DISTRICT HEALTH PLAN 2015/2016 UTHUKELA KWAZULU-NATAL UTHUKELA DISTRICT HEALTH PLAN 2015/16 1. ACKNOWLEDGEMENTS The District Health Plan is a collective effort. This report could not have been prepared without the generous contributions of the Hospital Management, Program managers in the District Office and partner support from HST. Information and Guidance from the Health Service Planning, Monitoring and Evaluation Component KZN Department of Health. The Provincial Office is dependent on the reports from the Districts to compile the Provincial District Health Plan. The demographic data was obtained from the District Profiles Document distributed at the Rationalisation Workshop. The poverty and social deprivation data was obtained from the following sources; District Health Barometer 2010/2011 Census 2011 document District Profiles Document distributed at the Rationalisation Workshop and DHER reports 2 | Page UTHUKELA 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 Uthukela 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 UTHUKELA DISTRICT HEALTH PLAN 2015/16 3. TABLE OF CONTENTS 1. ACKNOWLEDGEMENTS ........................................................................................... 2 2. OFFICIAL SIGN OFF ................................................................................................... 3 3. TABLE OF CONTENTS ............................................................................................... 4 4. LIST OF FIGURES........................................................................................................ 6 5. LIST OF GRAPHS ......................................................................................................... 6 6. LIST OF TABLES ........................................................................................................... 6 7. LIST OF ACRONYMS .................................................................................................. 8 8. EXECUTIVE SUMMARY BY DISTRICT MANAGER .......................................... 11 PART A - STRATEGIC OVERVIEW .............................................................................. 24 1. SITUATIONAL ANALYSIS........................................................................................ 24 6.1 MAJOR DEMOGRAPHIC CHARACTERISTICS ............................................ 31 6.3 EPIDEMIOLOGICAL (DISEASE) PROFILE OF THE DISTRICT ................. 35 7. DISTRICT SERVICE DELIVERY ENVIRONMENT ............................................. 44 7.1 DISTRICT HEALTH FACILITIES .................................................................. 44 7.2 TRENDS IN KEY DISTRICT HEALTH SERVICE VOLUMES ................ 48 8. DISTRICT PROGRESS TOWARDS THE ACHIEVEMENT OF THE MDG’S . 53 9. PROVINCIAL AND DISTRICT CONTRIBUTION TOWARDS THE NATIONAL DEVELOPMENT PLAN 2030 ........................................................................................ 55 10. SUMMARY OF MAJOR HEALTH SERVICE CHALLENGES AND PROGRESS MADE FOR THE PREVIOUS THREE FINANCIAL YEARS ............ 57 10.1 INTRA DISTRICT EQUITY IN THE PROVISION OF SERVICES ........................................ 59 11. ORGANISATIONAL ENVIRONMENT ................................................................. 62 Human Resources ........................................................................................................... 62 12. DISTRICT HEALTH EXPENDITURE ................................................................... 67 14. PART B - COMPONENT PLANS .......................................................................... 72 15. 13. SERVICE DELIVERY PLANS for district health services ............................. 73 13.1 SUB-PROGRAMME: District Health Services ...................................................... 73 13.2 Sub-Program: District Hospitals ......................................................................... 84 16. HIV & AIDS & TB CONTROL (HAST) ................................................................ 93 14.1 PROGRAMME Overview ....................................................................................... 93 14.2 HIV & AIDS, STI & TB CONTROL (HAST): Strategies/ Activities to be implemented 2015/16 ..................................................................................................... 101 17. MATERNAL, NEONATAL, CHILD AND WOMEN’S HEALTH AND NUTRITION ...................................................................................................................... 106 15.1 PROGRAMME Overview ..................................................................................... 106 15.2 STRATEGIES/ Activities to be implemented 2015/16 ......................................... 121 18. 16. DISEASE PREVENTION AND CONTROL (DPC) ...................................... 125 16.1 PROGRAMME Overview ..................................................................................... 125 16.2 STRATEGIES/ Activities to be implemented 2015/16 ......................................... 132 19. 17. INFRASTRUCTURE, EQUIPMENT AND OTHER SUPPORT SERVICES 135 4 | Page UTHUKELA DISTRICT HEALTH PLAN 2015/16 18. SUPPORT SERVICES ............................................................................................... 138 18.1 PHARMACEUTICAL SERVICES ....................................................................... 139 18.3 EQUIPMENT AND MAINTENANCE ................................................................ 147 18.4 EMERGENCY MEDICAL SERVICES (EMS) .................................................. 148 20. 19. HUMAN RESOURCES .................................................................................. 155 21. 20. DISTRICT FINANCE PLAN ......................................................................... 161 23. PART C: LINKS TO OTHER PLANS ................................................................. 163 24. 21. CONDITIONAL GRANTS (Where applicable) ............................................. 163 22. PUBLIC-PRIVATE PARTNERSHIPS (PPPs) and PUBLIC PRIVATE MIX (PPM) ............................................................................................................................................ 165 25. PART E: INDICATOR DEFINITIONS ............................................................... 167 part f: annexures ............................................................................................................. 168 Annexure 1 rEGIONAL HOSPITAL ............................................................................. 168 5 | Page UTHUKELA DISTRICT HEALTH PLAN 2015/16 4. LIST OF FIGURES Figure 1: UTHUKELA POPULATION PYRAMID 2014/15 ...................................................................................................... 31 Figure 2: Leading causes of years of life lost ....................................................................................................... 35 5. LIST OF GRAPHS Graph: 1: (a): Population distribution per Municipality - raw figurers.............................................................. 32 Graph: 2: PHC Utilisation (Provincial Clinics) vs. Population to PHC facility (Provincial clinics) – 2013/14.. 49 Graph: 3: PHC Utilisation rate in relation to PN Workload Provincial Clinics ................................................... 49 Graph: 4: District Hospitals Cost per PDE vs. IPD and OPD ................................................................................. 52 Graph: 5: Equity of resources vs population and headcount – 2013/14 ........................................................ 59 Graph: 6: District Hospital Expenditure in relation to Service Delivery – 2013/14 ........................................... 69 6. LIST OF TABLES Table 1: Population comparison DHIS 2014 and Census 2011 per sub-district ...................................................... 11 Table 2: Chemical poisoning cases April to September 2014 ............................................................................... 18 Table 3: Community Bursaries awarded. ................................................................................................................. 19 Table 4: District Population 2013/14 ..................................................................................................................... 32 Table 5 (A1): Social Determinants of Health ....................................................................................................... 33 Table 6: Infant and child mortality ......................................................................................................................... 36 Table 7: MCWH challenges .................................................................................................................................... 37 Table 8: HIV and AIDS / TB ...................................................................................................................................... 39 Table 9: HIV AIDS challenges ................................................................................................................................. 40 Table 10: (NDoH 1): PHC facilities (Provincial and LG combined) per Sub-District as at 31 March 2014 ... 44 Table 11: Provincial Clinic Facility to Population – 2013/14 .............................................................................