LIMPOPO DEPARTMENT OF HEALTH 18 MAY 2016 DURBAN 1 Introduction - - PowerPoint PPT Presentation

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HEALTH MARKET INQURY

PRESENTATION BY THE LIMPOPO DEPARTMENT OF HEALTH 18 MAY 2016 DURBAN

Introduction

• Approximately 80% of the population in

Limpopo is based in rural areas. This situation greatly impacts on the population’s capacity to acquire and access education, particularly tertiary education, which in turn influences the potential for gainful employment in the formal economic sector.

• The South African Multidimensional Poverty

Index (SAMPI) using census data has shown that Limpopo Province is having the third largest poverty headcount of all provinces in 2001 and 2011 after Eastern Cape and KwaZulu-Natal.

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Cont…

• The department is faced with multi-

challenges of poverty that affects indicators such as the incidence of severe acute malnutrition, diarrhea, prevalence of HIV and AIDS, etc. These multi- dimensional factors of poverty further constrain the resources of the department in delivering health care services.

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Cont….

• The province is a typical developing area,

exporting primary products and importing manufactured goods and services.

• It has a high potential for development,

with resources such as tourism, rain-fed agriculture, minerals and abundant labour

• ffering excellent investment
• pportunities.

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Cont….

• About 80% of South Africa’s

hunting industry is found in Limpopo.

• In addition to commercial

agriculture, subsistence farming is the mainstay of a large section

• f the rural population.

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Cont….

• Limpopo is the gateway to the rest of

Africa, with its shared borders making it favourably situated for economic cooperation with other parts of Southern Africa.

• The province borders the countries of

Botswana to the West, Zimbabwe to the North and Mozambique to the East. In the eastern region lies the northern half of the magnificent Kruger National Park.

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Cont….

• In keeping with the NHI White Paper the

LPDoH is pursuing a number of strategies to encourage greater cooperation between the public and private health care services.

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DEMOGRAPHIC PROFILE OF LIMPOPO

• Limpopo is the fifth largest of South

Africa’s nine provinces covering an area

• f 125 755 square kilometers, which is

10.3% of South Africa’s total land area.

• It has a population of 5.6 million (2014

Mid-Year Population Estimates).

• The population of Limpopo is youthful

with 33% (1.86 million) being children under the age of 15 years.

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Cont.…

• Economically active population (15 -

64years) constitutes 61% or 3.4 million, while elderly people are in the minority making up 5% of the province’s population.

• Females constitute the majority,

making up 53.1% (2.98 million) of the province’s population.

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Cont.…

• Average total fertility rate is estimated

at 3.01 for the period 2011 – 2016,

• while the average life expectancy at

birth for males is estimated at 58.3 years

• and that for females at 62.5 years in

the same reference period.

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Cont.…

• Migration is an important

demographic process in shaping the age structure of the provincial population.

• For the period 2011 – 2016, Limpopo

experienced an out-migration of nearly 303 101 people (Stats SA, 2014).

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Cont.…

• Table 1provides the age and sex

distribution of the population while figure 1 depicts the age and sex structure (Stats SA Mid-Year Population Estimates, 2014 ).

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AGE MALE FEMALE TOTAL 0-4 343943 336040 679983 5-9 302541 296251 598792 10-14 292885 290970 583855 15-19 315349 315383 630732 20-24 309034 307582 616616 25-29 264946 263728 528674 30-34 195662 207980 403642 35-39 144500 169732 314232 40-44 108106 150298 258404 45-49 88610 133734 222344 50-54 73872 117180 191052 55-59 61576 99094 160670 60-64 50762 83659 134421 65-69 36324 65198 101522 70-74 24839 50341 75180 75-79 18163 43320 61483 80+ 18003 50862 68865

Total 2649115 2981352 5630467

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Demographic profile cont.…

Table 1. Population of Limpopo Province by age and sex, 2014

Cont.…

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Cont.…

• The population pyramid above show

the distribution of males and females across age groups in Limpopo.

• The population pyramid resembles a

developing country where there is high birth rate and short life expectancy.

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Cont.…

• This is an indicative of future trends

which show that if not much is done in improving the health outcomes of the people, the life expectancy will continue to drop.

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DISTRIBUTION OF PUBLIC HEALTH CARE FACILITIES IN THE PROVINCE

• Limpopo Province is divided, for

local government purposes, into five district municipalities which are in turn divided into twenty-five local municipalities (see figure 2 below):

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Figure 2

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VhembeDistrict Municipality 21349 1294722 60,6 02 01 (Psychiatric) 11 6 08 06 01 CapricornDistrict Municipality 16988 261463 74,3 05 01 (Psychiatric) 96 04 06 02 MopaniDistrict Municipality 24489 1092507 44,6 02 01 (Psychiatric) 95 08 06 01 Sekhukhune District Municipality 13426 1076840 80,2 01 ж 84 03 05 02 Waterberg District Municipality 49504 679336 13,7 05 61 02 07 01 SA No..of District Hospitals No of Private Facilities Specialised Hospitals No..of Fixed Clinics Population Density (per km²) Name of District (Stats

• No. of CHC

Population 2011) No..of Hospitals Regional No..of Hospitals Tertiary

Table 2

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District Municipalitie s District Beds Regi

• nal

Beds Specia lised Beds Tertiar yBeds Private Beds (Active) Vhembe 1649 538 390 44 Capricorn 988 786 1210 493 Mopani 1216 400 400 197 Sekhukhune 853 938 *(14)* Waterberg 962 273 191 TOTAL 5668 2149 1576 1210 925

Table 3

DISTRIBUTION OF DESIGNATED HOSPITAL BEDS IN LIMPOPO – PUBLIC & PRIVATE

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IN SUMMARY – PROVINCE

• Fixed Clinics

: 452

• Community Health Centres:

25

• District Hospitals

Regional Hospitals Tertiary Hospitals Specialised Hospitals Private Health Facilities : : : : : 30 (5668 beds) 05 (2149 beds) 02 (1210 beds) 03 (1576 beds) 14

(925 approved beds)

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FUTURE PLANS

• Sefako Makgatho Academic Hospital: +-

800 Tertiary beds

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ESTABLISHMENT OF PRIVATE HOSPITALS IN THE PROVINCE

• The process start with the proprietor of the facility

submitting the application to the HOD.

• The application must contain the following

information:

• Description of premises.

Particulars regarding their location. The nature of the treatment to be rendered there. Population groups of the staff attached to the private hospital.

• Population group that will make use of the private hospital.
• Architectural plans of the buildings or proposed buildings

must accompany the application.

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Cont…

• Upon receipt of the application by the

HOD, it is forwarded to the Evaluation Committee for processing, then to the Adjudication Committee, which will then recommend to the HOD for approval or non approval.

• The HOD after consultation with the

committees, shall satisfy him or herself as to the necessity or otherwise for such a private hospital to be established before granting or refusing permission.

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Cont…

• If permission is granted to proceed with the

establishment , the applicant shall complete form 1 (Annexure B) attached in the R158 and submit architectural plans for approval by the HOD before construction can commence and/

• r resume.
• In addition, the applicant shall furnish the HOD

with proof in writing, that neither the Government Departments concerned nor the Local Authority concerned have any objection to the private hospital being constructed on the premises concerned.

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Cont…

• The applicant must also provide written proof

that the plans have been approved by the Local Authority concerned.

• The applicant shall inform the HOD about the

completion of construction of the private hospital, and the HOD shall dispatch a licensing team to conduct an inspection before the facility can be issued with a license to operate. the operating license shall be valid for a period

• f 12 months, subject to renewal after this

period.

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Cont…

• The proprietor is supposed to

submit an application for the renewal of the certificate of registration at least 90 days before the date of its expiry in accordance with Regulation 11.

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CRITERIA FOR LISENCING AND RENEWAL OF CERTIFICATES OF REGISTRATION

• Before a license/ certificate of registration

is issued to a private facility, a licensing team performs an inspection of the facility for compliance before recommendation to the HOD.

• The private hospital must comply with and

maintain compliance with the following:

• National building regulation (NBR) SABS

0400.

• Occupational Health and Safety Act, Act 85 of

1993.

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Cont…

• Regulation R158 of February 1980 as

regulation to the Health Act, Act no 63

• f 1977.
• Basic Conditions of Employment Act.
• National Department of Health

Guidelines.

• IUSS guidelines.

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Cont…

• In addition, more emphasis is put on

National Core Standards:

• Patient’s Rights.
• Patient safety , Clinical Governance and Clinical

Care.

• Clinical Support Services.

Operational Management. Facilities and Infrastructure. Leadership and Corporate Governance. Medicine Supplies and Laboratory services. Health Technology.

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Institution

Beds

• perational

Town Noof Beds RegistrationStatus Mediclinic Thabazimbi Thabazimbi 21 Fullyregistered MediclinicLephalale Lephalale 34of150 Fullyregistered STVincent Bela-Bela 42of83 Fullyregistered RPMUnionSwartklip Swartklip Mine 46 Fullyregistered RPMAmandelbult Amandelbult 48 Fullyregistered

• Institutions which applied for certificate of

registration for 2016.

Waterberg District: total no of beds: 191 of 348

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Institution

• perational

Town NoofBeds Registrationstatus Mediclinic Limpopo Polokwane 247of280 Fullyregistered Netcare Pholoso Polokwane 200 Fullyregistered MediclinicDay ClinicLimpopo Polokwane Dayclinic Fullyregistered UnicareSub- Acuteunit Polokwane 38of40 Fullyregistered CANSA hospital Polokwane 8 Fullyregistered

Cont…

• Capricorn: District no of Beds: 493 of 528

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Institution

• perational

Town Noofbeds Registration status Clinix Phalaborwa Phalaborwa 66 Fullyregistered (PPP) Mediclinic Tzaneen Tzaneen 131 Fullyregistered

Cont…

• Mopani: District no of beds: 197

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Institution

• perational

Town Noofbeds Registration status QualityCare Makhado 12of36 Fullyregistered Zoutpansberg Makhado 32of40 Fullyregistered

Cont…

• Vhembe: District no of beds: 44 0f 76

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Institution

• perational

Town Noofbeds Registration status Ndhlovu maternal Dennilton 14 Certificate suspendeddue tonon- compliance

Cont…

• Sekhukhune: District no of beds: 14 of 14

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Nameofproject Town Noofbeds Comment Mokgalakwena private Mokopane 45 Provisionalapproval lapsed Mokopane private Mokopane 100 Provisionalapproval lapsed Mokomedprivate Mokopane 30 Provisionalapproval lapsed Modimolle private Modimolle

• Applications not followed up by

proprietors

• Waterberg: No of beds: 175

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Nameofproject Town Noofbeds Comment Boroloprivate Polokwane 200 Provisionalapprovallapsed Polokwaneprivate Polokwane 200 Provisionalapprovallapsed CureDayclinic Polokwane 30 Provisionalapprovallapsed AcuteRehab Centre Polokwane

• Provisionalapprovallapsed

EyeLaserunit Polokwane 20 Provisionalapprovallapsed FloraDayClinic Polokwane 47 Provisionalapprovallapsed Medlabprivate Lebowakgo mo 50 Provisionalapprovallapsed BophelongRehab Centre Polokwane 120 Architecturalplans submitted

cont…

• Capricorn: no of beds: 667

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Nameofproject Town Noofbeds Comment Giyaniprivate Giyani 70 Provisionalapprovallapsed

Cont…

• Mopani: No of beds: 70

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Nameofproject Town Noofbeds Comment Burgersfortprivate Burgersfort 140 Provisional approvallapsed PlatinumHealth Burgersfort 14 Provisional approvallapsed

Cont…

• Sekhukhune: No of beds: 154

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Nameofproject Town Noofbeds Comment Thohoyandou private Thohoyandou 85 Provisional approvallapsed Fundamed Thohoyandou

• Provisional

approvallapsed

Cont…

• Vhembe: No of beds: 85

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Activebeds Bedsnotactive 881 1163

Total number of bed s

• Number of beds Adjudicated: 2044

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Categories ABLEA9:HEA DataSource:Pe Number employed PERSONN EL rsal(oruselate st %of total employe d IN2014/1 5 informatio nfrom Numberper 100,000 people SouthAfricanH e Number per 100,000 uninsured

2

people althReview2 013 Vacan cy

5

rate /14ifPer sal %of total person nel budget dataisn

• t

Annualcostperstaffmember available)

Medicalofficers 1082 3.1% 20 20 27.6% 9.5% 612377 Medicalspecialists 94 0.3% 2 2 49.5% 1.4% 1052140 Dentists 189 0.5% 3 3 4.1% 1.7% 638188 Dentalspecialists 5 0.0% 37.5% 0.1% 1187576 Professionalnurses 8993 25.5% 166 166 5.6% 34.7% 269627 EnrolledNurses 4245 12.1% 79 79 2.8% 7.8% 128885 EnrolledNursing

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Auxiliaries 4998 14.2% 92 92 3.3% 7.3% 101366 Studentnurses 912 2.6% 17 17 NA 1.1% 87290 Pharmacists 462 1.3% 9 9 4.5% 3.1% 465571 Physiotherapists 192 0.5% 4 4 7.2% 0.6% 234563

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Occupationaltherapists 158 0.4% 3 3 8.7% 0.6% 249480 Radiographers 209 0.6% 4 4 10.3% 0.8% 256612 Emergencymedicalstaff 1864 5.3% 34 34 0.9% 3.9% 147629 Nutritionists 44 0.1% 1 1 0.0% 0.2% 300495 Dieticians 293 0.8% 5 5 6.1% 1.0% 244855

HEALTH PERSONNEL : 2014 – 2015

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BROAD ISSUES OF CONCERN FOR LIMPOPO DEPT OF HEALTH

• There is an urgent need to review the

current Regulation 158 with the overall

• bjective of optimising the acquisition,
• peration and management of the private

healthcare infrastructure through all stages of infrastructure lifecycle.

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Cont.…

• Access and affordability are the

key issues in the context of the private health care sector in Limpopo.

• Cost escalations are rendering

private health care increasingly unaffordable to the majority of the Limpopo population.

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Cont.…

• The public healthcare sector

continues to bleed significantly from the health care personnel that are trained by the government and then join the private healthcare sector

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CONT…

• Non-compliance to the R158 regulations

also remains a critical challenge.

• Recently the department has had to

withdraw a certificate of registration / license from one of the private healthcare facility due to non-compliance.

• Quality and compliance are very critical

for certification of private health establishments and we regard these issues as non-negotiable.

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Challenges

• Lack of understanding of Department
• f Health Policies and Guidelines
• Applications vs Needs

Lack of applications for some districts which really need private facilities No follow up by proprietors

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THANK YOU

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