DISTRICT HEALTH PLAN 2015/2016 ETHEKWINI HEALTH DISTRICT KWAZULU-NATAL ETHEKWINI DISTRICT HEALTH PLAN 2015/16 1. ACKNOWLEDGEMENTS The following individuals are acknowledged for their role in the completion of this District Health Plan for 2014/15: Martin Gabela (Planning, Monitoring and Evaluation Manger) responsible for the drafting of the DHP 15/16 with input from Nicky Manivasen for the extraction and compilation of the DHIS data tables; the various program managers at the district office that provided strategic input regarding progress and plans for the next financial year. The finance information was compiled by Sandra Moodley. The Human Resource data was compiled by Melanie Dazel and Ronald Dukie. Nkosifikile Ndelu drew the revised map of the sub-districts. Acknowledgement is also extended to Shamim Ganie and Catherine Searle from MatCH (District Support Partner), for valuable assistance with the analysis and write up of the DHP. The support and input of the provincial team under Tracey Hattingh and Ester Snyman is also gratefully acknowledged. 2 | Page ETHEKWINI DISTRICT HEALTH PLAN 2015/16 2. OFFICIAL SIGN OFF It is hereby certified that this District Health Plan: Was developed by the district management team of eThekwini District with the technical support from the provincial district development directorate and the strategic planning unit. Was prepared in line with the current Strategic Plan and Annual Performance Plan of the Department of Health of KZN 3 | Page ETHEKWINI DISTRICT HEALTH PLAN 2015/16 3. TABLE OF CONTENTS 1. ACKNOWLEDGEMENTS ................................................................................................................ 2 2. OFFICIAL SIGN OFF ....................................................................................................................... 3 3. TABLE OF CONTENTS .................................................................................................................... 3 4. LIST OF ACRONYMS ...................................................................................................................... 5 5. EXECUTIVE SUMMARY BY DISTRICT MANAGER .......................................................................... 8 PART A - STRATEGIC OVERVIEW ..................................................................................................... 11 6. SITUATIONal ANALYSIS ................................................................................................................ 11 6.1 MAJOR DEMOGRAPHIC CHARACTERISTICS ..................................................................... 13 6.2 SOCIAL DETERMINANTS OF HEALTH .................................................................................... 15 6.3 EPIDEMIOLOGICAL (DISEASE) PROFILE OF THE DISTRICT .................................................. 17 7. DISTRICT SERVICE DELIVERY ENVIRONMENT ............................................................................ 19 7.1 DISTRICT HEALTH FACILITIES ........................................................................................... 19 7.2 TRENDS IN KEY DISTRICT HEALTH SERVICE VOLUMES .................................................. 23 8. DISTRICT PROGRESS TOWARDS THE ACHIEVEMENT OF THE MDG’S ...................................... 29 9. PROVINCIAL AND DISTRICT CONTRIBUTION TOWARDS THE HEALTH SECTOR NEGOTIATED SERVICE DELIVERY AGREEMENT (NSDA) ....................................................................................... 31 10. SUMMARY OF MAJOR HEALTH SERVICE CHALLENGES AND PROGRESS MADE FOR THE PREVIOUS THREE FINANCIAL YEARS ............................................................................................... 33 10.1 INTRA DISTRICT EQUITY IN THE PROVISION OF SERVICES ................................................ 33 11. ORGANISATIONAL ENVIRONMENT ......................................................................................... 38 11.1 Organisational Structure of the District Management Team ....................................... 38 11.2 Human Resources .............................................................................................................. 38 12. DISTRICT HEALTH EXPENDITURE ................................................................................................ 42 PART B - COMPONENT PLANS ............................................................................................... 48 13. SERVICE DELIVERY PLANS for district health services ............................................................ 48 13.1 Sub-Programme : District Health Services ...................................................................... 48 a. Sub-Program: District Hospitals ........................................................................................ 58 14. HIV & AIDS & TB CONTROL (HAST) .................................................................................... 66 14.1 Programme Overview ....................................................................................................... 66 14.2 HIV & AIDS, STI & TB CONTROL (HAST): Strategies/ Activities to be implemented 2015/16 ........................................................................................................................................ 75 15. MATERNAL, NEONATAL, CHILD AND WOMEN’S HEALTH AND NUTRITION .................... 76 15.1 Programme Overview ....................................................................................................... 76 15.2 Strategies/ Activities to be implemented 2015/16 ........................................................ 91 16. DISEASE PREVENTION AND CONTROL (Environmental Health Indicators) ......................... 93 16.1 Programme Overview ....................................................................................................... 93 16.2 Strategies/ Activities to be implemented 2015/16 ........................................................ 98 17. INFRASTRUCTURE, EQUIPMENT AND OTHER SUPPORT SERVICES .......................................... 99 18. SUPPORT SERVICES ................................................................................................................. 101 18.1 PHARMACEUTICAL SERVICES ........................................................................................... 101 18.2 EQUIPMENT AND MAINTENANCE ................................................................................... 104 18.3 EMERGENCY MEDICAL SERVICES (EMS) ........................................................................ 106 *INTER-FACILITY TRANSFER IS FOR OPERATIONS ONLY AND DOES NOT INCLUDE PPT................. 106 19. HUMAN RESOURCES ............................................................................................................... 107 20. DISTRICT FINANCE PLAN ........................................................................................................ 108 PART C: LINKS TO OTHER PLANS .................................................................................................. 110 21. CONDITIONAL GRANTS.......................................................................................................... 110 22. PUBLIC-PRIVATE PARTNERSHIPS (PPPs) and PUBLIC PRIVATE MIX (PPM) ........................... 112 4 | Page ETHEKWINI DISTRICT HEALTH PLAN 2015/16 4. LIST OF ACRONYMS Abbreviations Description A AIDS Acquired Immune Deficiency Syndrome ANC Ante Natal Care APP Annual Performance Plan ART Anti-Retroviral Therapy ARV Anti-Retroviral B BAS Basic Accounting System BLS Basic Life Support BUR Bed Utilisation Rate C CARMMA Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa CCG’s Community Care Givers CEO(s) Chief Executive Officer(s) CHC(s) Community Health Centre(s) COE Compensation of Employees D DCST(s) District Clinical Specialist Team(s) DHER(s) District Health Expenditure Review(s) DHIS District Health Information System DHP(s) District Health Plan(s) DHS District Health System DOH Department of Health DQPR District Quarterly Progress Report E EMS Emergency Medical Services ETB.R Electronic Tuberculosis Register ETR.net Electronic Register for TB F G G&S Goods and Services H HAST HIV, AIDS, STI and TB HCT HIV Counselling and Testing HIV Human Immuno Virus HOD Head of Department HPS Health Promoting Schools HPV Human papillo virus 5 | Page ETHEKWINI DISTRICT HEALTH PLAN 2015/16 Abbreviations Description HR Human Resources HTA High Transmission Area I IDP(s) Integrated Development Plan(s) IPT Ionized Preventive Therapy J K KZN KwaZulu-Natal L LG Local Government M M&E Monitoring and Evaluation MDG Millennium Development Goals MDR-TB Multi Drug Resistant Tuberculosis MEC Member of the Executive Council MNC&WH Maternal, Neonatal, Child & Women’s Health MO Medical Officers MOU Maternity Obstetric Unit MTEF Medium Term Expenditure Framework MTSF Medium Term Strategic Framework MUAC Mid-Upper Arm Circumference N NDOH National Department of Health NCS National Core Standards NGO(s) Non-Governmental Organisation(s) NHI National Health Insurance NIMART Nurse Initiated and Managed Antiretroviral Therapy O OSD Occupation Specific Dispensation OSS Operation Sukuma Sakhe P P1 Calls Priority 1 calls PCR Polymerase Chain Reaction PCV Pneumococcal Vaccine PDE Patient Day Equivalent Persal Personnel and Salaries System PHC Primary Health Care PN Professional Nurse R RV Rota Virus Vaccine S 6 | Page ETHEKWINI DISTRICT HEALTH PLAN 2015/16 Abbreviations Description SCM Supply Chain Management SHS School Health Services SLA Service Level Agreement Stats SA Statistics