Response from NDoH Jeanette R Hunter 29 January 2015 Problem Statement Policy limitations and rural realities Vuyokazi Gonyela The difficulty with policy implementation in a rural province ID: 599709
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Slide1
Launch: Rural Proofing GuidelinesResponse from NDoH
Jeanette R Hunter
29 January 2015Slide2
Problem StatementPolicy limitations and rural realities – Vuyokazi GonyelaThe difficulty with policy implementation in a rural province - Andrew Robinson Slide3
Problem StatementProblem statementPolicy formulated to address statementImplementation preparationImplementationApplying a systematic approach on a system
Result
Hit and
miss
- mostly
miss
Why ?????Slide4
Problem StatementPolicy limitations and rural realities – Vuyokazi GonyelaOut of stock medicinesLong queues, resulting in impossible waiting timesFunctionality of CHEs
Problems to information systemsSocial Determinants of HealthSystems inability to cope with the demand (CD4 of <500)The difficulty with policy implementation in a rural province - Andrew Robinson
A facilitator of services to communities feeling let down by the system, (peers and principals)
MISS in Hit and MissSlide5
Rural Proofing guidelinesDaygan: “The Guidelines are not going to propose solutions, its going to enable us to THINK RURAL”Thus on its own it will not improve the REAL SITUATION on the ground for communitiesSlide6
Development MUST be supported where people liveHealth System activities MUST support developmentSlide7
WHY the MISS in ImplementationNo blanket answer that will suffice for the entire health service environmentIn spite of good policies there are very specific problems from setting to settingIssue of funding is a good example of thisIan’s point about Equity – act in terms of specific need Slide8
HOWIdeal DHMT
Adequate Health Services
Ideal Clinic (rural/urban)
Ideal National Health Management
Ideal Provincial Management
Ideal Community Services
Ideal Political Leadership in Health
Slide9
Vhembe District Ideal Clinic StatusTotal of 120 clinics and CHCs in Vhembe health district Of these 61 have determined their Ideal Clinic status between April and October 2014The remaining 59 will be done by end January 2015The status determination is done by the Permanent Perfect Team for Ideal Clinic Realisation and Maintenance (PPTICRM) with the help of a PEPFAR funded implementation partner
The corrective interventions are done by the PPTICRM under guidance of the acting district manager and the team member from the NDoH who is responsible for VhembeSlide10Slide11Slide12
The following slides contain the summarised and aggregated results for the 61 clinics and CHCs in VhembeSlide13Slide14Slide15Slide16
Additional Consultation rooms have been completed for the clinics below 1
Matsheka
The additional doctors rooms for these clinics have been completed. Waiting for Municipality to sign off the occupation certificate before it can be practically handed over for
use
2
Nghezimane
3
Xhikundu
4
Duvhuledza
5
Tshifudi
6
Mukula
7
Phiphidi
8
Murangoni
9
Thondo
Tshivhase10Sambandou11Mutale
12Manenzhe13Makhado14Nkhensani15MuilaSlide17Slide18
Political CommitmentPressure from leadershipPremier in KZN now to be followed by premiers in other provinces steered by the deputy presidentService delivery committee chaired by Minister Gorhan, Task team chaired by DG Coperative governance with a very specific and practical approachMinister of Health – Operation PhakisaNDoH
using a population indicator approach (diarrhoea in children under 5)
Social Determinants of HealthSlide19
Thank youKeeping Rural In mindEducationalInstructive (Identify rural clinics as part if IC Process)Facilitate improvementBut only if we keep our eye on, plan for and make specific interventions
Value of Rural-Proofing GuidelinesSlide20
THANK YOU FOR YOUR ATTENTION!www.doh.gov.za