission
b. Strengthen the health system
Improve health facility planning by implementing norms and standards;
Tuberculosis (TB) prevention and cure progressively improved;
Maternal, infant and child mortality reduced
Prevalence of Non-Communicable Diseases
reduced
Injury, accidents and violence reduced by 50%
from 2010 levels
Health systems reforms completed
,PSURYH¿QDQFLDOPDQDJHPHQWE\LPSURYLQJ
capacity, contract management, revenue
collection and supply chain management
reforms;
c. Improve health information systems
'HYHORSDQHI¿FLHQWKHDOWKPDQDJHPHQWLQIRUmation system for improved decision making;
h. Improve quality by using evidence
Improve the quality of care by setting and
monitoring national norms and standards,
improving system for user feedback,
increasing safety in health care, and by
improving clinical governance
Primary health care teams deployed to provide
care to families and communities
Re-engineer primary healthcare by: increasing
the number of ward based outreach teams,
contracting general practitioners, and district
specialist teams; and expanding school health
services;
Universal health coverage achieved
e. Financing universal healthcare coverage
Make progress towards universal health coverage through the development of the National
Health Insurance scheme, and improve the
readiness of health facilities for its implementation;
3RVWV¿OOHGZLWKVNLOOHGFRPPLWWHGDQG
competent individuals
f. Improve human resources in the health
sector
g. Review management positions and
appointments and strengthen accountability
mechanisms
Improve human resources for health by
ensuring appropriate appointments, adequate
training and accountability measures.
5.5. Strategic goals of the Department
6. ORGANISATIONAL ENVIRONMENT
7KH'HSDUWPHQW¶V¿YH\HDUVWUDWHJLFJRDOVDUHWR
Prevent disease and reduce its burden, and promote health;
Make progress towards universal health coverage through
the development of the National Health Insurance scheme,
and improve the readiness of health facilities for its
implementation;
Re-engineer primary healthcare by: increasing the number
of ward based outreach teams, contracting general
practitioners, and district specialist teams; and expanding
school health services;
Improve health facility planning by implementing norms and
standards;
,PSURYH ¿QDQFLDO PDQDJHPHQW E\ LPSURYLQJ FDSDFLW\
contract management, revenue collection and supply chain
management reforms;
'HYHORSDQHI¿FLHQWKHDOWKPDQDJHPHQWLQIRUPDWLRQV\VWHP
for improved decision making
Improve the quality of care by setting and monitoring national
norms and standards, improving system for user feedback,
increasing safety in health care, and by improving clinical
governance
Improve human resources for health by ensuring appropriate
appointments, adequate training and accountability
measures.
The organisational structure of the National Department of
Health was approved by the Department of Public Service and
Administration and its implementation commenced in April 2012.
The transformation of the organisational structure was aimed at
ensuring an alignment with strategic priorities of the health sector
and to improve the department’s oversight function across the
health system.
The organisational structure has been reviewed to maximise
achievement of the Health Department’s strategic priorities. The
success of the implementation thereof is highly dependent on the
alignment with the allocated available budget. Through the years
the development of the organisational structure was done in
isolation from the budget process, and this practise has provided
challenges in actioning some of the key outputs. The current
approved organisational structure is taking into consideration the
change of organisational culture, improvement of productivity,
development of leadership capability and repositioning of NDoH
as an employer of choice whereby only candidates who meet
WKH SUR¿OH RI WKH GHVLUHG 1'R+ FDGUH RI HPSOR\HHV ZLOO EH
considered for appointment.
22
DDG: HIV/AIDS, TB AND
MATERNAL AND CHILD
HEALTH
DR Y PILLAY
DDG: NATIONAL HEALTH
INSURANCE
VACANT
HEAD: HEALTH INTERNATIONAL
DEVELOPMENT
MS N MATSAU
HEAD: CORPORATE SERVICES
MS V RENNIE
MS JR HUNTER
DDG: PRIMARY HEALTH
CARE
MS MP MATSOSO
DIR: OFFICE OF THE
DIRECTOR-GENERAL
DR T CARTER
DDG: HOSPITALS
TERTIARY HEALTH SERVICES
AND HUMAN RESOURCE
DEVELOPMENT
CHIEF OPERATION OFFICER
VACANT
CHIEF FINANCIAL OFFICER
MR I VAN DER MERWE
DIRECTOR-GENERAL: NATIONAL DEPARTMENT OF
HEALTH
DR A PILLAY
DDG: HEALTH
REGULATION AND
COMPLIANCE
ORGANISATIONAL STRUCTURE
23
216.2
18 514.2
1 403.1
Programme 4
Programme 5
Programme 6
30.7
1.5
7.7
Bursaries: Employees
Catering: Departmental activities
Consultants and professional services: Infrastructure
and planning
0.1
59.6
Consultants and professional services: Business and
advisory services
Consultants and professional services: Laboratory
services
29.6
114.4
Computer services
27.4
28.4%
29.7
Audit costs: External
Communication
14.4%
–
–
-21.2%
-0.2%
13.8%
9.9%
-1.3%
4.4%
16.1%
1.0
5.9%
8.9%
7.0%
8.3%
12.2%
3.0%
1.1%
17.8%
57.8
1 080.3
656.5
1 736.8
3.9%
23.1%
–
0.1%
0.5%
0.1%
0.1%
–
–
0.1%
–
0.1%
–
2.6%
2.0%
4.6%
100.0%
3.9%
59.3%
0.7%
34.0%
0.9%
1.2%
Expenditure/
total: Average (%)
2011/12 - 2014/15
Average
growth rate (%)
of which: Administration fees
Advertising
Assets less than the
capitalisation threshold
Goods and services
Compensation of employees
Current payments
Economic classi¿cation
Change to 2014 Budget estimate
33 624.3
12 772.3
Programme 3
Total
389.7
328.9
Programme 2
2014/15
Revised estimate
Programme 1
R million
Programme
1. Administration
2. National Health Insurance, Health Planning and Systems Enablement
3. HIV and AIDS, Tuberculosis, and Maternal and Child Health
4. Primary Health Care Services
5. Hospitals, Tertiary Health Services and Human Resource Development
6. Health Regulation and Compliance Management
Programmes
Expenditure estimates by programme and economic classi¿cation
7. OVERVIEW OF MTEF 2015/16 - 2017/18 BUDGETS
24
0.1
13.0
123.1
23.9
23.3
8.2
1.6
35.7
15.5
32.4
1.0
1 579.5
772.1
2 351.5
(610.8)
36 468.0
1 596.9
19 159.1
225.0
14 442.1
587.8
457.1
2015/16
0.4
13.0
142.4
16.5
25.9
4.9
1.3
33.1
6.7
23.9
0.4
1 412.3
813.8
2 226.0
(936.1)
38 923.5
1 687.7
19 961.4
239.3
16 002.7
576.6
456.0
2016/17
Medium-term expenditure estimate
–
13.0
126.8
13.8
21.8
2.8
2.0
38.7
4.8
9.3
0.2
1 533.4
854.7
2 388.1
(660.4)
42 337.2
1 718.4
21 220.0
251.8
17 972.9
682.1
492.1
2017/18
8.1%
-100.0%
-39.8%
3.5%
-22.4%
-7.3%
-28.5%
10.3%
8.0%
-45.5%
-45.6%
-41.1%
12.4%
9.2%
11.2%
8.0%
7.0%
4.7%
5.2%
12.1%
27.5%
–
0.1%
0.3%
0.1%
0.1%
–
–
0.1%
–
0.1%
–
3.7%
2.0%
5.7%
100.0%
4.2%
52.1%
0.6%
40.4%
1.4%
1.2%
Expenditure/
total: Average (%)
2014/15 - 2017/18
Average
growth rate (%)
25
Inventory: Materials and supplies
39.0
111.3
5.6
0.7
&RQVXPDEOHV6WDWLRQHU\SULQWLQJDQGRI¿FHVXSSOLHV
Operating leases
Property payments
Transport provided: Departmental activity
–
12.4
Inventory: Other supplies
Consumable supplies
74.1
Inventory: Medicine
153.2
1.5
Inventory: Learner and teacher support material
Inventory: Medical supplies
0.5
0.2
Inventory: Fuel, oil and gas
2.8
29.8
Inventory: Clothing material and accessories
Fleet services (including government motor transport)
0.8
17.4
Agency and support / outsourced services
Entertainment
85.8
1.1
45.6
2014/15
Revised estimate
Contractors
Consultants and professional services: Legal costs
&RQVXOWDQWVDQGSURIHVVLRQDOVHUYLFHV6FLHQWL¿FDQG
technological services
R million
Programme
287.8%
-1.7%
5.8%
7.6%
-100.0%
–
52.2%
0.2%
36.2%
–
16.3%
–
–
-2.4%
10.9%
111.5%
-66.7%
–
Average
growth rate (%)
–
–
0.3%
0.1%
–
–
0.1%
0.4%
–
–
–
–
–
–
–
0.1%
–
0.1%
2011/12 - 2014/15
Expenditure/
total: Average (%)
0.7
8.8
127.9
37.4
–
14.9
196.2
189.3
0.7
0.2
0.5
–
23.6
0.8
222.4
341.5
1.2
10.2
2015/16
0.8
10.1
132.5
26.4
–
13.0
2.9
210.1
0.7
–
1.0
–
11.6
0.1
234.9
324.4
1.0
25.5
2016/17
–
24.0
139.8
27.5
0.4
13.4
0.6
192.6
0.4
–
1.3
–
27.8
–
236.5
412.3
7.0
28.6
2017/18
-100.0%
62.8%
7.9%
-11.0%
–
2.6%
-79.9%
7.9%
-38.3%
-100.0%
39.4%
-100.0%
-2.2%
-100.0%
138.8%
68.7%
83.7%
-14.4%
Average
growth rate (%)
–
–
0.3%
0.1%
–
–
0.2%
0.5%
–
–
–
–
0.1%
–
0.5%
0.8%
–
0.1%
2014/15 - 2017/18
Expenditure/
total: Average (%)
26
100.7
Machinery and equipment
Total
33 624.3
9.8
188.0
Software and other intangible assets
298.4
%XLOGLQJVDQGRWKHU¿[HGVWUXFWXUHV
–
Payments for capital assets
Households
206.4
Foreign governments and international organisations
1RQSUR¿WLQVWLWXWLRQV
3.0
2.7
Higher education institutions
1 212.9
30 164.1
Departmental agencies and accounts
Provinces and municipalities
22.2
31 589.1
Venues and facilities
Transfers and subsidies
35.2
9.3
72.6
2014/15
Revised estimate
Operating payments
Training and development
Travel and subsistence
R million
Economic Classi¿cation
Expenditure estimates by programme and economic classi¿cation (continued)
8.3%
317.8%
41.6%
–
103.1%
-85.7%
6.0%
–
-40.9%
13.4%
7.9%
8.1%
6.5%
-3.9%
61.4%
-13.9%
Average
growth rate (%)
100.0%
–
0.2%
0.3%
0.4%
–
0.7%
–
–
3.4%
90.9%
95.0%
–
0.1%
–
0.3%
2011/12 - 2014/15
Expenditure/
total: Average (%)
36 468.0
–
105.5
562.5
668.0
–
171.1
–
3.1
1 416.4
31 857.9
33 448.5
18.5
35.9
4.8
66.1
2015/16
38 923.5
–
107.7
587.1
694.8
–
167.2
–
3.3
1 493.9
34 338.2
36 002.7
8.4
38.7
6.2
95.4
2016/17
42 337.2
–
118.4
634.0
752.3
–
181.8
–
3.5
1 516.1
37 495.5
39 196.8
11.6
57.6
8.1
110.7
2017/18
8.0%
-100.0%
5.5%
50.0%
36.1%
-100.0%
-4.2%
-100.0%
5.0%
7.7%
7.5%
7.5%
-19.5%
17.8%
-4.5%
15.1%
Average
growth rate (%)
100.0%
–
0.3%
1.3%
1.6%
–
0.5%
–
–
3.7%
88.4%
92.7%
–
0.1%
–
0.2%
2014/15 - 2017/18
Expenditure/
total: Average (%)
27
194
137
105
291
319
Programme 2
Programme 3
Programme 4
Programme 5
Programme 6
–
–
–
–
–
–
–
–
–
–
–
–
95.0
94.2
301
140.9
62.5
85.6
149.9
628.0
107.2
136.0
287.9
96.9
628.0
Cost
2013/14
Actual
282
437
132
184
506
1 842
116
241
877
608
1 842
Number
1. Data may not necessarily reconcile Zith of¿cial government personnel data.
2. Rand million.
458
Programme 1
128
13 – 16
1 504
11 – 12
Programme
591
246
7 – 10
539
1–6
Salary level
1 504
Number of funded posts
Health
Number of posts
additional to the
establishment
Number of posts estimated for
31 March 2015
1.PERSONNEL INFORMATION
Unit
Cost
0.3
0.3
0.3
0.5
0.5
0.3
0.3
0.9
0.6
0.3
0.2
0.3
358
300
440
137
177
468
1 880
131
267
856
626
1 880
Number
103.2
106.4
147.7
64.4
78.7
156.1
656.5
119.1
153.5
284.8
99.2
656.5
Cost
2014/15
Unit
Cost
Revised estimate
0.3
0.4
0.3
0.5
0.4
0.3
0.3
0.9
0.6
0.3
0.2
0.3
358
300
458
137
177
468
1 898
134
269
858
637
137.4
116.0
176.5
68.9
96.1
177.1
772.1
140.3
181.5
330.5
119.8
772.1
Cost
2015/16
1 898
Number
0.4
0.4
0.4
0.5
0.5
0.4
0.4
1.0
0.7
0.4
0.2
0.4
Unit
Cost
358
300
458
137
177
468
1 898
134
269
858
637
1 898
Number
145.1
122.4
186.2
72.7
101.4
185.9
813.8
147.1
191.6
348.9
126.2
813.8
Cost
2016/17
0.4
0.4
0.4
0.5
0.6
0.4
0.4
1.1
0.7
0.4
0.2
0.4
Unit
Cost
358
300
458
137
177
467
1 897
134
269
857
637
152.6
128.5
195.5
76.4
106.5
195.2
854.7
154.5
201.3
366.4
132.6
854.7
Cost
2017/18
1 897
Number
Number and cost2 of personnel posts ¿lled / planned for on funded establishment
0.4
0.4
0.4
0.6
0.6
0.4
0.5
1.2
0.7
0.4
0.2
0.5
Unit
Cost
Salary
level/total:
Average (%)
–
–
1.3%
–
–
-0.1%
0.3%
0.8%
0.2%
0.0%
0.6%
0.3%
18.9%
15.8%
24.0%
7.2%
9.3%
24.7%
100.0%
7.0%
14.2%
45.3%
33.5%
100.0%
2013/14-2016/17
Average
growth rate
(%)
Number
EXPENDITURE TRENDS
6LJQL¿FDQW SURJUHVV KDV EHHQ PDGH RYHU WKH ODVW \HDUV
towards ensuring a long and healthy life for all South Africans,
which is outcome 2 of government’s 2014-2019 medium term
strategic framework. Life expectancy has increased from 52.2
years in 2004 to 61.2 years in 2014, but this is still shorter than in
most other upper middle income countries and great challenges
remain. Over the medium term, the Department of Health will
continue to contribute to increased life expectancy and improved
quality of life for South Africans through sustaining the expansion
of the HIV and AIDS treatment and prevention programme,
revitalising public health care facilities, and ensuring the provision
of specialised tertiary hospital services. Spending on these three
areas takes up 85.2 per cent of the department’s total budget over
the MTEF period, and the activities contribute to sub-outcome 6
(improved health management and leadership), sub-outcome 7
(improved health facility planning and infrastructure delivery) and
sub-outcome 8 (HIV and AIDS and tuberculosis prevented and
successfully managed) of outcome 2. In line with the national
development plan and government’s 2014-2019 medium term
strategic framework, national health insurance is also a major
priority for the department over the medium term, although not
a large spending area at this early stage of its implementation.
R1.4 billion of the R2.4 billion Cabinet approved budget reductions
will be effected on most of the conditional allocations to provincial
departments of health over the MTEF period, and the department
ZLOOEHUHTXLUHGWR¿QGHI¿FLHQFLHVSDUWLFXODUO\LQLWVSURYLVLRQRI
infrastructure.
Sustained expansion of the HIV and AIDS treatment and
prevention programme
The department’s expansion of antiretroviral treatment is
projected to enable 4.8 million patients to be on treatment by
the end of 2017/18. The department is also expected to be
able to test 10 million adults for HIV every year, among other
HIV prevention interventions. The HIV and AIDS treatment and
prevention programme is supported by a Cabinet approved
additional allocation of R1.2 billion in 2017/18, hence the
projected average annual growth of 13 per cent over the MTEF
period in the comprehensive HIV and AIDS conditional allocation
in the HIV and AIDS, TB, Maternal and Child Health programme.
7KH QXPEHU RI GHDWKV GXULQJ WKH ¿UVW \HDU RI OLIH SHU OLYH ELUWKV KDV EHHQ VLJQL¿FDQWO\ UHGXFHG ODUJHO\ GXH WR WKH
success of the department’s programme to prevent mother-tochild transmission of HIV. Mother-to-child-transmission of HIV is
expected to decline to below 1 per cent by 2017/18.
Revitalisation of public health care facilities
Many public health care facilities are in a dire state and need
maintenance, refurbishment and in some cases complete
replacement. Government’s 2014-2019 medium term strategic
framework highlights this in sub-outcome 7 (improved health
facility planning and infrastructure delivery). Over the medium
term, the department will prioritise monitoring and oversight
of provincial health infrastructure delivery and implementing
national health insurance infrastructure projects, funded by the
R16.6 million transfer to provinces through the health facility
revitalisation grant in the Hospitals, Tertiary Health Services and
Human Resource Development programme.
The Hospitals, Tertiary Health Services and Human Resource
Development programme also manages the health facility
revitalisation component of the national health allocation in kind
to provinces. Due to underspending on the allocation since its
inception in 2013/14, R411.6 million will be reprioritised to other
key areas, such as for new equipment and staff in the four
forensic chemistry laboratories, sector wide procurement (which
deals with all the medicines and medical supplies procurement
IRUWKHGHSDUWPHQWSRUWKHDOWKVHUYLFHVDQGWKHQHZ2I¿FHRI
Health Standards Compliance.
The department estimates that it will invest R19.5 billion in
infrastructure over the MTEF period: R6.1 billion in 2015/16,
R6.4 billion in 2016/17, and R6.8 billion in 2017/18, excluding
investments by provincial health departments via their provincial
equitable share allocations. 8 mega infrastructure projects
(costing more than R1 billion) are currently being implemented
by national and provincial departments: Shoshanguve Hospital,
Tshilidzini Hospital, Cecilia Makiwane Hospital, Natalspruit
Hospital, King Dinuzulu Hospital complex (formerly King
George V Hospital), Ngwelezane Hospital, Lower Umfolozi War
Memorial Hospital complex, and Dr Pixley ka Seme Memorial
Hospital. 50 large projects (costing more than R250 million, but
less than R1 billion) are also being implemented, at a projected
cost of R9 billion over the medium term. Small projects, such
as the construction and upgrading of clinics, community health
centres and nursing colleges and schools, under the provincial
departments of health, will continue over the medium term,
including the installation of mobile doctors’ consulting rooms in
the national health insurance pilot districts. Spending on small
infrastructure projects is projected at R8 billion over the medium
term
Ensuring the provision of specialised tertiary hospital
services
Over the medium term, the department aims to provide tertiary
health services in 33 hospitals and hospital complexes and
to modernise tertiary facilities to improve equitable access.
Tertiary health services are usually for inpatients in a hospital
that has specialised personnel and facilities for advanced
medical investigation and treatment. After the Cabinet approved
reduction, the national tertiary services conditional allocation in
the Hospitals, Tertiary Health Services and Human Resource
Development programme is set to grow by 4.3 per cent over the
MTEF period (R10.4 million in 2015/16, R10.8 million in 2016/17,
and R11.5 million in 2017/18).
National health insurance
The Department of Health is in its fourth year of the phased
15-year rollout of national health insurance, government’s
chosen path to universal, quality and affordable health care.
Pilot activities are under way in 11 districts, and early in 2015
the department plans to release the White Paper on National
Health Insurance, which will elaborate on the proposed policy.
1DWLRQDOKHDOWKLQVXUDQFHHQWDLOVPDMRU¿QDQFLQJUHIRUPVLQWKH
health sector and the department is piloting innovative health
¿QDQFLQJPHFKDQLVPVLQFOXGLQJFRQWUDFWLQJZLWKSULYDWHJHQHUDO
practitioners to provide services in public facilities and developing
a new hospital reimbursement mechanism.
'LI¿FXOWLHVLQFRQWUDFWLQJSULYDWHJHQHUDOSUDFWLWLRQHUVGXHWRSRRU
working conditions was the main cause of slow spending on rolling
out national health insurance, and funding in the national health
insurance conditional allocation in the National Health Insurance,
Health Planning and Systems Enablement programme has been
reduced by Cabinet by R355.3 million to R884.17 million over the
MTEF period.
7RLPSURYHGDWDFROOHFWLRQDQG¿QDQFLDOPDQDJHPHQWIRUQDWLRQDO
health insurance, the department will be testing diagnosis related
groups as the basis for paying for services provided by central
hospitals. Diagnosis related groups classify hospital cases to
allow hospitals to work within a more predictable and structured
reimbursement system. Diagnosis related groups are used in
most of the developed world for hospital reimbursement, but
the groups have to be adapted for each country, and this is
what the Department of Health will be engaged with over the
28
medium term. R82.1 million over the MTEF period in the National
Health Insurance, Health Planning and Systems Enablement
programme has been earmarked for the diagnosis related group
project.
In addition to the current focus on contracting private health
professionals and developing a new hospital reimbursement
mechanism, the department plans to establish a national health
insurance fund over the medium term to purchase health care
services on behalf of the population. Details of how the fund
will function are being determined and will be set out in the
white paper. Further, provinces will be piloting health system
innovations and reforms, such as strengthening monitoring and
evaluation and supply chain management systems at the district
level, through funds from the national health insurance grant in
the National Health Insurance, Health Planning and Systems
(nablement programme
29
PART B
30
31
Establish ability to access domain services outside the
NDoH premises
Develop an integrated communication strategy and
implementation plan
Develop National Health Litigation Strategy
Fully implement the
Departmental Information
Communication
Technology (ICT) Service
Continuity Plan by the 31st
of March 2018
Provide support for
effective communication by
developing an integrated
communication strategy
and implementation plan
A National Health Litigation
Strategy developed and
fully implemented
Develop and Implement Employee health and wellness
programme that comply with Public Service Regulations
(PSR) and Employee Health and Wellness Strategic
Framework (EHWSF)
Average Turnaround times for recruitment processes
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
1XPEHURISURYLQFHVWKDWVXEPLWUHSRUWVDJDLQVWGH¿QHG
set of non-negotiable items on a monthly basis
(QVXUHHI¿FLHQWDQG
responsive Human
Resource Services through
the implementation of
HI¿FLHQWUHFUXLWPHQW
processes and responsive
Human Resource support
programmes
8QTXDOL¿HGDXGLW 8QTXDOL¿HG
opinion
audit opinions
Audit opinion from Auditor for Provincial Departments
of Health
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
8QTXDOL¿HGDXGLW
opinion
4XDOL¿HGDXGLW
opinions
Audit opinion from Auditor General
2012/13
(QVXUHHIIHFWLYH¿QDQFLDO
management and
accountability by improving
audit outcomes
2011/12
Performance Indicator
Strategic Objective
2013/14
New Indicator
New Indicator
New Indicator
Average
recruitment
process
turnaround time
will be 6 months
8QTXDOL¿HG
audit opinions
9
8QTXDOL¿HG$XGLW
Opinion
Audited/Actual performance
The Medico
-Legal Workshop
and summit held
with Provincial
Departments of
Health, State
Attorney and
other relevant
stakeholders
Integrated
communication
Strategy and
implementation
Plan developed
An approved ICT
Service Continuity
Plan
Average
recruitment
process turnaround
time will be 5
months
9
8QTXDOL¿HGDXGLW
opinions
8QTXDOL¿HG$XGLW
opinion
2014/15
Estimated
perfomance
9
9
The National
Litigation Strategy
developed, and
approved
Implement the
National litigation
strategy
Provincial
Communication
Strategies aligned to
National Integrated
Communication
Strategy
Ability to access all
domain services at
the DR site in event
of a Disaster
Ensure all Senior
Managers of NDoH
are able to access
Domain services at
DR site.
Communication
Toolkit developed to
integrate messages
Ability to recover all
Email Data of NDoH
in the event of a
Disaster
Implementation of
EHW pillars
Average recruitment
process turnaround
time will be 3 months
8QTXDOL¿HGDXGLW
opinions
8QTXDOL¿HG$XGLW
opinion
2016/17
Medium-term targets
Ability to recover all
Email Data of NDoH
in the event of a
Disaster
EHW induction
programme to Port
Health Employees
conducted
Average recruitment
process turnaround
8QTXDOL¿HGDXGLW
opinions
8QTXDOL¿HG$XGLW
opinion
2015/16
The table below summarisess the key strategic objectives, indicators and three-year targets for the various sub-programmes funded from the Administration Programme.
1.1. STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS FOR 2014/15 TO 2016/17
Programme 1: Administration
32
9
Review the National
litigation strategy
Measure the impact
of the Integrated
Communication
Strategy and
Implementation
Plan and review the
Strategy and Plan
ICT Service continuity
plan fully implemented
Monitoring and
evaluation of the EHW
programme
Average recruitment
process turnaround
8QTXDOL¿HGDXGLW
opinions
8QTXDOL¿HG$XGLW
opinion
2017/18
33
5%
Annual
Quarterly
Annual
Quarterly
Bi-annually
Develop and Implement Employee Health and wellness
programme that comply with Public Service Regulations (PSR)
and Employee Health and Wellness Strategic Framework
(EHWSF)
Establish ability to access domain services outside the
National DoH premises
Develop an integrated communication strategy and
implementation plan
Develop National Health Litigation Strategy
Annually
Bi-annually
Average Turnaround times for recruitment processes
Percentage of Senior Managers that have entered into
Performance agreements with their supervisors
The National Litigation Strategy developed and
approved
Annual
1XPEHURISURYLQFHVWKDWVXEPLWUHSRUWVDJDLQVWGH¿QHGVHWRI
non-negotiable items on a monthly basis
1st
2013/14
98%
5.08
The matter tabled for
discussion in the National
Legal Forum
98%
5%
2nd
Research conducted
and concept document
drafted
&RQ¿JXUHWKHGRPDLQ
services
Test recovery of email
data
5%
99 %
5%
The draft document
referred to the
TECH NHC for
recommendation to
NHC
Domain services
established at DR site
Test access to
domain services
3rd
2016/17
Medium-term targets
Quarterly targets
2015/16
Average recruitment
process turnaround time
will be 4 months for all
advertised posts
2014/15
Estimated
perfomance
Enter into a BCM agreement
with SITA for transversal
systems
Ascertain the implications of
duplicating all the existing
domain in a DR site
Procure hardware for Domain
services DR site
94%
4.34%
98% of SMS members timeously concluded
their Performance Agreement and Half-Yearly
Performance Reviews in terms of prescribed DPSA
timeline
Communication Toolkit developed to integrate
messages
Ability to recover all Email Data of NDoH
Ensure all Senior Managers of National DoH are
able to access Domain services at DR site
EHW induction programme to Port Health
Employees conducted
Average recruitment process turnaround time will
be 4 months
9
8QTXDOL¿HGDXGLWRSLQLRQV
Annual
Annual
8QTXDOL¿HG$XGLWRSLQLRQ
Annual target 2014/15
New Indicator
Audit opinion for Provincial Departments of Health
Reporting
period
2012/13
New Indicator
Audit opinion from Auditor General
Performance indicator
QUARTERLY TARGETS FOR 2015/16
New Indicator
Percentage of Senior Managers that have entered into Performance agreements with
their supervisors
2011/12
New Indicator
NDoH vacancy rate
Programme Performance Indicator
4th
2017/18
5%
The National Litigation
Strategy approved.
Domain services at DR
site established and
implemented
Average recruitment
process turnaround
for all advertised posts
100%
5%
The table below provides key programme performance measures that will be under taken by the Department to achieve the strategic objectives provided above. This table also provides three-year
targets for the various sub-programmes funded from the Administration Programme.
1.2 PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS
32 165
311 024
Financial Management
Total
Goods and services
–
6
Inventory: Food and food supplies
–
–
Inventory: Medicine
38
–
–
59
Entertainment
3 327
2 319
Contractors
10 109
2 572
Consultants and professional services: Business and advisory
services
6 518
13 527
Computer services
Communication
527
1 474
19 501
986
4 995
Assets less than the capitalisation threshold
Advertising
Administrative fees
82
191 597
of which:
299 564
107 967
Current payments
Change to 2014
Budget estimate
92 081
2I¿FH$FFRPPRGDWLRQ
145 313
14 185
Corporate Services
27 280
Management
2011/12
Ministry
R thousand
Subprogramme
1
–
6
489
11
–
–
45
78
5 861
14 592
36 296
6 327
10 444
754
797
22 763
962
2 386
187
228 273
133 952
362 225
372 922
83 305
92 978
158 081
13 011
25 547
2012/13
Audited outcome
2
2
7
126
22
2
3 706
15
500
4 822
3 690
3 630
3 672
8 372
1 127
1 115
30 560
811
2 673
160
190 787
149 850
340 637
347 342
54 521
93 532
157 816
13 878
27 595
2013/14
–
1
186
103
–
–
–
287
1 517
11 154
875
3 430
11 222
14 204
916
1 420
26 321
2 071
6 726
188
226 010
156 131
382 141
389 650
51 745
105 825
184 647
16 387
31 046
2014/15
Adjusted
appropriation
1.3 RECONCILING PERFORMANCE TARGETS WITH THE BUDGETS AND THE MTEF
Expenditure trends and estimates by subprogramme and economic classi¿cation
34
Expenditure/
total:
Average (%)
–
–
69.8%
158.0%
–
–
–
69.4%
-13.2%
49.7%
-55.8%
10.1%
19.9%
1.6%
20.2%
-1.2%
10.5%
28.1%
10.4%
31.9%
5.7%
13.1%
8.5%
7.8%
17.2%
4.7%
8.3%
4.9%
4.4%
–
–
–
0.1%
–
–
0.3%
–
0.3%
1.8%
2.1%
3.2%
2.0%
3.3%
0.2%
0.3%
7.0%
0.3%
1.2%
–
58.9%
38.6%
97.4%
100.0%
15.6%
27.1%
45.5%
4.0%
7.8%
2011/12 - 2014/15
Average
growth
rate (%)
–
1
194
108
–
–
9 000
300
2 632
13 930
915
3 285
13 817
14 289
1 018
1 485
32 000
1 828
12 148
197
270 360
177 115
447 475
30 632
457 078
66 243
125 810
213 467
19 641
31 917
2015/16
–
–
–
536
–
–
–
49
891
20 479
970
4 629
12 965
18 231
881
877
30 039
1 109
5 078
188
263 418
185 933
449 351
6 221
455 958
61 295
137 547
204 514
20 177
32 425
2016/17
Medium-term expenditure
estimate
–
–
–
100
–
–
2 300
–
400
10 000
7 000
4 135
6 000
15 914
1 000
2 000
35 200
900
900
200
289 979
195 207
485 186
17 488
492 052
65 095
154 053
218 046
21 048
33 810
2017/18
Expenditure/
total:
Average (%)
–
-100.0%
-100.0%
-1.0%
–
–
–
-100.0%
-35.9%
-3.6%
100.0%
6.4%
-18.8%
3.9%
3.0%
12.1%
10.2%
-24.3%
-48.9%
2.1%
8.7%
7.7%
8.3%
8.1%
8.0%
13.3%
5.7%
8.7%
2.9%
–
–
–
–
–
–
0.6%
–
0.3%
3.1%
0.5%
0.9%
2.5%
3.5%
0.2%
0.3%
6.9%
0.3%
1.4%
–
58.5%
39.8%
98.3%
100.0%
13.6%
29.2%
45.7%
4.3%
7.2%
2014/15 - 2017/18
Average
growth
rate (%)
35
1 470
4 609
4 185
–
424
Health and Welfare Sector Education and Training Authority
Public Service Sector Education and Training Authority
424
Current
Departmental agencies (non-business entities)
4 185
(PSOR\HHVRFLDOEHQH¿WV
1.2%
311 024
308
Current
Social bene¿ts
Households
Details of transfers and subsidies
expenditure to vote expenditure
Proportion of total programme
Total
Payments for ¿nancial assets
61
6 482
4 185
6 543
Households
424
2 510
Operating payments
2 850
17 628
3 732
Property payments
89 425
6 974
–
968
2011/12
Operating leases
Consumable supplies
R thousand
Subprogramme
–
479
479
136
136
1.3%
372 922
4 688
–
5 394
5 394
136
479
615
581
2 296
2 376
20 888
9 554
82 670
7 622
–
287
2012/13
Audited outcome
50
1 259
1 309
732
732
1.1%
347 342
506
–
4 158
4 158
732
1 309
2 041
342
3 147
3 472
15 415
11 374
83 940
7 859
224
–
2013/14
71
1 326
1 397
–
–
1.1%
389 650
–
–
6 112
6 112
–
1 397
1 397
1 257
3 931
5 437
14 506
5 563
102 905
10 984
–
806
2014/15
Adjusted
appropriation
–
46.2%
48.8%
-100.0%
-100.0%
–
7.8%
-100.0%
-100.0%
-1.9%
-2.2%
-100.0%
48.8%
-32.8%
-5.1%
16.1%
24.0%
-6.3%
14.2%
4.8%
16.3%
–
-5.9%
–
0.2%
0.3%
0.4%
0.4%
–
100.0%
0.4%
–
1.6%
1.6%
0.4%
0.3%
0.6%
0.3%
0.8%
1.0%
4.8%
2.1%
25.3%
2.4%
–
0.1%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
–
1 969
1 969
–
–
1.3%
457 078
–
–
7 634
7 634
–
1 969
1 969
1 376
5 342
4 699
15 413
8 819
119 954
10 629
–
844
2015/16
–
2 075
2 075
–
–
1.2%
455 958
–
–
4 532
4 532
–
2 075
2 075
761
1 542
3 030
20 749
9 610
127 317
11 041
–
312
2016/17
estimate
–
2 179
2 179
–
–
1.2%
492 052
–
–
4 687
4 687
–
2 179
2 179
400
7 000
6 520
23 147
23 000
134 453
10 310
200
–
2017/18
-100.0%
18.0%
16.0%
–
–
–
8.1%
–
–
-8.5%
-8.5%
–
16.0%
16.0%
-31.7%
21.2%
6.2%
16.9%
60.5%
9.3%
-2.1%
–
-100.0%
–
0.4%
0.4%
–
–
–
100.0%
–
–
1.3%
1.3%
–
0.4%
0.4%
0.2%
1.0%
1.1%
4.1%
2.6%
27.0%
2.4%
–
0.1%
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
37
–
–
–
–
–
37
56
160
253
506
Number
Actual
34.0
28.3
48.9
38.7
149.9
Cost
2013/14
0.9
0.5
0.3
0.2
0.3
Unit
Cost
30.3
39.9
41
2. Rand million.
45.9
40.0
156.1
Cost
49
133
245
468
Number
2014/15
1.0
0.6
0.3
0.2
0.3
Unit
Cost
Revised estimate
41
49
133
245
468
Number
45.0
34.5
52.2
45.5
177.1
Cost
2015/16
1.1
0.7
0.4
0.2
0.4
Unit
Cost
41
49
133
245
468
Number
47.2
36.2
54.8
47.7
185.9
Cost
2016/17
1.2
0.7
0.4
0.2
0.4
Unit
Cost
41
49
132
245
467
Number
1. Data has been provided by the department and may not necessarily reconcile Zith of¿cial government personnel data.
13 – 16
7 – 10
45
139
1–6
11 – 12
458
237
Salary level
Administration
Number of posts
additional to
the establishment
31 March 2014
Personnel information
36
49.6
38.0
57.5
50.1
195.2
Cost
2017/18
1.2
0.8
0.4
0.2
0.4
Unit
Cost
–
–
-0.3%
–
-0.1%
8.8%
10.5%
28.4%
52.4%
100.0%
2014/15-2017/18
Salary
level/total:
Average (%)
Number
Average
growth
rate (%)
PROGRAMME 2: NATIONAL HEALTH INSURANCE, HEALTH PLANNING AND SYSTEMS ENABLEMENT
2.1 Programme Purpose
Improve access to quality health services through the
development and implementation of policies to achieve universal
FRYHUDJH KHDOWK ¿QDQFLQJ UHIRUP LQWHJUDWHG KHDOWK V\VWHPV
planning, reporting, monitoring and evaluation and research.
7KHUHDUH¿YHEXGJHWVXESURJUDPPHV
Technical Policy and Planning provides advisory and strategic
technical assistance on policy and planning, and supports policy
DQDO\VLV DQG LPSOHPHQWDWLRQ FRPPLVVLRQV KHDOWK ¿QDQFLQJ
research including , oversees research into alternative healthcare
¿QDQFLQJ PHFKDQLVPV IRU DFKLHYLQJ XQLYHUVDO KHDOWK FRYHUDJH
develops policy for the medical schemes industry and provides
technical oversight over the Council for Medical Schemes;
Health Information Management, Monitoring and Evaluation
subprogramme develops and maintains a national health
information system, commissions and coordinates research,
develops and implements disease surveillance programmes, and
monitors and evaluates strategic health programmes.
The eHealth Strategy was adopted by National Health Council
and provides the roadmap for achieving a well-functioning
national health information system with the patient located at
the centre. The strategy also seeks to ensure that the integrated
national patient-based information system will be based on
DJUHHG VFLHQWL¿F VWDQGDUGV IRU LQWHURSHUDELOLW\ ZKLFK LPSURYHV
WKHHI¿FLHQF\RIFOLQLFDOFDUHSURGXFHVWKHLQGLFDWRUVUHTXLUHGE\
management, and facilitates patient mobility.
Health Research in South Africa has been prioritised with a
strategic framework for health research being developed. The
Research Summit which was convened in 2011 adopted seven
(7) themes as the main priorities for action by all key stakeholders
in the public health sector namely: Funding ; Human Resources;
Health Research Infrastructure; Priority Research Fields;
National Regulatory Framework; Planning and Translation; and
Monitoring and Evaluation. One of the key outputs expected is
the establishment of a Research Observatory for South Africa.
)XUWKHUEXLOGLQJRQWKH¿QGLQJVRIWKH1DWLRQDO5HVHDUFK(WKLFV
Audit (2012), the Department will continue to audit research
ethics committees (human and animal) and to ensure that
ethical research is conducted in the country while supporting
good governance of all Research Ethics Committees (RECs)
nationally.
The two statutory bodies that are pivotal in creating a conducive
environment for health research in South Africa are the National
Health Research Committee and the National Health Research
Ethics Council. They derive their mandate from the National
Health Act, 61 of 2003, Chapter 9. There are two other institutions
that drive the research agenda , the MRC which is a public entity
and HST which is a NGO.
Sector-wide Procurement sub programme is responsible for
developing systems to ensure access to essential pharmaceutical
commodities. This is achieved through the selection of essential
medicines, development of standard treatment guidelines,
administration of health tenders, licensing of persons and
premises that deliver pharmaceutical services and related
policies.
The Essential Medicines List (EML) and Standard Treatment
Guidelines (STGs) are available for all levels of care and
published on a 3 year cycle. These tools are used to promote
access to affordable medicines that are safe and effective at the
relevant level of care in both the public and private sector. Each
chapter is disseminated for peer review by relevant stakeholders
prior to publication. The EML and STGs are published in book,
web and cell phone application formats in order to improve
acceptability by health care professionals.
The Department of Health develops a procurement plan to
ensure valid contracts are available for the procurement of
essential medicines and pharmaceutical commodities. Prior to
the issue of a contract, market intelligence is undertaken in order
to facilitate the most economic tender and promote security of
supply. Supplier performance is monitored and used to exclude
poorly performing suppliers from participation in future tenders.
Bar code technologies are being implemented to improve the
HI¿FLHQFLHVRIWKHVXSSO\FKDLQ
Medicines availability - a network of linked stock system will
be established throughout the supply chain value chain to
improve availability. In order to simplify the supply chain and
its responsiveness direct deliveries are being implemented to
central and regional hospitals.
37
The National Department of Health maintains a buffer stock of
vital medicines at the central procurement unit for deployment in
the event of stock shortages.
In order to improve access, a system of central chronic medicines
dispensing and distribution service providers linked to pick up
points have been established in order improve access through
extended service hours and closer proximity to the patient’s
place of residence or work.
Permits are issued to various health care professionals in order
to promote access to medicines in a manner that maintains
safety of patients.
The Traditional Health Practitioners interim council (ITHPC) has
been established and systems developed to manage knowledge
of African Traditional Medicines.
Health Financing and National Health Insurance develops
and implements policies, legislation and frameworks for the
achievement of universal health coverage through the phased
implementation of National Health Insurance; commissions
KHDOWK ¿QDQFLQJ UHVHDUFK LQFOXGLQJ LQWR DOWHUQDWLYH KHDOWKFDUH
¿QDQFLQJ PHFKDQLVPV IRU DFKLHYLQJ XQLYHUVDO KHDOWK FRYHUDJH
develops policy for the medical schemes industry and provide
technical oversight over the Council for Medical Schemes;
and provides technical and implementation oversight for the
two national health insurance conditional grants. The cluster
also comprises the Directorate for Pharmaceutical Economic
Evaluation, which implements the single exit price regulations,
including policy development and implementation initiatives in
terms of dispensing and logistical fees. Over the medium term,
the initiatives implemented through the pilot districts will be
expanded to improve access and quality health care. In 2012/13
and 2013/14,a draft white paper for the National Health Insurance
and a draft National Health Insurance bill were developed. The
Minister of Health conducted road-shows involving a range of
stakeholders in each of the National Health Insurance districts.
The White Paper on the National Health Insurance will be tabled
in Parliament, legislation further developed and regulations
developed and implemented in the coming years.
International Health and Development sub programme
develops and implements bilateral and multilateral agreements
with strategic partners such as the Southern African Development
Community (SADC), the African Union (AU), United Nations (UN)
agencies as well as other developing countries and emerging
economic groupings such as Brazil-Russia-India-ChinaSouth Africa (BRICS) and IBSA (India, Brazil South Africa)
to strengthen the health system and coordinates international
development support.
7KHVSHFL¿FUROHVRIWKHEUDQFKLQFOXGHFRRUGLQDWHDQGIDFLOLWDWH
South-South partnerships and collaboration, ensuring effective
DQG HI¿FLHQW ZHOOFRRUGLQDWHG DQG UHVSRQVLYH SDUWQHUVKLSV DQG
collaborations with Africa and Middle East countries, mobilisation
RI KHDOWK WHFKQLFDO DQG ¿QDQFLDO UHVRXUFHV IURP LQWHUQDWLRQDO
GHYHORSPHQW DJHQFLHV DQG LQWHUQDWLRQDO ¿QDQFLDO LQVWLWXWLRQV
facilitation and coordination of the implementation of health
related outcomes of the African Union Commission to meet the
targets essential for Africa’s Renewal and achievement of the
African Agenda, and effective management of the deployment
of Health Attaches.
Over the medium term, and in line with NDP 2030, the cluster
will mobilise resources for national and regional health activities;
establish strategic bilateral cooperation, especially with BRICS
countries as well as other countries on the continent in areas of
PXWXDODQGPHDVXUDEOHEHQH¿WWKHUHE\PHHWLQJRXUREOLJDWLRQV
LQ1(3$'WRHQJDJHLQSRVWFRQÀLFWUHFRQVWUXFWLRQDQGGLVHDVHV
and emergencies in Africa; facilitate participation in various
multilateral and other global engagements such as AU, SADC,
WHO, UN and BRICS; implement cross border initiatives
to manage cross border care and enhance harmonisation
of regulations, treatment guidelines and policies; improved
management and related capacity of Health Attachés to identify
and analyse emerging issues and trends in global health; and
establishment of global health dialogue forums with other
stakeholders on intersectoral issues such as climate change,
trade and foreign policy.
South Africa is signatory to a number of international treaties
and instruments such as International Health Regulations
(2005), Framework Convention on Tobacco Control (FCTC),
including other human rights conventions such as International
Covenant on Civil and Political Rights, International Convention
on the Elimination of All Forms of Racial Discrimination, African
Charter on Human and Peoples’ Rights and the SADC Protocol
on Health. Furthermore, South Africa has supported adoption
of some important international reports and resolutions such
as WHO Action Plan for the prevention of avoidable blindness
and visual impairment, follow-up actions to recommendations
of the high-level commissions convened to advance women’s
and children’s health, Follow-up of the report of the Consultative
Expert Working Group on Research and Development: Financing
and Coordination, patient safety and Global strategy to reduce
the harmful use of alcohol, Abuja Call for Action and Maseru
Declaration on HIV and AIDS. As such, the cluster will accelerate
the domestication and implementation of these treaties and
resolutions in this mid-term cycle.
38
39
A discussion paper on
revenue retention models
developed and presented
to NHC and Financial and
Fiscal Committe (FFC)
,GHQWL¿HGWZR
provinces (WC and
FS) that have existing
Revenue Retention
Models.
Develop and implement a Revenue
Retention Model (RRM) at central
hospitals
New Indicator
New Indicator
New Indicator
New indicator
Strengthen Revenue
collection by
incentivising hospitals
to maximise revenue
generation.
New indicator
Implement the RRM at 4
Central Hospitals
Staff for Council for Traditional
Practitioners appointed
Antimicrobial stewardship
3ROLF\LGHQWL¿HGLQ$05
strategy developed and
implemented
Appointment of the MAC
Council for Traditional
Practitioners and Registrar
appointed
100% pharmaceutical and
medical related tenders
awarded at least 8 weeks prior
to expiration of outgoing tender
750,000 patients
Control towers implemented in
North West and KZN DoH
National surveillance centre
functional and reporting stock
availability at 10 Central,17
Tertiary hospitals and 46
regional hospitals., and 1800
PHC facilities..
Electronic stock management
system functional in 1800 PHC
facilities.
system implemented and
functional at 21 regional
hospitals and 50 district
hospitals
NHI fund created and
arrangements for the
contracting and purchasing of
GH¿QHGVHUYLFHVLQLWLDWHG
Publication of legislation and
regulations
2016/17
Medium-term targets
100% pharmaceutical
tenders awarded at least 8
weeks prior to expiration of
outgoing tender
500,000 patients
Interim Council
for Traditional
Practitioners
established and meets
quarterly
New indicator
Approved National
AMR Strategy
ARV Tender awarded
3 months prior to
expiry
200,000 patients
Control towers
implemented in Free State
and Eastern Cape
National surveillance
centre functional and
reporting stock availability
at 10 central hospitals, and
1200 PHC facilities.
Electronic stock
management system
functional in 1200 PHC
facilities.
Electronic stock
management system
implemented and functional
at 10 central hospitals. and
17 Tertiary hospitals and 25
regional hospitals.
Funding Modality for the
National Health Insurance
developed Fund including
budget reallocation for the
district primary health care
Finalise and publish White
Paper on NHI
Publication of White Paper
2015/16
Establish Council for Traditional
Practitioners
New indicator
New indicator
New indicator
Control towers have
been established
in Limpopo and
Gauteng.
Business plan for the
a national surveillance
centre developed
Electronic stock
management system
facilities
Electronic system
developed
Draft conceptual
document prepared
Draft White Paper
on NHI
Draft White Paper
on NHI
2014/15
Regulate African
Traditional
Practitioners
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
Draft document
outlining the
proposed
structure of
the NHI Fund
prepared
Draft White Paper
on NHI
Draft White Paper
on NHI
2013/14
Implementation plan for
AMR strategy developed
New indicator
Contracts are available at least 8 weeks
prior to expiration of outgoing tender
New indicator
New indicator
Number of patients receiving medicines
through the centralised chronic
medicine dispensing & distribution
system
New indicator
New indicator
New indicator
New indicator
New Indicator
Draft White
Paper on NHI
Green Paper
on NHI
2012/13
Implement the National AMR strategy
New indicator
New indicator
Establish a national surveillance centre
to monitor medicine availability
Establish Provincial Control Towers for
the management of direct delivery of
medicines
New indicator
Implement an Electronic system for
the early detection of stock outs of
medicines at PHC Facilities
New Indicator
Establishment of the National Health
Insurance Fund
New indicator
Green Paper for
NHI published
for comment
Legislation for NHI
medicines at hospitals
Green Paper
on NHI
2011/12
White Paper on NHI
Estimated
performance
Implement the
Strategy to address
antimicrobial
resistance (AMR)
Improve contracting
and supply of
medicines
Establish A national
stock management
surveillance centre
to improve medicine
availability
Achieve Universal
Health Coverage
through the phased
implementation of
the National Health
Insurance(NHI)
Strategic Objective
Implement the RRM at 7
Central Hospitals
Not Applicable
Surveillance system monitoring
resistance developed
100% pharmaceutical tenders
and medical related tenders are
awarded at least 8 weeks prior
to expiration of outgoing tender
1,000.000 patients
Control towers implemented in
Mpumalanga DoH
functional and reporting stock
availability at 10 Central,17
Tertiary, 46 regional and 100
District hospitals., and 2400
PHC facilities..
facilities
system implemented and
Functional at 100 District
Hospitals
NHI fund purchasing services
and the scope of services
purchased expanded
Publication of legislation and
regulations
2017/18
The table below summarises the key strategic objectives, indicators and three-year targets for the various budget sub-programmes funded from the National Health Insurance, Health Planning and
Systems Enablement.
2.2 STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS FOR 2014/15 TO 2016/17
40
Develop a complete System
design for a National
Integrated Patient based
information system
Implement eHealth
Strategy of South Africa
through the development
of the system design
of patient information
systems and implantation
National health research plan
developed and implemented
Integrated
monitoring and
evaluation plan implemented
number of International
treaties and multilateral
frameworks implemented
Number of Bilateral projects
implemented
Develop and implement
a national research
strategic plan
Develop and
implement an integrated
monitoring and
evaluation plan aligned
to health outcomes and
outputs contained in the
Health Sector Strategy
Domestication of
international treaties
and Implementation of
multilateral cooperation
on areas of mutual and
PHDVXUDEOHEHQH¿W
Implementation of
bilateral cooperation
on areas of mutual and
PHDVXUDEOHEHQH¿W
Number of health facilities
implementing improved
patient administration and
web based information
systems
Strategic Objective
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
Draft components
of the monitoring
and evaluation
systems are
implemented and
maintained. This
includes the NSDA
M&E plan
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
2012/13
New Indicator
2011/12
New indicator
New Indicator
Monitoring and
evaluation plan
for health was
revised
Draft Concept
paper for the
establishment
of the National
Health Research
Observatory
New Indicator
New Indicator
Normative
Standards
for eHealth
developed and
approved
2013/14
Two strategic bilateral
projects implemented
International treaties
and multilateral
frameworks
implemented
Monitoring and
evaluation plan for
health developed
Draft national research
plan developed
50 PHC Facilities
implementing
improved patient
administration and
systems
698 PHC Facilities
received required
IT Hardware for
the reference
implementation of the
eHealth Programme
Basic Health
Information Exchange
architecture
conceptualised
2014/15
Estimated
performance
Medium-term targets
Five strategic bilateral
Three International treaties
and multilateral frameworks
implemented
At least one national
evaluation conducted
Data collections systems
established for revised
indicators list
)XOO\GH¿QHG
comprehensive list of
indicators and data
elements approved
Seven strategic bilateral
Four International treaties
implemented
At least one national evaluation
conducted
Costed National Health
Research implementation plan
implemented
Additional 1400 PHC Facilities
implementing improved patient
administration and web based
information systems
Additional 1400 PHC
Facilities received required IT
Hardware for the reference
implementation of the eHealth
Programme
System , Technology and
Data architecture developed
and incorporated into the
Health Information Exchange
for integrating Patient Based
Information Systems
2016/17
National Health Research
strategic plan approved
Additional 700 Facilities
patient administration and
systems
Additional 1400 PHC
Facilities received required
IT Hardware for the
reference implementation
of the eHealth Programme
Basic Health Information
Exchange developed
to conduct a reference
implementation of eHealth
interoperability norms and
standards
2015/16
Eight strategic bilateral projects
implemented
Four International treaties
implemented
At least two national
evaluations conducted (on
health programme and health
systems)
Monitoring & Evaluation system
strengthened
National Health Research
priority research evidence
generated
Additional 1400 PHC Facilities
information systems
-
System , Technology, and Data
architectures integrated for
a National Integrated Patient
Based Information System
developed
2017/18
New indicator
New indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
9 Provincial
APPs reviewed
and feedback
provided
New Indicator
New Indicator
Develop Regulations pertaining to Uniform Patient Fee Schedule
(UPFS)
Develop a Central Repository for the funded and unfunded
patients
Percentage of the review process of the PHC Essential
Medicines List (EML) and Standard treatment Guidelines (STGs)
completed
Percentage of the review process of the Hospital Level Paediatric
Essential Medicines List (EML) and Standard treatment
Guidelines (STGs) completed
Percentage of the review process of the Hospital Level Adult
Essential Medicines List (EML) and Standard treatment
Number of medicines reviews conducted for the Tertiary and
Quaternary EML
Number of Provincial Annual Performance Plans (APPs) aligned
to the National Health System Priorities
Implement Patient Quality of care survey tool
Conduct a National Survey to measure Patient Quality of Care
New Indicator
New Indicator
9 Provincial
APPs reviewed
and feedback
provided
New Indicator
100%
50%
20%
New Indicator
New indicator
New indicator
New indicator
New indicator
Publish and Implement Single Exit Price Adjustments (SEPA)
Annually
Review Criteria for the approval of Pharmacy Licences
New indicator
2012/13
New indicator
2011/12
Review Annual dispensing fee.
New Indicator
New Indicator
9 Provincial
APPs reviewed
and feedback
provided
New Indicator
20%
100%
50%
New Indicator
New indicator
New indicator
New indicator
New indicator
2013/14
New Indicator
Patient Quality of care
survey protocol and tool
developed
9 Provincial APPs
reviewed and feedback
provided
12 reviews
50%
20%
100%
Develop the
VSHFL¿FDWLRQVRIWKH
Central Repository in
collaboration with CMS.
UPFS regulations
drafted
Criteria for the approval
of Pharmacy Licences
drafted
Implementation of the
gazette 2014/15 Annual
Price Adjustment
Systematic survey for
the dispensing fee
completed for 2015/16
cycle
Estimated
performance
2014/15
A national survey
conducted to measure
patient quality of care at
all PHC Facilities
Patient Quality of care
survey tool tested and
piloted
9 Provincial APPs
provided to ensure
APPs and DHPs sector
plans are aligned to the
National Health System
(NHS) Priorities
12 reviews
100%
50%
20%
A repository containing
funded patients
established by Council
for Medical Schemes
UPFS regulations
gazetted and
implemented
Criteria for the
approval of Pharmacy
OLFHQFHVDUH¿QDOLVHG
and published for
implementation
Price Adjustment
Review of the 2015/16
dispensing fee in
determining the 2016/17
maximum dispensing
fee
2015/16
Patient Quality of care survey
tool reviewed
A evaluation of Patient Quality
of Care conducted
A national survey conducted
to measure patient quality of
care at all Hospitals
9 Provincial APPs reviewed
and feedback provided to
ensure health sector plans are
aligned to the National Health
System (NHS) Priorities
12 reviews
50%
20%
100%
funded and unfunded patients
operational
UPFS regulations
implemented
Not Applicable
gazette 2017/18 Annual Price
Adjustment
dispensing fee in determining
the 2018/2019 maximum
dispensing fee
2017/18
Patient Quality of care survey
tool fully implemented
9 Provincial APPs reviewed
and feedback provided to
ensure health sector plans are
aligned to the National Health
System (NHS) Priorities
12 reviews
20%
100%
50%
A repository containing funded
patients integrated with Health
Patient Registration System
UPFS regulations
implemented
Criteria for the approval
of Pharmacy licenses
Implemented
gazette 2016/17 Annual Price
Adjustment
dispensing fee in determining
the 2017/2018 maximum
dispensing fee
2016/17
Medium-term targets
The table below provides key programme performance measures that will be under taken by the Department to achieve the strategic objectives provided above. This table also provides three-year
targets for the various sub-programmes funded from Programme 2.
41
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Establish Provincial Control Towers
for the management of direct delivery
of medicines
Number of patients receiving
medicines through the centralised
chronic medicine dispensing &
distribution system
Contracts are available at least 8
weeks prior to expiration of outgoing
tender
Implement the National AMR strategy
Establish Council for Traditional
Practitioners
Develop and implement a Revenue
Retention Model (RRM) at central
hospitals
Quarterly
Establish a national surveillance
centre to monitor medicine availability
Quarterly
Establishment of the National Health
Insurance Fund
Quarterly
Annual
White Paper on NHI
medicines at PHC Facilities
Reporting period
A discussion paper on revenue retention
models developed and presented to NHC
and FFC`
Council for Traditional Practitioners and
Registrar appointed
Implementation plan for AMR strategy
developed
Appointment of the (MAC) Ministerial Advisory
Commitee
100% pharmaceutical tenders awarded at
least 8 weeks prior to expiration of outgoing
tender
500,000 patients
Control towers implemented in Free State and
Eastern Cape DoH
National surveillance centre functional and
reporting stock availability at 10 central
hospitals, and 1200 PHC facilities.
Electronic stock management system
functional in 1200 PHC facilities.
implemented and functional at 10 central
hospitals
and 17 Tertiary hospitals and 25 regional
hospitals.
Funding Modality for the National Health
Insurance Fund including budget reallocation
for the district primary health care
Finalise and publish White Paper on NHI
Conduct a comparative
analysis of the WC and
FS Revenue Retention
Model
Advert placed for
appointment of
Practitioners and
Registrar
Development of terms
of reference.
Implementation plan
for AMR strategy
approved
100% of contract
expiring in Q1 have
been renewed at
least 8 weeks prior to
expiration.
275 000 patients
Project plan of the roll
out of control tower
developed for Eastern
Cape and Free State
DoH.
Business Plan for
centre developed and
approved
Electronic stock
management system
facilities.
Site assessments have
been completed for all
10 central hospitals,
None
1
st
Quarterly meeting
Finalise the discussion
paper by incorporating
comments from CFOF,
NHCC and PTS
Develop a discussion paper on
WKH¿QGLQJVRIWKH:&DQG)6
models, and present it to the
&KLHI)LQDQFLDO2I¿FHUV)RUXP
(CFOF), National Hospital
Coordinating Committee
(NHCC), and Consult with the
Financial and Fiscal Committee
(FFC)
Quarterly meeting of the
MAC
100% of contract expiring
in Q1 have been renewed
at least 8 weeks prior to
expiration.
425 000 patients
Control towers in Free State
Established
functional and tracking stock
availability at 10 central
hospitals,
Electronic stock
management system
facilities.
Electronic stock
management system
implemented and functional
at 10 central and 17 Tertiary
hospitals
Practitioners and Registrar
appointed
Implementation plan for AMR
strategy approved
Appointment of the MAC
100% of contract expiring in Q1
have been renewed at least 8
weeks prior to expiration.
350 000 patients
Control towers in Eastern Cape
Established
capacitated
facilities.
Site assessments have been
completed for 17 Tertiary
hospitals and 25 regional
hospitals.
Project Team created and
appointed
3rd
Quarterly targets
Funding modality for the creation
of the NHI Fund Project Team
determined and mobilised
2
nd
The reporting period for Most indicators under Programme 2 are annual, however where possible quarterly targets are provided for annual indicators
2.4 QUARTERLY TARGETS FOR 2015/16
42
the discussion paper presented at NHC
for approval
Quarterly meeting
Quarterly meeting of the MAC
100% of contract expiring in Q1 have
been renewed at least 8 weeks prior to
expiration.
500 000 patients
Control towers in Free State and
Eastern Cape DoH established and
Fully functional (delivering at least 70%
of their line items)
National surveillance centre functional
and tracking stock availability at 1200
PHC facilities.
functional in 1200 PHC facilities.
implemented and functional at 25
Regional hospitals
Funding Modality for the National
Health Insurance Fund including
EXGJHWUHDOORFDWLRQIRUDGH¿QHGVHWRI
personal health services developed
4th
43
Annual
Annual
Quarterly
Annual
Quarterly
Quarterly
Annual
Percentage of the review process
of the Hospital Level Paediatric
Essential Medicines List (EML) and
Standard treatment Guidelines (STGs)
completed
of the Hospital Level Adult Essential
Medicines List (EML) and Standard
treatment Guidelines (STGs)
completed
Number of medicines reviews
conducted for the Tertiary and
Quaternary EML
Develop System design for a National
Integrated Patient based information
system
Number of PHC health facilities with
required IT Hardware for the reference
implementation eHealth project
Number of health facilities
information systems
Integrated
monitoring and
evaluation plan implemented
Annual
Develop Regulations pertaining to
Uniform Patient Fee Schedule (UPFS)
Annual
Quarterly
Review Criteria for the approval of
Pharmacy Licences
of the PHC Essential Medicines
List (EML) and Standard treatment
Quarterly
Publish and Implement Single Exit
Price Adjustments Annually
Quarterly
Annual
Review Annual dispensing fee.
Develop a Central Repository for the
funded and unfunded patients
Reporting period
At least one national evaluation conducted
)XOO\GH¿QHGFRPSUHKHQVLYHOLVWRILQGLFDWRUV
and data elements approved
Additional 700 Facilities implementing
improved patient administration and web
based information systems
Additional 1400 PHC Facilities received
required IT Hardware for the reference
implementation of the eHealth Programme
Basic Health Information Exchange developed
to conduct a reference implementation of
eHealth interoperability norms and standards
12 reviews
100%
50%
20%
A repository containing funded patients
established by Council for Medical Schemes
UPFS regulations
Criteria for the approval of Pharmacy licences
DUH¿QDOLVHGDQGSXEOLVKHGIRULPSOHPHQWDWLRQ
Implementation of the gazette 2015/16 Annual
Price Adjustment
Review of the 2015/16 dispensing fee in determining the 2016/17 maximum dispensing fee
QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS
175 Facilities
implementing
improved patient
administration and
systems
350 PHC Facilities
receiving new IT
Hardware
Shared infrastructure
to host Health
established
3 reviews
Consultation with
Council for Medical
Schemes
Review of the Criteria
for the approval of
Pharmacy licences
published for
comments
SEPA adjustment for
2015.
1st
Criteria for the approval of
Pharmacy licences reviewed
based on comments
Finalisation of methodology
and application.
3rd
Quarterly targets
175 Facilities implementing
improved patient administration
and web based information
systems
350 PHC Facilities’ receiving
new IT Hardware
Exchange developed
3 reviews
175 Facilities implementing
improved patient
administration and web
based information systems
350 PHC Facilities’ receiving
new IT Hardware
Exchange Tested
3 reviews
User Requirement
6SHFL¿FDWLRQVGHYHORSHGIRUWKH funded patients receiving
central repository
patient data from one
medical scheme
None –
Criteria open for public
comments
Publication of methodology for
comment.
2nd
175 Facilities implementing improved
patient administration and web based
information systems
350 PHC Facilities receiving new IT
Hardware
Basic Health Information Exchange
implemented
3 reviews
A repository containing funded patients
functional
Criteria for the approval of Pharmacy
OLFHQFHVDUH¿QDOLVHGDQGSXEOLVKHGIRU
implementation
Recommendation of SEP adjustment
to Minister and publication of approved
SEP Adjustment.
4th
Annual
Implement International treaties and
multilateral frameworks
Annual
A national survey conducted to measure
patient quality of care at all PHC Facilities
Annual
Conduct a National Survey to measure Patient
Quality of Care
Number of Bilateral projects implemented
Patient Quality of care survey tool tested
and piloted
Annual
Implement Patient Quality of care survey tool
Five strategic bilateral projects implemented
Three International treaties and multilateral
frameworks implemented
9 Provincial APPs reviewed and feedback
provided to ensure health sector plans
are aligned to the National Health System
(NHS) Priorities
Annual
Number of Provincial Annual Performance
Plans (APPs) aligned to the National Health
System Priorities
Reporting period
QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS
44
1st
2nd
3rd
Quarterly targets
4th
45
39 807
51 246
Health Financing and National Health Insurance
International Health and Development
512
11
–
–
–
3
Inventory: Farming supplies
2 076
732
23
1
2 487
Entertainment
Contractors
&RQVXOWDQWVDQGSURIHVVLRQDOVHUYLFHV6FLHQWL¿FDQGWHFKQRORJLFDOVHUYLFHV
Consultants and professional services: Business and advisory services
48 403
Communication
Computer services
104
408
97
2 571
280
101 941
65 503
167 444
Advertising
Administrative fees
of which:
Goods and services
Current payments
Change to 2014 (Budget estimate)
182 212
15 569
Sector-wide Procurement
Total
14 581
58 015
Health Information Management, Monitoring and Evaluation
2 994
7
8
4
–
15
5 331
68
13
–
2 672
208
1 081
603
102
356
894
464
59 526
81 779
141 305
315 388
52 951
166 377
19 838
49 973
24 856
1 393
2012/13
Audited outcome
2011/12
Technical Policy and Planning
Programme Management
R thousand
Subprogramme
1.4. Reconciling Performance targets with the Budget and MTEF
6
16
–
1 973
39
789
5 106
30
–
9 823
181
713
434
–
391
768
21
69 149
85 612
154 761
222 556
64 298
76 029
20 817
44 355
16 704
353
2013/14
2
–
–
–
184
2 793
395 847
–
32 500
14 562
2 119
888
679
–
970
1 244
243
491 746
78 662
570 408
6 904
658 939
52 257
487 210
22 987
71 496
23 342
1 647
2014/15
Adjusted
appropriation
-12.6%
–
–
–
155.7%
10.4%
714.7%
-100.0%
3091.3%
80.2%
-64.8%
20.1%
18.5%
-100.0%
115.4%
-21.5%
-4.6%
69.0%
6.3%
50.5%
53.5%
0.7%
130.5%
13.9%
7.2%
17.0%
-18.1%
Average
growth
rate (%)
–
–
–
0.1%
–
0.8%
29.1%
–
2.4%
2.1%
3.7%
0.2%
0.2%
–
0.1%
0.4%
0.1%
52.4%
22.6%
75.0%
100.0%
16.0%
55.8%
5.7%
16.2%
5.8%
0.5%
2011/12 - 2014/15
Expenditure/
total:
Average (%)
2
–
–
4 000
193
3 421
321 892
–
6 343
2 405
2 539
928
710
–
1 015
1 300
253
392 080
96 077
488 157
(43 573)
587 807
63 521
414 388
29 729
57 280
19 869
3 020
–
–
–
1 000
17
2 273
293 019
–
18 173
3 349
66
1 118
556
–
469
1 215
133
371 710
101 360
473 070
(85 421)
576 608
68 464
390 017
30 401
59 233
25 306
3 187
2016/17
–
–
–
4 200
–
800
383 564
–
20 521
7 800
200
700
400
–
400
600
–
466 649
106 484
573 133
(19 957)
682 145
70 928
486 362
32 036
62 403
27 071
3 345
2017/18
2015/16
Expenditure/
total:
Average (%)
-100.0%
–
–
–
-100.0%
-34.1%
-1.0%
–
-14.2%
-18.8%
-54.5%
-7.6%
-16.2%
–
-25.6%
-21.6%
-100.0%
-1.7%
10.6%
0.2%
1.2%
10.7%
-0.1%
11.7%
-4.4%
5.1%
26.6%
–
–
–
0.4%
–
0.4%
55.7%
–
3.1%
1.1%
0.2%
0.1%
0.1%
–
0.1%
0.2%
–
68.7%
15.3%
84.0%
100.0%
10.2%
71.0%
4.6%
10.0%
3.8%
0.4%
2014/15 - 2017/18
Average
growth
rate (%)
46
3
3
31
–
–
Current
Other transfers to households
Households
31
0.7%
182 212
Current
Social bene¿ts
Households
Proportion of total programme expenditure to vote expenditure
Total
57
780
837
31
8 497
Households
5 400
–
13 928
6 903
14 869
1 804
15 537
3 093
364
1 426
Operating payments
Transport provided: Departmental activity
Operating leases
234
–
Consumable supplies
–
Inventory: Medicine
7
7
273
273
1.1%
315 388
182
–
1 266
1 266
280
12 852
9 503
150 000
172 635
1 763
17 983
3 135
17 689
3 227
433
3 134
329
5
2
–
2012/13
Audited outcome
2011/12
R thousand
Subprogramme
–
–
184
184
0.7%
222 556
18
–
1 409
1 409
184
15 231
–
50 953
66 368
2 075
23 182
7
21 208
259
662
1 270
195
–
1
–
2013/14
–
–
–
–
1.9%
658 939
–
–
2 664
2 664
–
15 867
–
70 000
85 867
6 199
12 414
–
12 917
700
1 021
4 669
–
1 737
–
58
2014/15
Adjusted
appropriation
–
–
-100.0%
-100.0%
–
53.5%
-100.0%
-100.0%
50.6%
47.1%
-100.0%
23.1%
-100.0%
–
83.4%
-3.5%
-5.8%
-100.0%
-6.0%
-39.1%
41.0%
48.5%
-100.0%
733.5%
–
–
Average
growth
rate (%)
–
–
–
–
–
100.0%
–
–
0.4%
0.4%
–
3.8%
1.1%
19.6%
24.6%
1.2%
5.0%
0.4%
4.9%
0.5%
0.2%
0.8%
0.1%
0.1%
–
–
2011/12 - 2014/15
Expenditure/
total:
Average (%)
–
–
–
–
1.6%
587 807
–
–
2 588
2 588
–
24 120
900
72 042
97 062
6 484
17 461
–
14 043
734
1 068
6 112
–
1 117
–
60
–
–
–
–
1.5%
576 608
–
–
2 741
2 741
–
25 364
–
75 433
100 797
1 893
20 907
1 436
18 730
784
502
6 026
–
44
–
–
2016/17
–
–
–
–
1.6%
682 145
–
–
2 907
2 907
–
25 948
–
80 157
106 105
2 200
19 800
–
23 364
–
500
1 400
200
–
–
–
2017/18
2015/16
Expenditure/
total:
Average (%)
–
–
–
–
–
1.2%
–
–
3.0%
3.0%
–
17.8%
–
4.6%
7.3%
-29.2%
16.8%
–
21.8%
-100.0%
-21.2%
-33.1%
–
-100.0%
–
-100.0%
–
–
–
–
–
100.0%
–
–
0.4%
0.4%
–
3.6%
–
11.9%
15.6%
0.7%
2.8%
0.1%
2.8%
0.1%
0.1%
0.7%
–
0.1%
–
–
2014/15 - 2017/18
Average
growth
rate (%)
47
Number
79
41
31
7 – 10
11 – 12
13 – 16
–
–
–
–
–
24
42
80
38
184
22.3
27.8
28.7
0.9
0.7
0.4
0.2
0.5
26
37
77
37
2 177
Number
23.6
22.9
25.6
6.6
78.7
Cost
2. Rand million.
0.9
0.6
0.3
0.2
0.4
Unit
Cost
2014/15
6.8
–
–
–
–
–
70 000
70 000
10 867
5 000
–
–
15 867
2014/15
Adjusted
appropriation
Average
growth
rate (%)
–
–
21.2%
27.7%
–
–
23.1%
–
-100.0%
–
–
-100.0%
2011/12 - 2014/15
Expenditure/
total:
Average (%)
19.6%
19.6%
2.6%
0.9%
0.3%
–
3.8%
–
0.4%
0.4%
0.3%
1.1%
72 042
72 042
11 367
12 103
26
37
77
37
177
30.5
26.9
30.8
7.8
96.1
Cost
2015/16
Number
1.2
0.7
0.4
0.2
0.5
Unit
Cost
26
37
77
37
177
31.5
28.7
32.9
8.3
101.4
Cost
2016/17
1.2
0.8
0.4
0.2
0.6
Unit
Cost
26
37
77
37
177
Number
Number
–
650
24 120
–
900
–
–
900
33.1
30.2
34.5
8.7
106.5
Cost
2017/18
75 433
75 433
11 969
12 745
–
650
25 364
–
–
–
–
–
2016/17
80 157
80 157
12 566
13 382
–
–
25 948
–
–
–
–
–
2017/18
2015/16
50 953
50 953
10 252
2013/14
85.6
–
–
4 979
Revised estimate
Cost
–
–
–
–
–
15 231
43
194
1–6
Salary level
National Health Insurance, Health Planning
and Systems Enablement
Number of posts
additional to
the
establishment
31 March 2015
150 000
150 000
8 252
–
4 600
–
12 852
462
–
5 000
4 041
9 503
2013/14
Actual
National health insurance grant
–
–
Current
Provincial Revenue Funds
Provinces
Unit
Cost
6 097
Health Systems Trust
2 400
Health Information Systems Programme
–
–
1RQ3UR¿W,QVWLWXWLRQV
8 497
–
Wits Health Consortium
Current
Non-pro¿t institutions
National Health Laboratory Services Cancer Registry
5 400
–
Human Sciences Research Council
–
South African Medical Research Council
5 400
2012/13
Audited outcome
2011/12
Council for Science and Industrial Research
Current
Departmental agencies (non-business entities)
R thousand
Subprogramme
1.3
0.8
0.4
0.2
0.6
Unit
Cost
–
–
–
–
–
–
–
–
–
Salary
level/total:
Average (%)
11.9%
11.9%
1.9%
1.7%
–
0.1%
3.6%
14.7%
20.9%
43.5%
20.9%
100.0%
2014/15 - 2017/18
Average
growth
rate (%)
Number
4.6%
4.6%
5.0%
38.8%
–
–
17.8%
–
–
–
–
–
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
Programme 3: HIV / AIDS, TB and Maternal and Child Health
3.1 PROGRAMME PURPOSE
Develop national policies, guidelines, norms and standards,
and targets to decrease the burden of disease related to the
HIV and tuberculosis epidemics; to minimise maternal and child
mortality and morbidity; and to optimise good health for children,
adolescents and women; support the implementation of national
policies, guidelines, and norms and standards; and monitor and
evaluate the outcomes and impact of these.
The programme has established that focussing on just 15
interventions can assist the country to reduce maternal,
QHRQDWDO DQG FKLOG PRUWDOLW\ VLJQL¿FDQWO\ ZLWKLQ D VKRUW SHULRG
of time (called the ‘Countdown to the MDGs’ and beyond).
This emphasises the importance of focusing on the basics and
ensuring that the basics are implemented in our facilities and
districts. The full implementation of the three streams of PHC
re-engineering, municipal ward based community health worker
teams, the integrated school health programme and the District
Clinical Specialist Teams will assist facilities and districts to fully
implement interventions to reduce maternal, neonatal and child
mortality, including those associated with HIV and TB.
The management of the programme has to ensure that all
efforts by all stakeholders are harnessed to support the overall
purpose. This includes ensuring that the efforts and resources
of Development Partners, funders, academic and research
organisations, non-governmental and civil society organisations
and civil society at large all contribute in a coherent, integrated
fashion.
HIV and AIDS sub programme is responsible is responsible for
policy formulation, coordination, and monitoring and evaluation
of HIV and sexually transmitted diseases services. This entails
coordinating the implementation of the National Strategic Plan
on HIV, STIs and TB, 2012-2016. Management and oversight
of the large conditional grant from the National Treasury for
implementation by the provinces is an important function of the
sub-programme. Another important purpose is the coordination
and direction of donor funding for HIV, especially Pepfar, and
Global Fund, in the health sector.
Key successes have been the reduction of mother-to-child HIV
transmission, which has resulted in lower child mortality rates;
increasing antiretroviral treatment coverage, which resulted in
lower adult mortality rates; increasing the number of medical
male circumcisions; and maintaining HIV testing at high levels.
Key challenges include improving preventive programmes
and decreasing the numbers of new infections; scaling up the
numbers of people on antiretroviral treatment and retaining those
on treatment over time.
TB Control and Management sub-programme is responsible
for coordination and management of a national response to
TB that incorporates strategies needed to prevent, diagnose
and treat both drug sensitive TB (DS-TB) and drug resistant TB
(DR-TB) TB. The sub-programme shall develop national policies
and guidelines, norms and standards to inform good practice at
provincial, district, sub-district and health facility levels. The subprogramme shall also monitor implementation of the National
Strategic Plan on HIV, STIs and TB, 2012-2016 with its vision
of achieving zero infections, mortality, stigma and discrimination
from TB and HIV/AIDS.
Until recently, the world relied on treating TB using drugs that
were developed more than 50 years ago. Since about 2 years
DJR D QHZ GUXJ EHGDTXLOLQH ZKLFK LV PXFK PRUH HI¿FDFLRXV
and has little side effects (such as loss of hearing) was
LQWURGXFHGJOREDOO\6RXWK$IULFDZDVWKH¿UVWLQWKHZRUOGWRXVH
the drug formally within its TB programme, and beyond small
scale research sites. The drug will be rolled out to ensure widescale availability to eligible DR-TB patients. The TB information
systems (ETR.Net and EDRWeb) will be integrated to those in
the HIV/AIDS programme (TIER.Ndet) and DHIS. A system for
tracing initial treatment interrupters, defaulters and contacts will
also be developed.
Women, Maternal, Neonatal and Reproductive Health sub
programme develops and monitors policies and guidelines,
sets norms and standards for maternal and women’s health and
monitors the implementation of these. Over the medium term,
key initiatives will be implemented as indicated in the maternal
and child health strategic plan. In addition efforts to reduce
maternal mortality will be based on the recommendations from
the ministerial committees on maternal mortality and the South
African Campaign on the Reduction of Maternal Mortality in Africa
(CARMMA) strategy. Interventions will include the following:
deploying obstetric ambulances, strengthening family planning
services, establishing maternity waiting homes, establishing
Kangaroo Mother Care facilities, taking Essential Steps in
Managing Obstetric Emergency (ESMOE) training for doctors
and midwives, intensifying midwifery education and training, and
strengthening infant feeding practices.
Child, Youth and School Health sub programme is responsible
for policy formulation, coordination, and monitoring and
evaluation of child, youth and school health services. Each
SURYLQFH DOVR KDV D XQLW ZKLFK LV UHVSRQVLEOH IRU IXO¿OOLQJ WKLV
role, and for facilitating implementation at the provincial level.
Most MNCWH and nutrition services are provided by the
provincial Departments of Health, who are thus central roleplayers in efforts to improve coverage and quality of MNCWH
& Nutrition services. At district level, services are provided by
a range of health and community workers, and other workers.
Many stakeholders outside of the health sector also have key
roles to play in promoting improved child and youth health and
nutrition – these include other government departments (such
as Social Development, Rural Development, Basic Education,
Water Affairs and Forestry, Agriculture and Home Affairs), local
government, academic and research institutions, professional
councils and associations, civil society, private health providers
and development partners, including United Nations and other
international and aid agencies.
48
49
Strategic objective
Expand the PMTCT coverage to pregnant women
by ensuring all HIV positive Antenatal clients are
placed on ARVs and reducing the positivity rate to
below 1%
Couple year protection rate
To improve access to sexual and reproductive
health services
Infant 1st PCR test positive around 6
weeks rate
Antenatal client initiated on ART rate
Cervical cancer screening coverage
Inpatient Neonatal death rate
(annualised)
Maternal mortality in facility ratio
(annualised)
Mother postnatal visit within 6 days rate
452 423
3.9%
8 959
230 480
Denominator
82 174
Denominator
Indicator
66 138
Numerator
Numerator
80.49%
13 837 584
Denominator
Indicator
41.85%
579 150
Indicator
14 335 730
Denominator
Numerator
29%
4 113 213
Indicator
3622676
Denominator
Numerator
41952
934143
Denominator
Numerator
1354
11.6
144.9
Indicator
Numerator
Indicator
530 425
943 876
Numerator
Denominator
56.20%
Indicator
1 126 555
Numerator
Denominator
40.2%
2011/12
Indicator
Consolidated Performance Indicator
Antenatal 1st visit before 20 weeks rate
To reduce the neonatal mortality rate to under 6
per 1000 live births
To reduce the maternal mortality ratio to under 100
per 100 000 live births
250 294
6 122
2.4%
74 696
60 951
81.60%
14 175 900
594 587
41.94%
14 527 073
4 756 021
33%
3736572
45416
12.2
939362
1302
138.6
948 070
617 195
65.10%
1 098 746
483 092
44.0%
2012/13
247 578
4 940
2.6%
232 068
178 024
76.71%
14 527 991
655 366
45.11%
14 721 211
5 485 636
37%
3757448
45424
12.1
938073
1249
133.1
945 028
689 299
72.94%
1 102 920
551 282
50.0%
2013/14
107 237
1 630
2.0%
87 111
74 238
85.22%
6 166 420
281 804
54.9%
14 870 108
2 322 300
55%
3748328
46536
12.4
397748
535
134.5
405 613
301 448
77.3%
454 231
235 811
55.5%
2014/15
Estimated
performance
247 578
3 714
1.50%
232 068
204 220
88%
14 527 991
871 679
60%
14 721 211
8 832 727
60%
3 757 448
37 574
10
938 073
1 126
120
945 028
803 274
85%
1 102 920
661 752
60%
2015/16
247 578
3 466
1.40%
232 068
208 861
90%
14 527 991
929 791
64%
14 721 211
9 568 787
65%
3 757 448
33 817
9
938 073
1 079
115
945 028
850 525
90%
1 102 920
716 898
65%
2016/17
Medium-term targets
Note: Targets are set Zith an assumption that denominators Zill remain stable over MT(F, unless otherZise speci¿ed Zhere estimated denominators are available.
247 578
2 971
1.20%
232 068
213 503
92%
14 527 991
987 903
68%
14 721 211
10 304 848
70%
3 757 448
30 060
8
938 073
1 032
110
945 028
897 777
95%
1 102 920
772 044
70%
2017/18
The table below provides consolidated indicators and three-year targets for the various budget sub-programmes funded from the HIV&AIDS, TB, Maternal and Women’s Health and child health
programme
3.2 CONSOLIDATED PERFORMANCE INDICATORS AND ANNUAL TARGETS
50
Strategic objective
1 589
12 108
Numerator
Denominator
New Indicator
Indicator
Indicator
TB client 5 years and older initiated on
treatment rate
TB Rifampicin Resistant clients
treatment initiation rate
Improve Access to treatment
New Indicator
New Indicator
New Indicator
New Indicator
Denominator
Indicator
New Indicator
Numerator
New Indicator
New Indicator
Denominator
Indicator
New Indicator
Numerator
New Indicator
Denominator
New Indicator
New Indicator
Indicator
New Indicator
Indicator
Numerator
Denominator
Numerator
12 848 703
New Indicator
Denominator
Indicator
77%
1 070 725
Indicator
Numerator
966 718
Denominator
Client 5 years and older screened at
health facilities for TB symptoms rate
HPV 2nd dose coverage
HPV 1st dose coverage
School Grade 8 screening coverage
(annualised)
(annualised)
Measles 2nd dose coverage
-1%
-12 723
Indicator
Numerator
DTaP-IPV/Hib 3 - Measles 1st dose
drop-out rate
New Indicator
1 092 583
Indicator
Denominator
Infant exclusively breastfed at HepB
3rd dose rate
83.86%
916 242
Indicator
Numerator
Immunisation coverage under 1 year
(Annualised)
13.1%
Indicator
New Indicator
43 137
Denominator
Indicator
4,1%
1 769
Indicator
Numerator
1 541
34 005
Numerator
Denominator
&RQ¿UPHGPHDVOHVFDVHLQFLGHQFHSHU
million total population
Child under 5 years severe acute
malnutrition case fatality rate
Child under 5 years pneumonia case
fatality rate
4.5%
2011/12
Indicator
Child under 5 years diarrhoea case
fatality rate
Undertake a massive TB screening campaign
To protect girl learners against cervical cancer
To contribute to health and wellbeing of learners by
screening for health barriers to learning
7RUHGXFHXQGHU¿YHPRUWDOLW\UDWHWROHVVWKDQ
per 1,000 live births by promoting early childhood
development
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
12 863 193
1 071 933
75%
890 094
-76 909
-9%
New Indicator
1 090 748
912 164
83.63%
New Indicator
12 877
1 638
12.7%
36 346
1 392
3.8%
35 599
1 523
4.3%
2012/13
14 964
1 677
11.2%
43 596
1 532
3.5%
46 109
1 776
4.2%
2013/14
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
411 434
57 459
4%
576 536
114 254
19.8%
12 798 474
1 066 540
75%
1 002 438
62 693
8%
New Indicator
1 078 799
910 291
84.38%
New Indicator
15%
457 276
429 840
94%
457 276
429 840
92%
453 602
59 468
13.1%
587 824
197 444
33.6%
5 282 815
1 056 563
79%
422 636
21 368
7%
1 059 660
New Indicator
New Indicator
44.5%
381 443
86.39%
< 4/ 1,000,000
7 931
900
11.0%
23 641
762
3.2%
20 092
719
3.6%
2014/15
Estimated
performance
6%
60 146
80%
85%
50%
457 276
365 821
80%
457 276
365 821
80%
910 000
91 000
10%
1 160 000
290 000
25%
1 066 540
885 228
83%
1 002 438

1 078 799
970 919
90%
< 3/1,000,000
15 000
1 500
10%
40 000
1200
3%
40 000
1 280
3.20%
2015/16
60%
85%
90%
75%
457 276
397 831
87%
457 276
397 831
87%
910 000
136 500
15%
1 160 000
406 000
35%
1 066 540
917 224
86%
1 002 438
60 146
6%
1 078 799
992 495
92%
< 2/1,000,000
15 000
1 350
9%
40 000
1100
2.75%
40 000
1 200
3.00%
2016/17
15 000
1 200
8%
40 000
1 000
2.50%
40 000
1 080
2.70%
2017/18
90%
95%
85%
457 276
402 403
88%
457 276
402 403
88%
910 000
182 000
20%
1 160 000
522 000
45%
1 066 540
938 555
88%
1 002 438
50 122
5%
1 078 799
1 003 283
93%
< 1/1,000,000
65%
Medium-term targets
51
N/A
Female Condoms Distributed
Number
Number
Number
Male Condoms Distributed
Total clients remaining on ART (TROA)
at the end of the month
Number
Number of medical male circumcisions
conducted
Increase the numbers of HIV positive people on
ARVs
Number
Number of client 15-49 Years tested
for HIV
To scale up combination of prevention interventions
to reduce new infections including HCT, male
medical circumcision and condom distribution
4654
Denominator
New Indicator
New indicator
New indicator
347 973
9 909 276 (Total
Population)
45%
1965
Numerator
Indicator
42% (2009
cohort)
859
4654
Numerator
Denominator
Indicator
19% (2009
cohort)
Indicator
833
4654
Numerator
Denominator
18% (2009)
cohort)
Denominator
Indicator
N/A
TB/HIV co-infected client on ART rate
TB MDR treatment success rate
TB MDR client death rate
TB MDR client loss to follow up rate
New Indicator
Indicator
New Indicator
Denominator
Numerator
New Indicator
TB Client death rate
New Indicator
Indicator
Numerator
TB Client loss to follow up rate
New Indicator
Indicator
TB new client treatment success rate
TB/HIV Co-infection
Strengthen patient retention in treatment and care
Strategic objective
New Indicator
New indicator
New indicator
442518
8 978 177
57%
4882
1971
40% (2010
cohort)
4882
844
17 % (2010
cohort)
4882
826
17 % (2010)
cohort)
394,790
33,300
8%
394,790
26,054
7%
74%
2012/13
353,928
29,709
8%
353,928
23,587
6.6%
76%
2013/14
2.7 million
13 254 025
506 427 732
512 902
6 688 950
65%
6523
2921
45% (2011
cohort)
6523
1157
18% (2011
cohort)
6523
1294
20% (2011)
cohort)
2011/12
3.0 million
15.2m
600m
550 000
8 million
70%
50%
18%
18%
7%
6%
79%
Estimated
performance
2014/15
75%
3.8 million
16.5m
700m
1 600 000
10 million
6 523
3 588
55%
6 523
978
15%
6 523
1 044
16%
353,928
21 236
6%
353928
17 696
5%
83%
2015/16
6 523
4.8 million
17.5m
800m
800 000
14 million
80%
3 914
60%
6 523
783
12%
6 523
913
14%
353,928
17 697
5%
353928
14 158
4%
84%
2016/17
6 523
Medium-term targets
6.0 million
18.5m
800m
650 000
17 million
85%
4 240
65%
6 523
587
9%
6 523
783
12%
353,928
14 158
4%
353928
10 618
3%
85%
2017/18
New Indicator
New Indicator
Develop Pharmacovigilance system for adverse events for
contraceptive implants
New Indicator
New indicator
New Indicator
New Indicator
New indicator
New indicator
New indicator
New indicator
New indicator
Develop breast cancer Policy
Develop 9 provincial reports to track progress on the
eliminations of mother-to-child transmission of HIV
Develop and implement the HIV Counselling and Testing
(HCT) policy
Monitor implementation of the HIV and AIDS Programme
Develop and implement HIV prevention strategy
Develop and implement adherence guidelines
Facilitate development of district plans to support NDoH
male and female condom distribution strategy
New indicator
New indicator
New indicator
New indicator
New Indicator
New Indicator
Develop cervical cancer control Policy
New Indicator
New Indicator
New Indicator
Develop Training manual for the implantation of
Contraception and Fertility Planning (CFP) Policy
New Indicator
New Indicator
2012/13
2013/14
New indicator
New indicator
New indicator
New indicator
New indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
2011/12
Monitor implementation of Maternal, Neonatal and
Woman’s health programmes using the standardised
dashboard reports
3.3 PERFORMANCE INDICATORS AND ANNUAL TARGETS
52
New indicator
New indicator
New indicator
New indicator
Draft Policy developed
New Indicator
New Indicator
New Indicator
New Indicator
CFP Policy training manual
drafted
2 reports produced and
implementation feedback provided
to all provincial DoH
Estimated performance
2014/15
Quarterly performance
reports produced with
feedback provided to each
provincial DoH
2016/17
Medium-term targets
52 district distribution
plans for male and female
condoms developed
and implemented with 9
provincial progress reports
Guidelines developed and
approved and produce 9
provincial reports on its
implementation
Strategy Developed and
Approved and produce 9
implementation
Monitor implementation of
the district plans and produce
9 provincial reports
Monitor the Implementation
of adherence guidelines
and produce 9 provincial
reports on its implementation
Monitor Implementation of
the HIV prevention strategy
reports
4 Quarterly reports produced
Implement and monitoring
of policy
+&7SROLF\¿QDOLVHGDQG
approved
9 Provincial visits
conducted and reports with
recommendations produced
Monitoring of the
new breast cancer policy
guidelines in all provinces
through quarterly M&E
processes
Monitoring of the
implementation of policy
processes
Quarterly reports
on functionality of
pharmacovigilance
information system for each
province drafted
9 Provincial visits
conducted and reports with
Breast cancer policy
guidelines Developed and
disseminated to facilities
Cervical cancer control policy
JXLGHOLQHV¿QDOLVHGDQG
Pharmacovigilance
information system for
adverse events developed
and implemented in All
Provincial DoH
CFP policy training manual
¿QDOL]HGGLVVHPLQDWHGDQG training plan monitored with 9
training commenced
provincial reports
provincial DoH
2015/16
2017/18
Monitor implementation
of the district plans and
produce 9 provincial
reports
Monitor the
Implementation of
adherence guidelines
and produce 9
implementation
Monitor Implementation of
HIV prevention strategy
reports
4 Quarterly reports
produced
Implement and monitoring
of policy
9 Provincial visits
conducted and reports
with recommendations
produced
Monitoring of the
new breast cancer policy
processes
Monitoring of the
implementation of revised/
updated policy guidelines
in all provinces through
quarterly M&E processes
Adverse events monitored
in each province with
quarterly reports
training plan monitored
with 9 provincial reports
provincial DoH
53
New Indicator
New indicator
Monitor implementation of child health programmes using the standerdised
dashboard reports
Number of community members in 6 Peri mining districts screened for TB
New indicator
Develop Adolescent and Youth health policy and implementation guidelines
New Indicator
New indicator
Convene Morbidity and Mortality in Children under 5 years (COMMiC)
quarterly meeting
New Indicator
New indicator
Develop and Distribute Guidelines for the management of common
childhood illness in district hospitals printed and disseminated
Percentage of mines providing routine TB screening
New indicator
Convene quarterly meetings of Ministers Polio Committees
Percentage of inmates screened for TB annually
New indicator
New indicator
Develop and Distribute EPI Disease Surveillance Manual
Develop and Distribute EPI Cold Chain Manual
New indicator
New Indicator
New Indicator
New Indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
2012/13
2013/14
New Indicator
New Indicator
New Indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
2011/12
Monitor the implementation of the HIV and AIDS Conditional grant
134,400
30%
50%
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
2014/15
462,000
60%
75%
Quarterly report
developed and
implementation feedback
provided
Adolescent and Youth
health policy and
JXLGHOLQHV¿QDOLVHG
printed and distributed
Guidelines printed and
disseminated to all
district hospitals
disseminated to all
district hospitals
One Ministerial Polio
committee meeting
convened per quarter,
and
Annual Report produced
EPI Cold Chain Manual
developed, printed
and distributed to 9
Provincial DoH with
9 province progress
reports produced
462,000
75%
80%
Reports sent to provinces
each quarter
Adolescent and
Youth health policy
implementation in all
provinces
Implementation of
guidelines monitored
and 9 provincial reports
produced
Implementation of
guidelines monitored
and 9 provincial reports
produced
committee meeting
convened per quarter, and
Annual Report produced
Orientate and capacitate
provinces on Cold
Chain Guidelines for
implementation with 9
province progress reports
produced
Orientate and capacitate
province on diseases
surveillance guidelines
for implementation with 9
provincial progress reports
produced
Annual HIV Conditional
Grant Report produced
Annual HIV Conditional
Grant Report produced
EPI Disease
Surveillance Manual
developed, printed
distributed and
implemented with 9
provincial progress
reports produced
4 x Quarterly HIV
conditional grant reports
within the required
timeframe produced
2016/17
Medium-term targets
4 x Quarterly HIV
conditional grant reports
within the required
timeframe produced
2015/16
2017/18
462,000
85%
85%
Reports sent to
provinces each
quarter
Adolescent and
Youth health policy
implementation in
all districts
Implementation
of guidelines
monitored and 9
provincial reports
produced
Implementation
of guidelines
monitored and 9
provincial reports
produced
One Ministerial
Polio committee
meeting convened
per quarter, and
Annual Report
produced
Monitoring and
Mentoring with 9
province progress
reports produced
Monitoring and
Mentoring with 9
provincial progress
reports produced
Annual HIV
Conditional Grant
Report produced
4 x Quarterly HIV
conditional grant
reports within the
required timeframe
produced
Annual
Antenatal client initiated on ART rate
85%
Annual
Annual
TB MDR client death rate
TB MDR treatment success rate
TB/HIV co-infected client on ART rate
Quarterly
Quarterly
Quarterly
Male condoms Distributed
Female Condoms Distributed
Total clients remaining on ART (TROA) at the end of the month
Quarterly
Annual
TB MDR client loss to follow up rate
Quarterly
Annual
TB Client death rate
Number of medical male circumcisions performed
Annual
TB client lost to follow up rate
HIV Tests (10 Years and above)
Annual
Annual
TB new client treatment success rate
Annual
Annual
TB client 5 years and older initiated on treatment rate
Annual
TB Rifampicin Resistant clients treatment initiation rate
50%
Annual
TB client 5 years and older screened at health facilities for TB
symptoms rate
3.8 m
16.5 m
700 m
1 600 000
10.0 m
75%
55%
15%
16%
7%
5%
83%
80%
80%
80%
10%
25%
HPV 2nd dose coverage
3.2 m
4.125 m
175 m
250 000
2.5 m

Annual

HPV 1st dose coverage
DTaP-IPV-HB-Hib 3 - Measles 1st dose drop-out rate

10%
3%
3.25%
1.8%
50%
60%
11.5
123
80%
55%

1st

Quarterly
Infant exclusively breastfed at HepB 3rd dose rate
Quarterly
Quarterly
Immunisation coverage under 1 year (annualised)
< 3/1,000,000
Annual
Quarterly
&RQ¿UPHGPHDVOHVFDVHLQFLGHQFHSHUPLOOLRQWRWDOSRSXODWLRQ
10%
3%
3.2%
School Grade 1 screening coverage (annualised)
Annual
Child under 5 years severe acute malnutrition case fatality rate
88%
60%
60%
10
120
85%
60%
1.5%
Measles 2nd dose coverage (annualised)
Quarterly
Quarterly
Child under 5 years pneumonia case fatality rate (%)
Quarterly
Quarterly
Cervical cancer screening coverage
Quarterly
Quarterly
Couple year protection rate
Child under 5 years diarrhoea case fatality rate
Quarterly
Inpatient Neonatal death rate (annualised)
Infant 1st PCR test positive around 6 weeks rate
Quarterly
Quarterly
Maternal Mortality in facility Ratio
Quarterly
Antenatal 1st visit before 20 weeks rate
Mother postnatal visit within 6 days rate
Reporting period
54
2nd
3.4 m
4.125 m
175 m
250 000
2.5 m

10%
3%
3.25%
1.7%
55%
60%
11
121
82%
57%
Quarterly targets
3rd
3.6 m
4.125 m
175 m
750 000
2.5 m

10%
3%
3.25%
1.6%
58%
60%
10.5
119
84%
59%
4th
3.8 m
4.125 m
175 m
450 000
2.5 m

10%
3%
3.2%
1.5%
60%
60%
10
120
85%
60%
55
Quarterly
Quarterly
Annual
Annual
Annual
Annual
Annual
Quarterly
Quarterly
Develop breast cancer Policy
Develop 9 provincial reports to track progress on the
eliminations of mother-to-child transmission of HIV
Develop and implement the HIV Counseling and Testing
(HCT) policy
Monitor implementation of the HIV and AIDS Programme
Develop and implement HIV prevention strategy
Develop and implement adherence guidelines
Facilitate development of district plans to support NDoH
male and female condom distribution strategy
Monitor the implementation of the HIV and AIDS Conditional
grant
Disease Surveillance Manual
Quarterly
Develop Pharmacovigilance system for adverse events
Quarterly
Quarterly
Develop Training manual for the implantation of
Contraception and Fertility Planning (CFP) Policy
Develop cervical cancer control Policy
Quarterly
Reporting
period
Monitor implementation of Maternal, Neonatal and Woman’s
health programmes using the standardised dashboard
reports
EPI Disease Surveillance Manual
developed, printed distributed
and implemented with 9 provincial
progress reports produced
4 x Quarterly HIV conditional grant
reports produced within the required
timeframe, and
Annual HIV Conditional Grant
Report produced
52 district distribution plans for male
and female condoms developed
and implemented with 9 provincial
progress reports
Guidelines developed and approved
and produce 9 provincial reports on
its implementation
Strategy Developed and Approved
and produce 9 provincial reports on
its implementation
+&7SROLF\¿QDOLVHGDQGDSSURYHG
9 Provincial visits conducted and
reports with recommendations
produced
Develop breast cancer policy
guidelines and implementation
strategy
Cervical cancer control policy
Pharmacovigilance information
system for adverse events
developed and implemented in All
Provincial DoH
CFP policy training manual
¿QDOL]HGGLVVHPLQDWHGDQGWUDLQLQJ
commenced
Quarterly performance reports
produced with feedback provided to
each provincial DoH
QUARTERLY TARGERS FOR PROGRAMME PERFORMANCE INDICATORS
Finalise the Surveillance
Manual
Quarterly HIV conditional grant
reports produced
Quarterly report produced
Conduct stocktaking workshops
in all 3 provinces to monitor
and evaluate progress towards
elimination and reports with
Consultative process with
relevant Stakeholders initiated
relevant Stakeholders initiated
review process for
the Development of a
pharmacovigilance system
completed
Quarterly report produced with
provincial DoH
1st
Print the Surveillance Manual
Quarterly HIV conditional
grant reports produced
Conduct stocktaking
workshops in 3 more
provinces to monitor and
evaluate progress towards
relevant Stakeholders
completed, and situational
analysis completed
Cervical Cancer control policy
guidelines drafted
pharmacovigilance information
system implementation plan
drafted
Draft CFP training manual,
3rd
Disseminate the Surveillance
Manual
Conduct stocktaking
workshops in the remaining
3 provinces to monitor and
evaluate progress towards
Draft Breast Cancer policy
guidelines document
developed
Finalisation and approval of
the Cervical Cancer control
policy guidelines
pharmacovigilance system for
adverse events piloted in 4
provincial DoH
Finalisation and approval of
the CFP training manual,
with feedback provided to
each provincial DoH
Quarterly targets
Quarterly report produced with
provincial DoH
2nd
Disseminate the
Surveillance Manual, 9
province progress reports
produced
Annual programme
performance analysis
report on progress towards
elimination completed and
submitted
Breast Cancer policy
approved
policy Guidelines approved
and distributed to ALL
facilities
pharmacovigilance system
for adverse events set up
in ALL 9 provinces
Dissemination of the CFP
training manual and
training commenced
with feedback provided to
each provincial DoH
4th
56
Quarterly
Monitor implementation of child health programmes using the
standardised dashboard reports
Annual
Quarterly
Develop Adolescent and Youth health policy and implementation
guidelines
Number of community members in 6 Peri mining districts screened
for TB
Quarterly
Convene Morbidity and Mortality in Children under 5 years
(COMMiC) Committee quarterly meeting
Annual
Quarterly
Develop and Distribute Guidelines for the management of common
childhood illness in district hospitals printed and disseminated
Annual
Quarterly
Convene quarterly meetings of Ministers Polio Committees
Percentage of mines providing routine TB screening
Quarterly
Develop and Distribute EPI Cold Chain Manual
Percentage of inmates screened for TB annually
Reporting
period
462,000
60%
75%
Quarterly report developed
and implementation feedback
provided
Adolescent and Youth health
SROLF\DQGJXLGHOLQHV¿QDOLVHG
printed and distributed
4 Quarterly CoMMiC meetings
convened
disseminated to all district
hospitals
committee meeting convened
per quarter
developed, printed and
distributed to 9 Provincial
DoH with 9 province progress
reports produced
Quarterly dashboard report produced
Presentation to the National Health
Council for adoption and approval.
Quarterly dashboard report produced
Printing of the guidelines
One meeting and minutes
Revise the Cold Chain Manual
1st
Quarterly dashboard report
produced
Printing of policy and
implementation guidelines
produced
One national dissemination
workshop for the paediatric
DCSTs and district
hospitals
Finalise the Cold Chain
Manual
3rd
Quarterly dashboard
report produced
National /Provincial
dissemination workshops
Quarterly dashboard
report produced
Provincial dissemination
workshops for the
programme managers
Print and disseminate the
Cold Chain Manual
Quarterly targets
2nd
4th
produced
Provincial dissemination
workshops
produced
Implementation in at least
three (3) provinces
One meeting and Annual
Report
Disseminate the Cold
Chain Manual,
57
Subprogramme
29 893
Child, Youth and School Health
406
Communication
–
6
1
9 942
–
Consumable supplies
6
20 013
Inventory: Medicine
124 122
–
11
1 548
25
–
2 800
Entertainment
Contractors
services
5
814
Computer services
691
19 827
–
205 248
52 967
258 215
Advertising
Administrative fees
of which:
Goods and services
Current payments
Change to 2014
Budget estimate
7 735 369
15 521
Women's Maternal and Reproductive Health
Total
16 592
7 672 312
1 051
1 386
–
7
–
112 353
–
5
8
–
–
1 401
1 099
–
9 505
1
626
656
335
6 040
–
160 038
59 447
219 485
8 979 307
13 388
10 724
13 426
8 938 272
3 497
2012/13
3 905
2013/14
6 059
26
296
1
70 134
–
5
13
3 277
–
–
3 833
65
12 914
2
523
429
429
5 808
–
151 304
62 475
213 779
10 763 504
16 603
14 117
23 800
10 705 079
Audited outcome
2011/12
Tuberculosis
HIV and AIDS
R thousand
11 473
–
44
141 850
152 400
2
4
–
29 550
149
10 248
2 861
–
16 511
129
4 733
3 013
4 545
46 258
330
458 212
64 404
522 616
12 840 709
218 396
17 058
26 442
12 575 204
3 609
2014/15
Adjusted
appropriation
3.4 RECONCILING PERFORMANCE TARGETS WITH THE BUDGETS AND THE MTEF
Expenditure/
total:
Average (%)
4.9%
–
94.3%
92.1%
7.1%
26.0%
-12.6%
–
–
138.4%
87.8%
385.5%
–
80.7%
195.5%
126.7%
54.7%
87.4%
32.6%
–
30.7%
6.7%
26.5%
18.4%
94.0%
3.2%
16.8%
17.9%
50.9%
0.1%
–
–
0.4%
1.1%
–
–
–
0.1%
–
–
–
–
0.1%
–
–
–
–
0.2%
–
2.4%
0.6%
3.0%
100.0%
0.7%
0.1%
0.2%
98.9%
–
2011/12 - 2014/15
Average
growth
rate (%)
9 724
–
54
195 000
187 473
2
4
–
5 000
200
5 490
2 994
–
18 391
144
737
3 049
1 653
14 668
345
471 006
68 937
539 943
(286 433)
14 442 144
221 190
18 778
27 771
14 170 753
3 652
2 515
–
–
–
208 612
–
–
–
5 555
–
2 541
2 263
–
28 519
–
731
887
392
13 322
–
302 719
72 727
375 446
(296 874)
16 002 675
21 506
18 758
27 683
15 930 874
3 854
2016/17
2015/16
7 100
–
400
–
191 093
–
–
–
11 377
–
–
4 000
–
13 531
–
600
500
500
3 900
–
280 810
76 365
357 175
(342 512)
17 972 937
22 526
20 527
28 862
17 896 977
4 045
2017/18
Expenditure/
total:
Average (%)
-14.8%
–
108.7%
-100.0%
7.8%
-100.0%
-100.0%
–
-27.3%
-100.0%
-100.0%
11.8%
–
-6.4%
-100.0%
-49.8%
-45.0%
-52.1%
-56.2%
-100.0%
-15.1%
5.8%
-11.9%
11.9%
-53.1%
6.4%
3.0%
12.5%
3.9%
0.1%
–
–
0.5%
1.2%
–
–
–
0.1%
–
–
–
–
0.1%
–
–
–
–
0.1%
–
2.5%
0.5%
2.9%
100.0%
0.8%
0.1%
0.2%
98.9%
–
2014/15 - 2017/18
Average
growth
rate (%)
58
Subprogramme
1 519
2
–
South African National AIDS Council
Current
Other transfers to private enterprises
Private enterprises
–
–
Human Science Research Council
Public corporations and private
enterprises
–
Current
Departmental agencies (non-business
entities)
2
29.5%
7 735 369
Current
Social bene¿ts
Households
Total
15
776
791
2
156 904
–
5 562
Households
Public corporations and private enterprises
–
7 312 376
3 818
7 474 844
4 046
569
16 281
40
–
7 000
7 000
48
48
31.7%
8 979 307
54
–
989
989
48
178 507
40
–
7 000
8 573 184
8 758 779
1 994
5 383
–
18 870
369
2012/13
–
25 951
–
25 951
269
269
35.6%
10 763 504
11
–
1 170
1 170
269
187 637
–
–
25 951
10 334 687
10 548 544
5 635
25 940
–
15 499
416
2013/14
Audited outcome
317
2011/12
Operating payments
Operating leases
R thousand
–
15 000
–
15 000
–
–
37.4%
12 840 709
–
–
12 227
12 227
–
185 758
–
3 000
15 000
12 102 108
12 305 866
11 601
13 412
–
8 398
701
2014/15
Adjusted
appropriation
30.3%
–
–
–
–
-100.0%
-100.0%
–
18.4%
-100.0%
-100.0%
150.7%
149.1%
-100.0%
5.8%
–
-18.6%
–
18.3%
18.1%
44.8%
49.1%
-100.0%
-19.8%
–
0.1%
–
0.1%
–
–
–
100.0%
–
–
–
–
–
1.8%
–
–
0.1%
95.0%
96.9%
0.1%
0.1%
–
0.1%
–
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
753
–
–
15 840
–
15 840
–
–
39.6%
14 442 144
–
–
1 802
1 802
–
144 109
–
3 138
15 840
13 737 312
13 900 399
7 704
8 173
–
16 711
–
16 711
–
–
41.1%
16 002 675
–
–
1 762
1 762
–
138 849
–
3 304
16 711
15 466 603
15 625 467
3 096
10 438
–
23 686
406
2016/17
11 982
2015/16
–
17 547
–
17 547
–
–
42.5%
17 972 937
–
–
1 767
1 767
–
152 646
–
3 469
17 547
17 440 333
17 613 995
6 300
21 286
–
18 382
300
2017/18
–
5.4%
–
5.4%
–
–
–
11.9%
–
–
-47.5%
-47.5%
–
-6.3%
–
5.0%
5.4%
13.0%
12.7%
-18.4%
16.6%
–
29.8%
-24.6%
–
0.1%
–
0.1%
–
–
–
100.0%
–
–
–
–
–
1.0%
–
–
0.1%
95.9%
97.0%
–
0.1%
–
0.1%
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
59
–
65 020
HIV and AIDS Non-Governmental Organisations
73
26
16
11 – 12
13 – 16
–
–
–
–
17
20
71
24
132
Number
17.9
12.3
27.8
4.4
62.5
Cost
2013/14
1.1
0.6
0.4
0.2
0.5
Unit
Cost
8 573 184
8 573 184
–
–
–
–
–
12 977
67 903
13 876
66 124
17 627
178 507
40
2. Rand million.
–
–
12 102 108
12 102 108
–
1 000
2 000
3 000
1 410
–
79 921
15 561
69 843
19 023
185 758
2014/15
18.3%
18.3%
-100.0%
–
52.7%
-18.6%
51.4%
–
7.1%
6.2%
4.0%
4.9%
5.8%
–
95.0%
95.0%
–
–
–
–
–
–
0.7%
0.2%
0.7%
0.2%
1.8%
–
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
–
13 737 312
13 737 312
–
1 046
2 092
3 138
–
–
53 538
16 277
54 396
19 898
16
26
73
22
137
Number
0.7
0.9
14.5
0.4
0.2
0.5
Unit
Cost
17.7
28.1
4.2
64.4
Cost
2014/15
Revised estimate
16
26
73
22
137
Number
15.5
18.9
30.0
4.5
68.9
Cost
2015/16
1.0
0.7
0.4
0.2
0.5
16
26
73
22
137
16.3
20.0
31.7
4.7
72.7
Cost
2016/17
Number
–
1 101
2 203
3 304
–
–
42 948
17 140
57 808
20 953
1.0
0.8
0.4
0.2
0.5
Unit
Cost
16
26
73
22
137
Number
15 466 603
15 466 603
Unit
Cost
–
138 849
2016/17
–
17.2
21.0
33.3
5.0
76.4
Cost
1.1
0.8
0.5
0.2
0.6
Unit
Cost
17 440 333
17 440 333
–
1 156
2 313
3 469
–
–
51 450
17 996
61 200
22 000
152 646
2017/18
2017/18
144 109
2015/16
10 334 687
10 334 687
–
–
–
–
–
–
76 079
22 820
70 430
18 308
187 637
2013/14
22
7 – 10
137
1–6
Salary level
HIV and AIDS, Tuberculosis, and Maternal and Child
Health
Number of posts
additional to
the establishment
31 March 2015
Actual
7 312 376
Comprehensive HIV and AIDS grant
7 312 376
5 000
–
562
5 562
Current
Provinces
University of the Witwatersrand
University of Cape Town: Pharmacovigilance
University of Limpopo: Pharmacovigilance
Current
–
12 977
Soul City
406
62 023
loveLife
Maternal, child and women's health
16 478
Lifeline
South African AIDS Vaccine Institute
156 904
Current
–
Topco Media
2012/13
Audited outcome
2011/12
Subprogramme
R thousand
Adjusted
appropriation
1.0%
Salary
level/total:
Average (%)
95.9%
95.9%
–
–
–
–
–
–
–
–
–
–
–
0.4%
0.1%
0.4%
0.1%
11.7%
19.0%
53.3%
16.1%
100.0%
2014/15 - 2017/18
Average
growth
rate (%)
Number
13.0%
13.0%
–
5.0%
5.0%
5.0%
-100.0%
–
-13.7%
5.0%
-4.3%
5.0%
-6.3%
–
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
PROGRAMME 4: PRIMARY HEALTH CARE SERVICES (PHC)
Develop and oversee the implementation of legislation, policies,
systems, and norms and standards for: a uniform district health
system, environmental health services, communicable and noncommunicable diseases, health promotion, and nutrition.
District Health Services: The District Health System (DHS)
is the vehicle for the delivery of Primary Health Care services.
The sub-programme is therefore central to supporting the health
V\VWHP WR EH HI¿FLHQW DQG HIIHFWLYH 7KH 1DWLRQDO +HDOWK $FW
Act 61 of 2003 makes provision for the establishment of health
districts and the organisation and delivery of services within the
'+6 :H QHHG IXQFWLRQLQJ GLVWULFW KHDOWK PDQDJHPHQW RI¿FHV
manage the primary health care facilities such that they meet the
VWDQGDUGVRIWKH2I¿FHRI+HDOWK6WDQGDUGV&RPSOLDQFH2+6&
as well as achieve their key population health indicators. The
National Health Facilities Audit report (2012) lists 3760 health
facilities as primary health care facilities (different categories of
clinics, community health centers and district hospitals). Over
WKHQH[W¿YH\HDUVWKLVVXESURJUDPPHZLOOFROODERUDWHZLWKRWKHU
programmes within the national department of health, other
government departments, development partners, private sector
and civil society organisations to ensure that weaknesses within
the DHS are addressed over this term. We will:
t
t
t
t
t
Improve district governance and strengthen leadership
and management of the district health system through
establishment of District Health Authorities;
Improve the governance of primary health care facilities;
Facilitate the establishment of a service delivery platform
for provision of primary health care services within the
District Health System;
Improve the integration of services at all levels of the health
system and between private sector and other government
departments to address the social determinants of health
and
Organise health services in the community and in primary
KHDOWKFDUHIDFLOLWLHVRSWLPDOO\WRPHHWWKH2I¿FHRI+HDOWK
Standards Compliance (OHSC) standards and to achieve
targets set for population health outcomes .
Environmental and Port Health services: Environmental Health
is at the heart of public health intervention for the health sector,
which is able lead the implementation of public awareness, health
promotion and disease prevention, surveillance and inspection
of both private and public premises. The sub programme will
work towards strengthening the delivery of Environmental
Health services including Port Health services. The department
has transferred Municipal Health Services, to the District and
Metropolitan Municipalities for which it must continue to provide
oversight and supportive role through policy development
and monitoring. The sub programme will collaborate with the
District and Metropolitan Municipalities, South African Local
Government Association (SALGA), Department of Cooperative
Governance and Traditional Affairs (COGTA), Department of
Environmental Affairs, Department of Human Settlements etc,
to support the delivery of municipal health services, which have
been promulgated in the Constitution, National Health Act and
Municipal Systems Act to be the function of the District and
Metropolitan Municipalities.
Health Promotion: Optimal health promotion and disease
prevention is essential to the success of PHC. In recognising
South Africa’s quadruple burden of disease. This sub-programme
ZLOORYHUWKHQH[W¿YH\HDUVLPSURYHKHDOWKSURPRWLRQVWUDWHJLHV
focussing on South Africa’s burden of disease and reduce risk
factors for Non-Communicable Diseases (NCDs) by designing
and implementing a mass mobilisation strategy focussing on
healthy options.
Nutrition: In South Africa, malnutrition is manifested in both
under-nutrition and over-nutrition. This paradox of over and
XQGHUQXWULWLRQDVZHOODVWKHUDQJHRIPLFURQXWULHQWGH¿FLHQFLHV
RISXEOLFKHDOWKVLJQL¿FDQFHUHTXLUHVFRPSOHPHQWDU\VWUDWHJLHV
and an integrated approach to ensure optimal nutrition for all
South Africans. The situation is further complicated by the
many causes of malnutrition, which could be direct factors
such as inadequate food intake, or underlying factors such as
household food insecurity or even basic factors such as a lack
of resources. Improving nutrition is thus an ethical imperative, a
sound economic investment and a key element of health care at
DOOOHYHOV,QWKHQH[W¿YH\HDUVWKHIRFXVZLOOEHRQWKHSUHYHQWLRQ
and management of obesity. This will require joint collaboration
from other stakeholders from other government departments, civil
society and the food industry to create an enabling environment
which will see us curbing the prevalence of obesity in 2020 by
10%. Attention will also be given to improving the quality of
nutrition services in hospitals through the development of clinical
nutrition guidelines.
Non-Communicable Diseases: The World Health Organisation
reports that more than 36 million people died globally from NCDs
in 2008, which constituted 63% of all deaths. This was mainly
from cardiovascular diseases (48%), cancers (21%), chronic
respiratory diseases (12%), and diabetes (3%). Critically more
than 9 million of these deaths could have been prevented.
Premature deaths from NCDs are particularly high in poorer
countries with around 80% of such deaths occurring in low
and middle income countries. Globally deaths due to NCDs
are projected to increase by 17% over the next ten years, but
the greatest increase (24%) is expected in the African region.
In managing NCDs we need to focus on disability as well.
Disability, if not attended to appropriately, has implications for
the optimal functioning of people, preventing them from being
JDLQIXOO\HPSOR\HGDQGRU¿QDQFLDOO\LQGHSHQGHQW7KLVVLWXDWLRQ
exacerbates the risk of out of pocket expenditure impacting
negatively on the development of individuals, families and
communities. Around 40% of deaths and 33% of the burden of
disease in South Africa are attributable to NCDs.
Mental health is an integral element of health and improved mental
health is fundamental to achieving government’s goal of “A Long
and Healthy life for all South Africans”. Mental Health disorders
are associated with the growing burden of NCDs. The mental
health epidemiological surveys conducted from 2003-2004 found
that the 12-month prevalence of adult mental disorders in South
Africa was 16.5% and of these only 25% accessed and received
treatment. The most prevalent disorders are anxiety disorders,
substance abuse disorders and mood disorders.
During this term, this sub-programme will focus on the reduction
of risk factors for NCDs, improvement of health systems and
services for detection and control of NCDs, improvement of the
60
service delivery platform for PHC focused eye-care, oral health,
care of the elderly, rehabilitation, disability and mental health.
The sub-programme will expand services to prevent disability
through coordinated multidisciplinary rehabilitation services. With
regard to mental health, we will collaborate with other sectors to
increase public awareness regarding mental health and reduce
stigma and discrimination associated with mental illness and
scale up decentralised integrated primary mental health services,
which include community-based care, PHC clinic care, and
district hospital level care.
Communicable Disease Control: Communicable diseases
are major causes of morbidity and mortality and through
effectively addressing communicable diseases, life expectancy
will increase. Communicable Diseases are therefore central to
obtaining the Departments vision of a long and healthy life for all
South Africans.
The National HIV Antenatal survey will as in the previous years
be conducted to provide South Africa with information to improve
our response to HIV and sexually transmitted deseases.
This sub-programme will devote this term to strengthening
disease detection through improved surveillance, strengthening
preparedness and core response capacities for public health
emergencies in line with International Health Regulations,
IDFLOLWDWLQJLPSOHPHQWDWLRQRIERWKWKH,QÀXHQ]DSUHYHQWLRQDQG
control and the Neglected Tropical Disease prevention and
control programmes, the elimination of Malaria.
61
New Indicator
New Indicator
New Indicator
Number of primary health care
facilities in the 52 districts that
qualify as Ideal Clinics
Number of municipalities that
meet environmental health
norms and standards in
executing their environmental
health functions
Hand hygiene campaign rolled
out in all 9 (nine) provinces
Health Care Risk Waste
Regulations Developed
Improve
environmental
health services
in all 52 districts
and metropolitan
municipalities in the
country
New Indicator
New Indicator
Improve quality of
services at primary
health care facilities
Number of functional
WBPHCOTs
New Indicator
Number of primary health care
facilities with functional clinic
committees
Improve access to
community based
PHC services
New Indicator
Number of Districts with
uniform management
structures
Improve district
governance
and strengthen
management and
leadership of the
district health system
2011/12
Objective Statement
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
2012/13
2013/14
New Indicator
New Indicator
New Indicator
New Indicator
1063
functional
WBPHCOTs
New Indicator
New Indicator
Regulations developed and
published in the government
gazette for public comment
Hand hygiene campaign
launched
Environmental Health
strategy developed
New Indicator
1500 functional WBPHCOTs
Implementation plan
approved and
Monitoring and evaluation
system developed
Uniform management
structures for Districts
2014/15
Health care risk waste
UHJXODWLRQV¿QDOLVHGDQG
tools for audit implementation
developed
A national Hand hygiene
strategy developed
20
municipalities meet
environmental health norms
and standards in executing their
environmental health functions
500 primary health care facilities
in the 52 districts qualify as
Ideal Clinics
1000 health care facilities with
functional clinic committees
15 Districts with uniform
management structures
2015/16
2016/17
50 public health facilities audited
3 provinces implementing hand
hygiene campaign targeting
commuters, early childhood
development centres and
schools
35 municipalities meet
1000 primary health care
facilities in the 52 districts
Medium-term targets
150 health facilities audited
6 provinces implementing hand
hygiene campaign targeting
commuters, early childhood
development centres and
schools
45municipalities meet
1500 primary health care
facilities in the 52 districts
2017/18
The tables below summarise the key strategic objectives, indicators and three-year targets for the various budget sub-programmes funded from the Primary Health Care Services (PHC) Programme.
4.2 STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS
62
63
New Indicator
New indicator
Number of National
government Departments
oriented on the National guide
for healthy meal provision in
the workplace
Regulations relating to
Labeling and packaging of
tobacco products and
smoking in indoor and outdoor
public places Developed
Reduce risk factors
and improve
management for
Non-Communicable
Diseases (NCDS) by
implementing the
Strategic Plan for
NCDs 2012-2017
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
Number of people screened
for high blood pressure as
part of comprehensive health
screening
for raised blood glucose levels
as part of comprehensive
health screening
for raised blood glucose levels
as part of comprehensive
health screening
Random Monitoring of
salt content in foodstuffs
conducted.
Awareness on health risks
related to alcohol, excessive
salt intake, excessive sugar
intake and physical inactivity
New Indicator
established
Establish a National
Health Commission
to address the social
determinants of health
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New indicator
New Indicator
New Indicator
2012/13
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
New indicator
New Indicator
New Indicator
2013/14
2011/12
Objective Statement
New Indicator
New Indicator
500 000 people screened
for raised blood glucose
levels
for raised blood glucose
levels
for high blood pressure
New indicator
New Indicator
New Indicator
2014/15
Content of campaign
¿QDOLVHGDQGSUHSDUHGIRU
implementation
Random samples from each
of 13 regulated food category
tested, reported on and
corrective action taken
8 Million people screened for
raised blood glucose levels
8 Million people screened for
8 million people screened for
high blood pressure
Tobacco Act amended
20 National Departments
Operating framework for
developed
2015/16
Key messages communicated
via atleast 3 forms of media
high blood pressure
Tobacco Act amended
Operating framework for
approved and resourced
2016/17
Medium-term targets
2017/18
Key messages communicated
via atleast 3 forms of media
high blood pressure
Regulations relating to smoking
in indoor and outdoor public
places
labelling and packaging of
tobacco products
(plain packaging) published
All National Departments
established
14
64
New Indicator
Number of Provincial Outbreak
Response Teams capacitated
to respond to zoonotic,
infectious and food-borne
diseases outbreaks
Number of high risk population
covered by the seasonal
LQÀXHQ]DYDFFLQDWLRQ
Strengthen preparedness and
core response capacities for
public health emergencies in
line with International Health
Regulations
Improve South Africa’s
response with regard to
,QÀXHQ]DSUHYHQWLRQDQG
control
New Indicator
New Indicator
2013/14
New Indicator
New Indicator
New Indicator
0.21 (4 247)
aggregate of
local cases
and cases
of unknown
origin
0.17 (3 408)
FRQ¿UPHG
local cases
Cataract
surgery rates
of 1 500
per million
population
reached in
one province
Draft
framework
and model for
rehabilitation
services
Zero
New Indicator
New Indicator
New Indicator
750 000 high risk
individuals covered
ZLWKVHDVRQDOLQÀXHQ]D
vaccination
New Indicator
3 malaria targeted
districts reporting malaria
cases within 24 hours of
diagnosis
0.3 malaria cases per
1000 population at risk
1 500 operations per
million un-insured
population
Draft Framework and
Model approved and
costed
Zero
14.2% (39/274) of
mental health inpatient
units attached to
designated district and
regional hospitals
Information system and
baseline established
Information system and
baseline established
2014/15
Targeted districts: Pre-elimination: Vhembe District Elimination: Mopani , Waterberg, Capricorn, Sekhukhune, Ehlanzeni, Nkangala, Umkhanyakude, Zululand, uThungulu
New Indicator
New Indicator
Number of districts targeted for
malaria elimination reporting
malaria cases within 24 hours
of diagnosis
New Indicator
0.40
FRQ¿UPHG
local cases
0.58
aggregate of
local cases
and cases
of unknown
origin
FRQ¿UPHG
local cases
0.62
aggregate of
local cases
and cases
of unknown
origin
Malaria Incidence per 1000
population at risk
New Indicator
Zero
New Indicator
New Indicator
New indicator
Eliminate Malaria by 2018, so
that there is zero local cases of
malaria in South Africa
2012/13
New Indicator
New indicator
Cataract Surgery Rate
Prevent avoidable blindness
New Indicator
Zero
Mental health teams
established in each district
Number of Districts
implementing the framework
and model for rehabilitation
services
New Indicator
Percentage of
mental health inpatient units
attached to designated district
and regional hospitals
Improve access to disability
and rehabilitation services
through the implementation
of the framework and model
for rehabilitation and disability
services
New Indicator
Percentage of people treated
for mental disorders
Improve access to and
quality of mental health
services in South Africa
2011/12
New Indicator
Percentage people screened
Objective Statement
2015/16
2016/17
9 Provincial Outbreak
to respond to food-borne
disease outbreaks
7 malaria targeted districts
reporting malaria cases within
24 hours of diagnosis
0.2 malaria cases per 1000
population at risk
1 500 operations per million
un-insured population
5 Districts implementing the
framework and model for
rehabilitation services
5 specialist mental health
teams established
18% of mental health inpatient
units attached to designated
district and regional hospitals
30 % of 16.5% (prevalence)
people treated for mental
disorders
people screened for mental
disorders
800 000 high risk individuals
1 000 000 high risk individuals
FRYHUHGZLWKVHDVRQDOLQÀXHQ]D covered with seasonal
vaccination
LQÀXHQ]DYDFFLQDWLRQ
to respond to zoonotic disease
outbreaks
reporting malaria cases within
24 hours of diagnosis
population at risk
Resources allocated for the
approved Framework and
Model
Strategy for establishment of
specialist mental health teams
approved by the TechNHC
16% of mental health inpatient
units attached to designated
district and regional hospitals
disorders
disorders
Medium-term targets
2017/18
1 000 000 high risk
individuals covered
ZLWKVHDVRQDOLQÀXHQ]D
vaccination
to respond to infectious
disease outbreaks
reporting malaria cases
within 24 hours of diagnosis
population at risk
15Districts implementing the
framework and model for
rehabilitation services
20 specialist mental health
teams established
20% of mental health
inpatient units attached
to designated district and
regional hospitals
disorders
disorders
65
A strategy and plan for
the integration of disease
surveillance systems for NMC
Developed and Implemented
Annual National HIV Antenatal
Prevalence Survey conducted
Objective Statement
Establish a coordinated
disease surveillance system for
1RWL¿DEOH0HGLFDOFRQGLWLRQV
(NMC)
Conduct Annual National HIV
Antenatal Prevalence Survey
2010Annual
National HIV
and Syphilis
Prevalence
Report was
¿QDOLVHGDQG
launched in
November
2011
New Indicator
2011 National
Antenatal
Sentinal HIV
and Herpes
Simplex Type
2 prevalence
Report
New Indicator
2012/13
2012 National
Antenatal
Sentinal HIV
and Herpes
Simplex Type
2 prevalence
Report
produced
Manual
disease
QRWL¿FDWLRQ
system
2013/14
2011/12
2013 National Antenatal
Sentinal HIV and
Herpes Simplex Type
2 prevalence Report
produced
Draft strategy for the
integration of disease
surveillance systems for
NMC developed
2014/15
2014 National Antenatal HIV
prevalence Report produced
Strategy for the integration
of disease surveillance
systems for NMC approved
and implementation plans
developed
2015/16
First Phase implementation
commenced
2016/17
Medium-term targets
2017/18
Second Phase
implementation commenced
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Quarterly
Annual
Annual
Annual
Annual
Annual
Annual
Quarterly
Hand hygiene campaign rolled out in all 9 (nine) provinces
Implement Health Care Risk waste Regulations
Establish National Health Commission
Number of National government Departments oriented on the National guide for healthy meal
provisioning in the workplace
Labelling and packaging of tobacco products and
smoking in indoor and outdoor public places Developed
Number of people screened for high blood pressure as part of comprehensive health screening
Number of people screened for raised blood glucose levels as part of comprehensive health
screening
Awareness on risk factors relating to excessive salt intake, excessive sugar intake, physical
inactivity and , alcohol related harm created
Random Monitoring of salt content in foodstuffs conducted.
Percentage people screened for mental disorders
Percentage of people treated for mental disorders
Percentage of
mental health inpatient units attached to designated district and regional hospitals
Number of Mental health teams established in each district
Number of Districts implementing the framework and model for rehabilitation services
Cataract Surgery Rate
Malaria Incidence per 1000 population at risk
0.2 malaria cases per 1000 population at risk
1 500 operations per million un-insured population
Resources allocated for the approved Framework and Model
Strategy for establishment of specialist mental health teams approved by
the TechNHC
16% of mental health inpatient units attached to designated district and
regional hospitals
28 % of 16.5% (prevalence) people treated for mental disorders
28 % of 16.5% (prevalence) people screened for mental disorders
Random samples from each of 13 regulated food category tested, reported
on and corrective action taken
&RQWHQWRIFDPSDLJQ¿QDOLVHGDQGSUHSDUHGIRULPSOHPHQWDWLRQ
8 Million people screened for raised blood glucose levels
8 million people screened for high blood pressure
Tobacco Act amended
Operating framework for National Health Commission developed
+HDOWKFDUHULVNZDVWHUHJXODWLRQV¿QDOLVHGDQGWRROVIRUDXGLW
implementation developed
A national Hand hygiene strategy developed
20
municipalities meet environmental health norms and standards in
executing their environmental health functions
Annual
Number of municipalities that meet environmental health norms and standards in executing their
500 primary health care facilities in the 52 districts qualify as Ideal
Clinics
Annual
1000 health care facilities with functional clinic committees
Annual
Annual
Number of primary health care facilities with functional clinic committees/ district hospital boards
15 Districts with uniform management structures
Number of primary health care facilities in the 52 districts that qualify as Ideal Clinics
Annual
Number of districts with uniform management structures for primary health care facilities
Number of functional WBPHCOTs
Reporting
period
66
0.2 malaria
cases
per 1000
population
at risk
1st
0.2
malaria
cases
per 1000
population
at risk
2nd
3rd
0.2
malaria
cases
per 1000
population
at risk
Quarterly targets
0.2
malaria
cases
per 1000
population
at risk
4th
12
67
Annual
Annual
Annual
Annual
Number of Provincial Outbreak Response Teams capacitated to respond to zoonotic, infectious
and food-borne diseases outbreaks
1XPEHURIKLJKULVNSRSXODWLRQFRYHUHGE\WKHVHDVRQDOLQÀXHQ]DYDFFLQDWLRQ
Develop and implement a strategy and plan for the integration of disease surveillance systems for
NMC
Annual National HIV Antenatal Prevalence Survey conducted
2015 National Antenatal HIV prevalence Report produced
Strategy for the integration of disease surveillance systems for NMC
approved and implementation plans developed
KLJKULVNLQGLYLGXDOVFRYHUHGZLWKVHDVRQDOLQÀXHQ]DYDFFLQDWLRQ
9 Provincial Outbreak Response Teams capacitated to respond to zoonotic
disease outbreaks
5 malaria targeted districts reporting malaria cases within 24 hours of
diagnosis
A functional WBPHCOT is one that is constituted according to the prescripts of the policy on WBPHCOTs and reports its activities on the District Health Information System
Annual
Number of districts targeted for malaria elimination reporting malaria cases within 24 hours of
diagnosis
Reporting
period
1st
2nd
3rd
Quarterly targets
4th
Environmental and Port Health Services
–
Inventory: Medicine
38
–
65
–
1
Inventory: Learner and teacher support material
–
3
–
–
14
Entertainment
15
14
9 877
&RQVXOWDQWVDQGSURIHVVLRQDOVHUYLFHV6FLHQWL¿FDQG
technological services
Contractors
35 004
Consultants and professional services: Business and
advisory services
1
337
Communication
Computer services
672
–
267
1 780
Advertising
Administrative fees
of which:
61 764
Goods and services
184 731
122 967
Current payments
Change to 2014 (Budget estimate)
187 515
12 288
93 889
Health Promotion and Nutrition
Total
24 155
9 706
Non-Communicable Diseases
45 009
Communicable Diseases
2 468
2011/12
9
32 083
–
–
–
3
8
–
–
–
8 734
18
10 557
4 364
14
352
377
–
322
1 104
2
74 623
126 907
201 530
206 380
99 121
14 114
22 692
43 624
24 932
1 897
2012/13
Audited outcome
District Health Services
R thousand
Subprogramme
–
451
45
–
–
3
11
–
1 539
–
–
4
11 113
86
1
479
415
–
99
747
22
33 889
140 861
174 750
183 488
104 624
23 880
25 541
13 784
13 970
1 689
2013/14
66
600
–
17
184
211
–
2 770
200
70
15
133
13 130
6 509
1 796
4 302
1 443
134
197
508
62
59 508
147 738
207 246
15 657
216 162
110 697
21 768
25 718
31 298
23 674
3 007
2014/15
Adjusted
appropriation
4.5 RECONCILING THE PERFORMANCE TARGETS FOR THE BUDGET AND MTEF
68
20.2%
–
-100.0%
157.1%
–
312.8%
–
–
–
71.0%
2.3%
107.0%
10.0%
-42.9%
1115.5%
133.7%
29.0%
–
-9.6%
-34.2%
–
-1.2%
6.3%
3.9%
4.9%
5.6%
21.0%
2.1%
47.7%
-19.3%
6.8%
–
4.2%
–
–
–
–
–
0.3%
0.2%
–
1.1%
–
5.6%
5.8%
0.2%
0.7%
0.4%
–
0.1%
0.5%
–
29.0%
67.9%
96.8%
100.0%
51.5%
9.1%
12.4%
12.4%
13.6%
1.1%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
69
1 116
–
17
192
221
–
–
2 600
73
23
139
11 187
3 699
1 879
3 500
1 609
140
475
876
65
43 268
176 511
219 779
(112 840)
225 005
130 095
22 525
28 259
16 550
24 481
3 095
2015/16
–
2 905
–
–
–
–
–
–
–
–
3 959
–
17 074
2 799
11
349
1 414
–
349
2 104
–
48 128
186 222
234 350
(121 538)
239 267
135 213
22 658
29 171
16 722
32 237
3 266
2016/17
estimate
–
600
–
–
–
–
–
–
2 000
–
5 000
–
12 520
2 100
–
700
500
–
–
800
–
50 737
195 531
246 268
(125 553)
251 793
144 789
24 790
29 510
17 462
31 814
3 428
2017/18
-100.0%
–
–
-100.0%
-100.0%
-100.0%
–
-100.0%
115.4%
-100.0%
593.4%
-100.0%
-1.6%
-31.4%
-100.0%
-45.4%
-29.8%
-100.0%
-100.0%
16.3%
-100.0%
-5.2%
9.8%
5.9%
5.2%
9.4%
4.4%
4.7%
-17.7%
10.4%
4.5%
–
0.6%
–
–
–
–
–
0.3%
0.5%
–
1.0%
–
5.8%
1.6%
0.4%
0.9%
0.5%
–
0.1%
0.5%
–
21.6%
75.7%
97.4%
100.0%
55.9%
9.8%
12.1%
8.8%
12.0%
1.4%
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
69
753
Total
0.7%
187 515
14
753
513
Households
1 504
–
–
2 017
Foreign governments and international organisations
534
1 614
7 154
343
3 790
–
2011/12
0.7%
206 380
686
621
621
15
3 528
–
–
3 543
1 745
4 150
8 340
325
2 103
–
2012/13
Audited outcome
Operating payments
Operating leases
Consumable supplies
R thousand
Subprogramme
0.6%
183 488
1 142
661
661
99
6 686
150
–
6 935
1 632
3 424
8 659
369
4 772
18
2013/14
0.6%
216 162
–
1 455
1 455
15
4 788
–
2 658
7 461
1 252
1 878
14 224
391
5 558
–
2014/15
Adjusted
appropriation
–
–
4.9%
-100.0%
24.6%
24.6%
-69.2%
47.1%
–
–
54.7%
-8.1%
52.1%
25.7%
4.5%
13.6%
–
100.0%
0.2%
0.4%
0.4%
0.1%
2.1%
–
0.3%
2.5%
0.8%
1.3%
4.8%
0.2%
2.0%
–
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
0.6%
225 005
–
2 325
2 325
–
2 901
–
–
2 901
1 351
2 006
6 440
499
5 075
–
2015/16
0.6%
239 267
–
1 881
1 881
–
3 036
–
–
3 036
1 689
5 064
7 090
347
3 660
–
2016/17
estimate
0.6%
251 793
–
2 355
2 355
–
3 170
–
–
3 170
2 150
4 800
14 467
400
5 700
–
2017/18
–
–
5.2%
–
17.4%
17.4%
-100.0%
-12.8%
–
-100.0%
-24.8%
19.8%
36.7%
0.6%
0.8%
0.8%
–
100.0%
–
0.9%
0.9%
–
1.5%
–
0.3%
1.8%
0.7%
1.5%
4.5%
0.2%
2.1%
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
70
R thousand
13
500
Donation for conference on Paediatric Cardiology and
Cardiac Surgery
–
–
Public Health Association of South Africa
Albinism Society of South Africa
–
Health Systems Global - South Africa
–
–
292
–
–
351
651
290
844
1 100
3 528
–
–
–
–
–
–
–
15
15
2012/13
–
–
5 000
169
100
428
684
305
–
–
6 686
–
–
50
100
150
–
–
99
99
2013/14
2 000
350
768
182
–
450
718
320
–
–
4 788
2 658
2 658
–
–
–
–
–
15
15
2014/15
1. The Port Health Services function shift will only start in 2015/16. This is shown retrospectively for comparative purposes.
–
293
National Kidney Foundation of South Africa
National Council Against Smoking
–
11
303
Medical Research Council: South African Community
Epidemiology Network on Drug Abuse
Mental Health Non-Governmental Organisations
620
South African National Council for the Blind
Inter-Academy Medical Panel
277
–
District Services and Environmental Health non-governmental organisations
South African Federation for Mental Health
–
Non-Communicable Disease non-governmental organisations
Current
1 504
World Health Organisation
–
–
Current
organisations
Foreign governments and international
–
Current
Other transfers to private enterprises
Private enterprises
500
Current
Other transfers to households
Households
13
2011/12
Audited outcome
Current
Social bene¿ts
Households
Subprogramme
Adjusted
appropriation
–
–
37.9%
154.8%
–
14.1%
5.0%
4.9%
–
–
47.1%
–
–
–
–
–
-100.0%
-100.0%
4.9%
4.9%
0.3%
–
0.8%
–
–
0.2%
0.3%
0.2%
0.1%
0.1%
2.1%
0.3%
0.3%
–
–
–
0.1%
0.1%
–
–
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
–
350
803
190
–
471
752
335
–
–
2 901
–
–
–
–
–
–
–
–
–
2015/16
–
350
845
200
–
496
792
353
–
–
3 036
–
–
–
–
–
–
–
–
–
2016/17
estimate
–
350
887
210
–
520
832
371
–
–
3 170
–
–
–
–
–
–
–
–
–
2017/18
-100.0%
–
4.9%
4.9%
–
4.9%
5.0%
5.1%
–
–
-12.8%
-100.0%
-100.0%
–
–
–
–
–
-100.0%
-100.0%
0.2%
0.2%
0.4%
0.1%
–
0.2%
0.3%
0.1%
–
–
1.5%
0.3%
0.3%
–
–
–
–
–
–
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
71
39
27
15
7 – 10
11 – 12
13 – 16
–
–
–
–
–
Number of posts
additional to
the
establishment
14
30
305
88
437
Number
Unit
Cost
12.4
17.9
97.2
13.3
140.9
0.9
0.6
0.3
0.2
0.3
15
33
306
86
440
Number
14.0
21.8
98.4
13.5
147.7
Cost
2. Rand million.
35
18
0.9
308
97
458
Number
17.6
24.4
116.6
17.9
176.5
Cost
2015/16
0.7
0.3
0.2
0.3
Unit
Cost
2014/15
Cost
Revised estimate
Actual
2013/14
1.0
0.7
0.4
0.2
0.4
Unit
Cost
18
35
308
97
458
Number
18.6
25.7
123.0
18.9
186.2
Cost
2016/17
1.0
0.7
0.4
0.2
0.4
Unit
Cost
18
35
308
97
458
Number
24
105
1–6
Salary level
Primary Health Care Service
Number of
funded
posts
31 March 2015
19.5
27.0
129.2
19.9
195.5
Cost
2017/18
1.1
0.8
0.4
0.2
0.4
Unit
Cost
6.3%
2.0%
0.2%
4.1%
1.3%
3.8%
7.6%
67.8%
20.8%
100.0%
2014/15 - 2017/18
Salary
level/total:
Average (%)
Number
Average
growth
rate (%)
Programme 5: Hospital, Tertiary Health Services and Human Resource Development
The purpose of the programme is to develop policies, delivery
models and clinical protocols for hospitals and emergency
medical services. Ensure alignment of academic medical
centres with health workforce programmes, training of health
professionals and to ensure the planning of health infrastructure
meet the health needs of the country. This programme will also
assist the government to achieve the population health goals of
the country through nursing and midwifery, by the provision of
expert policy and technical advice and recommendations on the
role of nurses in attainment of desired health outputs .
HOSPITALS AND TERTIARY HEALTH SERVICES is
responsible for tertiary services planning, policies that guides the
management of and service standards in hospitals as well as
to ensure the production of appropriate numbers, staff mix and
DSSURSULDWHO\TXDOL¿HGKHDOWKSURIHVVLRQDOV
TRAUMA, VIOLENCE, EMS AND PATHOLOGY MEDICAL
SERVICES: To improve the governance, management and
functioning of Emergency Medical Services (EMS) in the
whole country through strengthening the capacity and skills of
(06 SHUVRQQHO LGHQWL¿FDWLRQ RI QHHGV DQG VHUYLFH JDSV DQG
SURYLVLRQ RI DSSURSULDWH DQG HI¿FLHQW (06 WKURXJK SURYLGLQJ
oversight of Provinces. To provide a quality, effective system
of emergency medical care, each EMS System must have in
place comprehensive enabling legislation which governs the
provision of EMS. The key components of this legislation include
authority for national coordination, standardised treatment,
transport, communication and evaluation, including licensure
of ambulances and designation of emergency care centres.
The Cluster has developed National Regulations governing the
provision of EMS and these are in the process of publication for
public comment. It is responsible for ensuring the effective and
HI¿FLHQWUHQGHULQJRI)RUHQVLF&KHPLVWU\VHUYLFHVWRVXSSRUWWKH
Criminal Justice System and reduce the burden of disease and
unnatural causes of death. The Cluster is also responsible for
policies that guide the management of and service standards of
Forensic Pathology services.
OFFICE OF NURSING SERVICES: WKH SXUSRVH RI WKH RI¿FH
of nursing services is to ensure that nursing and midwifery
practitioners are competent and responsive to the burden of
desease and population health health needs .This subprogramme
is responsible for providing leadership in the implementation of
the recommendations emanating from the nursing strategy by
coordinating the three core areas of nursing including education
regulation and practice. This sub-programme is responsible for
the promotion and maintenance of a high standard and quality of
nursing and midwifery by ensuring that nursing education and
training is harmonised with population health needs and are
commensurate with competency framework ,provide guidance
LQ WKH SURGXFWLRQ RI VXI¿FLHQW QXPEHUV DQG WKH DSSURSULDWH
categories of nurses required to deliver healthcare services. .
This subprogramme is responsible for enabling intra and interprofessional liaison to harness nursing interventions into a
coherent response to population and health service needs.
HEALTH FACILITIES INFRASTRUCTURE PLANNING: The
Sub Programme coordinates and funds health infrastructure to
enable provinces to plan, manage, modernise, rationalise and
transform infrastructure, health technology, hospital management
and improve quality of care; and it is responsible for two
conditional grants for health infrastructure: the provincial health
facility revitalisation grant and, since 2013/14, the infrastructure
component of the national health grant. In 2012/13, guidance
was provided on infrastructure planning and design through
the infrastructure unit systems support and 32 sets of national
infrastructure norms, standards, guidelines and benchmarks for
all levels of health care facilities were developed. In addition, the
SURMHFW PRQLWRULQJ LQIRUPDWLRQ V\VWHP ZDV FRQ¿JXUHG WHVWHG
and piloted.
WORKFORCE DEVELOPMENT AND PLANNING: The subprogramme is responsible for medium to long-term health
workforce planning, development and management in the
national health system. this entails facilitating implementation of
the national human resources for health strategy, health workforce
capacity development for sustainable service delivery, and
development, and co-ordination of transversal human resources
management policies. The functions of the Sub Programme also
focus on the following: Facilitate the process of increasing the
number of health professionals in the health sector, facilitate
implementation of the HRH Strategy, development of health
ZRUNIRUFH VWDI¿QJ QRUPV DQG VWDQGDUGV IDFLOLWDWH LQVHUYLFH
training of the health workforce, including Community Health
Workers.
72
73
To improve quality of health infrastructure
in South Africa
Professionalise Nursing Training and
Practice through implementation of the
objectives of the Nursing Strategy
New indicator
New indicator
Develop a
standerdised
Nursing leadership
structure for Provincial
DoH
New indicator
New indicator
Develop a Nursing
and midwifery
educators’ training
and development
programme
Number of facilities
maintained, repaired
and/or refurbished in
NHI Districts
New indicator
Public Nursing
colleges offering new
Nursing programmes
(inline with National
4XDOL¿FDWLRQV
Framework)
New indicator
New indicator
New indicator
New indicator
New indicator
Develop guidelines
for HRH norms and
standards using the
WISN methodology
Develop and Implement health workforce
VWDI¿QJQRUPVDQGVWDQGDUGV
New indicator
New indicator
New indicator
benchmarked against
3+&VWDI¿QJQRUPDWLYH
guides
Number of Hospitals
that comply fully with
the National Core
Standards.
Ensure quality health care by improving
compliance with National Core Standards
at all Central, Tertiary, Regional and
Specialised Hospitals
New indicator
New indicator
2012/13
New indicator
Number of gazetted
Tertiary hospitals
providing the full
package of Tertiary1
Services
Ensure equitable access to tertiary
service through implementation of the
National Tertiary services plan
New indicator
2011/12
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New Indicator
2013/14
New indicator
Number of central
hospitals with full
delegated authority.
Increase capacity of central hospitals
to strengthen local decision making
and accountability to facilitate semiautonomy of 10 central hospitals
Objective Statement
Performance
Indicator
94 maintenance
projects for health
facilities in NHI
Districts
A national nursing
services leadership
structure established
Audit of capacity of
nurse educators
completed
A scope of
requirements for the
implementation of
the nursing strategy
developed
New indicator
Determine norms
for PHC. Orientate
District Hospital
managers
Varying degrees
of compliance with
the National Core
Standards in 5 Central
Hospitals
5 gazetted tertiary
hospitals providing
the full package of
Tertiary 1 services
0
2014/15
Estimated
performance
Medium-term targets
198 facilities
A provincial Nursing
structures to give authority
over nursing and midwifery
services tabled at NHC
a Nursing and midwifery
educators’ training and
development programme
developed
A national policy for nursing
education developed in the
context of bedside training
192 facilities
Provincial nursing structures
established and Functional
development programme piloted
(at 3 Public Nursing colleges)
and approved
3 Public Nursing Colleges
piloting new nursing
programmes
2400
Guidelines for HRH Norms for
Regional, Tertiary and Central
Hospitals developed
Tertiary, Regional and
Central Hospital managers
oriented on WISN tool and
methodology
1000
Guidelines for HRH Norms for
District and specialised hospitals
approved.
Full compliance with the National
Core Standards in 10 Central, 17
Tertiary, 25 Regional Hospitals
4 additional gazetted tertiary
hospitals (Mankweng, Rob
Ferreira, Kalafong, Kerksdorp /
Tshepong complex) providing
the full package of Tertiary 1
services
6 Central Hospitals with
reformed management
and governance structures
implement decentralised
accounting systems
2016/17
Guidelines for HRH Norms
for District and specialised
hospitals developed.
Full compliance with the
National Core Standards in
8 Central hospitals and 5
Tertiary Hospitals
4 additional tertiary hospitals
(Pietersburg, Frere, Kimberly
and Ngwelezana) providing
the full package of Tertiary 1
services
10 central hospitals with full
delegated authority
2015/16
212 facilities
Not Applicable
development programme
piloted at 10 Public
Nursing colleges
10 Public Nursing Colleges
offering new nursing
Programmes
3507
Guidelines for HRH Norms
for Regional, Tertiary and
Central Hospitals approved
Full compliance with the
National Core Standards in
10 Central, 17 Tertiary, 40
Regional Hospitals
4 additional gazetted
tertiary hospitals (Witbank,
Port Elizabeth, Pelonmi,
JST), providing the full
package of Tertiary 1
services
10Central Hospitals with
reformed management
and governance structures
implement decentralised
accounting systems
2017/18
The tables below summarises the key strategic objectives, indicators and three-year targets for the various budget sub-programmes funded from the Hospitals, Tertiary Health Services and Human
Resource Development
5.2. STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS FOR 2014/15 TO 2016/17
74
New indicator
New indicator
New indicator
New indicator
Number of clinics and
Community Health
Centres constructed or
revitalised
Number of hospitals
constructed or revitalised
Number of new facilities
that comply with gazetted
infrastructure Norms &
Standards.
New indicator
New indicator
Number of provinces that
are compliant with the
EMS regulations
Number of Blood Alcohol
reports produced
Number of Toxicology
reports produced
(QVXUHDFFHVVWRDQGHI¿FLHQW
effective delivery of quality
Emergency Medical Services (EMS)
To eliminate the backlog of blood
alcohol and toxicology tests by 2016
New indicator
New indicator
Establish a coaching
mentoring and training
programme for health
managers
Develop a knowledge
hub which includes a
web based interactive
information system
Improve management of health
facilities at all levels of care
through the Health Leadership and
Management Acadamy.
New indicator
Number of food tests
performed
To provide food analysis services
New indicator
Develop a Infrastructure
Monitoring System
New indicator
2011/12
maintained, repaired and/
or refurbished outside
NHI pilot Districts
Strengthen Monitoring of
Infrastructure projects
Objective Statement
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
2012/13
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
2013/14
New Indicator
New indicator
500 per lab per quarter(
2 FCLs)
375 reports per lab( 3
FCLs)
7500 reports per lab per
quarter
( 4 FCLs)
Draft EMS Regulations
developed
New Indicator
100% from date of
gazetting
7 hospitals constructed
or revitalised
72 clinics and community
health centres
constructed
249 maintenance
projects for health
facilities outside NHI pilot
Districts
2014/15
Framework for knowledge hub
developed and approved
Coaching mentoring
and training programme
developed and piloted
4 000
4 500
120 000
EMS Regulations and
compliance checklist gazetted
for implementation
Infrastructure Monitoring
System fully developed and
tabled at NHC
37 new facilities
2
35
310 facilities
2015/16
60% of Hospital CEOs and
PHC Facility managers
EHQH¿WWLQJIURPWKH
knowledge hub.
20% of Hospital CEOs
and PHC Facility Managers
EHQH¿WLQJIURPWKHFRDFKLQJ
and mentoring programme.
4 000
Backlogs Eliminated, and
4 500 toxicology reports
issued
120 000 blood alcohol
reports issued
3 provinces (WC, GP and
LP) compliant with EMS
Regulations
Infrastructure Monitoring
System approved by NHC
and implemented
54 new facilities
8
46
320 facilities
2016/17
Medium-term targets
100% of Hospital CEOs
and PHC Facility managers
EHQH¿WWLQJIURPWKHNQRZOHGJH
hub
40% of Hospital CEOs and
PHC Facility Managers
EHQH¿WLQJIURPWKHFRDFKLQJ
and mentoring programme.
4 000
4 500 toxicology reports issued
120 000 blood alcohol reports
issued
3 provinces (FS, NW,
NC) compliant with EMS
Regulations
Not Applicable
50 new facilities
8
42
335 facilities
2017/18
75
New Indicator
New Indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
Develop regulations for Emergency
Care Centres
Publish Regulations for EMS in Mass
Gatherings
Develop a monitoring system to
effectively measure turnaround time of
tests conducted at Forensic Chemistry
Laboratories
Regulations for the Rendering
of Forensic Pathology Services
promulgated
Publish Scope of Practice Guidelines
for the rendering of Forensic Pathology
Services
Number of Health Facilities that are
designated to render services for the
management of sexual and related
offences
Number of Regional Training Centre
(RTC) established
2011/12
Publish Policy on education and
training of EMS Personnel published
for implementation
Programme Performance indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New indicator
New Indicator
New Indicator
2012/13
2013/14
New Indicator
253
New indicator
New indicator
New indicator
New indicator
New Indicator
New Indicator
3 RTCs established
40 additional facilities
were designated
New indicator
New indicator
New Indicator
Regulations on EMS
in mass gatherings
developed
None
Policy on education and
training of EMS Personnel
drafted
2014/15
2013/14
5 RTCs established
60 additional facilities designated
Review and Finalise the Scope
of Practice Guidelines for the
rendering of Forensic Pathology
Services and Publish for
Implementation
9 RTCs
established
Implement the scope of practice
guidelines in 9 provinces
Publish Regulation on for the rendering
of Forensic Pathology Services for
implementation
Baselines established using the new
monitoring system
$VWDQGDUGLVHGZRUNÀRZDQG
monitoring system developed for
all 3 tests and implemented at 4
forensic chemistry laboratories
Regulations on for the Rendering
of Forensic Pathology Services
reviewed and Published for public
comment
Regulations implemented by 9 Provinces
PublishED Regulation on Emergency
Care Centres for public comment and
implementation
3 EMS Colleges implementing the
policy on education and training of EMS
Personnel published
2016/17
Medium-term targets
EMS in mass gatherings
published for public comment and
implementation
Regulations on Emergency Care
Centres Drafted
Policy on education and training
of EMS Personnel published
2015/16
9 RTCs
established
9 provinces compliant with the scope of
practice guidelines
Not Applicable
Not Applicable
9 Provinces compliant with regulations
Regulations implemented by 9 Provinces
Additional 3 EMS Colleges implementing
the policy on education and training of
EMS Personnel published
2017/18
The table below provides other key programme performance measures that will be under taken by the Department to achieve the strategic objectives provided above. This table also provides
three-year targets for the various sub-programmes funded from the Programme 5.
Quarterly
Quarterly
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Develop a Nursing and midwifery educators’ training
and development programme
Develop a standerdised
Nursing leadership structure for Provincial DoH
Number of facilities maintained, repaired and/or
refurbished in NHI Districts
Number of facilities maintained, repaired and/or
refurbished outside NHI pilot Districts
Number of clinics and Community Health Centres
constructed or revitalised
Number of hospitals constructed or revitalised
Number of new facilities that comply with gazetted
infrastructure Norms & Standards.
Develop a Infrastructure Monitoring System
Number of provinces that are compliant with the
EMS regulations
Number of Blood Alcohol reports produced
Number of Toxicology reports produced
Number of food tests performed
Establish a coaching mentoring and training
programme for health managers
Develop a knowledge hub which includes a web
based interactive information system
Annual
Develop guidelines for HRH norms and standards
using the WISN methodology
Quarterly
Annual
Number of Hospitals that comply fully with the
National Core Standards.
Public Nursing colleges offering new Nursing
SURJUDPPHVLQOLQHZLWK1DWLRQDO4XDOL¿FDWLRQV
Framework)
Annual
Number of gazetted Tertiary hospitals providing the
full package of Tertiary1 Services
Annual
Annual
Number of central hospitals with full delegated
authority.
Number of facilities benchmarked against PHC
VWDI¿QJQRUPDWLYHJXLGHV
Reporting period
Framework for knowledge hub
developed and approved
Coaching mentoring and training
programme developed and piloted
4 000
4 500
120 000
EMS Regulations and compliance
checklist gazetted for implementation
Infrastructure Monitoring System fully
developed and tabled at NHC
37
2
35
310 facilities
198 facilities
A provincial Nursing structures to give
authority over nursing and midwifery
services tabled at NHC
a Nursing and midwifery educators’
training and development programme
developed
A national policy for nursing education
developed in the context of bedside
training
1000
Tertiary, Regional and Central Hospital
managers oriented on WISN tool and
methodology
Guidelines for HRH Norms for District
and specialised hospitals developed.
Full compliance with the National
Core Standards in 8 Central hospitals
and 5 Tertiary Hospitals
4 additional tertiary hospitals
(Pietersburg, Frere, Kimberly and
Ngwelezane) providing the full
package of Tertiary 1 services
10 central hospitals with full delegated
authority
A national nursing structure
funded and functional
audit of the capacity of
nursing and midwifery
educators conducted
Components of the national
nursing education policy
GH¿QHG
1st
5.4 QUARTERLY TARGETS FOR STRATEGIC OBJECTIVE PERFORMANCE INDICATORS 2015/16
76
A provincial nursing
structure tabled to NHC
Content and scope of
the training programme
determined
3rd
A functional structure for
nursing and midwifery
First draft of the
curriculum developed
Second Draft policy
developed
Quarterly targets
First draft of the national
policy developed
2nd
None
Curriculum for capacity
development for nurse
educators approved
A national policy for
nursing educ ation
approved
4th
77
Annual
Number of Regional Training Centre established
Annual
Regulations for the Rendering of Forensic
Pathology Services promulgated
Annual
Annual
Develop a monitoring system to effectively measure
turnaround time of tests conducted at Forensic
Chemistry Laboratories
Number of Health Facilities that are designated to
render services for the management of sexual and
related offences
Annual
Develop regulations for Emergency Care Centres
Annual
Annual
Publish Policy on education and training of EMS
Personnel published for implementation
Publish Scope of Practice Guidelines for the
rendering of Forensic Pathology Services
Reporting period
5 RTCs established
Review and Finalise the Scope of
Practice Guidelines for the rendering
of Forensic Pathology Services and
Publish for Implementation
Regulations on for the Rendering of
Forensic Pathology Services reviewed
and Published for public comment
$VWDQGDUGLVHGZRUNÀRZDQG
monitoring system developed for all 3
tests and implemented at 4 forensic
chemistry laboratories
Regulations on Emergency Care
Centres Drafted
Policy on education and training of
EMS Personnel published
5.5 QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE INDICATORS
1st
2nd
Quarterly targets
3rd
4th
Change to 2014 Budget estimate
Total
Violence, Trauma and EMS
Forensic Chemistry Laboratories
Nursing Services
Human Resources for Health
16 838 944
3 699
650 322
–
2 000 988
9 432
8 051 780
Hospital Management
6 121 042
Tertiary Health Care Planning and Policy
17 399 552
3 699
64 221
503
2 111 834
21 427
8 882 258
6 314 812
798
2012/13
11 024
93 851
1 093
2 212 908
5 664
9 624 393
5 546 053
2 263
2013/14
17 497 249
Audited outcome
1 681
2011/12
Health Facilities Infrastructure Management
R thousand
Subprogramme
(113 000)
18 816 487
5 880
122 896
2 531
2 342 479
5 426
10 171 405
6 162 300
3 570
2014/15
Adjusted
appropriation
5.6. RECONCILING PERFORMANCE TARGETS WITH THE BUDGET AND MTEF
78
3.8%
16.7%
-42.6%
–
5.4%
-16.8%
8.1%
0.2%
28.5%
100.0%
–
1.3%
–
12.3%
0.1%
52.1%
34.2%
–
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
6 231 739
(538 235)
19 159 065
7 133
107 019
4 941
2 398 385
5 162
10 401 067
(803 915)
19 961 367
7 401
120 421
3 102
2 501 591
5 355
10 850 156
6 469 521
3 820
2016/17
3 619
2015/16
(585 172)
21 219 950
7 880
120 419
3 257
2 658 129
5 685
11 529 705
6 890 866
4 009
2017/18
4.1%
10.3%
-0.7%
8.8%
4.3%
1.6%
4.3%
3.8%
3.9%
100.0%
–
0.6%
–
12.5%
–
54.3%
32.5%
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
79
917
Computer services
16 684 175
–
410
Rental and hiring
3 608
–
Operating payments
1 237
6 706
698
–
5 125
14
6
Operating leases
Consumable supplies
Inventory: Medicine
75
–
88
–
5
–
Entertainment
2 141
2 179
–
–
Consultants and professional services: Laboratory services
Contractors
–
Consultants and professional services: Infrastructure and planning
52 926
862
Communication
services
229
–
199
2 638
Advertising
Administrative fees
37
80 100
Goods and services
of which:
55 922
136 022
2011/12
17 181 216
23
693
1 820
–
8 355
804
939
–
6 291
11
33
23
416
5
–
–
2
2 627
1 990
–
9
–
112 944
1 842
963
188
–
845
283
78
141 184
65 952
207 136
2012/13
–
252
1 320
–
9 010
567
804
42
7 477
18
213
11
960
7
29
1 368
–
1 641
1 644
150
–
–
104 472
582
847
113
–
463
780
–
132 770
94 956
227 726
2013/14
17 105 605
Audited outcome
Current payments
R thousand
17 992 004
–
790
539
30
4 188
4 760
1 561
–
8 587
30
65
1 059
160
–
–
–
18
1 832
4 502
–
80
171 459
48 820
1 849
1 216
1 008
69
10 653
1 220
108
264 603
106 380
370 983
2014/15
Adjusted
appropriation
2.5%
–
24.4%
-46.9%
–
-14.5%
56.7%
30.8%
–
18.8%
28.9%
121.3%
141.7%
22.1%
–
–
–
53.3%
-5.6%
28.1%
–
–
–
-2.7%
26.3%
12.2%
63.9%
–
276.9%
-22.7%
42.9%
48.9%
23.9%
39.7%
97.7%
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
0.2%
0.5%
–
–
–
–
–
–
–
0.9%
0.5%
1.3%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
18 048 519
–
1 464
718
131
5 386
5 092
1 923
–
11 647
40
1 090
223
175
–
–
3 000
18
209 787
1 082
–
80
13 000
79 934
2 203
1 690
1 162
72
1 728
1 499
133
344 477
116 037
460 514
2015/16
18 796 182
25
993
712
100
8 365
1 938
1 068
–
12 379
12
1 000
159
457
–
–
5 000
–
222 507
7 550
–
374
13 000
79 257
1 917
3 125
287
–
1 823
551
–
362 670
122 424
485 094
2016/17
19 975 004
–
500
1 700
100
18 043
2 077
1 300
–
13 000
–
1 300
159
1 200
–
–
4 200
–
227 389
13 500
–
–
13 000
80 475
700
1 100
100
–
500
1 000
–
379 745
128 544
508 289
2017/18
3.5%
–
-14.1%
46.7%
49.4%
62.7%
-24.2%
-5.9%
–
14.8%
-100.0%
171.4%
-46.9%
95.7%
–
–
–
-100.0%
398.8%
44.2%
–
-100.0%
-57.7%
18.1%
-27.7%
-3.3%
-53.7%
-100.0%
-63.9%
-6.4%
-100.0%
12.8%
6.5%
11.1%
94.5%
–
–
–
–
–
–
–
–
0.1%
–
–
–
–
–
–
–
–
0.8%
–
–
–
0.3%
0.4%
–
–
–
–
–
–
–
1.7%
0.6%
2.3%
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
80
23
–
–
–
University of Stellenbosch
Walter Sisulu University
7 200
–
University of Limpopo
University of the Witwatersrand
University of Cape Town
Current
7 200
–
+HDOWK)DFLOLWLHVDQG,QIUDVWUXFWXUH0DQDJHPHQW1RQSUR¿W
institutions
–
Current
23
64.2%
–
18 747
–
18 747
23
Current
6RFLDOEHQH¿WV
Households
Total
%XLOGLQJVDQGRWKHU¿[HGVWUXFWXUHV
Households
–
7 200
16 676 952
–
4 000
4 000
9 000
4 000
21 000
1 326
1 326
56
56
61.5%
14
11 186
–
11 186
56
1 326
21 000
17 158 834
2012/13
2013/14
4 000
–
–
–
–
4 000
–
–
66
66
57.9%
27
50 165
113 726
163 891
66
–
4 000
17 101 539
Audited outcome
2011/12
R thousand
–
–
–
–
–
–
–
–
–
–
54.8%
–
75 097
378 403
453 500
–
–
–
17 992 004
2014/15
Adjusted
appropriation
2.6%
–
–
–
-100.0%
–
-100.0%
–
–
-100.0%
-100.0%
–
–
58.8%
–
189.2%
-100.0%
–
-100.0%
–
–
–
–
–
–
–
–
–
–
–
–
0.2%
0.7%
0.9%
–
–
–
97.7%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
–
–
–
–
–
–
–
–
–
–
52.5%
–
87 516
562 516
650 032
–
–
–
18 048 519
–
–
–
–
–
–
–
–
–
–
51.3%
–
93 017
587 074
680 091
–
–
–
18 796 182
2016/17
–
–
–
–
–
–
–
–
–
–
50.1%
–
102 695
633 962
736 657
–
–
–
19 975 004
2017/18
2015/16
Expenditure/
total:
Average (%)
–
–
–
–
–
–
–
–
–
–
–
–
11.0%
18.8%
17.6%
–
–
–
3.5%
–
–
–
–
–
–
–
–
–
–
–
–
0.5%
2.7%
3.2%
–
–
–
94.5%
2014/15 - 2017/18
Average
growth
rate (%)
Infrastructure grant to provinces
Number
Actual
191
22
16
7 – 10
11 – 12
13 – 16
–
–
–
–
–
15
20
190
57
282
12.9
11.9
60.7
9.5
95.0
Cost
2013/14
0.9
0.6
0.3
0.2
0.3
Unit
Cost
2. Rand million.
–
–
–
5 290 816
5 290 816
–
–
9 620 357
2 190 366
11 810 723
–
–
–
5 501 981
5 501 981
–
–
10 168 235
2 321 788
12 490 023
2014/15
Adjusted
appropriation
5.6%
-100.0%
–
–
-2.4%
-3.2%
–
-100.0%
8.1%
5.5%
0.2%
0.1%
2.6%
29.8%
32.7%
–
0.8%
52.0%
12.1%
65.0%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average growth
rate (%)
18
22
190
70
300
Number
16.0
14.2
64.1
12.1
106.4
Cost
2014/15
0.9
0.6
0.3
0.2
0.4
Unit
Cost
Revised estimate
18
22
190
70
300
Number
17.5
15.6
69.8
13.2
116.0
Cost
2015/16
1.0
0.7
0.4
0.2
0.4
Unit
Cost
18
22
190
70
300
Number
18.5
16.4
73.6
13.9
122.4
Cost
2016/17
1.0
0.7
0.4
0.2
0.4
Unit
Cost
18
22
190
70
300
Number
–
–
–
5 275 762
5 275 762
–
–
10 398 035
2 374 722
12 772 757
19.4
17.2
77.3
14.6
128.5
Cost
2017/18
–
–
–
5 472 680
5 472 680
–
–
10 846 778
2 476 724
13 323 502
2016/17
1.1
0.8
0.4
0.2
0.4
Unit
Cost
–
–
–
5 817 010
5 817 010
–
–
11 526 145
2 631 849
14 157 994
2017/18
2015/16
–
100 000
1 800 981
4 289 595
6 190 576
15 000
–
8 878 010
2 075 248
10 968 258
2013/14
62
291
1–6
Salary level
Hospitals, Tertiary Health Services and
Human Resource Development
Number of posts
additional to
the
establishment
31 March 2015
135 132
–
–
Nursing colleges grant
5 925 252
Health facility revitalisation grant
Health Infrastructure grant
6 060 384
–
Capital
2013 African Cup of Nations medical services grant
590 380
8 048 878
National tertiary services grant
Forensic pathology services grant
1 977 310
2012/13
Audited outcome
10 616 568
2011/12
Health professions training and development grant
Current
Provinces
R thousand
81
Expenditure/
total:
Average (%)
66.6%
Salary
level/total:
Average (%)
–
–
–
–
–
–
–
–
27.9%
27.9%
–
–
54.2%
12.4%
6.0%
7.3%
63.3%
23.3%
100.0%
2014/15 - 2017/18
Average
growth
rate (%)
Number
–
–
–
1.9%
1.9%
–
–
4.3%
4.3%
4.3%
2014/15 - 2017/18
Average
growth
rate (%)
Programme 6: Health Regulation and Compliance Management
Regulate the sale of medicines and pharmaceutical supplies,
including food control, and the trade in health products and
health technology. Promote accountability and compliance by
regulatory bodies and public entities for effective governance and
the quality of health care.
Food Control Pharmaceutical Trade & Product Regulation:
The cluster Food Control Pharmaceutical Trade and Product
Regulation is responsible for the regulation of pharmaceutical
products for human and animal use with an aim of ensuring
WKDW WKH\ DUH VDIH HI¿FDFLRXV DQG RI TXDOLW\ 7KH &OXVWHU LV
also responsible for post marketing surveillance, and taking
appropriate remedial action where necessary. It also licenses
manufacturers, exporters, importers, wholesalers and distributors
of medicines and ensures compliance with standards. With
respect to Food Control, the cluster is responsible for developing
safety standards, monitoring compliance thereto and taking
appropriate remedial action where necessary. The cluster is also
responsible for approval and oversight of clinical trials.
The cluster has been regulating allopathic medicines and
recently embarked on complementary and alternative medicines
(CAMS) as well as medical devices and in vitro diagnostics.
During 2014/15 – 2016/17, the cluster will begin work on more
robust regulation of cosmetics.
The regulator (the Medicines Control Council, MCC) has been
experiencing an increasing workload both for new applications
and post- registration variations. This has resulted in inordinately
long review timelines and a backlog. Nonetheless, the cluster
has managed to register 114 antiretroviral within 15 months That
the Medicines Control Council is being re –engineered to a more
responsive structure, through the establishment South African
Health Products Regulatory Authority (SAHPRA). Legislation to
create SAHPRA is currently in parliament.
Compensation Commissioner for Occupational Diseases
and Occupational Health: is responsible for the payment of
compensation of active and ex-workers in controlled mines
DQG ZRUNV ZKR KDYH EHHQ FHUWL¿HG WR EH VXIIHULQJ IURP
cardio-pulmonary related diseases as a result of work place
exposures in the controlled mines or works. Over the medium
term, business processes will be re-engineered worth regard to
revenue collection; reducing the turnaround period in settling
claims, amending the Occupational Diseases in Mines and
Works Act(1973); and improving governance, internal controls
and relationships with the stakeholders.
Public Entities Management sub-programme supports the
Executive Authority’s oversight function and provides guidance
to health public entities and statutory health professional
councils (hereinafter referred to as entities’) falling within the
mandate of the health legislation with regard to planning, budget
SURFHGXUHVSHUIRUPDQFHDQG¿QDQFLDOUHSRUWLQJUHPXQHUDWLRQ
governance and accountability. The sub-programme further
assists the Minister in accounting to Parliament on activities and
performance of the entities.
The development of the sub-programmes’ strategic objectives
is guided by the enabling legislation, current legislative
developments and best practice which promote good corporate
governance.
Governance oversight over entities is conducted through
monitoring compliance to legislative requirements based on
entities enabling legislation, certain provisions of the Public
Finance Management Act, 1999 (PFMA) (Act 1 of 1999) as
amended in conjunction with the principles contained in King III
report on corporate governance as well as other relevant policies
and legislative prescripts. The strategic objectives of the Cluster
are to improve oversight and promote good corporate governance
practices over health entities and statutory councils by ensuring
by ensuring compliance to applicable legislative prescripts and
the production of governance reports bi-annually.
The following entities fall within the mandate of the Department of Health:
HEALTH ENTITIES
HEALTH STATUTORY COUNCILS
The National Health Laboratory Service (NHLS)
Allied Health Professions Council (AHPC)
The South African Medical Research Council (MRC)
South African Dental Technicians Council (SADTC)
The Council for Medical Schemes (CMS)
South African Nursing Council (SANC)
2I¿FHRI+HDOWK6WDQGDUGV&RPSOLDQFH2+6&
South African Pharmacy Council (SAPC)
Health Professions Council of South Africa (HPCSA)
Interim Traditional Health Practitioners Council of South Africa (ITHPCSA)
Medicines Control Council (MCC)
82
83
Prepare draft
legislation for
establishment
of SAHPRA
Establish SAHPRA as a
public entity
Institute of Regulatory
Science (IRS) providing
training
Review occupational health
legislative framework
Establish the South African
Health Product Regulatory
Authority (SAHPRA)
Establish Institute of Regulatory
Science (IRS)
To develop the policy and
legislative framework for
occupational health
New Indicator
New Indicator
New Indicator
Number of provinces with
One Stop Service Centres
to deliver occupational health
and compensation services
Develop legal framework
to establish National Public
Health Institutes of South
Africa (NAPHISA)
1XPEHURI+HDOWKHQWLWLHV·
DQG6WDWXWRU\+HDOWK
SURIHVVLRQDO&RXQFLOVIXOO\
functional and compliant to
good Governance practices
(structures, Finance, HR ,
6XSSO\&KDLQ0DQDJHPHQW
policies) and also respond to
KHDOWKVHFWRUSULRULWLHV
Develop and implement a
performance management
system for board members
To provide occupational health
and compensation services
through the development of
One Stop Service centres in
provinces
To establish the National Public
Health Institutes of South Africa
(NAPHISA) for disease and
injury surveillance
Improve oversight and
Corporate Governance
practices by establishing
effective governance structures,
policies and tools
New Indicator
occupational health cluster
established and functional
To establish an occupational
health cluster
New Indicator
-
New Indicator
2011/12
Strategic Objective
New Indicator
New Indicator
New Indicator
New Indicator
New Indicator
-
New Indicator
New Indicator
Concept document
for NAPHISA
No provinces
with One Stop
Service Centre for
occupational health
and compensation
services within their
health facilities
New Indicator
Consultative
meetings with
stakeholders on
amendments to
the Occupational
Diseases in Mines
and Works Act, 1973
New Indicator
Non standardised
system
2 health entities
Report on conceptual
framework and business
case for NAPHISA
One Stop Service Centre
for occupational health and
compensation services in
one health facility in Eastern
Cape and Gauteng province
established
Discussion document on
integration of the governance
and management of the
occupational health units
(NIOH, CCOD and MBOD)
1 consultative meeting
on amendments to the
Occupational Diseases in
Mines and Works Act, 1973
New Indicator
National Portfolio Committee
on Health deliberates over
the bill
Publish Bill 6 of 2014
(February 2014)
Publish
Medicine
Amendment Bill
(July 2012)
New Indicator
2014/15
2013/14
2012/13
Non standardised
system
4 health Entities’ and
6 statutory health
professional councils
Gazetted legislation on
NAPHISA
for occupational health
and compensation
services in one health
facility in Northern Cape
and Limpopo Established
Consultation on discussion
document and approval
of structure, organogram
and activities of the
by NHC
Draft amendments to the
in Mines and Works Act,
1973 and the occupational
health framework
Project Team appointed
with Business Plan drafted
and approved
SAHPRA Act (Bill 6 of
2014) Promulgated , and
transitional plan from MCC
to SAHPRA developed
2015/16
SAHPRA established
Board, CEO and
Committees Appointed
A standardised performance
management system
for board members fully
implemented
4 health Entities’ and 6
statutory health professional
councils
Assessment of other
business units within the
National Department of
Health that are transferred to
NAPHISA
for occupational health and
compensation services in one
health facility in North West
and Free State Established
Reorganisation of
and middle management
structures
Gazette legislation on
amendments to the
Occupational Diseases in
Mines and Works Act, 1973
Incorporate virtual university
within SAHPRA
t
t
2016/17
Medium-term targets
A standardised
performance
management system
for board members fully
implemented
4 health Entities’ and
6 statutory health
professional councils
Consolidation of other
business units into
NAPHISA
One Stop Service
Centre for occupational
health and
compensation services
in one health facility in
Mpumalanga and KZN
established
New structure for
occupational health
cluster implemented
Implementation
of legislative
ammendments to
in Mines and Works Act,
1973
IRS functional with
training provided
SAHPRA Operational
and functional
2017/18
The tables below summarise the key Strategic objectives, indicators and three-year targets for the various budget sub-programmes funded from the Health Regulation and Compliance Management.
6.2 STRATEGIC OBJECTIVE, PERFORMANCE INDICATORS AND ANNUAL TARGETS
New indicator
New indicator
New indicator
Develop and implement Dashboard to monitor
entities performance and compliance to
legislative prescripts
Develop a reporting template to enable
feedback to the executive authority.
758
Number of compensable disease claims paid
by CCOD other than pensioners
Number of newly appointed boards inducted
and trained
6367
1XPEHURIDSSOLFDWLRQVFHUWL¿HGDW0%2'DV
compensable disease claims
New indicator
New indicator
New indicator
New indicator
1779
4376
New indicator
New indicator
New indicator
Establish a MOU with Department of
Agriculture, Fisheries and Forestry’s (DAFF)`
Develop Regulations for Cosmetic products
New indicator
New indicator
Improve registration turnaround times of
ARV’s, TB, oncology and vaccines to treat
and prevent high burden of diseases
None
2012/13
New indicator
New indicator
New indicator
3124
4444
New indicator
New indicator
New indicator
Promulgate
Regulations
and implement
guidelines on
CAMS
2013/14
None
2011/12
Regulate Medical devices, IVDs, cosmetics
and expand on regulation of Complementary
medicines (CAMS)
PROGRAMME PERFORMANCE INDICATORS AND ANNUAL TARGETS
84
Develop draft regulations
and guidelines for
Medical devices and
IVDs
&DOOXSVSHFL¿FKLJKULVN
categories of CAMS for
registration purposes
No standardised Feedback
mechanism available for
Departmental representatives
serving on boards
New Indicator
1 new public entity board
(Council for Medical Schemes)
with 10 members appointed
inducted and trained
2700
7000
Draft Regulations produced
Draft MOU
50 % of priority medicine
registered NCE = 22 months
Generics = 18 months
t
t
2014/15
Promulgate Regulations for
Medical Devices and IVDs and
call up high risk Medical Devices
and IVDs
Call up additional categories of
CAMS
3000
8000
Standardised reporting template
developed and implemented for
Departmental representatives serving
on boards
10 Dashboards developed and piloted
(1 per entity or statutory council)
3 new boards appointed, inducted and
trained
(Health Professions Council of South
Africa; National Health Laboratory
Service and the Interim Traditional
Health Practitioners Council of South
Africa)
Regulations gazetted for public
comments
MOU Signed between DoH and DAFF
55 % of priority medicine registered
NCE = 36 months; Generics = 28
months
t
t
2015/16
2016/17
Call up additional
Medical Devices and
IVDs
Call up additional
categories of CAMS
2017/18
Regulate Medical Devices
and IVDs
Call up additional
categories of CAMS
Standardised reporting
template developed
and implemented for
serving on boards
10 Dashboards fully
implemented (1 per entity or
statutory council)
3 new boards appointed,
(MRC; OO H SC and
AHPCSA)
3300
serving on boards
10 Dashboards fully
implemented (1 per entity or
statutory council)
1 new board appointed,
(Council for Medical Schemes
Inducted
6000
12000
Regulations fully implemented
FRPPHQWVUHYLHZHGDQG¿QDO
regulations gazette
10000
DAFF Laboratories testing Food
Samples
65 % priority medicine
registered NCE = 36 months;
t
t
DAFF Laboratories testing
Food Samples
60 % priority medicine
registered NCE = 36 months;
t
t
Medium-term targets
85
Quarterly
Quarterly
Quarterly
Quarterly
Number of provinces with One Stop
Service centres in health facilities
to deliver occupational health and
compensation services
Develop legal framework to
establish National Public Health
Institutes of South Africa (NAPHISA)
Number of Health entities’ and
Statutory Health professional
Councils with fully functional and
compliant to good Governance
practices (structures, Finance, HR ,
Supply Chain Management policies)
and also respond to health sector
priorities
Develop and implement a
performance management system
for board members
Quarterly
Review occupational health
Quarterly
Quarterly
IRS Providing training
established and functional
Annual
Reporting period
Establish SAHPRA as a public entity
A standardised performance
management system for board
members developed and piloted
4 health Entities’ and 6 statutory
health professional councils
Gazetted legislation on NAPHISA
Establishment of One Stop Service
Centre for occupational health and
compensation services in one health
facility in Northern Cape and Limpopo
Consultation on discussion document
and approval of structure, organogram
and activities of the occupational
health cluster
Draft amendments to the
Occupational Diseases in Mines and
Works Act, 1973 gazetted
Business Plan drafted and approved
to allow establishment of IRS within
MCC/SAHPRA
SAHPRA Act (Bill 6 of 2014)
Promulgated and transitional plan
from MCC to SAHPRA developed
standardised performance
management system for
board members drafted and
circulated for consultation
checklists for measuring
functionality of health
entities and professional
councils developed and
consulted
Finalise legislative
framework for NAPHISA
1 preparatory meeting with
stakeholders and roleplayers in Northern Cape
Document on structure,
organogram and activities
of the occupational health
cluster
Report on occupational
health policy framework
Project team appointed
1st
2nd
Continue consultation on the
performance management system
for board members
checklists for measuring functionality
of health entities and professional
councils submitted for approval
Legislative framework submitted to
Cabinet
1 preparatory meeting with
stakeholders and role-players in
Limpopo
Submission of document on
structure, organogram and activities
of the occupational health cluster
Draft document on amendments
to the Occupational Diseases in
Mines and Works Act, 1973 and the
occupational health framework
3rd
members submitted for approval
checklists for measuring
functionality of health entities
and professional councils
approved, circulated for
implementation
Legislative framework submitted
to parliament
Establishment of One Stop
Service Centre in Northern Cape
1 consultative meeting
on amendments to the
Occupational Diseases in Mines
and Works Act, 1973 and the
occupational health framework
Work of Project team monitored
and Business plan available for
establishment of IRS
Quarterly targets
Work of Project team monitored
6.1 QUARTERLY TARGETS FOR STRATEGIC OBJECTIVES PERFORMANCE INDICATORS 2015/16
members approved and circulated
for implementation
Compile a functionality report
based on 10 checklists received
from health entities and
professional councils.
Gazetted legislation on NAPHISA
Establishment of One Stop
Service Centre in Limpopo
Approval of structure,
organogram and activities of the
1 consultative meeting on
amendments to the Occupational
Diseases in Mines and Works Act,
1973 and the occupational health
framework
Establish IRS as a virtual
university within MCC/SAHPRA
4th
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
1XPEHURIDSSOLFDWLRQVFHUWL¿HGDW
MBOD as compensable disease
claims
Number of compensable disease
claims paid by CCOD other than
pensioners
Number of newly appointed boards
Develop and implement Dashboard
to monitor entities performance and
compliance to legislative prescripts
Develop a reporting template to
enable feedback to the executive
authority.
Quarterly
Establish a MOU with Department
of Agriculture, Fisheries and
Forestry’s (DAFF)`
Quarterly
Quarterly
Improve registration turnaround
times of ARV’s, TB, oncology and
vaccines to treat and prevent high
burden of diseases
Develop Regulations for Cosmetic
products
Quarterly
Reporting period:
(Quarterly / Biannually / Annual)
Regulate Medical devices, IVDs,
cosmetics and expand on regulation
of Complementary medicines
(CAMS)
Programme Performance
Measure
Promulgate Regulations for
Medical Devices and IVDs and
call up high risk Medical Devices
and IVDs
Call up additional categories of
CAMs
Departmental representatives serving
on boards
3 new boards appointed, inducted and
trained
(Health Professions Council of South
Africa; National Health Laboratory
Service and the Interim Traditional
Health Practitioners Council of South
Africa)
3000
8000
Regulations gazetted for public
comments
MOU Signed between DoH and DAFF
55 % of priority medicines registered
NCE = 36 mnth; Generics = 28 mnth
t
t
1st
Evaluate stakeholder
comments on Medical
Devices and IVDs and
CAMs Regulations
in-house
Cosmetics: None
Standardised reporting
template drafted and
circulated for consultation
3 Dashboards developed
and piloted (1 per entity or
statutory council)
None
500
1500
Prepare draft Cosmetic
regulations
Identify tests to be carried
out by internal and external
laboratories
15 % of priority medicines
registered NCE = 36 mnth;
Generics = 28 mnth
t
t
2nd
Workshop comments on
Medical Devices and IVDs
received with stakeholders
Promulgate Regulations on
CAMs
3rd
Publish proposed
amended Regulations
on Medical Devices and
IVDs for a short period of
30 days
submitted for approval
None
1000
approved
2 Dashboards developed and
piloted (1 per entity or statutory
council)
Health Professions Council of
South Africa board appointed,
1000
2500
Cosmetic Regulations published
for comments
&RVPHWLF5HJXODWLRQV¿QDOLVHGIRU
publication
2000
Draft MoU to allow for external
testing
Identify lab/s for external testing
Generics = 28 mnth
t
Quarterly targets
30 % of priority medicines registered
NCE = 36 mnth; Generics = 28 mnth
t
t
6.2 QUARTERLY TARGETS FOR PROGRAMME PERFORMANCE MEASURES FOR 2015/16
86
4th
Finalise and promulgate
Regulations for Medical
Devices and IVDs and
call up high risk Medical
Devices and IVDs
implemented
2 Dashboards developed and
piloted (1 per entity or statutory
council)
2 new boards appointed, inducted
and trained
(National Health Laboratory
Service and the Interim
Traditional Health Practitioners
Council of South Africa)
500
2000
MOU signed
Generics = 28 mnth
t
87
Subprogramme
118
–
16
Inventory: Medicine
15
–
27
–
–
10
788
Entertainment
371
42
15 952
131
1 402
332
–
2 709
956
1 742
Contractors
services
Computer services
Communication
Advertising
Administrative fees
77
39 959
Goods and services
of which:
79 304
119 263
957 678
33 883
835 792
Current payments
Budget Estimates
Change to 2014
Total
Compensation Commissioner for Occupational Diseases and
Occupational Health
Public Entities Management
79 712
5 850
Pharmaceutical Trade and Product Regulation
2 441
269
31
31
24
2
3
–
–
2
1 658
734
–
20 399
930
1 377
396
1
1 000
573
1 165
32
47 656
86 274
133 930
1 008 950
36 181
874 300
85 848
9 928
2 693
2012/13
Audited outcome
Food Control
2011/12
R thousand
99
1
125
178
25
11
8
4 581
2
743
1 445
150
25 753
2 135
1 358
315
–
1
227
1 063
25
56 472
94 202
150 674
1 214 381
36 440
1 062 170
105 781
7 156
2 834
2013/14
1 158
55
686
210
–
–
–
–
56
970
1 409
254
24 595
12 437
2 041
596
–
4 234
11 294
1 797
48
90 513
103 224
193 737
35 534
1 403 140
55 912
1 198 590
136 999
7 512
4 127
2014/15
Adjusted
appropriation
6.3 RECONCILING PERFORMANCE TARGETS WITH THE BUDGET AND MTEF
114.1%
–
250.0%
141.0%
-100.0%
–
–
–
77.6%
7.2%
56.0%
82.2%
15.5%
356.2%
13.3%
21.5%
–
16.1%
127.8%
1.0%
-14.6%
31.3%
9.2%
17.6%
13.6%
18.2%
12.8%
19.8%
8.7%
19.1%
–
–
–
–
–
–
–
0.1%
–
0.1%
0.1%
–
1.9%
0.3%
0.1%
–
–
0.2%
0.3%
0.1%
–
5.1%
7.9%
13.0%
100.0%
3.5%
86.6%
8.9%
0.7%
0.3%
Expenditure/
total:
Average (%)
2011/12 - 2014/15
Average
growth
rate (%)
1 211
58
718
220
–
–
–
–
59
1 015
1 474
266
15 428
3 327
2 135
624
–
3 536
8 767
1 880
51
58 268
137 411
195 679
339 635
1 596 919
58 644
1 399 991
124 816
9 798
3 670
293
32
534
523
–
–
–
–
–
2 750
1 099
–
23 798
1 521
2 368
878
451
3 100
2 578
1 664
29
63 624
145 111
208 735
365 470
1 687 672
61 643
1 477 122
134 862
10 171
3 874
2016/17
–
–
200
200
–
–
–
3 737
–
2 900
1 200
–
18 800
6 900
2 800
300
–
3 500
2 500
2 100
–
65 449
152 588
218 037
395 303
1 718 362
65 064
1 498 355
140 281
10 597
4 065
2017/18
2015/16
-0.5%
-100.0%
-100.0%
-33.7%
-1.6%
–
–
–
–
-100.0%
44.1%
-5.2%
-100.0%
-8.6%
-17.8%
11.1%
-20.5%
–
-6.1%
-39.5%
5.3%
-100.0%
-10.2%
13.9%
4.0%
7.0%
5.2%
7.7%
0.8%
12.2%
–
–
–
–
–
–
–
0.1%
–
0.1%
0.1%
–
1.3%
0.4%
0.1%
–
–
0.2%
0.4%
0.1%
–
4.3%
8.4%
12.7%
100.0%
3.8%
87.0%
8.4%
0.6%
0.2%
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
88
–
272
National Health Laboratory Services
2 777
2 777
Compensation Fund
4 194
Current
Social security funds
Council for Medical Schemes
12 289
534 487
South African Medical Research Council
2I¿FHRI+HDOWK6WDQGDUGV&RPSOLDQFH
834 534
283 564
Current
entities)
Departmental agencies (non-business
272
3.7%
957 678
Current
Social bene¿ts
Households
Total
–
2
830
272
830
Households
837 311
459
837 583
1 556
174
11 109
–
805
1 168
2011/12
6
2 916
2 916
4 310
23 675
558 801
283 863
870 649
539
539
3.6%
1 008 950
31
–
885
885
539
873 565
874 104
104
2 178
6
14 496
22
969
1 248
2012/13
Audited outcome
Operating payments
Property payments
Operating leases
Consumable supplies
R thousand
Subprogramme
3 062
3 062
4 525
31 252
603 534
419 460
1 058 771
119
119
4.0%
1 214 381
4
–
1 751
1 751
119
1 061 833
1 061 952
133
3 459
–
12 104
15
938
1 466
112
2013/14
–
3 215
3 215
4 751
76 953
665 252
446 331
1 193 287
–
–
4.1%
1 403 140
–
9 770
3 131
12 901
–
1 196 502
1 196 502
1 082
3 036
–
18 349
–
1 479
4 727
2014/15
Adjusted
appropriation
Average
growth
rate (%)
5.0%
5.0%
4.2%
84.3%
7.6%
16.3%
12.7%
-100.0%
-100.0%
–
13.6%
-100.0%
–
55.7%
149.6%
-100.0%
12.6%
12.6%
33.1%
25.0%
-100.0%
18.2%
–
22.5%
59.4%
–
2011/12 - 2014/15
0.3%
0.3%
0.4%
3.1%
51.5%
31.3%
86.3%
–
–
–
100.0%
–
0.2%
0.1%
0.4%
–
86.6%
86.6%
–
0.2%
–
1.2%
–
0.1%
0.2%
–
Expenditure/
total:
Average (%)
–
3 363
3 363
2 556
88 906
678 926
623 892
1 394 280
–
–
4.4%
1 596 919
–
–
3 597
3 597
–
1 397 643
1 397 643
132
2 175
–
12 803
–
547
3 942
2015/16
–
3 541
3 541
1 613
100 535
711 871
657 590
1 471 609
–
–
4.3%
1 687 672
–
–
3 787
3 787
–
1 475 150
1 475 150
–
86
2 273
16 750
522
2 007
2 111
2016/17
–
3 718
3 718
5 496
125 711
746 464
614 961
1 492 632
–
–
4.1%
1 718 362
–
–
3 975
3 975
–
1 496 350
1 496 350
–
3 000
2 500
13 286
1 000
2 100
1 700
2017/18
5.0%
5.0%
5.0%
17.8%
3.9%
11.3%
7.7%
–
–
–
7.0%
–
-100.0%
8.3%
-32.5%
–
7.7%
7.7%
-100.0%
-0.4%
–
-10.2%
–
12.4%
-28.9%
–
0.2%
0.2%
0.2%
6.1%
43.7%
36.6%
86.7%
–
–
–
100.0%
–
0.2%
0.2%
0.4%
–
86.9%
86.9%
–
0.1%
0.1%
1.0%
–
0.1%
0.2%
–
Expenditure/
total:
Average (%)
2014/15 - 2017/18
Average
growth
rate (%)
89
151
70
85
13
1–6
7 – 10
11 – 12
13 – 16
–
–
–
–
–
9
73
71
148
301
Number
Actual
7.7
37.8
24.6
24.2
94.2
Cost
2013/14
0.9
0.5
0.3
0.2
0.3
Unit
Cost
15
100
77
166
358
Number
11.1
46.6
22.7
22.8
103.2
Cost
2014/15
0.7
0.5
0.3
0.1
0.3
Unit
Cost
Revised estimate
15
100
77
166
358
Number
14.3
61.1
31.1
30.9
137.4
Cost
2015/16
100
15
1.0
77
166
358
Number
0.6
0.4
0.2
0.4
Unit
Cost
15.0
64.5
32.9
32.6
145.1
Cost
2016/17
1.0
0.6
0.4
0.2
0.4
Unit
Cost
15
100
77
166
358
Number
2. Rand million.
319
Salary level
Health Regulation and Compliance
Management
Number of posts
additional to
the
establishment
31 March 2015
15.8
67.9
34.6
34.3
152.6
Cost
2017/18
1.1
0.7
0.4
0.2
0.4
Unit
Cost
–
–
–
–
–
4.2%
27.9%
21.5%
46.4%
100.0%
2014/15 - 2017/18
Salary
level/total:
Average (%)
Number
Average
growth rate
(%)
PART C
Links to other plans
90
91
PART A: Direct (NHI Pilot Districts)
To improve the performance of the District Health System through testing
service delivery and provision innovations in readiness for the implementation of
National Health Insurance (NHI);
Test innovations in health services delivery and provision for implementing
NHI, allowing for each district to interpret and design innovations relevant to its
VSHFL¿FFRQWH[WLQOLQHZLWKWKHYLVLRQIRUUHDOLVLQJXQLYHUVDOKHDOWKFRYHUDJHIRU
all;
7RXQGHUWDNHKHDOWKV\VWHPVWUHQJWKHQLQJDFWLYLWLHVLQLGHQWL¿HGIRFXVDUHDV
To assess the effectiveness of interventions/activities undertaken in the district
funded through this grant.
National Health Insurance
Purpose of the grant
Support provinces to fund services costs associated with the training of health
science trainees on the public service platform
Name conditional grant
Health Professional Training
and Development
HEALTH PROFESSIONS TRAINING AND DEVELOPMENT GRANT
t
t
t
t
t
t
PART B: As part of the National Health Grant (Contracting of Health Practitioners and
phased roll-out of the Centralised Chronic Medication Dispensing and Distribution
model)
Innovative models for the purchasing of health care services, including:
&RQWUDFWLQJRIPHGLFDOSURIHVVLRQDOVDVGH¿QHGE\QHHGWKURXJKH[WHUQDO
service provider organisations
Establishment of fully constituted and functional District Clinical Specialist
Teams linked to the achievement of the Millennium Development Goals (MDGs)
Strengthening of School Health Services linked to addressing the learning
FKDOOHQJHVRIOHDUQHUVLQLGHQWL¿HGVFKRROV
An alternative chronic care dispensing and distribution model implemented
To improve spending, performance, monitoring and evaluation on National
Health Insurance pilots.
t
t
t
t
Name of conditional grant
NATIONAL HEALTH INSURANCE GRANT
1. CONDITIONAL GRANTS
92
Appropriate and innovative models for purchasing
VHUYLFHVIURPKHDOWKSURIHVVLRQDOVLGHQWL¿HGDQG
tested
Implement an alternative distribution model for
chronic medication
Monthly and Consolidated quarterly performance reports
submitted to National Treasury
Consolidated annual performance evaluation report
Independent evaluation report for 2014/15
9 Provincial Consolidated business plans.
1XPEHURIIDFLOLW\EXVLQHVVSODQVZLOOEHFRQ¿UPHGDIWHU
February 2015.
9 Provincial Consolidated business plans
1XPEHUIDFLOLW\VLWHYLVLWVZLOOEHFRQ¿UPHGDIWHU)HEUXDU\
2015.
9 Annual performance reports
1XPEHURITXDUWHUO\UHSRUWVZLOOEHFRQ¿UPHGDIWHU)HEUXDU\
2015.
Minimum 5 to 10
Number of site visits.
Availability of quarterly & annual performance report.
1XPEHURIDXGLW¿QGLQJV
Indicator targets
t
t
t
Availability of Business Plans.
Performance indicators
t
t
Approved business plans for all 10 pilot districts
Consolidated quarterly performance reports submitted to
National Treasury
t
t
t
t
t
t
t
10 pilot districts across the country
Approved business plans for all 10 pilot districts
Quarterly and annual performance reports
Indicator targets for 2014/15
93
National Tertiary services
COMPREHENSIVE HIV
AIDS CONDITIONAL
GRANT
To enable the health sector to develop and effective response to preventing cervical
cancer by making available HPV vaccination for grade 4 school girls.
To fund the introduction of HPV vaccination programme in schools.
To help accelerate construction, maintenance, upgrading and rehabilitation
of new and existing infrastructure in health, including health technology,
organisational systems (OD) and quality assurance (QA) in National Health
Insurance (NHI) pilot districts
Supplement expenditure on health infrastructure delivered through publicprivate partnerships
To enhance capacity to deliver infrastructure in health
To address capacity constraints in the provinces and to create an alternative
track to speed up infrastructure delivery.
HPV Grant
t
t
t
t
t
To help accelerate construction, maintenance, upgrading and rehabilitation
of new and existing infrastructure in health including: health technology (HT),
organisational design (OD) systems and quality assurance (QA)
To enhance capacity to deliver health infrastructure
t
HPV GRANT
National Health Grant:
Health Facility Revitalisation Component
Health Facility Revitalisation Grant
HEALTH FACILITY REVITALISATION GRANT
To enable the health sector to develop an effective response to HIV/AIDS and TB
To support the Department with the PEPFAR transition process.
COMPREHENSIVE HIV/AIDS GRANT
To compensate tertiary facilities for the costs associated with the provision of these
services
To ensure provision of tertiary health services for all South African citizens
NATIONAL TERTIARY SERVICES GRANT
160,000
861,071
387,297
11,000,000
1,600,000
Number of babies Polymerase Chain Reaction (PCR)
tested at 6 weeks
Number of HIV positive clients screened for TB
Number of HIV positive patients that started on IPT
Number of HIV tests done
Number of Medical Male Circumcisions performed
80% per cent of eligible grade 4 school girls received the HPV
vaccination
80% per cent of schools with grade 4 girls reached by the HPV
vaccination team
Percentage of schools with grade 4 girls reached by the
HPV vaccination team
Indicator targets
Monitor implementation of all conditional grant funded projects
Percentage of eligible grade 4 school girls who receive
the HPV vaccination
Monitoring number of projects receive funding from
Health Facility Revitalisation Grant and National Health
Grant
Availability of approved Annual Implementation Plans (AIP) for
all projects funded from National Health grant and Health facility
Revitalisation Grant
Monitor implementation of all conditional grant funded projects
Monitoring number of projects receive funding from
Health Facility Revitalisation Grant and National Health
Grant
Approved Annual Implementation plans for both Health
Facility Revitalisation Grant and National Health Grant
Availability of approved Annual Implementation Plans (AIP) for
all projects funded from National Health grant and Health facility
Revitalisation Grant
Approved Annual Implementation plans for both Health
Facility Revitalisation Grant and National Health Grant
Indicator targets
93,000
Number of Antenatal Care (ANC) clients initiated on lifelong ART
3,800,000
First Quarter 25%
Second Quarter 50%
Third quarter 75%
Fourth quarter 100% Expenditure.
Number of patients on ART remaining in care
([SHQGLWXUHDWWKHHQGRI¿QDQFLDO\HDU
9 SLA
39 Business Plans
3URYLQFLDORI¿FHYLVLWVFRPELQHGZLWKIDFLOLWLHVIDFLOLWLHVSURYLQFLDORI¿FH DQQXDOVLWHYLVLWV
9 Annual performance reports and 39 quarterly reports
SURYLQFLDOFRQVROLGDWLRQSURYLQFLDORI¿FHIDFLOLW\UHSRUWV
Minimum of 3 audits
t
t
t
t
t
t
t
t
t
9 Service Level Agreements (SLA)
Availability of Business Plans.
Number of site visits.
Availability of quarterly & annual performance
report.
1XPEHURIDXGLW¿QGLQJV
t
t
t
t
t
2. Public Entities
The National Department of Health has oversight over the
following public entities
1. Council for Medical Schemes
The Council for Medical Schemes is the national medical
schemes regulatory authority established in terms of the Medical
Schemes Act (1998). The council’s vision for the medical scheme
industry is that it is effectively regulated to protect the interests of
members and promote fair and equitable access to private health
¿QDQFLQJ
2. National Health Laboratory Service
In terms of the National Health Laboratory Service Act (2000)
the National Health Laboratory Service is required to: provide
FRVWHIIHFWLYHDQGHI¿FLHQWKHDOWKODERUDWRU\VHUYLFHVWRDOOSXEOLF
sector health care providers, other government institutions and
any private health care provider in need of its service; support
health research; and provide training for health science education.
The service’s overarching goals are to restructure and transform
laboratory services in order to make them part of a single national
public entity and develop policies that will enable it to provide
health laboratory services as the preferred provider for the public
health sector; and to provide cost-effective and professional
ODERUDWRU\PHGLFLQHWKURXJKFRPSHWHQWTXDOL¿HGSURIHVVLRQDOV
and state-of-the-art technology supported by academic and
internationally recognised research, training and product
development in order to support optimal healthcare delivery for
the country.
RI WKH RI¿FH ZDV LQDXJXUDWHG LQ -DQXDU\ DQG WKH 2I¿FH
started to function as an independent entity on 1 April 2014.
The 12-member board consists of healthcare professionals,
DFDGHPLFV DQG DFWLYLVWV 7KH HVWDEOLVKPHQW RI WKH 2I¿FH RI
Health Standards Compliance is another step towards realising
universal healthcare coverage and improving the quality of care
LQ6$7KH2I¿FHRI+HDOWK6WDQGDUGV&RPSOLDQFHZLOOFRQGXFW
compliance inspections at health facilities. It will also have an
ombudsman, which will make it possible for patients to complain
about healthcare institutions.
3. Public Private Partnership
Bio Vac
In 2003 the National Department of Health established the
Biological and Vaccines Institute of Southern Africa (Biovac)
through a strategic equity partnership with the Biovac Consortium
(Pty) Ltd. The two aims of the partnership were: revive the
declining vaccine production capacity in South Africa; and supply
of vaccines for the expanded programme on immunisation (EPI)
to the public sector. The project agreement is structured to give
HIIHFW WR WKHVH REMHFWLYHV E\ FUHDWLQJ VSHFL¿F 6WUDWHJLF (TXLW\
Partnership Undertakings. The current Agreement is effective
until 31 December 2016 in accordance with Regulation 16.8 of
the Public Financial Management Act.
Infrastructure PPPs
The National Department of Health through its infrastructure
unit, is actively involved together with the Provinces in the
HVWDEOLVKPHQW RI VHYHQ 333 ÀDJVKLS SURMHFWV IRU LGHQWL¿HG
hospitals.
3. South African Medical Research Council
The South African Medical Research Council was established in
1969 in terms of the South African Medical Research Council
Acts (1969 and 1991). The Intellectual Property, Rights from
Publicly Financed Research and Development Act (2008) also
informs the council’s mandate. The Council is required to promote
the improvement of health and quality of life through research
development and technology transfer. Research and innovation
are primarily conducted through council-funded research units
located within the council and in higher education institutions.
The council’s strategic focus is determined in the context of
the priorities of the Department of Health and government. The
council’s research therefore plays a key role in responding to
government’s key health outcome: a long and healthy life for all
South Africans.
4. Compensation Commissioner for Occupational Diseases
in Mines and Works
The Compensation Commissioner for Occupational Diseases in
Mines and Works was established in terms of the Occupational
Diseases on Mines and Works Act (1973). It operates a trading
account in terms of the act. The commissioner is mandated to
compensate ex-miners and miners for impairment of lungs
or respiratory organs and reimbursement for loss of earnings
incurred during tuberculosis treatment. In the case where the
H[PLQHU LV GHFHDVHG LW FRPSHQVDWHV WKH EHQH¿FLDULHV RI WKH
ex-miner. The commissioner also administrates the government
grant for pensioners.
5. The Of¿ce of Health Standard Compliance
7KH 2I¿FH RI +HDOWK 6WDQGDUG &RPSOLDQFH LV HVWDEOLVKHG LQ
terms of the National Health Amendment Act (2013). The board
94
95
Documented
Evidence:
Annual Report
Auditor General’s
Report
Provincial Reports
DJDLQVWGH¿QHGVHW
of non-negotiable
items
Personnel Files
To strengthen
¿QDQFLDO
management
monitoring and
evaluation
To strengthen
¿QDQFLDOPDQDJHment monitoring and
evaluation
Purpose: to measure
the time it takes to
¿OOYDFDQFLHVLQWKH
department.
Importance:
6LJQL¿FDQW
To provide maximum
levels of health,
quality of life, work
performance and
health care to
employees.
Audit opinion
for Provincial
Departments of
Health
Number of provinces
that submit reports
DJDLQVWGH¿QHGVHWRI
non-negotiable items
on a monthly basis
Rate at which
recruitment
processes are
concluded,
represented as the
number of average
days taken for the
recruitment process
The employer
approach/activities/
programmes to
improve employee
health and well
being for improved
productivity and
performance.
Audit opinion from
Auditor General
for Provincial
Departments of
Health
Number of provinces
that submit reports
DJDLQVWGH¿QHGVHW
of non-negotiable
items on a monthly
basis
Average
Turnaround times
for recruitment
processes
Develop and
Implement
Employee wellness
programme that
comply with
Public Service
Regulations (PSR)
and Employee
Health and Wellness
Strategic Framework
(EHWSF)
Documented
evidence
Documented
Evidence:
Annual Report
Auditor
General’s Report
To strengthen
¿QDQFLDO
management
monitoring and
evaluation
Audit opinion from
Auditor General for
National Department
of Health
Source
Audit opinion from
Auditor General
Purpose /
Importance
Short De¿nition
Indicator name
PROGRAMME 1:
ANNEXURE A: TECHNICAL INDICATOR DESCRIPTIONS
Existence of
a customized
implementation
plan for the
Department
Turnaround
time could be
hampered by
poor response
from SAQA and
NIA
Numerator:
Total number of
Days taken to
make all appointments
Denominator:
Total number of
appointments
N/A
Provincial DoH
FDQEHFODVVL¿HG
compliant if
reports were
submitted for 10
months in the
year
N/A
N/A
Sum
N/A
Data
Limitations
N/A
Calculation
Method
Cumulative
Cumulative
Impact
Sum of
province
N/A
N/A
Calculation
Type
Outcome
Input
Outcome
Outcome
Type of
Indicator
Annual
Bi-Annually
Annual
Annual
Annual
Reporting
Cycle
No
No
No
No
No
New
Indicator
All 4 EHW Pillars
policies are
implemented and
improved quality
of work life
A lower number
indicates better
performance
All provinces
submitting reports
DJDLQVWGH¿QHG
set of non-negotiable items on a
monthly basis
Cluster Manager:
Employment Relations
Cluster Manager: HR
&KLHI)LQDQFLDO2I¿FHU
National DoH
&KLHI)LQDQFLDO2I¿FHUVRI
Provincial Departments of
Health
National DoH
8QTXDOL¿HG$XGLW
Opinion from the
Auditor General
Responsibility
8QTXDOL¿HG$XGLW
Opinion from the
Auditor General
Desired
Performance
96
Percentage of
Senior Managers
that have entered
into Performance
agreements (PAs)
with their supervisors
by 1 June 2015
NDoH vacancy rate
remains within DPSA
threshold of 10%
NDoH vacancy rate
Percentage of
Senior Managers
that have entered
into Performance
agreements with
their supervisors
Develop National
Health Litigation
Strategy
Short De¿nition
Develop National
Health Litigation
Strategy
Develop an
integrated
communication
strategy and
implementation plan
Indicator name
Track implementation
of PMDS
Track vacancy rate
Signed
Performance
Agreements
Persal system
providing vacancy
reports
National Health
Litigation Strategy
N/A
To harmonise
communication
efforts in the
Department so as to
break the culture of
working in silos
Mitigate litigations
Source
Purpose /
Importance
None
N/A
Data
Limitations
Numerator: Total
number of senior
managers with
signed PAs
Denominator:
Total number of
Senior Managers
on the staff
establishment
None
Numerator: Total
None
QXPEHURIXQ¿OOHG
Posts
Denominator:
Total number of
posts on the staff
establishment
None
N/A
Calculation
Method
Process
Input
Output
Outcome
Type of
Indicator
Percentage
Percentage
None
Cumulative
Calculation
Type
Annual
Bi-Annualy
Quarterly
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
New
Indicator
All managers
signing PAs
timorously
NDoH vacancy
rate remains
within DPSA
threshold of 10%
National Health
Litigation Strategy
developed and
approved
N/A
Desired
Performance
Cluster: HRM&D
Cluster: HRM&D
Cluster: Legal Services
Cluster Manager:
Communications
Responsibility
Implement an
Electronic system for
the early detection
of stock outs of
for the management of
medicines supply
Implement an
Electronic system for
the early detection of
stock outs of medicines
at PHC Facilties for
the management of
medicines supply
Establish a national
surveillance centre
for the triangulation
of stock out signals,
YHUL¿FDWLRQDQG
tracking.
Implement
an Electronic
system for the
early detection
of stock outs of
medicines at
hospitals
Implement
an Electronic
system for the
early detection
of stock outs of
medicines at
PHC Facilities
Establish
a national
surveillance
centre to
monitor
medicine
availability
Determination of
the legal framework
to enable the
implementation of NHI
Legislation for
NHI
To initiate work on the
creation of a functional
NHI Fund.
White Paper on NHI
published in the public
domain
White Paper on
NHI
Establishment
of the National
Health
Insurance Fund
Short De¿nition
Indicator name
PROGRAMME 2:
97
Communication and
correction of stock outs.
Timeous detection and
correction of facility
stock outs.
Timeous detection and
correction of facility
stock outs.
To initiate work on the
NHI Fund as part of the
preparatory work for the
phased implementation
of NHI
To measure progress
towards ensuring
an enabling legal
framework to support
NHI.
To measure progress
towards ensuring
an enabling legal
framework to support
NHI.
Purpose /
Importance
Sum of PHC
Facilties reporting
data electronically
'DVKERDUGFRQ¿UPing the use of the
electronic system
at PHC Facilities
Most recent
update is within 1
month of the date
of assessment.
Sum of hospitals
reporting data
electronically
'DVKERDUGFRQ¿UPing the use of the
electronic system
at hospitals
Date of most recent
update of the
National stock out
website
N/A
N/A
Documented
evidence: Records
in the branch
Documented
evidence:
Records in the
Branch and relevant Cluster
N/A
Calculation
Method
Documented
evidence:
Publication
Source
Reporting by
stake holders
Submission of
electronic data is
equated to implementation.
Submission of
electronic data
is equated to
implementation
Progress on the
determination of
the concept of
the NHI Fund is
dependent on
WKH¿QDOL]DWLRQRI
the White Paper
on NHI
The drafting of
the NHI Bill is
dependent on the
¿QDOL]DWLRQDQG
approval of the
White Paper
None
Data
Limitations
Count
None
Output
Count
N/A
N/A
N/A
Calculation
Type
Output
Output
Activity
Activity
Activity
Type of
Indicator
Quarterly
Quarterly
Quarterly
Quarterly
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
Yes
New
Indicator
centre functional and
reporting stock availability
at 10 central hospitals, and
Electronic stock management system functional in
Electronic stock management system implemented
and functional at 10 central
hospitals.
Fully functional NHI Fund
established as per the
NHI Act
Full approval and
promulgation of the NHI
Act
White Paper on NHI published in the public domain
Desired
Performance
Cluster:
Sector Wide
Procurement
Cluster:
Sector Wide
Procurement
Cluster: Sector
Wide Procurement
Cluster: NHI
Cluster : NHI
Cluster : NHI
Responsibility
98
To improve hospital
accountability in
revenue generation
and minim
Develop a Revenue
retention model to
incentivize hospitals
to improve revenue
collection
Review Annual
dispensing fee.
Develop and
implement
a Revenue
Retention
Model (RRM)
at central
hospitals
Review
Annual
dispensing
fee.
Track review of
dispensing in South
Africa
Dispensing fee
publication
Compare actual
revenue collection to annual
revenue targets
None
Inter-Year
Monitoring of
the revenue
collection performance
None
Establish Council
for Traditional
Practitioners
Establish
Council for
Traditional
Practitioners
Appointment
letters
Track
institutionalisation of
Traditional medicine
practice
Implementation of
the AMR strategy
Implement the
National AMR
strategy
Numerator
number of
contracted > 8
weeks prior to
expiration.
Denominator
Total number
of contracts
renewed for the
quater
Process
inputs
Sound revenue
reporting and
stable ICT
infrastructure
None
None
None
None
None
Collaboration
of all stake
holders.
N/A
Revenue
collection
should
exceed the
revenue
targets
Count
Count
Percentage
Sum of
Districts
Output
Not all patients
in the District
may be participating in this
new model
Total number
of patients
receiving
medicines via
the chronic
medicine
dispensing &
distribution
system per
district.
None
Contract circular
To facilitate smooth
progression between
contracts an initial
lead time of at least
8 weeks is required
to minimise the risk
of interruptions in
medicines supplies
Contracts for health
related items are
awarded at least 8
weeks prior to the
expiration of the
outgoing contract.
Contracts
are available
at least 8
weeks prior
to expiration
of outgoing
tender
Sum of
Provincial
DoH
Calculation Type
Output
Type of
Indicator
Not all facilities
in the province
may be participating in this
new model
Data
Limitations
Count of
Provinces that
implement the
direct delivery
to facilities
model
Calculation
Method
Appointment
letters and implementation plan
Monthly reports
from contracted
suppliers that
FRQ¿UPPHGLFLQH
is distributed.
Measure
implementation of
CCMDD.
Number of district
where Patient
access their
chronic medicines
at CCMDD pickup
points
Number
of patients
implementing
centralised
chronic
medicine
dispensing &
distribution
(CCMDD)
system
Track Implementation
of the AMR strategy
A report
FRQ¿UPLQJWKH
direct delivery of
medicines
Source
$QHI¿FLHQWVXSSO\
chain system that
minimises stock outs.
Purpose /
Importance
Establish Provincial
Control Towers for
the management
of direct delivery of
medicines
Short De¿nition
Establish
Provincial
Control
Towers for the
management
of direct
delivery of
medicines
Indicator
name
Annual
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Reporting
Cycle
No
no
Yes
Yes
Yes
Yes
Yes
New
Indicator
dispensing fee in
determining the
2016/17 maximum
dispensing fee
A discussion paper
on revenue retention
models developed and
presented to NHC
Practitioners and Registrar appointed
Appointment of the
MAC
Implementation plan for
AMR strategy
developed
100% pharmaceutical
tenders awarded at
least 8 weeks prior to
expiration of outgoing
tender
500 000 patients
Control towers have
been implemented in 7
provinces.
Desired
Performance
Cluster: NHI
Cluster: NHI
Cluster:
Sector Wide
Procurement
Cluster:
Sector Wide
Procurement
Cluster: Sector
Wide Procurement
Cluster:
Sector Wide
Procurement
Cluster:
Sector Wide
Procurement
Responsibility
99
Develop a Central
Repository
consisting of all
funded patients
personal,
demographic and
PHGLFDOEHQH¿W
details.
EML is required
to ensure that the
correct medicine
is available at the
correct facility for
treatment of most
prevalent conditions
in the country.
The associated
Standard Treatment
Guidelines (STGs)
are required to
promote the rational
use of these
medicines
Develop
a Central
Repository
for the funded
and unfunded
patients
Percentage
of the review
process of
the PHC
Essential
Medicines
List (EML)
and Standard
treatment
Guidelines
(STGs)
completed
The EML is used
to establish the
list of medicines to
be procured and
to guide rational
prescribing.
Monitor the development of Central
Repository
Paper or electronic publication
available physically or on DoH
website. The
progress indicator is informed
by chapters
reviewed and
approved by
the National
EML Committee (NEMLC)
for comment
by means of a
circular.
Documentary evidence
FRQ¿UPLQJWKH
quarterly and
annual targets
Reliance
on external
reviewers
Numertor:
number
of chapters
approved by
NEMLC and
circulated for
comment
Denominator:
Number of chapWHUVLGHQWL¿HG
for review by
NEMLC
None
UPFS is not
cost recovery
None
None
Data
Limitations
N/A
N/A
UPFS tariffs and
related addendums
Track development of
Uniform Patient Fee
Schedule (UPFS)
Develop legal
Regulations
pertaining to
Uniform Patient Fee
Schedule (UPFS)
Develop
Regulations
pertaining
to Uniform
Patient Fee
Schedule
(UPFS)
N/a
Gazette
Create governance;
Ensure
standardization and
uniformity in the
issuing of licences
Develop guidelines
to strengthen the
process of issuing
licences
Review
Criteria for
the approval
of Pharmacy
Licences
Calculation
Method
None
Source
SEP Publication
Track publication
of SEP annual
adjustments
Purpose /
Importance
Publish and
Implement
Single Exit Price
Adjustments
Annually
Short De¿nition
Publish and
Implement
Single
Exit Price
Adjustments
Annually
Indicator
name
Output
Inputs
Inputs
Input
Process
Type of
Indicator
Cumulative
N/A
N/A
N/a
N/A
Calculation Type
Annual
Quarterly
Annual
Quarterly
Quarterly
Reporting
Cycle
No
Yes
Yes
Yes
No
New
Indicator
Cluster: NHI
Responsibility
Higher performance will
result in earlier access
to new medicines
funded patients established by Council for
Medical Schemes
UPFS regulations
for legal comments
disseminated
Cluster:
Sector Wide
Procurement
Cluster: NHI
Cluster: NHI
(I¿FLHQWDGPLQLVWUDWLRQ Cluster:
system of Pharmacy
Sector Wide
licensing
Procurement
Price Adjustment
Desired
Performance
100
EML is required
to ensure that the
correct medicine
is available at the
correct facility for
treatment of most
prevalent conditions
in the country.
The associated
Standard Treatment
Guidelines (STGs)
are required to
promote the rational
use of these
medicines
Tertiary level EML
is required to
ensure that the
correct medicine is
available at tertiary
and academic
hospitals.
Develop software
to integrate Patient
based information
systems
Number of PHC
health facilities
with required IT
Hardware for
the reference
implementation
eHealth project
Number of
medicines
reviews
conducted
for the
Tertiary and
Quaternary
EML
Develop a
complete
System
design for
a National
Integrated
Patient based
information
system
Number of
PHC health
facilities with
required IT
Hardware for
the reference
implementation eHealth
project
Short De¿nition
Percentage
of the review
process of
the Hospital
Level Adult
Essential
Medicines
List (EML)
and Standard
treatment
Guidelines
(STGs)
completed
Indicator
name
of eHealth Project
Delivery Note
and/or Job Card
FRQ¿UPLQJ&RPputer hardware
delivery and
installation
software that
demonstrated
capability to
exchange health
information
Tertiary EML is
published on
DoH website
and medicines
reviews are
on record in
the affordable
medicines
knowledge
management
system.
The EML is used
to establish the list
of medicines to be
procured for use at a
tertiary level.
Integrate patient and
health information
residing in separate
repositories
Paper or
electronic
publication
available
physically or on
DoH website.
The progress
indicator is
informed
by chapters
reviewed and
approved by
the National
EML Committee
(NEMLC) for
comment by
means of a
circular.
Source
The EML is used
to establish the
list of medicines to
be procured and
to guide rational
prescribing.
Purpose /
Importance
Sum
N/A
Number of
medicines
review reports
approved by
the NEMLC
Numertor:
number
of chapters
approved by
NEMLC and
circulated for
comment
Denominator:
Number of
chapters idenWL¿HGIRUUHYLHZ
by NEMLC
Calculation
Method
None
Reliance
on external
reviewers and
availability of
member for a
quorum.
Reliance
on external
reviewers
Data
Limitations
Output
Output
Output
Output
Type of
Indicator
Sum
N/A
Non cumulative
Cumulative
Calculation Type
Quarterly
Annual
Annual
Annual
Reporting
Cycle
Yes
No
No
No
New
Indicator
Additional 1400 PHC
Facilities received
required IT Hardware
for the reference
eHealth Programme
Basic Health
developed to
conduct a reference
implementation of
eHealth interoperability
norms and standards
to new medicines
to new medicines
Desired
Performance
Policy coordination and
Integrated
Planning
Cluster
Policy co-ordination and Integrated Planning
Cluster
Cluster:
Sector Wide
Procurement
Cluster:
Sector Wide
Procurement
Responsibility
101
Facilitate alignment
of provincial plans
with National Health
sector priorities
Improve quality of
care
Provincial APPs
reviewed for
alignment with
national health
sector priorities
and feedback
provided
Implement Patient
Quality of care
survey tool to
ensure consistent
measurement of
patient satisfaction
levels in South
Africa
Number of
Provincial
Annual
Performance
Plans (APPs)
aligned to
the National
Health
System
Priorities
Implement
Patient
Quality of
care survey
tool
Report from DHIS
WKDWFRQ¿UPVSLORW
implementation of
Patient Quality of
care survey tool
Evidence
providing review of
9 X Provincial APPs,
and/or Agendas
for Provincial
feedback sessions
and/or copies of
correspondence to
Provinces providing
feedback
Documented Evidence that demonstrated integration of
M&E reports
implement
Integrated
monitoring and
evaluation plan for
the health sector
Integrated
monitoring
and
evaluation
plan
implemented
Improve integration
between different
M&E Systems
National Health Research Plan
To ensure health research contributes
to improving health
outcomes
Develop and
Implement National
health research
plan
National
health
research plan
developed
and
implemented
N/A
N/A
No
calculation
required
N/A
The scale of
the pilot is
unknown at this
stage.
None
N/A
None
Reliant on
accuracy of
reports sent by
Provincial DoH
Sum
Health Patient
Registration System
(HPRS)reports
FRQ¿UPLQJWKH
number of facilities
reporting data
electronically
Track
implementation of
eHealth Project
Number of
health facilities
implementing
improved patient
administration
and web based
information
systems
Number
of health
facilities
implementing
improved
patient
administration
and web
based
information
systems
N/A
Reliant on
accuracy of
reports sent by
Provincial DoH
Data
Limitations
Sum
Calculation
Method
Reports from
Provincial DoH or
-REFDUGVFRQ¿UPLQJ
installation of internet
connectivity
Source
Track
implementation of
eHealth Project
Purpose /
Importance
Number of PHC
health facilities
connected to the
internet
Short De¿nition
Number of
PHC health
facilities
connected to
the internet
Indicator
name
Process
Process
Output
Output
Output
Output
Type of
Indicator
None
None
N/A
N/A
Sum
Sum
Calculation Type
Annual
Annually
Annual
Annual
Quarterly
Quarterly
Reporting
Cycle
Yes
No
No
Yes
Yes
Yes
New
Indicator
A national survey
that measure patient
experience of care
conducted
Quality
Assurance
Directorate
Cluster: Policy
Coordination
and Integrated
Planning
Health
Information
Management
Monitoring and
Evaluation
(HIMME)
Cluster
)XOO\GH¿QHGFRPSUHhensive list of indicators and data elements
approved
At least one national
evaluation
All provincial plans
provided
Health
Information
Management
Monitoring
and Evaluation (HIMME)
Cluster
Policy coordination and
Integrated
Planning
Cluster
Policy
co-ordination
and Integrated
Planning
Cluster
Responsibility
National Health
Research strategic plan
approved
Additional 700 Facilities
patient administration
and web based
information systems
Additional 700 PHC
Facilities in NHI
Pilot Districts with
1 Megabytes Per
Second speed internet
connectivity;
Desired
Performance
102
N/A
Number of
Bilateral projects
implemented
Number of
Bilateral
projects
implemented
Documented
evidence
N/A
Documented
evidence
To strengthen
international
relations for health
Number of
International
treaties and
multilateral
frameworks
Number of
International
treaties and
multilateral
frameworks
To strengthen international relations for
health
N/A
Calculation
Method
Documented
evidence that
FRQ¿UPVD1DWLRQDO
survey has been
conducted
Source
Improve quality of
care
Purpose /
Importance
Conduct a National
Survey to establish
baseline of patient
satisfaction levels
in South Africa
Short De¿nition
Conduct
a National
Survey to
measure
Patient
Quality of
Care
Indicator
name
N/A
N/A
The scale of
the National
survey is
unknown at this
stage.
Data
Limitations
Output
Output
Process
Type of
Indicator
N/A
N/A
None
Calculation Type
Annual
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
New
Indicator
Impliment Bilateral
projects
Implement
International treaties
A national survey
that measure patient
experience of care
conducted
Desired
Performance
International
Health Liaison
International
Health Liaison
Quality
Assurance
Directorate
Responsibility
103
Numerator:
Inpatient death
neonatal
Denominator:
Live birth in
facility
Facility Register
This indicator
assists in tracking
maternal and child
health progress, in
line with the MDGs
Inpatient deaths
ZLWKLQWKH¿UVW
days of life per
1,000 estimated
live births.
Inpatient
Neonatal
Death Rate
(annualised)
Numerator:
Maternal death
in facility
Denominator:
Live births
Facility Register
This population
based indicator
is a measure of
women’s health
across the country
Ratio of the
number of
maternal deaths
in public health
facilities (excluding
accidental or
incidental causes)
per 100,000
live births for a
VSHFL¿HG\HDU
Maternal
mortality in
facility ratio
(annualised)
Numerator:
Mother
postnatal visit
within 6 days
after delivery
Denominator:
Delivery in
facility total
Facility Register
Tracks proportion
of mothers that
received postnatal
care within 6 days
from giving birth
Mothers who
received postnatal
care within 6 days
after delivery
as proportion of
deliveries in health
facilities
Mother
postnatal visit
within 6 days
rate
Calculation
Method
Numerator:
Antenatal 1st
visit before 20
weeks
Denominator:
Antenatal 1st
visit total
Source
Tracks proportion
Facility Register
of pregnant women
that presented at a
health facility within
WKH¿UVWZHHNVRI
pregnancy
Purpose /
Importance
Women who have
DERRNLQJYLVLW¿UVW
visit) before they
are 20 weeks into
their pregnancy as
proportion of all
antenatal 1st visits
Short De¿nition
Antenatal 1st
visit before 20
weeks rate
Indicator
name
PROGRAMME3:
Accuracy
dependent
on quality of
data submitted
health facilities
Accuracy
dependent
on quality of
data submitted
health facilities
Accuracy
dependent
on quality of
data submitted
health facilities
Accuracy
dependent
on quality of
data submitted
health facilities
Data
Limitations
Impact
Impact
Process
Process
Type of
Indicator
Per 1 000
Live Births
Ratio per
100 000
live births
Percentage
Percentage
Calculation Type
Quarterly
Quarterly
Quarterly
Quarterly
Reporting
Cycle
Yes
No
No
No
New
Indicator
Lower rate indicates
fewer deaths.
Lower rate indicates
improved access to
SRH services.
Higher percentage
indicates better uptake
of postnatal services
Higher percentage
indicates better uptake
of ANC services
Desired
Performance
MNCWH
programme
manager
MNCWH
programme
manager
MNCWH
programme
manager
MNCWH
programme
manager
Responsibility
104
6KRUW'H¿QLWLRQ
Women protected against
pregnancy by using modern
contraceptive methods,
including sterilizations,
as proportion of female
population 15-44 year.
Contraceptive years are the
total of (Oral pill cycles / 13)
0HGUR[\SURJHVWHURQH
LQMHFWLRQ
(Norethisterone enanthate
LQMHFWLRQ,8&'[
Male condoms distributed /
0DOHVWHULOL]DWLRQ[
)HPDOHVWHULOL]DWLRQ
x 10)s
Cervical smears in women
30 years and older as a
proportion of 10% of the
female population 30 years
and older.
Antenatal client initiated on
ART
Indicator name
Couple year
protection
Rate
Cervical
cancer
screening
coverage
(annualised)
Antenatal
client initiated
on ART rate
Monitors
implementation of
PMTCT guidelines
in terms of ART
initiation of eligible
HIV positive
antenatal clients.
Monitors
implementation of
policy on cervical
screening
Track the extent
of the use of
contraception (any
method) amongst
women of child
bearing age
Purpose /
Importance
Facility Register
Denominator:
StatsSA
Facility Register
Denominator:
StatsSA
Facility Register
Source
Denominator:
SUM([Antenatal client
+,9VWWHVWSRVLWLYH@
+,9UHWHVWSRVLWLYH@
known HIV positive but
NOT on ART at 1st visit
Numerator:
INITIATED on ART])
Denominator:
(SUM([Female 30-34
\HDUV@680>)HPDOH
\HDUV@680>)HPDOH
\HDUV@
SUM([Female 45 years
and older])) / 10
Numerator:
SUM([Cervical cancer
screening 30 years and
older])
Denominator:
SUM {[Female 15-44
\HDUV@`680^>)HPDOH
45-49 years]}
Numerator
(SUM([Oral pill cycle]) /
680>0HGUR[\SURgesterone injection]) / 4)
680>1RUHWKLVWHURQH
enanthate injection]) / 6)
680>,8&'LQVHUWHG@
680>0DOHFRQGRPV
GLVWULEXWHG@
(SUM([Sterilisation - male])
680>6WHULOLVDWLRQ
- female]) * 10)
Calculation Method
Accuracy
dependent on
quality of data
submitted health
facilities
Process
Output
Outcome
Accuracy
dependent on
quality of data
submitted health
facilities
Reliant on population estimates
from StatsSA,
and Accuracy
dependent on
quality of data
submitted health
facilities
Type of
Indicator
Data
Limitations
Percent
Percentage
Percentage
Calculation
Type
Quarterly
Quarterly
Quarterly
Reporting
Cycle
No
No
No
New
Indicator
Higher
percentage
indicate better
ART coverage
amongst
HIV Positive
pregnant women
Higher
percentage
indicate better
cervical cancer
coverage
Higher
percentage
indicates
higher usage of
contraceptive
methods.
Desired
Performance
MNCWH
Programme
Manager
MNCWH
Programme
Manager
Health Information,
Epidemiology
and Research
Programme
MCWH&N
Programme
Responsibility
105
Proportion of children under 5
years admitted into any public
health facility with severe
acute malnutrition who died
Incidence of Measles per
million total population
Child under
5 years
severe acute
malnutrition
case fatality
rate
&RQ¿UPHG
measles case
incidence per
million total
population
health facility with diarrhoea
who died
Child under
5 years
diarrhoea case
fatality rate
health facility with pneumonia
who died
Infants PCR tested for the
¿UVWWLPHDURXQGZHHNV
after birth as proportion of live
births to HIV positive women
Infant 1st PCR
test positive
around 6
weeks rate
Child under
5 years
pneumonia
case fatality
rate
Short De¿nition
Indicator
name
To monitor measles
vaccine coverage
Monitors treatment
outcome for children
under 5 years who
were admitted
with severe acute
malnutrition.
Includes under 1
year severe acute
malnutrition deaths
NHLS
Laboratory
report
FRQ¿UPLQJ
Denominator:
StatsSA
Facility Register
Facility Register
Facility Register
Monitors treatment
under 5 years who
were admitted with
diarrhoea. Include
under 1 year
diarrhoea deaths
Monitors treatment
under 5 years who
were admitted with
pneumonia. Include
under 1 year
diarrhoea deaths
Facility Register
Source
This indicator is
used to measure
mother to child
transmission rate
Purpose /
Importance
Accuracy
dependent on
quality of data
submitted health
facilities
Numerator:
SUM [Child under 5 years
severe acute malnutrition
deaths]
Denominator:
SUM [Total population]
Numerator
SUM [Number of Measles
cases]
Denominator:
SUM [Children under
5 years severe acute
malnutrition admitted]
Denominator:
with pneumonia admitted]
Accuracy
dependent
on quality of
specimen tested
by NHLS
Reliant on
accuracy of
diagnosis /
cause of death;
Accuracy
dependent on
quality of data
submitted health
facilities
Numerator:
with pneumonia death]
Denominator:
with Diahorrea admitted]
Reliant on
accuracy of
diagnosis / cause
of death
Accuracy
dependent on
quality of data
submitted health
Accuracy
dependent on
quality of data
submitted health
facilities
Data
Limitations
Numerator:
with diahorrea death]
Denominator:
SUM [Live birth to HIV
positive women
Numerator:
SUM[Infant 1st PCR test
positive around 6 weeks
Calculation Method
Outcome
Impact
Impact
Rate: Per
Million population
Percentage
Percentage
Percentage
Rate
Output
Impact
Calculation
Type
Type of
Indicator
Annual
Quarterly
Quarterly
Quarterly
Quarterly
Reporting
Cycle
Yes
Yes
Yes
No
No
New
Indicator
Incidence rate
should decrease
Lower children
mortality rate is
desired
Lower children
mortality rate is
desired
Lower children
mortality rate is
desired
Lower percentage
indicates fewer
infants received HIV
from their mothers
Desired
Performance
Responsibility
MNCWH
MNCWH
Programme
manager
MNCWH
Programme
manager
MNCWH
Programme
manager
PMTCT
Programme
106
Monitor exclusive
breastfeeding
Monitors children
who drop out of the
vaccination program
after 14 week
vaccination.
Percentage of Infants
exclusively breastfed at HepB
3rd dose rate
DTaP-IPV/ Hib3 to
Measles1st dose drop-out
Measles 2nd dose coverage
Infant exclusively
breastfed at
HepB 3rd dose
rate
DTaP-IPV/Hib 3 Measles 1st dose
drop-out rate
Measles 2nd
dose coverage
Monitors protection
of children against
measles. Because
the 1st measles dose
is only around 85%
effective the 2nd dose is
important as a booster.
Vaccines given as part
of mass vaccination
campaigns should not
be counted here
Monitor the
implementation of
Extended Programme in
Immunisation (EPI)
Percentage children under
1 year who completed
their primary course of
immunisation The child
should only be counted
ONCE as fully immunised
when receiving the last
vaccine in the course (usually
the 1st measles and PCV3
vaccines) AND if there is
documented proof of all
required vaccines (BCG,
OPV1, DTaP-IPV/Hib 1, 2, 3,
HepB 1, 2, 3, PCV 1,2,3, RV
1,2 and measles 1) on the
Road to Health Card/Booklet
AND the child is under 1
year old
Immunisation
coverage under 1
year (Annualised)
Purpose /
Importance
Short De¿nition
Indicator name
Denominator:
StatsSA
Facility Register
Facility Register
Facility Register
Denominator:
StatsSA
Facility Register
Source
Denominator:
SUM([Female 1 year])
680>0DOH\HDU@
Accuracy
dependent on
quality of data
submitted health
facilities
Accuracy
dependent on
quality of data
submitted health
facilities
Numerator:
SUM([DTaP-IPV/
Hib 3rd dose]) SUM([Measles 1st
dose under 1 year])
Denominator:
SUM([DTaP-IPV/Hib
3rd dose])
Numerator:
SUM([Measles 2nd
dose])
Reliant on honest
response from
mother; and
accuracy dependent on quality of
data submitted
health facilities
Reliant on under
1 population
estimates
from StatsSA,
and accurate
recording of
children under
1 year who are
fully immunised at
facilities (counted
only ONCE when
last vaccine is
administered.)
Data
Limitations
Numerator:
SUM([Infants
exclusively breastfed at
HepB 3rd dose])
Denominator:
SUM([HepB 3rd dose])
Denominator:
SUM([Female under
\HDU@680>0DOH
under 1 year])
Numerator:
SUM([Immunised fully
under 1 year new])
Calculation
Method
Output
Outcome
Percent
Percent
Percentage
Percentage
Annualised
Output
Output
Calculation
Type
Type of
Indicator
Quarterly
Quarterly
Quarterly
Quarterly
Reporting
Cycle
No
No
Yes
No
New
Indicator
Higher coverage
rate indicate
greater
protection
against measles
Lower dropout
rate indicates
better vaccine
coverage
Higher
percentage
indicate better
exclusive
breastfeeding
rate
Higher
percentage
indicate better
immunisation
coverage
Desired
Performance
Responsibility
EPI
EPI
Cluster: Child
Health
EPI Programme
manager
107
Proportion of grade 4 girl
OHDUQHUV\HDUVYDFFLQDWHG
per year with the 1st dose of
the HPV vaccine during the
Second round
Proportion of grade 4 girl
OHDUQHUV\HDUVYDFFLQDWHG
per year with the 2nd Dose of
the HPV vaccine during the
Second round
Patients 5 years and older
screened in health facilities
for TB symptoms rate
HPV 2nd dose
coverage
Patients 5
years and older
screened in
health facilities
for TB symptoms
rate
To determine whether all
persons attending health
facilities are screened
for TB
This indicator will
provide overall yearly
coverage value which
will aggregate as the
campaign progress and
UHÀHFWWKHFRYHUDJH
so far
This indicator will
provide overall yearly
coverage value which
will aggregate as the
campaign progress and
UHÀHFWWKHFRYHUDJH
so far
Monitors implementation
of the Integrated School
Health Program (ISHP)
Proportion of Grade 8
learners screened by a nurse
in line with the ISHP service
package
School Grade
8 screening
coverage
(annualised)
HPV 1st dose
coverage
Monitors implementation
of the Integrated School
Health Program (ISHP)
Proportion of Grade 1
learners screened by a nurse
in line with the ISHP service
package
School Grade
1 screening
coverage
(annualised)
Purpose /
Importance
Short De¿nition
Indicator name
Facility Register
HPV Campaign
Register
Denominator:
Report from
Department of
Basic Education
HPV Campaign
Register
Denominator:
Report from
Department of
Basic Education
Denominator:
Report from
Department of
Basic
Numerator:
Facility Register
Denominator:
Report from
Department of
Basic Education
Numerator:
Facility Register
Source
Numerator: Patients
over 5 screened for TB
Denominator:
Headcount of those
over 5 not attending TB
treatment
Denominator:
*UDGHJLUOOHDUQHUV
9 years
Numerator:
Girls 9 years and older
that received HPV 2nd
dose
Denominator:
*UDGHJLUOOHDUQHUV
9 years
Numerator:
Girls 9 years and older
that received HPV 1st
dose
Denominator:
SUM [School Grade 8 learners total]
Numerator:
SUM [School Grade 8 learners screened]
Denominator:
SUM [School Grade 1 learners total]
Numerator:
SUM [School Grade 1 learners screened}
Calculation
Method
Accuracy
dependent on
quality of data
from reporting
facility
None
None
None
None
Data
Limitations
Output
Output
Output
Process
Process
Type of
Indicator
Rate
Percentage
annualised
Percentage
annualised
Percentage
Percentage
Calculation
Type
Annually
Annually
Quarterly
Annually
Quarterly
Reporting
Cycle
Yes
Yes
No
Yes
Yes
New
Indicator
Higher
Higher
percentage
indicate better
coverage
Higher
percentage
indicate better
coverage
Higher
percentage
indicates greater
proportion of
school children
received health
services at their
school
Higher
percentage
indicates greater
proportion of
school children
received health
services at their
school
Desired
Performance
Responsibility
TB Programme
Manager
MNCWH
Programme
Manager
MNCWH
Programme
Manager
School health
services
School health
services
108
Facility
Register
Monitors success of
TB treatment for ALL
types of TB
Proportion TB patients
(ALL types of TB) cured
or those who completed
treatment
Percentage of smear
positive PTB cases who
interrupted (defaulted)
treatment
Proportion TB patients
who died during treatment
period
Percentage of MDR TB
cases who interrupted
(defaulted) treatment
TB MDR died
TB new client
treatment
success rate
TB Client loss
to follow up
rate
TB Client
death rate
TB MDR client
loss to follow
up rate
TB MDR client
death rate
To monitor deaths
during TB MDR
treatment
SUM [TB client (new
pulmonary) initiated
on treatment]
Denominator:
SUM [TB client
cured OR completed
treatment]
Facility
Register
To determine whether
all clients diagnosed
with RR TB are
started on treatment.
TB Rif Resistant
FRQ¿UPHGWUHDWPHQWVWDUW
rate
TB Rifampicin
Resistant
clients
treatment
initiation rate
Facility
Register
Accuracy
dependent on
quality of data
from reporting
facility
Facility
Register
Facility
Register
Denominator
Facility
Register
Source
To determine
whether all laboratory
FRQ¿UPHG7%
patients are started
on treatment
Purpose /
Importance
TB client 5 years and
older treatment start rate
Short De¿nition
TB client 5
years and
older initiated
on treatment
rate
Indicator
name
Numerator: TB MDR
client died
Denominator:
All MDR TB on
treatment
Outcome
Denominator:
SUM([TB (new
pulmonary)
client initiated on
treatment])
Numerator:
SUM([TB client
death during
treatment])
Denominator:
SUM [TB (new
pulmonary)
client initiated on
treatment]
Numerator:
SUM [TB (new
pulmonary)
treatment defaulter]
Denominator:
SUM [TB (new
pulmonary)
client initiated on
treatment]
Numerator:
SUM [TB Clients
cured or completed
treatment]
Numerator: All
RRTB clients started
on treatment
Denominator: All
FRQ¿UPHG557%
clients
Numerator: TB
clients started on
treatment
Denominator: laboUDWRU\FRQ¿UPHG7%
clients
Calculation
Method
Accuracy
dependent on
quality of data
from reporting
facility
Percentage
Accuracy
dependent on
quality of data
from reporting
facility
Accuracy
dependent on
quality of data
from reporting
facility
Accuracy
dependent on
quality of data
from reporting
facility
Output
Annually
Outcome
Outcome
Output
Output
Output
- Accuracy
dependent on
quality of data
from reporting
facility
Accuracy
dependent on
quality of data
from reporting
facility
Type of
Indicator
Data
Limitations
Rate
Yes
Percentage
Percentage
Rate
Rate
Rate
Calculation Type
Annually
Higher
percentage
suggests
better
treatment
success
rate.
Annually
Annually
Annually
Annually
Annually
Reporting
Cycle
No
TB Programme
Manager
Yes
No
Yes
Yes
Yes
New
Indicator
Lower
Lower
Lower levels
of death
desired
Lower levels
of interruption
UHÀHFW
improved case
holding, which
is important
for facilitating
successful TB
treatment
Higher
Higher
Higher
Desired
Performance
Norbert
Ndjeka,
Director: DRTB
Norbert
Ndjeka,
Director: DRTB
TB Programme
Manager
TB Programme
Manager
TB Programme
Manager
TB Programme
Manager
TB Programme
Manager
Responsibility
109
HIV Tests (15 Years and
older)
Total number of Medical
Male Circumcisions
(MMCs) conducted
Total number of Male
condoms supplied
distributed to Provincial
DoH
Number of
Medical Male
Circumcisions
conducted
Male Condoms
Distributed
Tracks the supply
of male condoms in
South Africa
Tracks the number of
the MMCs conducted
Monitors annual
testing of persons 15
years and older
Monitors TB/HIV coinfection at point of
ART initiation
HIV/TB co-infected client
started on ART
TB/HIV coinfected client
on ART rate
HIV Tests (15
Years and
older)
Monitors success of
MDR TB treatment
Purpose /
Importance
TB MDR client
successfully treated
Short De¿nition
TB MDR
treatment
success rate
Indicator
name
Delivery
notes or
reports of
Condoms
distributed
by service
providers to
Provincial
DoH
Facility
Register
Facility
Register
Facility
Register
Facility
Register
Source
Total number of
Male condoms
distributed in South
Africa
Total number of
Medical Male
Circumcisions
(MMCs) conducted
Numerator:
SUM [HIV test client
\HDUV@
SUM [HIV test
client 50 years and
DERYH@
SUM [Antenatal
FOLHQW+,9VWWHVW@
Sum [Antenatal
client HIV re-test]
Denominator
SUM([TB/HIV
co-infected client total])
Numerator
SUM([TB/HIV
co-infected client
initiated on ART])
Denominator:
SUM([TB MDR con¿UPHGFOLHQWLQLWLDWHG
on treatment])
Numerator:
SUM([TB MDR
client successfully
treated])
Calculation
Method
None
None
Dependent on
the accuracy of
facility register
Process
Output
Process
Process
Outcome
Accuracy
dependent
on quality of
data submitted
health facilities
None
Type of
Indicator
Data
Limitations
Number
Sum
Percentage
Percent
Percentage
Calculation Type
Quarterly
Quarterly
Quarterly
Annually
Annually
Reporting
Cycle
Yes
Yes
Yes
No
Yes
New
Indicator
Higher
number
indicated
better
distribution
(and indirectly
better uptake)
of condoms in
South Africa
Higher
number
indicates
greater
availability of
the service or
greater uptake
of the service
Higher
percentage
indicate
increased
population
knowing their
HIV status.
Higher
percentage
indicates
a higher
proportion of
co-infected
clients
Higher
percentage
indicates
a better
treatment rate
Desired
Performance
HIV/AIDS
Cluster
HIV/AIDS
Programme
Manager
HIV/AIDS
Programme
Manager
HIV/AIDS
Programme
Manager
TB Programme
Manager
Responsibility
Input
None
Numerator:
SUM [Total clients
remaining on ART at
end of the reporting
period]
SUM Clients
remaining on ART
equals [Naive
(including PEP
DQG307&7
Experienced (Exp)
7UDQVIHULQ7),
5HVWDUW@PLQXV
>'LHG5,3/RVW
WRIROORZXS/7)
Transfer out (TFO)]
Facility
Register
Track the number
of patients on ARV
Treatment
Total clients remaining on
ART (TROA) are the sum
of the following:
- Any client that has a
current regimen in the
column designating the
month at the end of the
reporting period.
- Any client that has a star
without a circle (someone
who is not yet considered
lost to follow-up (LTF) in
the column designating
the month at the end of
the reporting period.
Total clients
remaining on
ART (TROA) at
the end of the
month
Process
Total number of
female condoms
distributed in South
Africa
None
Type of
Indicator
Data
Limitations
Calculation
Method
Delivery
notes or
reports of
Condoms
distributed
by service
providers to
Provincial
DoH
Source
Tracks the supply of
female condoms in
South Africa
Purpose /
Importance
Total number of female
condoms supplied
distributed to Provincial
DoH
Short De¿nition
Female
Condoms
Distributed
Indicator
name
Cumulative
total
Number
Calculation Type
Quarterly
Quarterly
Reporting
Cycle
No
Yes
New
Indicator
Higher total
indicates
a larger
population on
ART treatment
Higher
number
indicated
better
distribution
(and indirectly
better uptake)
of condoms in
South Africa
Desired
Performance
1RWH$OOSRSXODWLRQ¿JXUHVDUHVRXUFHGIURP6WDWV6$DQGLPSRUWHGLQWKH'+,6WRFDOFXODWHSHUIRUPDQFH'HQRPLQDWRUVIRU6FKRROKHDOWKVHUYLFHVDQG+39LQGLFDWRUVLVVRXUFHGIURP'HSDUWPHQWRI+LJKHU(GXFDWLRQ
110
Responsibility
HIV/AIDS
Programme
Manager
HIV/AIDS
Cluster
Develop breast
cancer Policy
Develop 9 provincial
reports to track
progress on the
eliminations of
mother-to-child
transmission of HIV
Policy to guide
implementation of
HCT services
Guidelines to
standardize
implementation of
adherence strategy.
Develop breast
cancer Policy
Develop 9
provincial reports
to track progress
on the eliminations
of mother-to-child
transmission of
HIV
Develop and
implement the
HIV Counseling
and Testing (HCT)
policy
Develop and
implement
adherence
guidelines
To provide a legal
framework to guide
Adherence strategy.
To standardize the
implementation of
HCT services.
To ensure that ALL
HIV positive mothers
are initiated on
lifelong ART and
retained in care
Availability of
policy guidelines
and strategies will
provide guidance
to manage cancer
patients
Adherence
guidelines
HIV Counseling
and Testing
(HCT) policy
Provincial
M&Ereports
Breast cancer
Policy
Cervical cancer
policy
Policy guidelines
and implementation
strategies to guide
early diagnosis and
management of
cervical cancers
Develop cervical
cancer control
Policy
Availability of policy
guidelines and strategies will provide
guidance and ensure
that quality screening
Pharmacovigilance system
document
Track development of
a Pharmacovigilance
system for adverse
events
Develop
Pharmacovigilance
system for adverse
events
Develop
Pharmacovigilance
system for adverse
events
N/A
N/A
n/a
n/a
n/a
N/A.
N/A
Implementation depends
on NHC
approval
Implementation
depends
on NHC
approval
None
None
Not Applicable
Training
manual for the
implantation of
Contraception
and Fertility
Planning (CFP)
Policy
To scale up
existing sexual and
reproductive health
services in an effort
to achieve universal
coverage
Develop Training
manual for the
implantation of
Contraception and
Fertility Planning
(CFP) Policy
Develop Training
manual for the
implantation of
Contraception and
Fertility Planning
(CFP) Policy
Not Applicable
None
Not Applicable
Standardized
feedback
dashboard
reports
of a feedback
mechanism to
provincial DoH
Data
Limitations
Monitor
implementation of
Maternal, Neonatal
and Woman’s health
programmes using
the standardized
dashboard reports
Calculation
Method
Monitor implementation of Maternal,
Neonatal and
Woman’s health
programmes using
the standardized
dashboard reports
Source
Short De¿nition
Indicator name
Purpose /
Importance
PROGRAMME 3 : PROGRAMME PERFORMANCE INDICATOR DEFINITIONS
111
Input
Input
Output
Output
Output
Process
Process
Process
Type of
Indicator
N/A
N/A
n/a
n/a
n/a
Not Applicable
Not Applicable
Not
Applicable
Calculation Type
Annual
Annual
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
New
Indicator
Women’s
Maternal and
Reproductive
Health Cluster
Manager
Responsibility
HIV and
AIDS cluster
manager
HIV AIDS
Cluster
Manager
+&73ROLF\¿QDOLVHG
and approved
Adherence
guidelines developed
and implemented
Women’s
Maternal and
Reproductive
Health Cluster
Manager
Women’s
Maternal and
Reproductive
Health Cluster
Manager
Women’s
Maternal and
Reproductive
Health Cluster
Manager
Women’s
Maternal and
Reproductive
Health Cluster
Manager
9 Provincial visits
conducted and
reports produced
Breast cancer policy
guidelines Developed and disseminated to facilities
Cervical cancer
control policy
JXLGHOLQHV¿QDOL]HG
and disseminated to
facilities
Pharmacovigilance
information system
for adverse events
developed and
piloted in All
Provincial DoH
CFP policy training
Women’s
PDQXDO¿QDOL]HGDQG Maternal and
disseminated
Reproductive
Health Cluster
Manager
4x Quarterly report
produced and implementation feedback
provided to all
provincial DoH
Desired
Performance
112
To provide a
framework to guide
the implementation
of HIV prevention
services
To guide male and
female condom
distribution scale up
plan in districts.
To track HIV AIDS
Conditional Grant
resource utilization.
To provide guidance
to provinces and
districts
A framework to guide the
implementation of HIV
prevention services
Facilitate development of
district plans to support
NDoH male and female
condom distribution plan
through standardized
framework
Monitor the
implementation of the HIV
and AIDS Conditional
grant
Develop and Distribute
EPI Disease Surveillance
Manual
Convene quarterly
meetings of Ministers
Polio Committees
Develop HIV
prevention
strategy
Facilitate
development of
district plans to
support NDoH
male and
female condom
distribution
plan
Monitor the
implementation
of the HIV
and AIDS
Conditional
grant
Develop and
Distribute
EPI Disease
Surveillance
Manual
Develop and
Distribute EPI
Cold Chain
Manual
Convene
quarterly
meetings of
Ministers Polio
Committees
To provide guidance
and advice to the
National Department
of Health
To provide guidance
to provinces and
districts in optimal
vaccine management
and logistics
? uniformity of
service delivery
To monitor the
program performance
Purpose /
Importance
Programme performance
monitoring.
Short De¿nition
Monitor
implementation
of the HIV
and AIDS
Programme
Indicator
name
Annual
Reports and
meeting
minutes
EPI Cold
Chain Manual
EPI Disease
Surveillance
Manual
Quarterly
reports.
Minutes of
meetings
FRQ¿UPLQJ
facilitation,
and/or District
plans
HIV
prevention
strategy
Quarterly
progress
reports
Source
None
None
N/A
None
N/A
N/A
Progress on
the indicator
depends on
NHC approval
Delayed
submission of
reports
Data
Limitations
N/A
N/A
N/A
N/A
N/A
N/A
Calculation
Method
Activity
Activity
Activity
Input
N/A
N/A
N/A
N/A
N/A
N/A
Output
Input
N/A
Calculation Type
Activity
Type of
Indicator
Quarterly
Quarterly
Quarterly
Quarterly
Annual
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
Yes
Yes
New
Indicator
Annual report
Finalisation of
the EPI Cold
Chain Manual
Finalisation
of the EPI
Disease
Surveillance
Manual
4 x Quarterly
HIV
conditional
grant reports
produced
Annual HIV
Conditional
Grant Report
produced
52 district
distribution
plans for
male and
female
condoms
developed
Strategy
Developed
and Approved
HIV and AIDS
programme
monitored and
implemented
Annual report
developed
available
Desired
Performance
Child Health
Cluster
Child Health
Cluster
Child Health
Cluster
HIV and
AIDS cluster
manager
HIV and
AIDS cluster
manager
HIV and
AIDS cluster
manager
HIV and
AIDS cluster
manager
Responsibility
113
To determine whether
all inmates are
screened for TB
To track
implementation
of TB Screening
programme in Mines
Monitor implementation of
child health programmes
using the standerdised
dashboard reports
Percentage of inmates
screened for TB annually
Percentage of mines
providing routine TB
screening
Monitor
implementation
of child health
programmes
using the
standerdised
dashboard
reports
Percentage
of inmates
screened for
TB annually
Percentage
of mines
providing
routine TB
screening
To monitor child
health programmes
To measure progress
towards ensuring
an enabling policy
and legal framework
to support the
implementation of
Adolescent and Youth
Health guidelines
Develop Adolescent and
Youth health policy and
implementation guidelines
Develop
Adolescent
and Youth
health
policy and
implementation
guidelines
Audit deaths of
FKLOGUHQXQGHU¿YHLQ
the country (South
Africa)
Provide standardized
guidelines for
the management
childhood illness in
district hospitals
Purpose /
Importance
Convene Morbidity and
Mortality in Children
under 5 years (COMMiC)
quarterly meeting
Guidelines for the
management of common
childhood illness in district
hospitals printed and
disseminated
Short De¿nition
Convene
Morbidity
and Mortality
in Children
under 5 years
(COMMiC)
quarterly
meeting
Develop and
Distribute
Guidelines
for the
management
of common
childhood
illness in
district
hospitals
printed and
disseminated
Indicator
name
Numerator:
Number of mines
screening for TB
Denominator:
Number of mines
Monitoring
Quarterly Report
from mines
None
None
Numerator:
Number
of inmates
screened for TB
Denominator:
Total number of
inmates
Monitoring
Quarterly Report
from correctional
services
Progress on
the indicator
depends on
adoption of the
policy and the
implementation
guidelines by
NHC
None
None
Data
Limitations
None
N/A
N/A
N/A
Calculation
Method
N/A
standerdised
dashboard
reports
Adolescent and
Youth health
policy and
implementation
guidelines
Minutes of
meetings and
Report/s
Guidelines on
the management
of common
childhood illness
Source
Output
Output
Activity
Activity
Activity
Activity
Type of
Indicator
Percentage
Percentage
N/A
N/A
N/A
N/A
Calculation Type
Quarterly
Quarterly
Quarterly
Quaterly
Quaterly
Quarterly
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
Yes
New
Indicator
Higher
Higher
Quarterly report
developed and
implementation
feedback
provided
Approval of the
Adolescent and
Youth health
policy and
implementation
guidelines
Four
Ministerial audit
Committee
meetings on
Morbidity and
Mortality in
Children under
5 years
Guidelines
on the
management
of common
childhood
illness in district
hospitals
developed and
implemented
Desired
Performance
TB Programme
Manager
TB Programme
Manager
Child Health
Cluster
Child Health
Cluster
Child Health
Cluster
Child Health
Cluster
Responsibility
114
Number of
community
members in
6 Peri mining
districts
screened for
TB
Indicator
name
Number of community
members in 6 Peri mining
districts screened for TB
Short De¿nition
To identify people
with TB symptoms
Purpose /
Importance
Reports from
sub-sub recipient
Source
Sum of
community
members in
6 Peri mining
districts
screened for TB
Calculation
Method
None
Data
Limitations
Output
Type of
Indicator
Count
Calculation Type
Quarterly
Reporting
Cycle
Yes
New
Indicator
Higher
Desired
Performance
TB Programme
Manager
Responsibility
Measures the number
WBPHCOTs that
report their activities
on the DHIS
Measures the number
of clinics where
weakness have
been systematically
and sustainably
addressed to meet
OHSC standards
Measures the number
of municipalities that
meet environmental
health norms
and standards in
executing their
environmental health
functions
Hand hygiene
campaign rolled out
Number of functional WBPHCOTs
Number of primary
health care
facilities in the 52
districts that qualify
as Ideal Clinics
Number of
municipalities
that meet
environmental
health norms
and standards in
executing their
environmental
health functions
Hand hygiene
campaign rolled
out in all 9 (nine)
provinces
Hand hygiene is a key
method for prevention of
VSHFL¿FFRPPXQLFDEOH
diseases
The status of the
environment impacts on
other population health
indicators and has to
be monitored to prevent
negative effects on these
To function optimally and
provide quality services
to communities there
are prerequisites that
clinics must meet. The
Ideal Clinic project aim to
address this and ensure
that clinics are compliant
with OHSC standards.
Evaluation
reports
Inspection
reports
OHSC reports
DHIS
District Reports
Services at clinic level
that are not planned and
executed in collaboration
with the communities may
not meet communities’
QHHGV&OLQLFVEHQH¿WLQ
multiple ways from community involvement
Determines whether a
clinic’s health service
provision activities are
planned, implemented
and monitored
and evaluated
in collaboration
with community
representatives
No of primary
health care
facilities with
functional clinic
committees/ district
hospital boards
Functional WBOTs are an
essential component to
ensuring quality PHC to
communities
District Reports
Ensures that districs can
IXOO¿OOWKHLUUHVSRQVLELOLWLHV
Determines whether
districs have the
required management
capacity
Source
Number of Districts
with uniform
management
structures
Purpose /
Importance
Short De¿nition
Indicator name
PROGRAMME 4
115
Number
Number
Number
Number
Number
Number
Calculation
Method
Will be communicated
in evaluation
reports
Inspectors
need to be
calibrated
Dependent
on auditable
records kept
by districts
Provinces
not submitting reports
due to
structural
problems
Dependent
on auditable
records kept
by districts
Dependent
on auditable
records kept
by districts
Data
Limitations
Process
Process
Process
Input
Process
Process
Type of
Indicator
Annual
status
Annual
status
Annual
status
Cumulative
Sum
Sum
Calculation Type
Annual
Annual
Annual
Annual
Annual
Annual
Reporting
Cycle
yes
No
No
No
yes
yes
New
Indicator
increase
Greater number
of municipalities
meet
environmental
health
norms and
standards in
executing their
environmental
health functions
Roll out plan
approved and
resourced
Increase
Greater
number of
health care
facilities with
functional clinic
committees
Greater number
of Districts
with uniform
management
structures
Desired
Performance
CD DHS
CD :
Environmental
Health Services
CD DHS
CD DHS
Cd DHS
CD DHS
Responsibility
116
Measure the number
of people counseled
and screened
for high blood
pressure as part
of comprehensive
health screening
Number of
people screened
for high blood
pressure as part
of comprehensive
health screening
Counseling and
screening increases early
detection and treatment
before complications
set in
Reduce risk factors
for NCDs through the
amendment of Tobacco
Control Act which enables
development of
Labeling and packaging
of tobacco products and
smoking in indoor and
outdoor public places
Amend Tobacco
control act
to facilitate
development of
Regulations relating
to
Labeling and
packaging of
tobacco products
and
smoking in indoor
and outdoor public
places
Regulations
relating to
Labeling and
packaging of
tobacco products
and
smoking in indoor
and outdoor public
places Developed
Not Applicable
Documented evi- number
GHQFHFRQ¿UPLQJ
the number of
screenings
Amended
Tobacco control
Act
Sum
Tracks implementation
of government’s healthy
lifestyle programme
Number of National
government
Departments
oriented on the
National guide
for healthy meal
provisioning in the
workplace
Number of
National
government
Departments
oriented on the
National guide
for healthy meal
provisioning in the
workplace
Minutes of
workshops
FRQ¿UPLQJ
orientation of
government
Department
N/A
Report for
CD Noncommunicable
diseases
A National Health Commission will facilitate the
reduction in the negative
effects of social determinants of health
Establish National
Health Commission
to address of social
determinants of
health
Establish
National Health
Commission
Calculation
Method
Number
Source
Inspection
reports
Implement Health
Care Risk waste
Regulations in all 9
provinces
Health Care Risk
waste Regulations
Developed
Purpose /
Importance
Appropriate health care
risk waste management
is a key method for
SUHYHQWLRQRIVSHFL¿F
communicable diseases
Short De¿nition
Indicator name
To be determined
None
None
N/A
Inspectors
need to be
calibrated
Data
Limitations
output
Process
Process
process
Process
Type of
Indicator
sum
None
Sum
Annual
Status
Annual
status
Calculation Type
Annual
Annual
Annual
Annual
Annual
Reporting
Cycle
No
Yes
Yes
yes
yes
New
Indicator
Greater number
of people
screened for
high blood
pressure
Tobacco Act
amended
Higher number
indicated
better uptake of
healthy eating
programme by
government
Departments
National Health
Commission
established
Health care
risk waste
regulations
¿QDOL]HGDQG
tools for audit
implementation
developed
Desired
Performance
Responsibility
CD HP
CD NCDs
CD: Nutrition
and Health
Promotion
Cd NCD
CD DHS
117
Measures proportion
of population
screened for mental
disorders
Percentage people
screened for
mental disorders
Monitored to increase
early detection
NDoH Mini
Survey
Documented
evidence
FRQ¿UPLQJ
the approved
content for
campaign
Random Monitoring
of salt content
in foodstuffs
conducted.
Random
Monitoring of
salt content
in foodstuffs
conducted.
Track Health Promotion
programme
Documented evi- None
GHQFHFRQ¿UPLQJ
the approved
content for campaign
Track Health Promotion
programme
Visible media
campaign creating
awareness on
excessive salt
intake, excessive
sugar intake,
physical inactivity
and alcohol related
harm conducted
Awareness on risk
factors relating
to excessive salt
intake, excessive
sugar intake,
physical inactivity
and , alcohol
related harm
created
Denominator
Total population
in survey area:
Numerator:
Number of
people
screened for
mental disorder
None
number
Documented
evidence
FRQ¿UPLQJ
the number of
screenings
Counseling and
screening increases early
detection and treatment
before complications
set in
Calculation
Method
Measure the number
of people counseled
and screened for
raised blood glucose
levels as part of
comprehensive
health screening
Source
Number of
people screened
for raised blood
glucose levels
as part of
comprehensive
health screening
Purpose /
Importance
Short De¿nition
Indicator name
To be
determined
None
None
To be determined
Data
Limitations
Output
Input
Input
output
Type of
Indicator
Percentage
None
None
Sum
Calculation Type
Annual
Annual
Annual
Quarterly
Reporting
Cycle
yes
Yes
Yes
No
New
Indicator
Greater number
of people
screened for
mental health
disorders
Monitor salt
content in
Foodstuffs
Content of
campaign
¿QDOL]HGDQG
ready for
implementation
Greater number
of people
screened for
raised blood
glucose levels
Desired
Performance
CD NCD
CD NCD
CD NCD
CD HP
Responsibility
118
Short De¿nition
Measures proportion
of population treated
Percentage of
mental health
inpatient units
attached to
designated district
and regional
hospitals
Number of Mental
health teams
established in each
district
Measure number
of Districts
implementing
the framework
and model for
rehabilitation
services
Clients who had
cataract surgery per
1 million uninsured
population
Indicator name
Percentage of
people treated for
mental disorders
Percentage of
mental health
inpatient units
attached to
designated district
and regional
hospitals
Mental health
teams established
in each district
Number of Districts
implementing
the framework
and model for
rehabilitation
services
Cataract Surgery
Rate
Monitors access
to cataract surgery
(preventing disability
through blindness)
Tracking this will ensure
that communities receive
access to rehabilitation
services
Or Facility
Register
DHIS
District reports
Documented
evidence
FRQ¿UPLQJWKH
establishment of
the mental health
team
Documented
evidence con¿UPLQJWKHXQLWV
providing Mental
health services
at district and regional hospitals
Track implementation of
Mental Health Policy
Track implementation of
Mental Health policy
NDoH Mini
Survey
Source
Monitored to decrease
the incidence of mental
disorders going untreated
Purpose /
Importance
Numerator:
Total number
of Cataract
surgeries
completed
Denominator:
Uninsured
population
Number
Sum of Mental
health teams
Numerator
Number of
hospitals with
mental health
inpatient units:
Denominator
Number of designated district
and regional
hospitals as per
the policy
Numerator
Number of people being treated for a mental
disorder:
Denominator
Number
of people
with mental
disorder in that
population:
Calculation
Method
Accuracy
dependant
on quality
of data from
health facilities
None
None
It is assumed
that the inpatient provides
mental health
services after
it has been
initiated in
the hospital
To be
determined
Data
Limitations
Outcome
Process
Input
Output
Output
Type of
Indicator
Rate
Sum
Sum
Percentage
Percentage
Calculation Type
Annual
Annual
Annual
Quarterly
Annual
Reporting
Cycle
No
yes
Yes
No
No
New
Indicator
1 500
operations
per million
un-insured
population
Resources
allocated for
the approved
Framework and
Model
Strategy for
establishment
of specialist
mental
health teams
approved by
the TechNHC
Greater
percentage of
mental health
inpatient units
attached to
designated
district and
regional
hospitals
Greater
number of
people treated
for mental
disorders
Desired
Performance
CD: Non
communicable
Diseases
CD NCD
CD NCD
CD NCD
Responsibility
119
Measures the
Number of
Provincial Outbreak
Response Teams’
capacity to respond
to zoonotic,
infectious and
food-borne disease
outbreaks
The number of
people at risk, which
has been vaccinated
ZLWKLQÀXHQ]D
vaccine.
Develop and
implement a
strategy and plan
for the integration of
disease surveillance
systems for NMC
Annual National
HIV Antenatal
Prevalence Survey
conducted
Number of
Provincial
Outbreak
Response Teams
capacitated
to respond to
zoonotic, infectious
and foodborne diseases
outbreaks
Number of high
risk population
covered by the
VHDVRQDOLQÀXHQ]D
vaccination
A strategy and plan
for the integration
of disease
surveillance
systems for NMC
Developed and
Implemented
Annual National
HIV Antenatal
Prevalence Survey
conducted
Track status of HIV
AIDS amongst pregnant
women in South Africa
Improve disease
surveillance
Tracks the number of
people in the high risk
population that is covered
E\LQÀXHQ]DYDFFLQDWLRQ
Measures the ability of
the country to respond
adequately to outbreaks
of disease and halt
further spread
Annual National
HIV Antenatal
Prevalence
Survey report
Documented
evidence
Number of people vaccinated
ZLWKLQLQÀXHQ]D
vaccines with be
provided by the
Communicable
Disease Control
Coordinators in
provinces
None
N/A
Indicator will
be monitored
by the number
of vaccines
administered.
None
N/A
Dependant
on accuracy
of capture of
data at facility level and
ÀRZWRWKH
next level.
Output
Output
Output
process
None
N/A
N/A
Sum
number
Provincial
reports
N/A
N/A
Output
Dependent
on the accuracy of data
inputs from
the provinces
Number
malaria districts
reporting
malaria cases
in endemic
provinces
National and
Provincial
malaria
information
systems
Tracks performance of
districts to report malaria
cases within 24 hours of
diagnosis
Malaria case
QRWL¿FDWLRQDPRQJ
endemic provinces
Number of districts
targeted for
malaria elimination
reporting malaria
cases within 24
hours of diagnosis
Calculation Type
Impact
Type of
Indicator
Dependent on the
accuracy
of data
inputs
from the
provinces
Data
Limitations
Local malaria
cases divided by the total population
at risk
Calculation
Method
National and
Provincial
malaria
information
systems
Tracks new
malaria cases in
malaria affected
districts
Tracks new malaria
cases in malaria affected
districts
Malaria cases
among population
at risk
Source
Malaria Incidence
per 1000
population at risk
Purpose /
Importance
Short De¿nition
Indicator name
Annual
Quarterly
Quarterly
Annual
Annual
Reporting
Cycle
No
No
no
No
Yes
Quarterly
New
Indicator
2015 National
Antenatal HIV
prevalence
Report
produced
Electronic
disease
surveillance
system for
1RWL¿DEOH
medical
conditions
Greater number
of high risk
individuals
covered with
seasonal
LQÀXHQ]D
vaccination
Greater number
of Provincial
Outbreak
Response
Teams
capacitated
to respond
to zoonotic
disease
outbreaks
Greater number
of malaria
endemic
districts
reporting
malaria cases
within 24 hours
of diagnosis
No
Desired
Performance
Communicable
Diseases
programme
manager
Communicable
Diseases
programme
manager
Communicable
Diseases
programme
manager
Communicable
Diseases
programme
manager
Communicable
Diseases
programme
manager
Communicable
Diseases
programme
manager
Responsibility
Short De¿nition
Number of central
hospitals that have
UHFHLYHG¿QDQFLDO
delegations
Number of Tertiary
Hospitals where all
the general tertiary
services are provided
DVGH¿QHGDV/HYHO
or Provincial Tertiary
Services
Number of Hospitals
that comply fully (total
score >80%, and
100% compliance
with extreme
measured, and >90%
compliance with
vital; measures) with
the National Core
Standards.
Develop guidelines
for Human Resources
for Health norms and
standards using the
WISN methodology
benchmarked
DJDLQVW3+&VWDI¿QJ
normative guides
Indicator name
Number of central
hospitals with full
delegated authority.
Number of gazetted
hospitals providing
the full package of
Tertiary 1 Services
Number of Hospitals
that comply fully
with the National
Core Standards.
Develop guidelines
for HRH norms and
standards using the
WISN methodology
benchmarked
against PHC
VWDI¿QJQRUPDWLYH
guides
PROGRAMME 5
120
Track
implementation
RI3+&6WDI¿QJ
norms
Establish
guidelines for
HRH Norms to
ensure equitable
distribution of HRH
Benchmark Reports,
and copies of letters
WR+2'VFRQ¿UPLQJ
distribution of the
benchmark reports
Draft Normative
Guidelines and
attendance register
of meetings
Hospital Peer assessment report
N/A
N/A
Number of
Hospitals
that comply
fully (total
score >80%,
and 100%
compliance
with extreme
measured,
and >90%
compliance
with vital;
measures)
with the
National Core
Standards.
None
None
Could be
Subject to
bias because
performance
dependant
on selfassessment
None
Sum
The National Tertiary
Serivces Grant
(NTSG) Business
plan providing a
list of Tertiary 1
services provided
by hospitals, and
an inspection report
FRQ¿UPLQJWKHOLVWRI
services rendered
by facility
Tracks the number
of Tertiary Hospitals where all the
general tertiary
services are proYLGHGDVGH¿QHG
as Level 1 or
Provincial Tertiary
Services
Tracks quality of
care at hospitals
None
Sum
Data
Limitations
Calculation
Method
Letter of Delegation
provided to CEOs of
central hospitals
Source
Tracks
implementation
of decentralized
decision making
and accountability
Purpose /
Importance
Output
Output
Output
indicator
Output
Process
indicator
Type of
Indicator
N/A
N/A
Annualised
Cummulative
Cummulative
Calculation Type
Annual
Annual
quarterly
quarterly
quarterly
Reporting
Cycle
Yes
No
yes
yes
yes
New
Indicator
PHC Facilities
implementing
HR Normative
guidelines
Guidelines
developed
Higher percentage
A higher
number
indicates
greater number
of tertiary
hospitals
providing full
package of care
A higher
number
indicates
greater number
of central
hospitals with
autonomy.
Desired
Performance
Responsibility
Cluster
Manager :
Workforce
Development
and Planning
Cluster
Manager :
Workforce
Development
and Planning
Cluster manager: Hospital
Services
Cluster manager: Hospital
Services
Cluster
manager:
Hospital
Services
121
Document describing draft Nursing
2I¿FHVWUXFWXUHRI
Provincial DoH
Track implementation of Nursing
strategy
Develop a
standerdised
Nursing leadership
structure for
Provincial DoH
with executive
authority over nursing
and midwifery
services
Number of
facilities receiving
maintenance, repair
and/or refurbishments
(dependant on their
status and need) in
11 NHI pilot Districts
Number of
facilities receiving
maintenance, repair
and/or refurbishments
(dependant on their
status and need) in
11 NHI pilot Districts
community health
centres constructed
Develop a standerdised
Nursing leadership
structure for Provincial DoH
maintained, repaired
and/or refurbished
in NHI Districts
maintained,
repaired and/or
refurbished outside
NHI pilot Districts
Number of clinics
and Community
Health Centres
constructed or
revitalised
Track scale up
of infrastructure
programme
Track scale up
of infrastructure
programme
Practical Project
completion reports
Practical Project
completion reports
Practical Project
completion reports
Document
describing draft
Training Programme
Track implementation of Nursing
strategy
Develop a Nursing
and midwifery
and development
programme
Develop a Nursing
and midwifery
and development
programme
Track scale up
of infrastructure
programme
policy document
Track
implementation of
Nursing strategy
Public Nursing
colleges offering new
Nursing programmes
in line with National
4XDOL¿FDWLRQV
Framework
Source
Public Nursing
colleges offering
new Nursing
programmes
Purpose /
Importance
Short De¿nition
Indicator name
Sum of clinics
and community
health centres
constructed
Sum of facilities
that received
maintenance,
repair and/or
refurbishments
(dependant on
their status and
need)
Sum of facilities
that received
maintenance,
repair and/or
refurbishments
(dependant on
their status and
need)
None
Number of
facilities
targeted is
determined
by the scope
of work. This
scope may
be amended
at the time
of project
inception
Number of
facilities
targeted is
determined
by the scope
of work. This
scope may
be amended
at the time
of project
inception
None
None
N/A
N/A
None
Data
Limitations
N/A
Calculation
Method
Output
Output
Output
Output
Output
Output
Type of
Indicator
Sum
Sum
Sum
N/A
N/A
N/A
Calculation Type
Annual
Annual
Annual
Annual
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
Yes
New
Indicator
Improve quality
of health
facilities
Reduce
infrastructure
maintenance
backlog
Reduce
infrastructure
maintenance
backlog
Provincial
Nursing
structures
established
and providing
leadership
for the
implementation
of the Nursing
strategy
A training
programme
developed and
implemented
Nursing policy
approved
Desired
Performance
Responsibility
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
2I¿FHRIWKH
Chief Nursing
2I¿FHU
2I¿FHRIWKH
Chief Nursing
2I¿FHU
2I¿FHRIWKH
Chief Nursing
2I¿FHU
122
Practical Project
completion reports
To track
compliance with
Infrastructure
Norms and
Standards
To determine the
extent to which health
facilities comply
with proper working
environment and
reduced occupational
health and safety
risks.
Develop a Balanced
scorecard Monitoring
System to improve
monitoring of
infrastructure
projects.
Number of provinces
that are compliant
with the EMS
regulations
Number of Blood
Alcohol reports
issued in the
reporting period
Number of Toxicology
reports issued in the
reporting period
Number of food tests
performed in the
reporting period
Number of new
facilities that comply
with gazetted
infrastructure Norms
& Standards.
Develop a
Infrastructure
Monitoring System
Number of
provinces that are
compliant with the
EMS regulations
Number of Blood
Alcohol reports
produced
Number of
Toxicology reports
produced
Number of food
tests performed
Track the scale up
programme of food
sample testing
Track the scale
up programme to
eliminate backlog
of toxicology tests
Track the scale
up programme to
eliminate backlog
of blood alcohol
tests
Track
implementation of
EMS regulations
food test reports
Toxicology reports
Blood Alcohol
reports issued
Documented
(YLGHQFHFRQ¿UPing regulations are
gazetted
Document that describes the Balance
Scorecard system
Practical Project
completion reports
Track scale up
of infrastructure
programme
Number of hospitals
constructed or
revitalized in other
Districts
Number of hospitals
constructed or
revitalized in other
Districts
Ensure timely
completion of
Infrastructure
projects.
Sum of
hospitals
constructed or
revitalized
Peer review
assessment reports
Track scale up
of infrastructure
programme
Number of hospitals
constructed or
revitalized
Number of new
facilities that comply
with gazetted
infrastructure Norms
& Standards.
Sum of food
tests performed
Sum of Toxicology reports
issued
Sum of Blood
Alcohol reports
issued
Sum of
Provinces that
comply to EMS
regulations
N/A
Sum of new
facilities that
comply with
gazetted
infrastructure
Norms &
Standards
Sum of hospitals constructed
or revitalized
Sum of clinics
and community
health centres
constructed
Practical Project
completion reports
Track scale up
of infrastructure
programme
Calculation
Method
community health
centres constructed
outside NHI pilot
Districts
Source
Number of hospitals
constructed or
revitalised
Purpose /
Importance
Short De¿nition
Indicator name
None
None
None
None
None
None
Output
Output
Output
Output
Output
Input
Output
Output
None
None
Output
Type of
Indicator
None
Data
Limitations
Sum
Sum
Sum
Sum
None
Sum
Sum
Sum
Sum
Calculation Type
Quarterly
Quarterly
Quarterly
Annual
Annual
Annual
Annual
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
New
Indicator
Higher number
indicates
greater scale
up
Higher number
indicates
greater scale
up
Higher number
indicates
greater scale
up
Higher number
indicates
greater number
of provinces
compliant
to the EMS
Regulations
Infrastructure
Monitoring
System
developed
All health facilities complaint
with Infrastructure Norms and
Standards
Improve quality
of health
facilities
Improve quality
of health
facilities
Improve quality
of health
facilities
Desired
Performance
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Cluster:
Violence
Trauma and
Injury
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
Cluster: Health
Facilities and
Infrastructure
Planning
Responsibility
123
Develop a training
programme for
Knowledge hub
Develop a framework
for knowledge hub
(information system)
Develop a
knowledge hub
which includes
a web based
interactive
information system
Approved framework
for knowledge hub
Document
describing
mentoring and
training programme
for health managers
Source
N/A
N/A
Calculation
Method
Regulate Emergency Care
Centres
Regulate EMS for
mass gatherings
Develop systems
to improve
HI¿FLHQF\DW
Forensic Chemistry
Laboratories
Publish Policy on
education and
training of EMS
Personnel published
for implementation
Develop regulations
for Emergency Care
Centres
Publish Regulations
for EMS in Mass
Gatherings
Develop a
monitoring system to
effectively measure
turnaround time of
tests conducted at
Forensic Chemistry
Laboratories
Regulations for
the Rendering of
Forensic Pathology
Services (FPS)
promulgated
Publish Policy
on education
and training of
EMS Personnel
published for
implementation
Develop
regulations for
Emergency Care
Centres
Publish Regulations for EMS in
Mass Gatherings
Develop a
monitoring system
to effectively
measure
turnaround time of
tests conducted
at Forensic
Chemistry
Laboratories
Regulations for
the Rendering
of Forensic
Pathology
Services
promulgated
Regulate FPS
Improve quality of
EMS training
Short De¿nition
Indicator name
Purpose /
Importance
Regulations for
the Rendering of
Forensic Pathology
Services
Document outlining
monitoring system
for measuring turnaround times and
UHSRUWVFRQ¿UPLQJ
implementation
of new monitoring
system
Regulations for EMS
in Mass Gatherings
regulations for
Emergency Care
Centres
Policy on education
and training of EMS
Personnel
Source
None
None
N/A
N/A
None
None
None
Data
Limitations
None
None
Data
Limitations
N/A
N/A
N/A
Calculation
Method
INDICATOR DESCRIPTIONS OF PROGRAMME PERFORMANCE INDICATORS
Establish a
mentoring
programme for
health managers
Develop and
Establish a coaching
mentoring and
training programme
for health managers
Establish a
coaching mentoring
and training
programme for
health managers
Purpose /
Importance
Short De¿nition
Indicator name
Process
Process
Process
Process
Process
Type of
Indicator
Process
Process
None
None
Calculation Type
None
None
None
None
None
Calculation Type
Type of
Indicator
Annual
Annual
Annual
Annual
Annual
Reporting
Cycle
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
Yes
Yes
New
Indicator
No
No
Framework for
knowledge hub
developed and
approved
Coaching
mentoring
and training
programme
developed and
established
Desired
Performance
Regulations on for
the Rendering of
Forensic Pathology
Services reviewed
and Published for
public comment
A standardized
ZRUNÀRZDQG
monitoring system
developed for
all 3 tests and
implemented at 4
forensic chemistry
laboratories
EMS in mass
gatherings
published for public
comment and
implementation
Regulations on
Emergency Care
Centres Drafted
Policy on education
and training of
EMS Personnel
published
Desired
Performance
New
Indicator
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Chief Director:
Violence
Trauma and
Injury
Responsibility
Programme 5
Manager
Programme 5
Manager
Responsibility
124
Sum of
RTC's established
None
Number of Regional
Training Centres
(RTCs) established in
Provincial DoH
Number of Regional
Training Centres
(RTCs) established
Site Inspection
UHSRUWFRQ¿UPLQJ
establishment of
RTC
None
N/A
Document published
by National DoH
listing designated
facilities providing
services for the
management of
sexual and related
offences
Improve access
to health services
for sexual related
offences
Number of Health
Facilities that are
designated to render
services for the
management of
sexual and related
offences
Number of Health
Facilities that are
designated to
render services for
the management of
sexual and related
offences
Improve training
capacity of the
health sector
None
N/A
Scope of Practice
Guidelines for
the rendering of
Forensic Pathology
Data
Limitations
Develop Scope of
Practice for FPS
Calculation
Method
Publish Scope of
Practice Guidelines
for the rendering of
Forensic Pathology
Services
Source
Publish Scope of
Practice Guidelines
for the rendering of
Forensic Pathology
Services
Purpose /
Importance
Short De¿nition
Indicator name
Input
Process
Process
Type of
Indicator
Cumulative
None
None
Calculation Type
Annual
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
New
Indicator
Higher Number
60 additional
facilities
designated
Review and
Finalise
the Scope
of Practice
Guidelines for
the rendering
of Forensic
Pathology
Services and
Publish for
Implementation
Desired
Performance
Cluster Manager : Workforce
Development
and Planning
Chief Director:
Violence Trauma and Injury
Chief Director:
Violence
Trauma and
Injury
Responsibility
Short De¿nition
Establish new
regulatory authority
to allow for oversight
of medical devices,
IVDs, food, cosmetics
Institute of Regulatory
Science (IRS)
providing training
Occupational health
for occupational
health services
and compensation
through amendments
to the Occupational
Diseases in Mines
and Works Act, 1973
Governance and
management of the
occupational health
cluster for enhanced
occupational health
service delivery
Indicator name
Establish SAHPRA
as a public entity
Institute of
Regulatory Science
(IRS) providing
training
Review
occupational
health legislative
framework
Occupational health
cluster established
and functional
PROGRAMME 6:
125
Will assist with
HI¿FLHQF\JDLQVLQ
occupational health
service delivery
and effective
management of
the occupational
health cluster
Legal framework
to provide for
occupational
health services
and compensation
Documented
evidence of report
and submissions;
agendas, attendance registers and
minutes of management meetings
of the occupational
health cluster
Submissions to
Cabinet and Parliament
Occupational
health legislative
framework for
occupational
health services
and compensation
through
amendments to
the Occupational
Diseases in Mines
and Works Act,
1973
N/A
N/A
N/A
Documented
evidence
Establish Institute
of Regulatory
Sciences for
capacity building
Calculation
Method
N/A
Source
Promulgated Act
,PSURYHHI¿FLHQF\
of Regulatory
Authority
Purpose /
Importance
The reports
are dependent
RQDXQL¿HG
management
structure across
MBOD/CCOD
and NIOH
The drafting of
amendments
is dependent
RQDXQL¿HG
management
structure for
MBOD/CCOD
and NIOH and
amendments to
the NHLS Act
Progress
depends on
appointment
of the Project
Team
Progress
depends on
¿QDOLVDWLRQRI
parliamentary
process
Data
Limitations
N/A
Output
N/A
N/A
Activity
Output
N/A
Calculation Type
Activity
Type of
Indicator
Quarterly
Quarterly
Quarterly
Annual
Reporting
Cycle
Yes
Yes
Yes
No
New
Indicator
Approved
document
on structure,
organogram
and functions
of the
occupational
health cluster
Gazetted
legislation on
occupational
health
service and
compensation
framework and
amended NHLS
Act
Project Team
appointed and
business plan
prepared to
establish IRS
within MCC/
SAHPRA
Promulgation
of the Act and
¿QDOLVDWLRQ
of the legal
framework,
and transitional
plan from MCC
to SAHPRA
developed
Desired
Performance
Occupational
Health Cluster
Occupational
Health Cluster
FCPTPR
FCPTPR
Responsibility
126
Establish National
Public Health
Institutes of South
Africa (NAPHISA)
for coordinated
disease and injury
surveillance and
research
Number of Functional
Health entities’ and
Statutory Health
professional Councils
DVGH¿QHGE\WKH
checklist
Develop and
implement an
annual performance
management system
for board members
Number of
Functional Health
entities’ and
Statutory Health
professional
Councils
Develop and
implement a
performance
management
system for board
members
One Stop Service
Centres in provincial
health facilities to
deliver occupational
health services
Number of
provinces with
One Stop Service
Centres in health
facilities to deliver
occupational health
and compensation
services
Develop legal
framework to
establish National
Public Health
Institutes of South
Africa (NAPHISA)
Short De¿nition
Indicator name
Monitor functionality of the
board in terms
of compliance to
good Governance
practices (structures, Finance,
HR , Supply Chain
Management
policies) and also
respond to health
sector priorities
Improve disease
and injury surveillance, research,
monitoring and
evaluation of
health and disease
trends
Ensure the
availability of
occupational health
services through
decentralized
facilities in
provinces
Purpose /
Importance
Health entities
monitoring reports
(checklist)
Documented
evidence of
submissions and
reports on legislative
framework for
NAPHISA
Activity reports from
One Stop Service
Centres
Source
Sum of
Functionality
to be de¿QHGLQWKH
checklist;
N/A
Sum of
provinces
with at least
one facility
in a province
having a
One Stop
Service
Centre
Calculation
Method
Functionality
measurement
is limited to the
criteria in the
checklist
The introduction
of legislation
on NAPHISA is
dependent on
amendments to
the NHLS Act
The setting up
and recurrent
costs of One
Stop Service
Centres is
dependent on
funding availability, buy in
from provincial
departments
of Health and
inputs from the
private sector
Data
Limitations
Process
Sum
N/A
N/A
Output
Outcome
Calculation Type
Type of
Indicator
Quarterly
Annual
Annual
Reporting
Cycle
Yes
Yes
Yes
New
Indicator
A standardized
performance
management
system for
board members
developed and
piloted
4 health
Entities’ and 6
statutory health
professional
councils fully
functional and
compliant
to good
Governance
practices as per
the check list
Gazetted
legislation on
NAPHISA and
amended NHLS
Act
Establishment
of the One Stop
Service Centres
in provinces
Desired
Performance
Responsibility
Cluster:
Health Entities
Management
Cluster: Health
Entities Management
Occupational
Health Cluster
Occupational
Health Cluster
127
To measure
progress towards
improved timelines
To measure
progress towards
improving testing
of food
Develop legal
framework to regulate
Medical devices,
IVDs, cosmetics
expand on regulation
of Complementary
medicines (CAMs)
Shorten registration
time for priority
medicines
Improved testing
capabilities of food
To measure progress
towards amending
the cosmetic
regulations
Compensable claims
paid by CCOD
Number of newly
appointed boards
inducted and
trained in corporate
governance and
legislation.
Regulate Medical
devices, IVDs,
cosmetics and
expand on
regulation of
Complementary
medicines (CAMs)
Improve registration
turnaround times
of ARV’s, TB,
oncology medicines
and vaccines to
treat and prevent
high burden of
diseases
Establish a MOU
with Department
of Agriculture,
Fisheries and
Forestries (DAFF)
Amend legislation to
regulate cosmetics
to be in line with
international
standards
Number of
compensable
disease claims paid
by CCOD other than
pensioners
Number of newly
appointed boards
Monitor the
capacity building
programme of
newly appointed
boards
To assess the
claims payment
processes of the
CCOD
Documented
evidence
To measure
progress towards
ensuring legal
framework to
support regulatory
oversight of
Medical devices,
IVDs, cosmetics,
CAMs
Short De¿nition
Indicator name
Purpose /
Importance
Attendance register
FRQ¿UPLQJWKH
training session with
board member
List of approved
payments of compensable claims
reconciled with bank
statements at the
CCOD
More than
80% of
board
members
constitute
a inducted
and trained
board
Numerator:
number of
compensable claims
paid and
reconciled
with bank
statements
at CCOD
Progress
depends on
legislative
processes
N/A
Documented evidence
N/A
Numerator:
Total no.
of products
registered
per priority
group within
the timeline
N/A
Calculation
Method
Documented
evidence
Documented evidence
Source
INDICATOR DEFINITIONS FOR PROGRAMME PERFORMANCE INDICATORS
Output
Output
None
N/A
Activity
None
Activity
Output
Activity
Type of
Indicator
Progress
depends on
information from
internal and
external labs,
and resources
Limited resources
Progress
depends on
parliamentary
processes
Data
Limitations
Sum of
boards
N/A
Quarterly
N/A
Non cumulative
N/A
Calculation Type
Quarterly
Quarterly
No
Quarterly
Quarterly
Quarterly
Reporting
Cycle
Yes
No
Regulations
promulgated
No
No
No
New
Indicator
All new boards
appointed,
inducted and
trained
100% of target
Amend
legislation
to regulate
cosmetics to
be in line with
international
standards
Signed MoU
Higher level
of output
may indicate
improved
HI¿FLHQF\
Regulations
promulgated
Desired
Performance
Cluster:
Health Entities
Management
Occupational
Health Cluster:
MBOD
FCPTPR
FCPTPR
FCPTPR
FCPTPR
Responsibility
128
Short De¿nition
Develop and
implement
Dashboard to monitor
entities performance
and compliance to
Develop a reporting
template to enable
feedback to the
executive authority.
Indicator name
Develop and
implement
Dashboard to
monitor entities
performance and
compliance to
Develop a reporting
template to enable
feedback to the
executive authority.
None
None
Approved reporting
template
Improve monitoring
and feedback
from appointed
managers at
board meetings of
entities
Calculation
Method
Approved Dashboards
Source
Improve monitoring
of entities
Purpose /
Importance
None
None
Data
Limitations
Output
Output
Type of
Indicator
None
None
Calculation Type
Quarterly
Quarterly
Reporting
Cycle
Yes
Yes
New
Indicator
Standardized
reporting
template
developed and
implemented for
Departmental
representatives
serving on
boards
10 Dashboards
developed and
piloted (1 per
entity or statutory council)
Desired
Performance
Cluster:
Health Entities
Management
Cluster:
Health Entities
Management
Responsibility
129
National Department of Health
Switchboard:
012 395 8000
Physical address:
Civitas Building
Cnr Thabo Sehume and Struben Streets
Pretoria
Postal Address:
Private Bag X828
Pretoria
0001
RP75 / 2015
ISBN: 978-0-621-43413-2