NATIONAL DEPARTMENT OF HEALTH
PRESENTATION TO THE STANDING
COMMITTEE ON APPROPRIATIONS
2015/16: QUARTER ONE PERFORMANCE
Director General
02 SEPTEMBER 2015
Purpose
Present Progress Report on the Annual Performance Plan
2014/15. The report is presented by the following programmes:
1.
2.
3.
4.
5.
Programme 1 : Administration
Programme 2: Health Planning and Systems Enablement
Programme 3: HIV & AIDS, TB and MCWH
Programme 4: PHC Services
Programme 5: Hospitals, Tertiary Services and Workforce
Development
6. Programme 6: Health Regulation and Compliance
Management
2
Medium Term Strategic Framework
(MTSF) 2014-2019
The Department Annual Performance Plan is designed to deliver on
the MTSF commitments, namely:
Sub-outcome 1: Universal Health coverage progressively achieved through
implementation of National Health Insurance
Sub-outcome 2: Improved quality of health care
Sub-outcome 3. Implement the re-engineering of Primary Health Care
Sub-outcome 4: Reduced health care costs
Sub-outcome 5: Improved human resources for health
Sub-outcome 6: Improved health management and leadership
Sub-outcome 7: Improved health facility planning and infrastructure delivery
Sub-outcome 8: HIV & AIDS and Tuberculosis prevented and successfully managed
Sub-outcome 9: Maternal, infant and child mortality reduced
Sub-outcome 10 : Efficient Health Management Information System developed and
implemented for improved decision making
3
Total Targets in the Annual
Performance Plan of 2015/16
Programmes
Quarterly
Targets
6 monthly
Targets
Programme 1
5
2
Programme 2
Annual
Targets
Total
targets
5
12
16
15
31
Programme 3
28
17
45
Programme 4
1
25
26
Programme 5
3
24
27
Programme 6
15
1
16
Total
69
86
157
2
4
Progress Report
PROGRAMME 1 : ADMINISTRATION
6
Programme 1: Administration
Strategic
Objective
Ensure effective
financial
management and
accountability by
improving audit
outcomes
Indicator
Audit opinion from
Auditor-General
Annual Target
Annual Target:
Unqualified
Audit Opinion
Audit opinion from Annual target: 3
Auditor-General for Unqualified audit
Provincial
opinions
Departments of
Health
Number of
Annual target: 9
provinces that
submit reports
against defined set
of non-negotiable
items on a monthly
basis
Actual
performance
Performance
Rating
NDoH obtained
unqualified Audit
Achieved
3 Unqualified audit Achieved
opinions for
2014/15 for
Western Cape,
Limpopo and
North West
Partially achieved
7 (out of 9)
provinces
submitted signed
off reports.
7
Programme 1: Administration
Strategic Objective
Ensure efficient and
responsive Human
Resource Services
through the
implementation of
efficient recruitment
processes and
responsive Human
Resource support
programmes
Indicator
Target
Actual performance
Performance
Rating
Average Turnaround
times for recruitment
processes
Bi-annual Target:
Average
recruitment
process
turnaround time
will be 4 months
This is a biannual target.
Figures will be
consolidated
end of 2nd and
4th quarters
NDoH vacancy rate
Bi-Annual target:
5%
2% (2/98) were filled
within four months as
per FOSAD target 7%
(7/98)of the vacant
posts were filled
within six months as
Public Service
Regulation of 2001
and
5%
Percentage of Senior
Managers that have
entered into
Performance
Agreements with
their supervisors
Annual target:
98%
95%
Achieved.
8
Achieved.
Same above
Programme 1: Administration
Strategic Objective
Indicator
Quarter Target
Actual performance
Ensure efficient and responsive
Human Resource Services
through the implementation of
efficient recruitment processes
and responsive Human
Resource support programmes
Develop and
Implement Employee
wellness programme
that comply with
Public Service
Regulations (PSR)
and Employee Health
and Wellness
Strategic
Framework(EHWSF)
Quarter target: EHW
induction programme
to Port Health
employees
Induction Schedule
drawn to resume in
July 2015 and meeting
held with
Environmental Health
Partially Achieved
Fully implement the
Departmental Information
Communication Technology
(ICT) Service Continuity Plan by
the 31st of March 2018
Establish ability to
access domain
services outside the
NDoH premises
Quarter target: Enter
into a BCM
agreement with SITA
for transversal
systems.
Quarter target:
Ascertain the
implications of
duplicating all the
existing domain in a
DR site.
Quarter target:
Procure hardware for
Domain services DR
site.
BCM agreement with
SITA for transversal
systems approved and
signed
Achieved
The requirements to
duplicate the domain
services were
established
Achieved
First draft of the
integrated
communication
strategiy and
implementation plan,
which includes a draft
tool kit has been
Partially Achieved
9
Performance Rating
Programme 1: Administration
Strategic Objective
Indicator
Target
Provide support for
effective
communication by
developing an
integrated
communication
strategy and
implementation plan
Develop an
integrated
communication
strategy and
implementation
plan
Annual Target:
Communicatio
n Toolkit
developed to
integrate
messages
A National Health
Litigation Strategy
development and
implemented
Develop National
Health Litigation
Strategy
Quarter
Target: The
matter tabled
for discussion
in the National
Legal Forum
Actual performance
Performance
Rating
Partially achieved:
1. A guide on writing a
Annual target
communication strategy for
public health campaigns
developed.
2. A guide to writing the
Ministry's Persuasive
Speeches
3.Communication
strategy/plan guide (events
specific)
4. MBOD and CCOD
Communication strategy/plan
and fact sheet for Project KuRiha
There is a declaration
Partially achieved
emanating from the medico
legal summit held on the 09-10
March 2015.
10
Progress Report
PROGRAMME 2 : HEALTH PLANNING AND
SYSTEMS ENABLEMENT
11
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Achieve Universal
Health Coverage
through the phased
implementation of the
National Health
Insurance(NHI
implementation of
the National Health
Insurance (NHI).
Indicator
Target
Actual performance
White Paper on
NHI
Annual Target: Finalise
and publish White
Paper on NHI
Partially achieved
Legislation for
NHI
Annual Target:
Publication of the
White Paper
Quarter target: Funding
Modality for the
National Health
Insurance Fund
including budget
reallocation for the
district primary health
care (PHC)
Annual target: Review
of the 2015/16
dispensing fee in
determining the
2016/17 maximum
dispensing fee
Draft White Paper
has been prepared
and is available for
use in consultation
purposes with
National Treasury.
The draft NHI Bill has
been prepared.
The draft concept
document on the NHI
Fund is available.
Partially achieved
The Draft dispensing
fee for Pharmacists
was published on 15
June 2015.
Partially achieved
Establishment of
the National
Health Insurance
Fund
Review Annual
dispensing fee
12
Partially achieved
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Strengthen
revenue
collection by
incentivizing
hospitals to
maximise
revenue
generation
Indicator
Target
Actual performance
Performance
Rating
Publish & implement
Single Exit Price
Adjustments
Annually.
Develop and
implement a
Revenue Retention
Model (RRM) at
central hospitals
Annual Target: SEPA
adjustment for 2015
Draft SEPA developed for
publication in gazette in Q2.
Partially
achieved
Quarter Target
Conduct a
comparative analysis
of the WC and FS
Revenue Retention
Model
Annual Target: UPFS
regulations gazetted
and implemented
Comparative analysis of
Revenue Retention Models
concluded.
Achieved
Draft regulations developed
Partially
Achieved
Quarter Target:
Consultation with
Council for Medical
Schemes (CMS)
Consulted with the CMS
regarding the draft
specifications and data
required.
Achieved
Develop regulations
pertaining to
Uniform Patient Fee
Schedule
Develop a Central
Repository for the
funded and
unfunded patients
13
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Target
Actual performance
Improve
Management
and control of
pharmaceutic
al services
Percentage of the review
process of PHC Essential
Medicines List (EML) and
Standard treatment Guidelines
(STGs) completed
Percentage of the review
process of Hospital Level
Paediatric Essential Medicines
List (EML) and Standard
treatment Guidelines (STGs)
completed
Percentage of the review
process of Hospital Level Adult
Essential Medicines List (EML)
and Standard treatment
Guidelines (STGs) completed
Number of medicines review for
the Tertiary & Quaternary EML
Annual Target:
20%
5%
Partially achieved :
annual target
Annual Target:
50%
28%
Partially achieved :
annual target
Annual Target:
100%
46%
Partially achieved
annual target
Quarter Target :
3 reviews
3 reviews
Achieved
14
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Target
Actual
performance
Performance Rating
Establish a
national stock
management
surveillance
centre to
improve
medicine
availability
Implement an Electronic system
for the early detection of stock
outs of medicines at hospitals
Quarter target : Site
assessment
completed in 10
central hospitals
Site assessment
completed in 6
central hospitals.
The remaining four
suite assessments
done in quarter
two
Partially achieved :
Implement an Electronic system
for the early detection of stock
outs of medicines at PHC
facilities
Quarter target :
Electronic stock
management system
functional in 750
PHC facilities
Electronic stock
management
system functional
in 750 PHC
facilities
Achieved
Establish a national surveillance
centre to monitor medicine
availability
Quarter target :
Business Plan for
National surveillance
centre developed
and approved
(quarter target)
Draft Business
Plan for National
surveillance
centre developed.
Partially achieved
15
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Target
Actual performance
Improve
contractin
g and
supply of
medicines
Establish Provincial
Control Towers for the
management of direct
delivery of medicines
Quarter Target: Project plan
of the rollout of control
tower developed for Eastern
Cape and Free State
Established
Quarter Target:
275,000 patients
Achieved
Project plan
developed to
implement FS and EC
control towers.
Number of patients
receiving medicines
through the centralised
chronic medicine
dispensing & distribution
system
Contracts are available at
least 8 weeks prior to
expiration of outgoing
tender
Review Criteria for the
approval of Pharmacy
Licences
Performance
Rating
Partially Achieved
210, 840
patients
Quarter Target: 100% of
Nil contract expired
contract expiring in Q1 have in the Quarter 1.
been renewed at least 8
weeks prior to expiration.
Quarter Target: Review of
the Criteria for the approval
of Pharmacy licences
Criteria for the
approval of
Pharmacy licences
reviewed
16
Achieved
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Target
Actual performance
Performance
Rating
Implement the
Strategy to
address
antimicrobial
resistance (AMR)
Implement the
National AMR
strategy
Quarter Target:
Development of
Terms of Reference.
Terms of Reference
developed.
Achieved
Regulate African
Traditional
Practitioners
Establish
Council for
Traditional
Practitioners
Quarter Target:
Advert placed for
appointment of
Council for
Traditional
Practitioners and
Registrar
Approval for advert
finalised
Partially Achieved
17
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Performance Rating
Strategic
Objective
Indicator
Target
Actual performance
Implement
eHealth
Strategy of
South Africa
through the
development
of the
system
design of
patient
information
systems and
implementati
on
Develop a complete
System design for a
National Integrated
Patient based
information system
Quarter targets:
Shared
infrastructure to
host Health
Information
Exchange
established
Quarter targets:
350 PHC Facilities
receiving new IT
Hardware
Shared Infrastructure Achieved
established for hosting
Health
Information
Exchange
Developed and tested
integration
between
HPRS and Tier.net.
Number of PHC
health facilities
with required IT
Hardware for the
reference
implementation
eHealth project
Number of health
facilities
implementing
improved patient
administration and
web based
information systems
Quarter targets:
175 Facilities
implementing
improved patient
administration and
web based
information system
NDoH has received
quotations for seeking
funding approval from
National Treasury for
the procurement of
equipment from the
Infrastructure grant.
50 PHC Facilities
implemented the
patient administration
systems due to
unavailability of
required network
connectivity in
facilities
Not Achieved
Not Achieved
18
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Annual Target
Actual performance
Develop and implement
a national research
strategic plan
National health
research plan
developed and
implemented
Annual target: National
Health Research strategic
plan approved
Partially Achieved:
Annual target
Develop and implement
an integrated
monitoring and
evaluation plan aligned
to health outcomes and
outputs contained in
the Health Sector
Strategy
Integrated monitoring
and evaluation plan
implemented.
Annual target: Fully defined
comprehensive list of
indicators and data
elements approved
At least one national
evaluation conducted
Draft 2 of the National
Research Strategy document
was produced after
consultation with
international reviewers.
Lists of international and
other indicators have been
identified
Branches engaged on
identification of evaluations
to be conducted
Partially Achieved:
Annual target
Number of Provincial
Annual Performance
Plans (APPs) aligned
to the National
Health System
Priorities
Implement Patient
Quality of care
survey tool.
Conduct a National
Survey to measure
Patient Quality of
care
Annual target: 9 Provincial
APPs reviewed and
feedback provided to
ensure health sector plans
are aligned to the National
Health System (NHS)
Priorities
Annual target: Patient
Quality of care survey tool
tested & piloted
Annual target
A national survey
conducted to measure
patient quality of care at all
PHC facilities
Performance
Rating
Partially Achieved:
Annual target
Partially Achieved:
The Department reviewed
provincial APPs in second and Annual target
third quarters of 2015/16
financial year
The survey tool for outpatients/primary health care
facilities has been fieldtested.
National survey will be
conducted once database and
protocol has been finalised
and provincial training in this
regard has taken place.
19
Partially Achieved:
Annual target
Partially Achieved:
Annual target
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Annual
Target
Actual performance
Domestication of
international
treaties and
Implementation
of multilateral
cooperation on
areas of mutual
and measurable
benefit
Number of
International
treaties and
multilateral
frameworks
implemented
Annual
Target: 3
international
treaties and
multilateral
frameworks
implemented
The Memorandum of Understanding between South Africa
and African Union on contributing resources to support
EBOLA Outbreak in West Africa was signed on the 15th
June 2015. South Africa is currently implementing one (1)
cross border project of Phase two (II) of the SADC HIV
and AIDS Trust Fund. The project is: Strengthening and
consolidating the engagement of Religious leaders living
with HIV to promote positive health, Dignity and
Prevention. Facilitated the SADC HIV and AIDS Trust fund
payment of R3 792 802.18 for 2015/16.
Partially
Achieved:
Annual
target
Implementation
of bilateral
cooperation on
areas of mutual
and measurable
benefit.
Number of
Bilateral
projects
implemented.
Annual
Target: 5
strategic
bilateral
projects
implemented
During 31 March to 3 April 2015, a delegation from the
Ministry of Health of Zanzibar visited South Africa to
share experiences on port health services. The visit
resulted in the development of Programme of Action (PoA)
on port health services as well as work plan to implement
the PoA. During 4 to 15 May 2015, Coordinated visit to
South Africa by the delegation from Ministry of Health and
Social Welfare of Tanzania visited South Africa to share
information and experiences on how new emerging issues
in Antiretroviral Therapy (ART) are implemented at
community level. The visit resulted in sharing of
information and best practices on new emerging issues in
ART.
Partially
Achieved:
Annual
target
20
Mechanisms to fast-track performance
A total of 50 facilities had internet connectivityagainst the first
quarter one target of 175 PHC facilities.
In order to address the challenge is unavailability of broad band
connectivity in PHC facilities that will enable implemented the webbased patient administration systems; NDoH is actively working with
Department of Telecommunications and Postal Services (DTPS) to
address this challenge broadband internet connectivity in primary
health care facilities of the NHI Pilot districts, as announced by the
Minister of DTPS in his budget speech.
21
Progress Report
PROGRAMME 3 : HIV AND AIDS,
TUBERCULOSIS , MATERNAL, CHILD AND
WOMEN’S HEALTH
22
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
To scale up
combination of
prevention
interventions to
reduce new
infections
Number of HIV test client
15-49 years
Number of Medical Male
circumcisions performed
Quarter Target: 2.5
million
Quarter Target: 250
000
Male Condoms Distributed
Quarter Target: 175
million
Quarter Target:
4.125 million
Quarter target: 3.2
million
Increase the numbers
of HIV positive people
on ARVs
Female Condoms
Distributed
Total clients remaining on
ART (TROA) at the end of
the month
Develop and implement
the HIV Counselling and
Testing (HCT) policy
Monitor implementation of
the HIV and AIDS
Programme
Target
Annual target: HCT
policy finalised and
approved
Quarter target:
Quarterly report
developed
Actual performance
2,600,316
Performance
Rating
Achieved
137 640 (including MMCs
Partially
performance by doctors in achieved
traditional settings and in
the private sector).
181, 252, 919
Achieved
5, 211, 220
Achieved
3,053,294
Achieved
The draft policy document
has been prepared
Achieved:
Partially
Final quarter one report
available end of July 2015. achieved
Annual report 2014/16
available
23
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
Indicator
Target
Actual performance
Develop and implement
HIV prevention strategy
Annual Target: Strategy
Developed and Approved and
produce 9 provincial reports on
its implementation
Annual target: Guidelines
developed and approved and
produce 9 provincial reports on
its implementation
Annual Target: 52 district
distribution plans for male and
female condoms developed and
implemented with 9 provincial
progress reports
Quarter Target: Quarterly HIV
conditional grant reports
produced
Latest draft of the HIV
Partially
prevention strategy has achieved: annual
target
been prepared
Develop and implement
adherence guidelines
for health programmes
Facilitate development
of district plans to
support NDoH male and
female condom
distribution strategy
Monitor the
implementation of the
HIV and AIDS
Conditional grant
Annual Target : Annual HIV
Conditional Grant Report
produced
Performance
Rating
It will be implemented
from quarter two
A draft plan is available
for Gert Sibande. The
plan is being finalised.
Partially
achieved: annual
target
Final quarter one report Partially
Achieved
was available for
quarter one data. It was
consolidated and
submitted as per DORA
timelines.
Annual Evaluation
Achieved
report for 2014/15
produced
24
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Annual Target
Actual
performance
Performance Rating
Undertake a massive TB
screening campaign
TB client 5 years
and older screened
at health facilities
for TB symptoms
rate
Percentage of
inmates screened
for TB annually
Annual Target:
50%
28.5%
Partially achieved:
Annual target
Annual Target:
75%
72.7%
Achieved: Annual
targets
Percentage of mines
providing routine TB
screening
Annual Target:
60%
83.2%
achieved: Annual target
Number of
community
members in 6 Peri
mining districts
screened for TB
Annual Target: 462
000
329,448
Partially achieved:
Annual target
25
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Annual
Target
Actual
performance
Improve Access to
treatment
TB client 5 years and older
initiated on treatment rate
TB Rifampicin Resistant
clients treatment initiation
rate
TB new client treatment
success rate
Annual
target: 85%
80%
94.6%
achieved: Annual targets
76.6%
Partially achieved:
Annual targets
Annual
target: 83%
79.9%
Partially achieved:
Annual target
TB client loss to follow up
rate
Annual
target: 5%
5.9%
Partially achieved:
Annual target
TB client death Rate
Annual
target: 6%
6.4%
Partially achieved:
Annual target
TB/HIV co-infected client
on ART rate
Annual
target: 75%
74.4%
achieved: Annual target
Strengthen patient
retention in treatment
and care
TB/HIV Co-infection
Performance
Rating
26
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Annual
Target
Actual
performance
Strengthen patient
retention in treatment
and care
TB MDR client loss to follow
up rate
TB MDR client death Rate
Annual
Target: 16%
Annual
Target: 15%
18.4%
Partially achieved:
Annual target
22.8%
Annual Target
TB MDR treatment success
rate
Annual
Target: 55%
43.4%
Partially achieved:
Annual target
27
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
To reduce the
maternal mortality
ratio to under 100
per 100 000 live
births.
Indicator
Quarter Target
st
Antenatal 1
weeks rate
visit before 20 Quarter target:
55%
Mother postnatal visit
within 6 days rate
Maternal mortality in
facility ratio (annualised)
To reduce the
neonatal mortality
rate to under 6 per
1000 live births.
Quarter target:
80%
Quarter target: 123
per 100000 live
births
Performance
Rating
Actual
performance
54.3%
Achieved
70.9%
Partially Achieved
115.6 per 100 000
live births
Achieved
Not achieved:
Quarter target: 11.5 13.5 per 1000 live
per 1000 Live Births births. Mortality
tends to be higher
in the first quarter
compared to other
quarters
Quarterly
Dashboard Achieved
Monitor implementation of Quarter target:
report for 2014/15
Maternal, Neonatal and
Quarterly report
shared with
Woman’s health
produced with
provinces on 9 July
programmes using the
feedback provided
2015
standardised dashboard
to each provincial
reports
DoH
Inpatient Neonatal death
rate (annualized)
28
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Performance
Rating
Strategic Objective
Indicator
Target
Actual
performance
Expand the PMTCT
coverage to pregnant
women by ensuring all
HIV positive Antenatal
clients are placed on
ARVs and reducing the
positivity rate to
below 1%
Antenatal client initiated on
ART rate
Infant 1st PCR test positive
around six week rate
Develop provincial reports
to track progress on the
eliminations of mother-tochild transmission of HIV
Annual target: 88%
91.6%
Achieved
Quarter Target : 1.8%
1.6%
Achieved
Quarter Target: Conduct
stocktaking workshops in all
3 provinces to monitor and
evaluate progress towards
elimination
Quarter Target: 60%
Stocktaking
workshops
will be
conducted in
quarter tw
44.7%
Not achieved
Quarter Target: 55%
51.8%
Quarter Target: Target: Draft
CFP training manual
Final draft 0
was piloted
during master
training in
June 2015
Pharmacovigi
lance form
distributed to
province in
January 2015
Consultative Achieved
meeting was
held.
To improve access to
Couple year protection rate
sexual and reproductive
health services by
Cervical cancer screening
expanding the
coverage
availability of
Develop Training manual for
contraceptives.
the implantation of
Contraception and Fertility
Planning (CFP) Policy
Develop Pharmacovigilance
system for adverse events
for contraceptive implants
Quarter Target:
Pharmacovigilance
information system
implementation plan drafted
Develop cervical cancer
control Policy
Quarter Target: Consultative
process with relevant stake
holders intitiated
29
Partially
Achieved
Partially
Achieved
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
To reduce underfive mortality rate
to less than 23
per 1,000 live
births by
promoting early
childhood
development
Indicator
Target
Develop breast cancer
Policy
Quarter Target:
Consultative process with
relevant Stakeholders
completed, and situational
analysis completed
Child under 5 years
diarrhoea case fatality
rate
Child under 5 years
pneumonia case
fatality rate
Child under 5 years
severe acute
malnutrition case
fatality rate
Confirmed measles
case incidence per
million total
population
Immunisation
coverage under 1 year
(annualised)
Quarter Target: 3.25%
Actual
performance
Consultative
Partially achieved
meeting was held
with technical group
participants on 10
July 2015, and the
report was finalised
in July 2015
Achieved
2.7%
Quarter Target: 3%
1.9%
Achieved
Quarter Target: 10%
10.9%
Partially Achieved
Annual Target:
<3/1,000,000
0.171/1,000,000
population
Achieved : Annual
Target
Quarter Target: ≥90%
90.7%
Achieved
30
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
Indicator
Annual Target
Actual performance
Contribute to
health and
wellbeing of
learners by
screening for
health barriers to
learning
School Grade 1 screening
coverage (annualised)
School Grade 8 screening
coverage (annualised)
Annual Target
25%
Annual Target
10%
42%
To protect girl
learners against
cervical cancer
HPV 1st dose coverage
Annual target:
80%
HPV 2nd dose coverage
Annual target:
80%
Achieved: Annual
target
Achieved: Annual
target
16%
Vaccinations to be
administered in the
second and fourth
quarters
Vaccinations to be
administered in the
second and fourth
quarters
31
Mechanisms to fast-track performance
•NDoH will strengthen data management systems for collection of data on
medical male circumcisions conducted outside public health facilities to
ensure that all MMCs conducted are reported on
•The stocktaking workshops on PMTCT were postponed in Q1 to implement
birth PCR testing; all 9 provincial stocktaking workshops will be completed in
Q2 and Q3
•To address the high neonatal death rate in Q1, data inaccuracies will be
addressed urgently (hospitals reported deaths but no deliveries); training of
master trainers in management of sick and small babies has commenced –
training to be cascaded in all provinces; NDOH to monitor implementation of
provincial newborn care plans
•To address the high TB MDR client death rate the NDOH is developing a
mhealth based tracing system which links the lab diagnosis to patient tracers
to close the gap between diagnosis and initiation on treatment; expansion of
access to new TB medication (bedaquiline and lineozoid) should improve
treatment outcomes
Progress Report
PROGRAMME 4 : PRIMARY HEALTH CARE
SERVICES
33
Programme 4: Primary Health Care
Services
Strategic
Objective
Improve district
governance and
strengthen
management and
leadership of the
district health
system.
Improve access
to community
based PHC
services
Improve quality
of services at
primary health
care facilities
Indicator
Annual Target
Actual performance
Performance
Rating
Number of districts
with uniform
management
structures for primary
health care facilities.
Number of primary
health care facilities
with functional clinic
committees/ district
hospital boards.
Number of functional
WBPHCOTs
Annual target: 15
Districts with
uniform
management
structures.
Annual target: 1000
health care facilities
with functional
clinic committees.
Currently evaluating to
determine existing
management structures
Partially achieved :
Annual target
1209 Clinics with
functional clinic
committees
Partially achieved :
Annual target
Annual target; 2000
functional
WBPHCOTs
1740 functional
WBPHCOTs
Partially achieved :
Annual target
Number of primary
health care clinics in
the 52 districts that
qualify as Ideal Clinics
Annual target; 500
primary health care
facilities in the 52
districts qualify as
Ideal Clinics
Preparatory work
underway in facilities;
1234 clinics assessed
during first quarter
1 PHC clinic qualified as
ideal clinic out of
Partially achieved :
Annual target
34
Programme 4: Primary Health Care
Services
Strategic
Objective
Improve
environmental
health services
in all 52 districts
and
metropolitan
municipalities in
the country.
Establish an
intersectoral
forum that will
plan and
oversee the
implementation
of interventions
across all
sectors.
Indicator
Number of municipalities
that meet environmental
health norms and
standards in executing
their environmental
health functions.
Annual Target
Annual target: 20
Municipalities meet
environmental health
norms and standards in
executing their
environmental health
functions
Hand hygiene campaign
Annual target: A
rolled out in all nine (9)
national hand hygiene
provinces
strategy developed
Ensure compliance with
Annual target: Health
Health Waste
care risk waste
management regulations regulations finalised
and tools for audit
implementation
developed
Establish National Health Annual target:
Commission
Operating framework
for National Health
Commission developed
Actual performance
Performance
Rating
Audits of the
Partially
municipalities have been achieved :
completed. In process of Annual target
analyzing data to
determine compliance
First draft completed. It
is in circulation for
comment
Health care risk waste
regulations approved by
the Minister. In process
of developing audit tool
Partially
achieved :
Annual target
Partially
achieved :
Annual target
Draft framework is ready. Partially
Will present this to
achieved :
executive management
Annual target
in the second quarter
35
Programme 4: Primary Health Care
Services
Strategic
Objective
Indicator
Annual and Quarter
Target
Actual performance
Reduce risk
factors and
improve
management for
NonCommunicable
Diseases (NCDS)
by implementing
the Strategic
Plan for NCDs
2012-2017
Number of National
government Departments
oriented on the National
guide for healthy meal
provision in the workplace
Regulations relating to
Labelling and packaging of
tobacco products and
smoking indoor and outdoor
public places developed
Annual target: 20
National Departments
Awareness on risk factors
relating to excessive salt
intake, excessive sugar
intake, physical inactivity
and , alcohol related harm
created
Random Monitoring of salt
content in foodstuffs
conducted
Annual target: Content
of campaign finalised
and ready for
implementation
The draft National guide
for healthy meal provision
in the workplace has
been developed and
circulated for comment.
First draft submitted to
Legal Services for
onward submission to
State Legal Advisors.
Meeting held to review
State Law advisors
inputs on 22 May 15
In process of awarding a
tender for the content
development in
cooperation with
programme 3 managers
Annual target: Tobacco
Act amended
Annual Target :Random
samples from each of 13
regulated food category
tested, reported on and
corrective action taken
Performance
Rating
Partially
achieved :
Annual target
Partially
achieved :
Annual target
Partially
achieved :
Annual target
Obtained agreement from Not achieved
laboratories on how
testing will be done and a
budget drawn up.
36
Programme 4: Primary Health Care
Services
Strategic
Objective
Improve access
to and quality of
mental health
services in South
Africa
Indicator
Annual Target
Actual performance
Number of people
screened for high
blood pressure as
part of
comprehensive
health screening
Annual target: 8
million people
screened for high
blood pressure
Annual target: 8
million people
screened for raised
blood glucose levels
Annual target; 28 %
of 16.5% (prevalence)
people screened for
mental disorders
Annual target: 28 %
of 16.5% (prevalence)
people screened for
mental disorders
Annual target: 16% of
mental health
inpatient units
attached to
designated district
and regional hospitals
2 468 177
Achieved : Annual
target
1 4113 541
Partially achieved :
Annual target
290690 out of 664000
annual target
Partially achieved :
Annual target
16 504 out of 66400
annual target
Partially achieved :
Annual target
Percentage people
screened for mental
disorders
Percentage of
people treated for
mental disorders
Percentage of
mental health
inpatient units
attached to
designated district
and regional
hospitals
38/274 (14%) of mental
health inpatient units
attached to general
hospitals are under
planning and
construction
37
Performance
Rating
Partially achieved
: Annual target
Programme 4: Primary Health Care
Services
Strategic Objective
Improve access to
disability and
rehabilitation
services through the
implementation of
the framework and
model for
rehabilitation and
disability services
Indicator
Annual Target
Mental health
teams established
in each district
Annual target:
Strategy for
establishment of
specialist mental
health teams
approved by the TAC
NHC
Annual target:
Resources allocated
for the approved
Framework and Model
Number of Districts
implementing the
framework and
model for
rehabilitation
services
Actual
performance
Performance
Rating
Draft Strategy is
Partially achieved :
being circulated for Annual target
comment
Framework has
been approved by
NHC. Costing is in
progress
38
Partially achieved :
Annual target
Programme 4: Primary Health Care
Services
Strategic Objective
Indicator
Annual and
Quarter Target
Prevent avoidable
blindness
Cataract Surgery Rate
Annual target:
1 500 operations
per million uninsured population
Eliminate Malaria by
2018, so that there
is zero local cases
of malaria in South
Africa
Malaria incidence per
1000 population at risk
Quarter Target: 0.2
malaria cases per
1000 population at
risk (quarter)
Annual target: 5
malaria targeted
districts reporting
malaria cases
within 24 hours of
diagnosis
Number of districts
targeted for malaria
elimination reporting
malaria cases within 24
hours of diagnosis
Actual
performance
217 per million uninsured population
0.055 (533
confirmed local
cases)
Partially achieved :
Annual target
Achieved
10% of malaria
Partially achieved :
cases in 1 district Annual target
reported within 24
hours
39
Programme 4: Primary Health Care
Services
Strategic Objective
Indicator
Annual and Quarter
Target
Actual performance
Strengthen
preparedness and core
response capacities for
public health
emergencies in line
with International
Health Regulations
Improve South Africa’s
response with regard
to Influenza prevention
and control
Number of Provincial
Outbreak Teams
capacitated to
respond to zoonotic,
infectious and foodborne disease
outbreaks
Number of high risk
population covered by
the seasonal influenza
vaccination
Held a workshop
planning meeting on 8
May.Submission for
training approved.
Partially
achieved :
Annual target
513718 vaccines
administered to high
risk individuals
Partially
achieved :
Annual target
Establish a
coordinated disease
surveillance system for
Notifiable Medical
conditions (NMC)
A strategy and plan for
the integration of
disease surveillance
systems for NMC
Develop and
implemented
Conduct Annual
National HIV Antenatal
Prevalence Survey
Annual National HIV
Antenatal Prevalence
Survey conducted
Annual target: 9
Provincial Outbreak
Teams capacitated to
respond to zoonotic,
infectious and foodborne disease
outbreaks
Annual target: 800
000 high risk
individuals covered
with seasonal
influenza vaccination
Annual target:
Strategy for the
integration of disease
surveillance systems
for NMC approved and
implementation plans
developed
Annual target: 2015
National HIV
prevalence report
produced
A list of stakeholders
Partially
achieved :
to be consulted in the
drafting of the strategy Annual target
compiled and meeting
arranged
Submission prepared
for the 2015 survey to
be conducted in the
third quarter of 2015
41
Partially
achieved :
Annual target
Progress Report
PROGRAMME 5 : HOSPITALS, TERTIARY
SERVICES AND WORKFORCE DEVELOPMENT
41
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic Objective
Indicator
Target
Actual performance
Increase capacity of central
hospitals to strengthen local
decision making and
accountability to facilitate
semi-autonomy of 10 central
hospitals
Ensure quality health care by
improving compliance with
National Core Standards at all
Central, Tertiary, Regional and
Specialised Hospitals
Number of
central hospital
with full
delegated
authority
Annual target: 10
central hospitals
with full delegated
authority
Task team on delegation Partially
achieved :
framework for central
hospitals established and Annual target
two meetings held to
prepare hospitals
Number of
Hospitals that
comply fully with
the National Core
Standards
3 Central hospitals (Steve Partially
achieved :
Biko, Groote Schuur
and Tygerberg Hospitals) Annual target
fully complied with the
National Core Standard in
2014/15
Ensure equitable access to
tertiary service through
implementation of the
National Tertiary services plan
Number of
gazetted
hospitals
providing the full
package of
Tertiary1
Services
Annual target: Full
compliance with
the National Core
Standards in 8
Central hospitals
and 5 Tertiary
Hospitals
Annual target
additional tertiary
hospitals
(Pietersburg,
Frere, Kimberley
and Ngwelezana)
providing the full
package of
Tertiary 1 services
Public Health Registrar
appointed to finalise
tertiary services plan
Plan of action developed
by the National Hospital
Coordinating Committee
42
Performance
Rating
Partially
achieved :
Annual target
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Annual Target
Actual performance
Performance
Rating
Improve
quality of
health
infrastructur
e in South
Africa
Number of facilities
maintained, repaired and/or
refurbished in NHI Districts
Annual target: 198
facilities
Partially achieved
: Annual target
Number of facilities
maintained, repaired and/or
refurbished outside NHI pilot
Districts
Annual target: 310
facilities
Refurbishment in process
of 23 Clinics in the Eastern
Cape. In tendering process
of appointment of
contractors & Professional
Services Providers for
maintenance.
188 facilities in
Renovations, Rehabilitation
or Refurbishments phase.
Number of clinics and
Community Health Centres
constructed or revitalised
Number of hospitals
constructed or revitalised
Annual target: 35
9 Clinics & 3 CHC's in
handover phase
Partially achieved
: Annual target
Annual target: 2
8 Hospitals in handover
phase
Partially achieved
: Annual target
Number of new facilities that
comply
with
gazetted
infrastructure
Norms
&
Standards
Develop a Infrastructure
Monitoring System
Annual target: 37 new
facilities
8 new facilities under
construction with the Inkind Grant
Partially achieved
: Annual target
Annual target:
Infrastructure
Monitoring System fully
developed and tabled at
NHC
Monitoring systems has
been developed
Partially achieved
: Annual target
43
Partially achieved
: Annual target
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Develop and
implement
health
workforce
staffing
norms and
standards
Develop guidelines for HRH
norms and standards using
the WISN methodology
Number of facilities
benchmarked against PHC
staffing normative
guidelines
Number of RTC's
established
Target
Actual performance
Performance
Rating
Annual target;
Guidelines for HRH
Norms for District and
specialised hospitals
developed.
Unpacking of activities
leading to production of
staffing norms for district
and specialised hospitals
Partially
achieved :
Annual target
Annual target; 1000
About 508 facilities have
started with the process of
benchmarking against PHC
staffing normative guides
based on the
implementation Guideline
in 6 out of 9 provinces
Orientation workshops
held with provincial
representatives
Achieved :
Annual target
5 RTCs established
Achieved:
Annual Target
Annual target:
Tertiary, Regional and
Central Hospital
managers oriented on
WISN tool and
methodology
Annual target: 5RTCs
established
44
Partially
achieved
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Target
Actual performance
Performance
Rating
Professiona
lise Nursing
training and
Practice
implementa
tion of the
objectives
of the
Nursing
Strategy
Public nursing colleges
offering new nursing
programmes (in line with
National Qualifications
Framework)
Quarter Target: A
national policy for
nursing education
developed in the
context of bedside
training
Quarter Target: A
Nursing and midwifery
educators’ training
and development
programme
developed
Quarter target:
Provincial Nursing
structures to give
authority over nursing
and midwifery
services tabled at
NHC
Components of the
national nursing education
policy have been defined
Partially
achieved
Audit of capacity of nurse
educators completed
Achieved
Recommended structures
for authority for nursing at
provincial levels identified
and reviewed
Partially
achieved
Develop a Nursing and
Midwifery educators'
training and development
programme
Develop a standardised
Nursing leadership
structure for Provincial DoH
45
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Annual Target
Actual performance
Performance
Rating
Ensure
access to
and
efficient
effective
delivery of
quality
Emergency
Medical
Services
(EMS).
Number of provinces that
are compliant with the EMS
regulations.
Annual target: EMS
Regulations and
compliance checklist
gazetted for
implementation.
Annual target: Policy
on education and
training of EMS
Personnel published.
Circulation of the Gazetted
Regulations.
Partially
achieved:
Annual target
The draft policy was
presented and approved at
the NHC TAC. The
migration plan to
operationalise the policy
was drafted
Draft regulations
completed
Partially
achieved:
Annual target
Final draft document
prepared
Partially
achieved:
Annual target
Publish Policy on education
and training of EMS
Personnel published for
implementation
Develop regulations for
Emergency Care Centres
Publish Regulations for EMS
in Mass Gatherings
Annual target:
Regulations on
Emergency Care
Centres Drafted
Annual target: EMS
regulations in mass
gatherings published
for public comment
and implementation
46
Partially
achieved:
Annual target
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Annual Target
Actual performance
To eliminate
the backlog of
blood alcohol
and toxicology
tests by 2016
Number of Blood Alcohol
reports produced
Annual target: 120 000
28,656
Partially
achieved:
Annual target
Number of Toxicology
reports produced
Annual target: 4500
583
Partially
achieved:
Annual target
Number of food tests
performed.
Annual target: 4000
3417
Partially
achieved:
Annual target
Develop a monitoring
system to effectively
measure turnaround time
of tests conducted at
Forensic Chemistry
Laboratories
Annual target: A
standardised workflow and
monitoring system
developed for all 3 tests
and implemented at 4
forensic chemistry
laboratories
A draft standardised
workflow and
monitoring system has
been prepared
Partially
achieved:
Annual target
To provide food
analysis
services
47
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Target
Actual performance
Regulations for the
Rendering of Forensic
Pathology Services
promulgated
Annual Target:
Regulations on for the
Rendering of Forensic
Pathology Services
reviewed and Published
for public comments
Annual target: Review
and Finalise the Scope
of Practice Guidelines
for the rendering of
Forensic Pathology
Services and Publish for
Implementation
NFPSC meeting held on
25 March 2015 agreed to
review the regulations
under priority 1 item
Partially
achieved:
Annual target
NFPSC meeting held on
25 March 2015 agreed to
review the scope of
practice under priority 1
item. Questionnaire
developed for provinces
to gather information on
what scope of practice is
done by the FPO's
Mpumalanga province
identified 4 new
designated facilities.
Western Cape province
identified 7 new
designated facilities
Partially
achieved:
Annual target
Publish Scope of Practice
Guidelines for the
rendering of Forensic
Pathology Services
Number of Health
Facilities that are
designated to render
services for the
management of sexual
and related offences
Annual target: 60
additional facilities
designated
48
Partially
achieved:
Annual target
Progress Report
PROGRAMME 6 : HEALTH REGULATION AND
COMPLIANCE MANAGEMENT
49
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Indicator
Annual and Quarter
Target
Actual performance
Establish the South
African Health
Product Regulation
Authority (SAHPRA)
Establish SAHPRA as a
public entity
Establish Institute of
Regulatory Science
(IRS)
Institute of Regulatory
Science (IRS) providing
training
Regulate Medical
devices, IVDs, cosmetics
and expand on regulation
of Complementary and
Alternative Medicines
(CAMS)
Annual target: SAHPRA
Act (Bill 6 of 2014)
Promulgated , and
transitional plan from
MCC to SAHPRA
developed
Quarter target: Project
team appointed
Finalized
corrections to the
Bill as per directive
of Portfolio
Committee of
Health
Project team
appointed
Quarter Target: Evaluate
stakeholder comments
on Medical Devices and
IVDs and CAMs
Regulations in-house
• Cosmetics: None
Quarter Target: 15 % of
priority medicines
registered NCE = 36
month; Generics = 28
month
Evaluated
Achieved
stakeholders
comments and
prepared new set of
Medical Device and
IVD Regulations
Improve registration
turnaround times of
ARV’s, TB, oncology and
vaccines to treat and
prevent high burden of
diseases
13%
(88 human
medicines
registered of which
7 were priority
medicines)
50
Performance
Rating
Partially
Achieved
Achieved
Partially
achieved
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Indicator
Quarter Target
Actual performance
Establish a MOU with
Department of
Agriculture, Fisheries and
Forestry’s (DAFF)`
Quarter Target:
Identify tests to be
carried out by
internal and
external
laboratories
Quarter Target:
Prepare draft
Cosmetic
regulations
Tests identified to be
carried out on foodstuffs
for internal and external
laboratories
Achieved
Cosmetic Regulations
prepared
Achieved
Policy document drafted.
Achieved
No structure and
organogram document
developed until NAPHISA
structure finalised
Not achieved
Develop Regulations for
Cosmetic products
To develop the policy
and legislative
framework for
occupational health
and compensation
To establish an
occupational health
cluster
Review occupational
health legislative
framework
Occupational health
cluster established and
functional
Quarter Target:
Report on
occupational
health policy
framework
Quarter Target:
Document on
structure,
organogram and
activities of the
occupational
health cluster
51
Performance
Rating
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Indicator
Target
Actual performance
To provide
occupational health
and compensation
services through the
development of One
Stop Service centres
in provinces
To establish the
National Public
Health Institutes of
South Africa
(NAPHISA) for
disease and injury
surveillance
Number of provinces with
One Stop Service Centres
to deliver occupational
health and compensation
services
Quarter target :1
preparatory
meeting with
stakeholders and
role-players in
Northern Cape
3 preparatory meetings
have been hosted in
Northern Cape and 1 in
Limpopo
Develop legal framework
to establish National
Public Health Institutes
of South Africa
(NAPHISA)
Number of applications
certified at MBOD as
compensable disease
claims
Quarter target:
Finalise legislative
framework for
NAPHISA
Legislative framework
being reviewed with legal
section and includes
amendments to NHLS Act
Partially
achieved
Quarter target:
1500
1137
Partially
achieved
Number of compensable
disease claims paid by
CCOD other than
pensioners
Quarter target:
500
447
partially
achieved
52
Achieved
Programme 6: Health regulations
and Compliance Management
Strategic
Objective
Indicator
Improve
oversight and
Corporate
Governance
practices by
reviewing the
Governance
Framework
and
Implementati
on Plan
biennially.
Number of Health entities’
and
Statutory
Health
professional
Councils with fully functional and
compliant to good Governance
practices (structures, Finance, HR ,
Supply Chain Management policies)
and also respond to health sector
priorities
Develop
and
implement
a
performance management system
for board members
Target
Quarter target:
Checklists for
measuring
functionality of
health entities and
professional
councils developed
and consulted
Quarter target:
Standardised
performance
management
system for board
members drafted
and circulated for
consultation
Number of newly appointed boards Quarter target:
inducted and trained
None
Actual performance
Draft Checklist for Entities
to include specific internal
control system circulated
for input.
Partially
Achieved
Draft performance
assessment system for
board members developed.
Partially
Achieved
Call for nominations for
candidates for the new
term of Office of the
Professional Boards of the
HPCSA published. The
panel to consider and make
recommendations for
appointment has been
appointed by the Minister.
Partially
Achieved
53
Programme 6: Health regulations
and Compliance Management
Strategic
Objective
Indicator
Quarter Target
Actual performance
Performance
Rating
Develop
and
implement
Dashboard to monitor entities
performance and compliance to
legislative prescripts
Quarter target: 3
Dashboards
developed and
piloted (1 per
entity or statutory
council)
Quarter target:
Standardised
reporting template
drafted and
circulated for
consultation
Dashboard developed
for NHLS, SAMRC and
CMS finalized
Achieved
Reporting template
developed, presented
and circulated to
Departmental
representatives serving
on Boards/Councils
Achieved
Develop a reporting template to
enable feedback to the
executive authority
54
Mechanisms to fast-track performance
Document on structure, organogram and activities of the
occupational health cluster have not been finalised until the structure
of NAPHISA is finalised.
Registration turnaround times of ARV’s, TB, oncology and vaccines
to be improvoed through training of additional evaluators, propose
prioritisation of existing applications based on public health needs.
55
Summary of Quarter One 2015/16
APP Performance
Programmes
Quarterly
Targets
Total
Achieved
Total
Partially
Achieved
Total
Not Achieved
Programme 1
5
2
3
0
Programme 2
16
7
8
1
Programme 3
28
15
11
2
Programme 4
1
1
Programme 5
4
1
2
Programme 6
15
8
6
1
Total
70
32
31
6
56
FIRST QUARTER EXPENDITURE 2015/16
57
Background
Quarterly performance briefings for the Committee.
The Department of Health recorded an expenditure of
R8.70 billion or 23.9% of an allocation of R36.47 billion at
the end of the first quarter of the 2015/16 financial year.
The table below explains the financial performance for
each programme.
58
Financial Performance per programme
Programme
R million
1. Administration
2. National Health
Insurance, Health
Planning and Systems
Enablement
3. HIV and AIDS,
Tuberculosis, Maternal
an Child Health
4. Primary Health Care
Services
2014/15
Outcomes
Comments
2015/16
Main
Appropriati
on
Available
budget
April to
Reasons
June
for
percentage
variances
spent
135 307
29,60% Note 1
April to June
expenditure
386 476
457 078
457 078
316 667
587 807
587 807
95 418
16,23% Note 2
13 027 910
14 442 144
14 442 144
3 370 520
23,34% Note 3
102 355
225 005
225 005
45 766
20,34% Note 4
18 482 048
19 159 065
19 159 065
4 650 918
24,28% Note 5
839 199
33 154 655
1 596 919
36 468 018
1 596 919
36 468 018
395 098
8 693 027
24,74% Note 6
23,84%
Current payments
Compensation of
Employees
1 662 362
2 351 547
2 351 547
397 294
16,90%
608 140
772 088
772 088
177 325
22,97%
Goods and Services
Interest and Rent on
Land
Total transfers and
subsidies
Payments for capital
assets
Payments for Financial
Assets
Total
1 054 222
1 579 459
1 579 459
219 969
13,93% Note 7
0
0
0
0
31 263 725
33 448 493
33 448 493
8 243 332
227 635
667 978
667 978
52 273
933
33 154 655
0
36 468 018
0
36 468 018
128
8 693 027
5. Hospitals, Tertiary
Health Services and
Human Resource
Development
6. Health Regulation
and Compliance
Management
Total
Economic Classification
59
24,64%
7,83% Note 8
23,84%
Reasons for variances
Note 1 – Programme 1 - Administration
The outstanding invoices for office accommodation for
the 2014/15 financial year were processed during the
first quarter of 2015/16;
The renewal of the IT-related licences is due in the fourth
quarter of the year;
The maintenance of Civitas' security equipment
amounting to R4million is scheduled to take place during
November 2015;
Electronic boards, digital recording equipment and other
capital assets were ordered but not yet received and paid.
60
Reasons for variances
Note 2 – Programme 2 – National Health Insurance, Health
Planning and Systems Enablement
NHI Direct Grant spending low due to:
• As per operational plans the SCM processes were planned to be
finalised by end of Quarter 1
– Improvements have been in recorded in quarter 2 with spending
at 16%;
– Procurement plans have been delayed in many pilot districts;
– Capacity constraints continue to plague some of the pilot
districts;
– Some districts have low levels of financial delegations;
– Delays by appointed suppliers to deliver key equipment/kits for
the MWBOTs for which contracts have already been awarded.
60
Reasons for variances - Continue
Note 2 – Programme 2 – National Health Insurance,
Health Planning and Systems Enablement
The tender for the printing and publication of the Essential
Medicines List will be paid in the second quarter of the year;
The planned publication of the STG of PHC could not be
finalized during the 1st quarter due to a delay in the contracting
of a printing service provider;
The appointment of Health Practitioners at the NHI pilot sites
is complete and it is expected that the expenditure increase
accordingly;
Contract for mid-level workers not finalized during the 1st
quarter.
Reasons for variances - Continue
Note 3 – Programme 3 – HIV and Aids, TB, Maternal and
Child Health
The National TB Meeting was postponed from May until September
2015 as the provinces were developing district improvements plans to
implement the 90,90,90 targets for HIV and TB;
There were delays in printing the Saving Mothers Report (softcopies of
the report have been distributed);
Payment for the printing of the TB Patient Treatment Cards has not
been effected as less than half the order has been delivered. Payment
will be made once the full order has been delivered.
63
Reasons for variances - Continue
Note 4 – Programme 4 – Primary Health Care Services
The project on Regulatory Impact Assessment on the
Control of Marketing Alcohol Beverages Bill is not finalized
yet;
The printing of the Road-to-Health booklets is not finalized;
The development of clinical guidelines on Management of
Co-morbidity Psychiatric and Substance Abuse is taking
longer than expected;
Developing procurement processes and guidelines in line with
PFMA requirements to be finalised.
64
Reasons for variances - Continue
Note 5 – Programme 5 – Hospital, Tertiary Services and
Human Resource Development
Liquid chromatography systems, nitrogen analyser and
LIMS server are not yet delivered. Delivery expected in 2nd
quarter;
Construction of new clinics and relocatable doctor consulting
rooms ongoing. See progress on PICC expectations.
64
Reasons for variances - Continue
Note 6 – Programme 6 – Health Regulation and
Compliance Management
File servers and steel shelving was ordered for MCC but not
delivered during the 1st quarter.
65
Reasons for variances - Continue
Note 7 – Goods and Services
Goods and Services expenditure is R219,9 million or 13,9% of
the budget of R1,5 billion.
Spending on the Human Papilloma Virus vaccines did not
occur in Q1 because the vaccine is administered in two years
each calendar year - the first dose is administered in
February/March and the second dose in August/September.
The South African Demographic Health Survey is running over
three financial years. The first payments to this project are
anticipated to flow in the latter half of the year;
67
Reasons for variances - Continue
Note 7 – Goods and Services
The printing of the Tuberculosis Pamphlets in Braille has
been delayed because of the poor quality of the format and
layout (not approved by the Society for the Blind), the
procurement will be done through the Society to ensure
compliance with quality standards.
WHO membership fees will be paid in the 4th quarter.
68
Reasons for variances - Continue
Note 8 – Payment of Capital Assets
The renewal of the IT-related licences is due in the fourth
quarter of the year;
File servers and steel shelving was ordered for MCC but not delivered
during the 1st quarter;
The maintenance of Civitas' security equipment amounting
to R4million is scheduled to take place during November 2015;
Electronic boards, digital recording equipment and other
assets were ordered but not yet received and paid;
Liquid chromatography systems, nitrogen analyser and
LIMS server are not yet delivered. Delivery expected in 2nd quarter;
Construction of new clinics and relocatable doctor consulting rooms
ongoing (PICC progress).
69
CONDITIONAL GRANTS
Conditional Grants expenditure as at 30 June 2015:
Total CG spending is at 22.6 % or R7.2 bn against total original budget of
R31.8 bn.
 The overall spending of the Provinces is not on par with the current
norm of 25%.
 The major contributors to under spending are:
• National Health Insurance Grant (6.5%)
•
Health Facility Revitalisation Grant (19%)
 HPTDG, NTSG & CHIV/AIDS spent within the acceptable norm at 26.1%,
24.0% and 22.5% respectively.
70
Expenditure Summary Per Grant
(Schedule 4 and 5 grants)
2015/16
Budget vs Expenditure
Grant Name
Health Professions Training and
Development Grant
National Tertiary Services Grant
Transfers
Transfers
% Spent per
Original Expenditur of Payment
Budget
e
Budget Schedule
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Transfers Transfers
%
per % of Received % of
Spent
Payment
by Transfers Original Expenditur of
Schedule province Received Budget
e
Budget
R'000
R'000
%
R'000
%
R'000
%
R'000
2,374,722
620,146
26.1%
593,685
100%
581,065
97.9% 2,321,788
R'000
%
%
Spent
Original
of
Budget Expenditure Budget
R'000
R'000
566,844 24.4%
2,190,366
413,339 18.9%
9,620,357
1,944,062 20.2%
10,398,034 2,491,682
24.0% 2,599,512
100% 2,492,607
95.9% 10,168,235 2,428,525 23.9%
Comprehensive HIV&AIDS Grant 13,737,312 3,087,004
Health Facility Revitalis. Grant
5,275,762 1,000,862
National Health Insurance Grant
72,042
4,701
TOTAL
31,857,872 7,204,395
22.5% 3,340,119
19.0% 1,346,182
6.5% 14,400
22.6% 7,893,898
100% 3,120,521
100% 1,230,107
100%
8,944
100% 7,433,244
93.4% 12,311,322 2,491,939
91.4% 5,239,981 892,553
62.1%
70,000
8,806
94.2% 30,111,326 6,388,667
20.2% 10,533,886
17.0% 5,123,542
12.6%
48,500
21.2% 27,516,651
71
2,175,374
727,288
14,688
5,274,751
%
20.7%
14.2%
30.3%
19.2%
Health Professions Training Grant
2015/16
Budget vs Expenditure
Province
Original
Budget
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
TOTAL
R'000
204,431
149,757
829,606
299,514
118,856
97,460
78,446
106,970
489,682
2,374,722
Transfers
Transfers
% Spent Transfers per % of
of per Payment Payment
Expenditure Budget Schedule Schedule
R'000
37,608
28,586
227,567
81,105
37,750
26,219
29,053
29,837
122,421
620,146
%
18.4%
19.1%
27.4%
27.1%
31.8%
26.9%
37.0%
27.9%
25.0%
26.1%
R'000
51,108
37,440
207,402
74,880
29,715
24,366
19,611
26,742
122,421
593,685
%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
% of
Transfers Transfers
Received Received
R'000
37,608
28,436
227,567
74,880
29,715
20,622
13,074
26,742
122,421
581,065
%
73.6%
76.0%
109.7%
100.0%
100.0%
84.6%
66.7%
100.0%
100.0%
97.9%
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Original
Budget
R'000
199,874
146,419
811,114
292,837
116,206
95,288
76,697
104,586
478,767
2,321,788
% Spent
of
Expenditure Budget
R'000
35,025
35,731
223,558
73,209
14,907
16,097
21,128
27,498
119,691
566,844
%
17.5%
24.4%
27.6%
25.0%
12.8%
16.9%
27.5%
26.3%
25.0%
24.4%
72
Original
Budget
R'000
188,560
138,131
765,202
276,262
109,628
89,894
72,356
98,666
451,667
2,190,366
%
Spent
of
Expenditure Budget
R'000
11,026
31,921
90,579
69,066
43,529
11,169
18,740
24,392
112,917
413,339
%
5.8%
23.1%
11.8%
25.0%
39.7%
12.4%
25.9%
24.7%
25.0%
18.9%
Health Professions Training Grant
 Overall spending has improved this financial year from
18.9% (2013/14) and 24.4% (2014/15) to 26.1% and is
within the norm.
 All provinces spent within the acceptable norm with the
exception of EC and FS that spent 18.4% and 19.1%
respectively.
 The under spending for the two provinces is attributed to:
 Delays in recruitment process for Registrars
 Dual registrar intake (January and July intake)
73
National Tertiary Services Grant
2015/16
Budget vs Expenditure
Province
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
TOTAL
Original
Budget
Transfers
Transfers
% Spent Transfers per % of
of per Payment Payment
Expenditure Budget Schedule Schedule
R'000
R'000
803,770
264,646
918,387
226,992
3,572,852
818,493
1,530,246
303,207
330,462
72,591
99,311
17,771
305,478
83,167
242,626
57,153
2,594,902
647,662
10,398,034 2,491,682
%
R'000
32.9% 200,943
24.7% 229,596
22.9% 893,214
19.8% 382,563
22.0%
82,614
17.9%
24,828
27.2%
76,368
23.6%
60,657
25.0% 648,729
24.0% 2,599,512
% of
Transfers Transfers
Received Received
%
R'000
100% 200,943
100% 226,987
100% 818,493
100% 382,563
100%
82,614
100%
21,776
100%
50,912
100%
60,657
100% 647,662
100% 2,492,607
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Original
Budget
%
R'000
100.0%
786,007
98.9%
898,091
91.6% 3,493,891
100.0% 1,496,427
100.0%
323,158
87.7%
97,116
66.7%
298,727
100.0%
237,264
99.8% 2,537,554
95.9% 10,168,235
% Spent
of
Expenditure Budget
Original
Budget
%
Spent
of
Expenditure Budget
R'000
151,450
262,658
755,732
394,573
70,010
22,888
88,304
44,747
638,163
2,428,525
R'000
743,621
849,661
3,305,931
1,415,731
305,732
91,879
282,618
224,470
2,400,714
9,620,357
R'000
149,483
183,540
693,237
139,622
58,914
10,350
76,100
41,755
591,061
1,944,062
%
19.3%
29.2%
21.6%
26.4%
21.7%
23.6%
29.6%
18.9%
25.1%
23.9%
74
%
20.1%
21.6%
21.0%
9.9%
19.3%
11.3%
26.9%
18.6%
24.6%
20.2%
National Tertiary Services Grant
 Overall spending has improved this financial year from
20.2% (2013/14) and 23.9% (2014/15) to 24.0% and is
within the acceptable norm.
 All provinces spent within the acceptable norm with the
exception of LP, MP and KZN that spent 22.0% and 17.9%
and 19.8% respectively.
 The under spending for the three provinces is attributed to:
 PERSAL linkages
 Expenditure for salary adjustment not yet effected.
 Delays in supply chain management processes
(changing from quotation to contract for
pharmaceuticals)
 Delays on supplier delivery.
75
Comprehensive HIV/AIDS Grant
2015/16
Budget vs Expenditure
Province
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
TOTAL
Original
Budget
Transfers
Transfers
% Spent Transfers per % of
of per Payment Payment
Expenditure Budget Schedule Schedule
R'000
R'000
1,577,065
398,044
911,946
141,674
2,928,300
654,110
3,813,094 1,013,397
1,056,975
182,987
927,214
194,533
371,253
64,546
1,012,984
201,082
1,138,481
236,631
13,737,312 3,087,004
%
R'000
25.2% 387,834
15.5% 197,047
22.3% 732,075
26.6% 880,734
17.3% 276,234
21.0% 242,186
17.4%
95,193
19.9% 253,246
20.8% 275,570
22.5% 3,340,119
% of
Transfers Transfers
Received Received
%
R'000
100% 372,635
100% 141,284
100% 654,110
100% 880,734
100% 276,234
100% 242,186
100%
63,462
100% 253,245
100% 236,631
100% 3,120,521
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Original
Budget
%
R'000
96.1% 1,449,237
71.7%
843,026
89.4% 2,632,578
100.0% 3,257,992
100.0%
978,132
100.0%
818,836
66.7%
342,789
100.0%
936,938
85.9% 1,051,794
93.4% 12,311,322
% Spent
of
Expenditure Budget
R'000
254,374
118,254
654,926
668,277
126,387
216,808
83,339
173,545
196,029
2,491,939
Original
Budget
%
R'000
17.6% 1,273,296
14.0%
742,984
24.9% 2,258,483
20.5% 2,652,072
12.9%
861,143
26.5%
690,591
24.3%
302,468
18.5%
825,302
18.6%
927,547
20.2% 10,533,886
76
%
Spent
of
Expenditure Budget
R'000
304,944
169,255
379,940
705,444
56,938
180,718
47,606
169,761
160,768
2,175,374
%
23.9%
22.8%
16.8%
26.6%
6.6%
26.2%
15.7%
20.6%
17.3%
20.7%
Comprehensive HIV/AIDS Grant
 Overall spending has improved this financial year from
20.7% (2013/14) and 20.2% (2014/15) to 22.5% and is
within the acceptable norm.
 All provinces spent below the norm with the exception of
EC and KZN that spent 25.2% and 26.6% respectively.
 The under spending is attributed to:
 Centralized delegations at Provincial Treasury.
 Delays in recruitment processes and supplier delivery
lead time (condoms).
 Late submission of invoices by suppliers.
 Moratorium on filling of posts
 Outstanding accruals for key accounts (NHLS,
condoms and drugs).
77
Health Facility Revitalisation Grant
2015/16
Budget vs Expenditure
Transfers
Transfers
% Spent Transfers per % of
of per Payment Payment
Expenditure Budget Schedule Schedule
Province
Original
Budget
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
TOTAL
R'000
R'000
592,073
90,991
564,950
80,971
313,630
90,649
1,229,775
271,396
194,256
72,383
287,942
48,247
593,590
97,975
695,404
124,393
804,142
123,857
5,275,762 1,000,862
%
R'000
15.4% 152,055
14.3% 108,907
28.9%
78,408
22.1% 352,786
37.3%
48,564
16.8%
71,986
16.5% 113,200
17.9% 257,102
15.4% 163,174
19.0% 1,346,182
% of
Transfers Transfers
Received Received
%
R'000
100%
90,991
100%
80,972
100%
90,649
100% 352,786
100%
48,564
100%
71,986
100% 113,200
100% 257,102
100% 123,857
100% 1,230,107
%
59.8%
74.3%
115.6%
100.0%
100.0%
100.0%
100.0%
100.0%
75.9%
91.4%
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Original
Budget
R'000
599,231
448,962
671,033
1,162,469
467,442
343,509
421,428
486,121
639,786
5,239,981
% Spent
of
Expenditure Budget
R'000
64,582
101,848
57,781
233,015
69,202
34,926
84,306
141,516
105,377
892,553
%
10.8%
22.7%
8.6%
20.0%
14.8%
10.2%
20.0%
29.1%
16.5%
17.0%
78
Original
Budget
R'000
562,792
538,962
771,033
962,469
457,442
283,509
421,428
496,121
629,786
5,123,542
%
Spent
of
Expenditure Budget
R'000
73,278
69,121
79,073
186,826
2,564
76,495
119,862
54,864
65,205
727,288
%
13.0%
12.8%
10.3%
19.4%
0.6%
27.0%
28.4%
11.1%
10.4%
14.2%
Health Facility Revitalisation Grant
 Overall spending has improved this financial year from
14.2% (2013/14) & 17% (2014/15) to 19.0% and is below
the norm.
 All provinces spent below the norm with the exception of
GP and LP that spent 28.9% and 37.3% respectively.
 The under spending is attributed to:
 Slow SCM processes (tender processes).
 Centralised delegations at provincial treasury.
 Poor performance of contractors.
 Inability to attract scarce skills – some projects not
initiated.
 Cancellation of contracts and sourcing of new
contractor.
79
National Health Insurance Grant
2015/16
Budget vs Expenditure
Province
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
TOTAL
Original
Budget
R'000
7,206
7,204
7,204
14,408
7,204
7,204
7,204
7,204
7,204
72,042
Transfers
Transfers
% Spent Transfers per % of
of per Payment Payment
Expenditure Budget Schedule Schedule
R'000
91
176
313
640
657
218
995
347
1,264
4,701
%
1.3%
2.4%
4.3%
4.4%
9.1%
3.0%
13.8%
4.8%
17.5%
6.5%
R'000
1,440
1,440
1,440
2,880
1,440
1,440
1,440
1,440
1,440
14,400
%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
% of
Transfers Transfers
Received Received
R'000
91
231
313
2,880
1,440
325
960
1,440
1,264
8,944
%
6.3%
16.0%
21.7%
100.0%
100.0%
22.6%
66.7%
100.0%
87.8%
62.1%
2014/15
2013/14
Budget vs Expenditure
Budget vs Expenditure
Original
Budget
R'000
7,000
7,000
7,000
14,000
7,000
7,000
7,000
7,000
7,000
70,000
% Spent
of
Expenditure Budget
R'000
1,097
2
3,174
592
449
1,113
698
381
1,300
8,806
%
15.7%
0.0%
45.3%
4.2%
6.4%
15.9%
10.0%
5.4%
18.6%
12.6%
80
Original
Budget
R'000
4,850
4,850
4,850
9,700
4,850
4,850
4,850
4,850
4,850
48,500
%
Spent
of
Expenditure Budget
R'000
2,193
552
3,013
4,921
1,538
1,373
158
940
14,688
%
45.2%
11.4%
62.1%
50.7%
31.7%
0.0%
28.3%
3.3%
19.4%
30.3%
National Health Insurance Grant
NHI Direct Grant spending low due to:
• As per operational plans the SCM processes were planned to be
finalised by end of Quarter 1
– Improvements have been in recorded in quarter 2 with spending
sitting at 16%
– Procurement plans have been delayed in many pilot districts
– Capacity constraints continue to plague some of the pilot districts
– Some districts have low levels of financial delegations
– Delays by appointed suppliers to deliver key equipment/kits for
the MWBOTs for which contracts have already been awarded
80
National Health Grant
(Schedule 6 – Indirect Grant)
Component
National Health Insurance
Health Practitioners contracting
CCMDD
Health Facility Revitalisation
Human Papillomavirus
Total
Budget
Expenditure Commitment % Spent
298,100
53,919
83,618
18
228,100
70,000
50,661
3,258
83,422
196
22
5
913,176
200,000
1,709,376
97,760
14,643
220,241
117,924
54,585
339,745
11
7
13
82
INTRODUCTION TO PROGRESS (PICC SUMMARIZED REPORT) AND
CASH FLOW ANALYSIS –IN KIND GRANT 2015/16 F/Y-Q1
 In-Kind budget = R913 m, 146 multi and single Projects
 Delays due to new approach to Ideal Clinics
 Delays due to magnitude of procurement process
 Several innovative initiatives
 Contract for mid-level workers not finalized during the 1st
quarter.
83
Progress on In Kind Grant projects (PICC
summarized report) Q1
Program
Allocated
Budget
2015/16 F/Y
Ideal Clinic building R218 559 411
Number of projects
contractually committed as at
July 2015-2015/16 F/Y
Progress

16 clinics (8 in EC, 3 in FS
and 5 in LP)

Business cases, Clinical and technical briefs have been prepared along with final design of all 8
clinics in EC approved by EC province and NDoH.

All 8 in EC are under construction

The Business cases, Clinical and Technical briefs and concept design of 5 clinics in LP and 3 in FS
have been prepared and approved by the relevant provinces and NDoH and currently they are at final
design and documentation stage and construction to start in Nov. 2015
Community Health R 5000 000
Centers building

5 Community Health
Centers in MP

Business cases, Clinical and technical briefs for 4 of the CHCs have been prepared and approved
by the MP and NDoH and are at final design stage-To go on Construction by Nov. 2015

Doctors Consulting R 147 749 641
room building

61 Doctors consulting
rooms in NHI areas where the
space shortage is critical to
functionality
The fifth one is at concept design stage and construction to start in Dec. 2015

12 in EC all at construction stage
. 16 in LP all at construction stage



6 in FS all at construction stage
22 in MP all at construction stage
5 in WC all at construction stage
The whole program to be completed by the end of current F/Y
Hospital Building
R117 493 239

8 Hospitals (2 in EC, 3 in LP,
1 in FS and 1 in GP and I hospital
housing project)

The Business cases, clinical briefs and technical briefs of 2 hospitals in EC and 3 Hospital in LP and
1 in FS have been prepared by the Infrastructure Unit in conjunction with the relevant provinces and
all have been approved by those provinces, while the one of the GP hospital is being prepared and land
for it has been identified.

The Hospital Housing in Siloam of LP is at construction stage

It is planned to start the construction of the, two hospitals in EC in November 2016, 1 in GP in
April 2017, 1 in FS in April 2016, Siloam hospital in December 2015, the other 2 in LP in April 2017
84
Progress on In Kind Grant projects (PICC
summarized report) Q1
Program
Allocated
Budget
2015/16 F/Y
Ideal Clinic building R218 559 411
Number of projects
contractually committed as at
July 2015-2015/16 F/Y
Progress

16 clinics (8 in EC, 3 in FS
and 5 in LP)

Business cases, Clinical and technical briefs have been prepared along with final design of all 8
clinics in EC approved by EC province and NDoH.

All 8 in EC are under construction

The Business cases, Clinical and Technical briefs and concept design of 5 clinics in LP and 3 in FS
have been prepared and approved by the relevant provinces and NDoH and currently they are at final
design and documentation stage and construction to start in Nov. 2015
Community Health R 5000 000
Centers building

5 Community Health
Centers in MP

Business cases, Clinical and technical briefs for 4 of the CHCs have been prepared and approved
by the MP and NDoH and are at final design stage-To go on Construction by Nov. 2015

Doctors Consulting R 147 749 641
room building

61 Doctors consulting
rooms in NHI areas where the
space shortage is critical to
functionality
The fifth one is at concept design stage and construction to start in Dec. 2015

12 in EC all at construction stage
. 16 in LP all at construction stage



6 in FS all at construction stage
22 in MP all at construction stage
5 in WC all at construction stage
The whole program to be completed by the end of current F/Y
Hospital Building
R117 493 239

8 Hospitals (2 in EC, 3 in LP,
1 in FS and 1 in GP and I hospital
housing project)

The Business cases, clinical briefs and technical briefs of 2 hospitals in EC and 3 Hospital in LP and
1 in FS have been prepared by the Infrastructure Unit in conjunction with the relevant provinces and
all have been approved by those provinces, while the one of the GP hospital is being prepared and land
for it has been identified.

The Hospital Housing in Siloam of LP is at construction stage

It is planned to start the construction of the, two hospitals in EC in November 2016, 1 in GP in
April 2017, 1 in FS in April 2016, Siloam hospital in December 2015, the other 2 in LP in April 2017
85
Progress on In Kind Grant projects(PICC
summarized report) Q1
Program
3 mega Projects
Allocated
Budget
2015/16 F/Y
R 0.000
Number of projects
contractually
committed as at July
2015-2015/16
3 Mega
hospitals inF/Y
GP,
KZN and LP
Progress

Extent of the work: Limpopo Academic Hospital (LAH), Dr George Mukhari Hospital (DGMH) and
King Edward VIII Hospital(KE8H)

Total Estimated value of the works: LAH:R4 162 467 968, DGMH:R5 550 182 205, KE8H:R11 627 798
550, Total: R21 340 448 723

Program duration and Cash Flow projection: LAH: Construction, April 2016- Completion, Nov.
2020, DGMH and KE8H, Construction, May 2017- Completion, Dec. 2021, with average annual budget
requirement of R724M, R832M and R1.744 B respectively-Pending capital financial availability

Phase 1 covering the planning and design of these projects to start in current F/Y, this can be
provided under In Kind Grant allocation in the current F/Y
It is planned to establish the “Project Office” under the Infrastructure Unit Strategic Support (IUSS)
program phase 2 to enrich the process. It is essential to activate this office in the current F/Y to oversee
the development of the 3 mega projects to comply with the implementation schedule
Maintenance
program in NHI
Districts including
the maintenance
and revitalization
of Nursing
Education
Institutions
R 323 027 384

200 Facilities

The PSPs appointed for the condition assessment of the 840 facilities have already covered 400
clinics and busy with the documentation of the condition assessment reports and preparation of Bills
th
of quantities. A target of 40 clinics report and BOQ per week has been set as from the week of the 10
Aug. 2015. The first 40 has been submitted as at 13 Aug.2015
o Currently maintenance contractors are busy in 23 clinics in EC while the site handing over for
balance of 17 is in progress under DBSA as the Implementing Agent-Total Value R110 M. In F/Y 2014/15
they completed the maintenance program in 103 clinics in all NHI districts.

Currently the department appointed 11 contractors and 3 PSPs for removal of Asbestos cement
ceilings (55 clinics and 4 CHCs), Improving water supply and sanitation (89 clinics and 2 CHCs) as well as
security fencing (8 clinics and 1 CHC) which will be followed by other maintenance works in those
facilities- Total value R120 M
o The PSP for maintenance contracts for Edendale Hospital in KZN has been appointed and tender
documentation for the appointment of the contractor will follow-Total estimated value R240 M
o
The CPM for the maintenance contract for Dihlabeng hospital in FS has been appointed by the CDC
the project IA and it is expected to have the contractor on site by December 2015 . Total Estimated
value of contract is R 100 M
o The PSP for the maintenance contract of Knysna hospital in WC has already been appointed by the
province. Tender documentation for this contract is being prepared by NDoH for appointment of the
contractor-Total Estimated cost R20 M
86
Progress on In Kind Grant Projects (PICC
summarized report) Q1
Program
3SCM
mega
Projects
Support
Allocated Number of projects
Budget
contractually
2015/16 F/Y committed as at July
2015-2015/16
F/Y
RR 0.000
3Covering
Mega
hospitals
6 000 000
all In Kindin GP, 
Projects Oversight R 91 000 000
support (PMSU)
and Major project
Residence staff
Grant projects
Covering all provinces
and In Kind Grant
Projects
Progress
Extent
of the
work:
Limpopoto Academic
(LAH), Drprocess
GeorgeofMukhari
Hospital
(DGMH) and
1 Firm has
been
appointed
support theHospital
procurement
the health
infrastructure
projects for three years started in F/Y 2014/15
 Currently there are 24 Built environment professionals and support staff assisting the
department to perform its oversight roles and responsibilities at provincial projects Funded by Health
Facility Revitalization Grant (HFRG)-In the process of extension as from end March 2016 when current
contract is expired. Also developing the Maintenance strategy and plans for the Health facilities in the
country.
 Currently 17 In Loco Monitors (Built Environment Professionals) appointed for critical provincial
projects as well as the In Kind Projects for quality and quantity control and risk management-3 years
as from F/Y 2014/15

10 Year
R 4 346 325
Infrastructure Plan
Total
Full Plan
Project Management Information System Support in Place
At advance stage
R 913 176 000
87
DOCTOR’S CONSULTING ROOMS
Cumulative Cash flow, (R 000)
160,000
140,000
120,000
100,000
80,000
60,000
40,000
20,000
0
Doctor's Consulting Room General
Apr15
0
May15
3,408
Jun15
5,680
Jul-15
5,680
Aug15
42,507
SepOctNovDecJanFebMar15
15
15
15
16
16
16
79,748 117,741 123,189 128,287 137,244 141,579 141,579
IDEAL CLINIC
160,000
140,000
Cumulative planned cash flow (R 000)
120,000
100,000
80,000
60,000
40,000
20,000
0
Apr-15
Ideal Clinic
Apr-15
4,756
May-15
May-15
8,095
Jun-15
Jun-15
14,490
Jul-15
Jul-15
20,084
Aug-15
Aug-15
29,369
Sep-15
Sep-15
44,116
Oct-15
Oct-15
59,545
Nov-15
Nov-15
75,045
Dec-15
Dec-15
90,545
Jan-16
Feb-16
Mar-16
Jan-16
106,045
Feb-16
121,945
Mar-16
137,845
COMMUNITY HEALTHCARE CENTRES
6,000
Cumulative planned cash flow (R 000)
5,000
4,000
3,000
2,000
1,000
0
Apr-15
Ideal CHC
Apr-15
0
May-15
May-15
0
Jun-15
Jun-15
0
Jul-15
Jul-15
0
Aug-15
Aug-15
170
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Sep-15
170
Oct-15
170
Nov-15
170
Dec-15
1,420
Jan-16
2,670
Feb-16
3,920
Mar-16
5,170
HOSPITAL BUILDING PROGRAMME
700,000
Cumulative planned cash flow (R 000)
600,000
500,000
400,000
300,000
200,000
100,000
0
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Hospital building (Flagship)
Apr-15
0
May-15
0
Jun-15
0
Jul-15
0
Aug-15
0
Sep-15
0
Oct-15
0
Nov-15
20,000
Dec-15
60,000
Jan-16
100,000
Feb-16
140,000
Mar-16
180,000
Hospital building (Sakhiwo)
0
0
0
0
0
44,000
79,000
135,000
176,000
176,000
233,000
248,000
Hospital building (General)
5,455
13,758
27,254
37,254
52,093
76,856
90,068
106,254
121,446
136,291
148,765
157,815
NURSING EDUCATION
INSTITUTION (COLLEGES)
70,000
Cumulative planned cash flow (R 000)
60,000
50,000
40,000
30,000
20,000
10,000
0
Nursing Education Institution
Apr-15
Apr-15
384
May-15
May-15
3,061
Jun-15
Jun-15
4,782
Jul-15
Jul-15
9,540
Aug-15
Aug-15
15,070
Sep-15
Sep-15
20,630
Oct-15
Oct-15
26,230
Nov-15
Nov-15
31,830
Dec-15
Dec-15
38,430
Jan-16
Jan-16
45,030
Feb-16
Feb-16
51,630
Mar-16
Mar-16
59,230
MAINTENANCE
350,000
Cumulative planned cash flow (R 000)
300,000
250,000
200,000
150,000
100,000
50,000
0
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Maintenance (Ideal Clinic)
Apr-15
0
May-15
2,462
Jun-15
6,393
Jul-15
25,327
Aug-15
40,327
Sep-15
55,327
Oct-15
70,327
Nov-15
85,327
Dec-15
100,327
Jan-16
115,327
Feb-16
130,327
Mar-16
145,327
Maintenance (Generator)
0
0
0
0
0
0
0
0
0
5,000
10,000
15,000
Maintenance (KZNl)
0
0
0
0
0
0
0
0
0
15,000
30,000
45,000
Maintenance (General)
0
0
4,858
4,858
4,858
17,101
29,344
29,344
30,344
54,344
83,844
112,344
PROFESSIONAL AND TECHNICAL
SUPPORT
120,000
Cumulative planned cash flow (R 000)
100,000
80,000
60,000
40,000
20,000
0
Professional & Technical Support
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Apr-15
5,448
May-15
10,040
Jun-15
21,269
Jul-15
32,130
Aug-15
40,830
Sep-15
49,530
Oct-15
58,230
Nov-15
66,930
Dec-15
75,630
Jan-16
84,330
Feb-16
92,930
Mar-16
101,530
IN-KIND TOTAL
1,600,000
Cumulative planned cash flow (R 000)
1,400,000
1,200,000
BUDJET OF R 913000
1,000,000
800,000
600,000
400,000
200,000
0
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
TOTALS (Additional)
Apr-15
0
May-15
0
Jun-15
0
Jul-15
0
Aug-15
0
Sep-15
44,000
Oct-15
79,000
Nov-15
155,000
Dec-15
236,000
Jan-16
296,000
Feb-16
413,000
Mar-16
488,000
TOTALS (General only)
16,043
40,824
84,726
134,873
225,224
343,478
451,655
518,089
586,429
681,281
774,940
860,840
BUDGET
913000
913000
913000
913000
913000
913000
913000
913000
913000
913000
913000
913000
TOTALS (General only)
TOTALS (Additional)
BUDGET
• Low road: Expenditure amounts to R860m (potential under spending of R53m)
• High road: Expenditure amounts to R1 348m (potential over spending of R435m)
SUPPLIER PAYMENT PERIOD
1. Monthly statistics on late payments relating to the
2014/2016 financial year are as follows:
Month
Number of invoices paid late
Value of invoices paid late
April 2015
1
R 24, 307.08
May 2015
1
R 129, 418.00
June 2015
0
0
July 2015
0
0
Total
2
R 153, 725.08
96
SUPPLIER PAYMENT PERIOD
2. The results can be attributed to the following actions;
 A circular under signature of the DG was distributed to all
NDOH staff to raise the awareness of invoices being paid
within 30 days;
 Monthly letters are being issued for signature of the DG to
units responsible for late payments;
 Orders are not being placed if bank details of service
providers are not active on the system;
 Funding are being confirmed before placing orders.
97
SUPPLIER PAYMENT PERIOD
3. The department is currently in process of procuring an
invoice tracking system after funding was secured which
will further contribute in an reduction in late payments.
The invoice tracking system will be used as an early
warning system to flag all invoices reaching a preset
number of days (e.g. 14 days).
4. It is trusted that the abovementioned input will suffice.
98
The End
99