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South Africa National Master Plan for the Elimination of Neglected Tropical Diseases (2019 - 2025)

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South Africa National Master Plan for the Elimination of Neglected Tropical Diseases (2019 - 2025) South Africa National Master Plan for the Elimination of Neglected Tropical Diseases (2019 - 2025) Version 1.3 Contents PREFACE VII INTRODUCTION 1 PART I: SITUATION ANALYSIS 2 1. COUNTRY CONTEXT 2 1.1. ADMINISTRATIVE STRUCTURES, COMMUNITY STRUCTURE AND DEMOGRAPHY 2 1.2. GEOGRAPHY 5 1.3. SOCIO- ECONOMIC STATUS AND INDICATORS 6 1.4. WATER AND SANITATION 7 1.5. TRANSPORT AND COMMUNICATION 7 2. HEALTH SYSTEM SITUATION ANALYSIS 8 2.1. HEALTH SYSTEM GOALS AND PRIORITIES 8 2.2. HEALTH FINANCING 8 2.3. LEADERSHIP AND GOVERNANCE 9 2.4. HEALTH SERVICE DELIVERY 10 2.5. MEDICAL PRODUCTS 11 2.6. HEALTH WORKFORCE 11 2.7. HEALTH INFORMATION 12 3. NEGLECTED TROPICAL DISEASE SITUATIONAL ANALYSIS 13 3.1 EPIDEMIOLOGY AND BURDEN OF NTDS 13 a. Schistosomiasis 13 b. Soil-Transmitted Helminthiasis 14 c. Leprosy 15 d. Rabies 16 e. Co-endemicity of NTDs in South Africa 17 3.2 NTD PROGRAMME CONTEXT 19 3.3 GAPS AND PRIORITIES – SWOT ANALYSIS 20 PART II: STRATEGIC AGENDA 22 4. NTD PROGRAMME STRATEGIC AGENDA 22 4.1. NTD PROGRAMME MISSION AND STRATEGIC GOALS 22 4.2 GUIDING PRINCIPLES 22 4.3. STRATEGIC PRIORITIES AND PILLARS 22 4.4 NATIONAL NTD PROGRAMME GOALS, OBJECTIVES, STRATEGIES AND TARGETS 25 4.5 NATIONAL NATIONAL MILESTONES FOR TARGETED NTDS 26 PART III: OPERATIONAL FRAMEWORK 28 5. NTD PROGRAMME OPERATIONAL PILLARS 28 SOUTH AFRICA NTD MASTER PLAN 2019-2025 i 5.1: PILLAR 1 - ENSURE UNIVERSAL ACCESS TO NTD CHEMOTHERAPY AND INTERVENTIONS 28 5.2: PILLAR 2 - STRENGTHEN VECTOR CONTROL, ENVIRONMENT AND RESEARCH AND INNOVATIONS FOR NTD ELIMINATION 32 5.3: PILLAR 3 - TRANSFORM NTD SURVEILLANCE INTO A CORE INTERVENTION 34 5.4: PILLAR 4 - STRENGTHEN PLANNING, RESOURCE MOBILIZATION, COORDINATION AND INTER-SECTORAL COORDINATION FOR ELIMINATION OF NTDS 38 PART IV: BUDGET JUSTIFICATION AND ESTIMATES 47 6. PROGRAMME BUDGET ESTIMATES 47 REFERENCES 49 SOUTH AFRICA NTD MASTER PLAN 2019-2025 ii List of Figures Figure 1: Provinces, health districts and district codes of South Africa (provincial boundaries in grey, national boundaries in black (Sartorius and Sartorius, 2015) .............................................................................................. 2 Figure 2: Urbanisation, Structural Transformation and Rural-Urban Linkages in South Africa, Channing Arndt, Rob Davies and James Thurlow April 2018 (Red (green) indicates a higher (lower) density of urban shares) ....... 3 Figure 3: South Africa Population Pyramid showing a larger population below 35 years old ............................... 4 Figure 4: Koppen climate types pf South FRICA ..................................................................................................... 5 Figure 5: The poverty head count in the share of households in South Africa ....................................................... 6 Figure 6: The SA district health system ................................................................................................................ 10 Figure 7: Endemicity of schistosomiasis ............................................................................................................... 13 Figure 8 Point Prevalence for schistosomiasis ..................................................................................................... 14 Figure 9 Endemicity status for soil transmitted helminthiasis ............................................................................. 14 Figure 10: Point Prevalence for Soil Transmitted helminths ................................................................................ 14 Figure 11: Number of newly detected cases, 5-year period ................................................................................. 16 Figure 12 2009 Distribution of laboratory-confirmed animal rabies cases in the province. (Gauteng Province: 0.5%) .................................................................................................................................................................... 16 Figure 13: Laboratory confirmed human rabies cases in South Africa from 1983 – 2017, per province(Centre for Emerging Zoonotic and Parasitic Diseases, 2017) ............................................................................................... 17 Figure.: 14 Co-endemicity map for schistosomiasis and soil transmitted helminthiasis ...................................... 17 Figure 16Vector Control interventions ................................................................................................................. 32 Figure 17: Monitoring and Evaluation framework ............................................................................................... 34 Figure 18: Programmatic approach to achieve and sustain elimination ............................................................. 42 List of Tables Table 1 Demography of South Africa, (Source: STATS SA 2018 mid-year estimates) 4 Table 2: Summary of NTD Mapping status 18 Table 3: Summary of intervention information on existing PCT programmes 19 Table 4: Summary of intervention information on existing CM programme 19 Table 5: SWOT Analysis 20 Table 6: Strategic Agenda for the Elimination of Neglected Tropical Diseases in South Africa, 2019 -2025 23 Table 7: Summary of NTD Disease specific goals and objectives 25 Table 8: Milestones for targeted NTDs 26 Table 9: Pillar 1: Ensure universal access to NTD chemotherapy and interventions 30 Table 10: Pillar 2: Strengthen vector control, environment and research and innovations for NTD elimination 33 Table 11: Pillar 3: Transform NTD Surveillance into a Core Activity, Monitoring & Evaluation 35 Table 12: Pillar 4: Strengthen planning, resource mobilization, coordination and inter-sectoral coordination for elimination of NTDs 40 Table 13: Performance Indicators Pillar 1: Ensure universal access to NTD chemotherapy and interventions 43 Table 14: Performance Indicators Pillar 2: Strengthen vector control, environment and research and innovations for NTD elimination 44 Table 15: Performance Indicators for Pillar 3: Transform NTD Surveillance into a Core Activity, Monitoring & Evaluation 45 Table 16: Performance Indicators for Pillar 4: Strengthen planning, resource mobilization, coordination and inter-sectoral coordination for elimination of NTDs 46 SOUTH AFRICA NTD MASTER PLAN 2019-2025 iii List of Annexes Annex 1: Distribution of the Population by District, the corresponding number of Primary Schools and Health Facilities. The Departments of Basic Education and Health Demarcation Districts and sub-districts differ as seen below. __________________________________________________________________________________ 50 Annex 2 NDP Goals and Priorities 2030 and DOH Strategic Goals 2014 to 2019 _________________________ 52 Annex 3 The burden of disease that the NHI aims to improve _______________________________________ 52 Annex 4: Co-endemicity status of NTDs ________________________________________________________ 53 Annex 5: Types of Mass Drug Administration ____________________________________________________ 55 Annex 6 Department of Basic Education districts by province _______________________________________ 57 Annex 7: Organisational Chart of the MoH and NTD National Programme ____________________________ 58 Annex 8: Distances between Major Cities in South Africa __________________________________________ 59 Annex 9: PCT Algorithms ____________________________________________________________________ 59 Annex 10: Package of preventive chemotherapy and case management NTDs _________________________ 60 Annex 11: Package of Transmission Control - Vector Or Reservoir Control _____________________________ 60 Annex 12: Package of Improvement of Environment, Supply of Safe Drinking Water, Sanitation and Operational Research ________________________________________________________________________________ 60 Annex 13: Drug estimates and logistics ________________________________________________________ 61 Annex 14: Drug forecasting and logistics _______________________________________________________ 61 Annex 15: Summary of progressive scale up and phase out of PCT interventions package ________________ 61 SOUTH AFRICA NTD MASTER PLAN 2019-2025 iv Acronyms CBO Community Based Organization CDC Communicable Disease Control CM-NTD Case Management NTDs COGTA Cooperative Governance and Traditional Affairs DAFF Department of Arts, Forestry and Fisheries DHIS District Health Information Service DHS District Health Service DOBE Department of Basic Education DoH Department of Health DRDLR Department of Rural Development and Land Reform DWS Department of Water and sanitation ECD Early childhood Development EH Environmental Health EHP Environmental Health Practitioner EMIS Education Management Information System EMS Emergency Medical Services EPI Expanded Program on Immunisation FBO Faith-Based Organization IDM Innovative and Intensified Disease Management IGR Intergovernmental relations ISHP Integrated School Health Program LF Lymphatic Filariasis M&E Monitoring and Evaluation MCWH&N Maternal, Child, Women Health and Nutrition MDA Mass Drug Administration NGO Non-Governmental organisation NHLS National Health Laboratory Service NICD National Institute for Communicable Disease NSC National Steering Committee NSNP National School Nutrition Program NTD Neglected Tropical Diseases NTD-TAG NTD Technical Advisory Groups PHASE Preventive chemotherapy, Health education, Access to clean water, Sanitation improvement, and Environmental manipulation PHC Primary Health Care SAC School-Age Children SANDF South African Defence Force SAPS South African Police
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