Status Quo and Progress Report
Ugu District Municipality
Report Presented By :
Clr N.H. Gumede
District Mayor 20 March 2013
BACKGROUND
• Review of Ugu District Strategy 2007 -2011
• Final Draft Strategy developed, to be adopted by EXCO
• Operation Sukuma Sakhe (DTT) (26/6/12), delegated to
organize 3 task teams to accelerate service delivery on key
areas – DOH to deal with HAST matters ,DOE to deal with
teenage pregnancy and DAEA to deal with food security .
These were identified as key drivers /priority areas/ as
reflected by the UDAC in the review 2007-2011
• Various stakeholders, including civil society organizations
enrolled and participating in the campaign .Intense
mobilization targeting the following :
-HIV Prevalence, HCT and access to ART, Condom distribution
,MMC, TB/MDR, Sexual Assault under 12yrs, Men-s sector
and Teenage Pregnancy. Operation Sukuma Sakhe
monitoring
Accelerated interventions in place ,commenced July 2012
1. HIV prevalence ,HCT and access to ART
• Increasing HIV Prevalence was noted. Extensive testing
needed.
• Operation MBO services planned ,to focus on Malnutrition ,
diarrhoea, breastfeeding. EPI programmes coupled with
HCT to high transmission areas e.g. informal settlements Mobile clinics
• Dedicated HCT campaigns in industries, farms, churches
• Weekly Nerve Centre
• Gains :Number of people tested for HIV this financial year:
87215 end Sept (but still short of the target)
• Dramaide to initiate behaviour change programmes to
reduce incidence
• NIMART - biggest contributor to achieving the target of
number of clients on ARTs. Will continue in the subsequent
reporting quarters
HCT Report : -01 July 2012 - 20 January 2013
Target: 276671
120000
100000
112208
110872
Reached: 110872
40%
80000
60000
40000
20000
12859
0
Client pre-test counselled
for HIV
Client tested for HIV - total
Client tested positive for
HIV - total
Clients - HCT Testing Progress
LM
Q1
Q2
Q3
Ezinqoleni
3454
3328
3767
Hibiscus
15813
17678
15880
Umdoni
4084
3962
4728
Umuziwabantu
7201
8253
10937
Umzumbe
7658
7332
9135
Vulamehlo
4197
4255
4477
42407
44808
48924
HCT testing
• Targets are monitored monthly ,from July 2012 –June 2013 .
Currently 40% reached.
• Compared to last quarter, improvement in all LMs exc HCM .
• Roving mobile vehicle with a dedicated professional nurse in
place from March 2013 in HCM.
• Dedicated roving HCT team for Umdoni in the next quarter
• Strategies implemented in the current reporting quarter:
• Operation MBOs AFCON launch event and parliamentary event
for disability in Umzumbe
• Kwa Jali clinic outreach project in Umuziwabantu
• Roving High Transmission Areas team functional 1 March 2013 in
HCM, 2nd one for Umdoni scheduled for the next quarter
Condom Distribution
• Condom Distribution - at its highest peak in the district
• Training done with distributors
• Increase in condom distribution attributed to Hlola Manje campaigns
• Partners in distribution/and or condo can installation include:
•
•
•
•
•
•
•
•
SC Hospice and Red Cross
Traditional health practitioners in Umzumbe
CHUBB security company.
CCGs
DOE (installation at FET colleges)
Private GPs/Gynae’s -female condoms.
Ugu Municipality
OSS (distribution at war rooms)
Condom Distribution
• Hibiscus operation MBO in January contributed to 4000 female condoms
and 30000 male condoms distributed with the assistance of Red Cross
• Strategy to increase in Ezinqoleni – Operation MBO at Izingolweni taxi rank
• Umzinto Taxi Rank - Operation MBO with DOH and Red Cross on the 1st Feb
• Collaboration with private GPs in Umzinto for distribution of female
condoms
• Farmers association to be engaged by Mobiles
Male Medical Circumcisions
•
•
•
•
Chaplains are engaging FBOs to mobilize initiates
Weekly monitoring via nerve centre (MaTCH attending)
High volume centre-Nyangwini Functional
TMMCs -Advocacy through School governing bodies and radio
slots
• MaTCH providing further technical assistance (doctor support)
• Neonatal Circumcisions –no one trained to conduct at present
and this is a limiting factor.
• Role players partnering with DOH in undertaking camps
MMC
Q1
Q2
Q3
Hibiscus
932
582
493
Umdoni
293
84
50
Umuziwabantu
348
467
Umzumbe
489
1216
2062
2349
179
260
982
-December (Q3) were not effective in obtaining initiates due to
the summer holiday season especially in December .
-11 camps planned for q4 to compensate for poor performance.
Slots to pastors forum to advocate for and plan for MMC.
-DOH Currently strengthening relations between Amakhosi and
MMC coordinators by initiating forums
MMC
2500
2349
2000
TARGET
: 3000
1963
2062
1747
1500
1314
1000
982
936
655
500
0
2010/11 Q4
2011/12Q2
2011/12Q4
2012/2013Q2
Sexual Assault
•
•
•
•
•
•
•
•
•
•
Awareness campaigns in identified problematic areas involving stakeholders.
SAPS visiting schools to address learners on sexual assault during the assembly.
Engaged community safety liaison officer-via OSS to the premier
Presented statistics and sensitize role-players at the Men’s Summit on the 1617 July 2012
Women’s sexual assault event held to conduct awareness-coordinated by SAPS
Hospice – working together with child welfare to identify and refer cases of
sexual assault among children.
SAP is currently involved in sensitizing Indunas to correct reporting via the
existing legal structures i.e. SAP.
Submitted request for Sexual offences court to be planned as part of the new
court development for Port Shepstone. Harding requires a child/sexual offence
court-faced with lack of funding for proposed infrastructure.
Investigate progress of ECD in every area of high incident of sexual assault
among children
Gender forums revived
Sexual Assault
•
•
•
•
•
Talk show at Thuthuzela with pastors and SAPS regarding 16 days
of activism against women.
Road shows also held with stakeholders and high risk areas were
visited, including the taxi rank.
Training done by SA Depression and anxiety programme.
Staff at crisis centre have attended DNA training to assist with
taking samples
Integration with mental health as perpetrators sometimes have
mental disorders or substance abuse
Sexual Assault
Sexual Assault under 12
Future plans Revive community structures like men’s and
women’s forums that fight against abuse
• Feedback on sexual assault to relevant managers via OSS
• In-service staff on new sexual policy
• Gains – 130 in q4 (11/12) to 94 in q1 and q2(12/13) and
71 in Quarter 3.
• Number of new sexual assault cases :
LM
Q1
Q2
Q3
Hibiscus
47
57
38
Umdoni
37
32
20
Umuziwabantu
9
5
8
Umzumbe
1
0
5
94
94
71
Teenage Pregnancy
Increase in Learner Teenage pregnancy,1200 reported in
2011. Task Team in place, led by DOE but supported by
DOH and other stakeholders .
Proposed strategies include:
- Rolling out of the anti-sugar daddy campaign,
- substance abuse campaign and improving recreation
facilities in areas with high incidence of teenage
pregnancy
- Explore end of term and matric dance parties
*Sinomusa high with Leleti Khumalo project -50% decrease
& increased pass rate in 2012
500 learner pregnancies reported for 2012
MDR TB
MDR –TB ON THE INCREASE
•Nurse initiated MDR treatment commenced at Murchison
Hospital site
• IPT Rollout – preventive strategy
• Intensive case finding
• NGOs (Red cross) now involved in door to door campaigns
Future plans
Partners willing to procure gene Xpert-diagnostic to reduce
waiting time for results
Add 19 new injection teams
Screening all pregnant women for TB
DOH providing partners with sputum bottles
Cure Rate
80%
74%
72%
70%
70%
75%
71%
72%
74%
60%
54%
50%
TARGET:
72%
40%
30%
20%
10%
0%
2010/11 Q4
2011/12Q1
2011/12Q2
2011/12Q3
2011/12Q4
2012/2013Q1
2012/2013Q2
2012/2013Q3
•
•
•
TB cure rate has improved to 72%.
Results not evaluated are consistent.
The challenge experience is lack of transport to render the TB
services for outreach teams. Awaiting additional vehicles
from Province
COMMENTS ON TB DEFAULTER RATE
•TB tracers in 2 sub districts are unable to go out due to in consistent
transport.
•Cellphone notification to be implemented to remind patients.
•District to ensure that clinics allow TB facility Co-Ordinators to
telephone their patients
COMMENTS ON SMEAR CONVERSION
•
•
•
Improvement in smear conversion.
The district has trained 90 nurses on nurse initiated
MDR TB management.
The intention is for 6 PHC clinics to commence nurse
initiated MDR from April 2013.
Men’s Sector
-Men’s sector is a subsection of the gender forum of the district.
Forums based in municipalities- a basis for planning Advocacy
for the Accelerated OSS HAST at the mens’forum.
-AFSA to reintroduce youth ambassadors to the facilities and
their role in health-clinics to utilize youth ambassadors in
health promotion, and marketing of services esp. males health
- Engagements with community members -behavior
change and strategies for addressing issues of HAST,
family planning and service delivery expected
- Performing Arts generating discussions with DramAide
and Brothers for life , in Vulamehlo and Umdoni (Dumisa
and Amahlongwa areas ). To be rolled to other Local
Municipalities.
Strategic Objective 1
Intervention area: Community Mobilisation
INDICATOR
Q1
Q2
Q3
Number of people aged 25-29 reached with
prevention information including anti-gender
based violence information
5760
3456
5000
Number of young people aged 15-24 reached
with prevention information including antigender based violence information
7350
2300
4500
COMMENT
Increase in quarter 3 due to the implemented accelerated interventions
e.g. build up activities for world AIDs day 2012 ,16 days of activism against
women and children
Cont’ : Progress on prevention strategies
COMMENTS: Baby PCR tested positive around 6 weeks rate
•
•
•
•
•
•
There was a decrease in transmission rate. The district has involved
partners to assist with survey on the PCR positive children. Letters written
to CEOs to seek permission for files on mothers for the mini survey
One of the challenges is cross border patients from the Eastern Cape –
District manager is reviving communication with EC
Challenge with ART initiation of pregnant women. Hence there will be a
roll out of NIMART training to mobiles
Identification of children and initiate children under 5 by screening and
testing all babies that are coming at 18 months for immunization
Community dialogues to encourage early ANC booking
Sub district data validation sessions to improve the quality of data at
facility level, re enforce the monitoring of dash board indicators(a few
important indicators that were identified by National that highlights the
progress of the programme)
COMMENTS
•
•
•
•
•
•
Improvement in testing noted, as a result of integration.
Training of staff nurses in well baby clinic to be done.
Continuous on site visits will take place
Continuous monitoring of baby nevirapine uptake
Adherence to treatment by pregnant women before and after delivery
Need to review our targets e.g to increase in areas already achieved
Cont’ : Progress on prevention strategies
Comments
•
•
•
•
Extend working hours of clinics to increase accessibility.
Meet with traditional leaders, traditional healers and clinic
committees.
Pregnancy screening of all women of child bearing age
ANC still not provided on a daily basis. OMs to ensure that
ANC is provided every day and district to monitor daily ANC
attendance
Cont’: Progress :Orphans & Vulnerable Children
INDICATOR
Q1
Q2
Q3
Number of registered OVC
15554
16450
17278
Number of registered OVC of school going
age in school
13567
14286
15376
Number of registered OVC receiving care and
support
1377
3303
4705
Comments
Increase in numbers noted due to accelerated interventions through
Operation Sukuma Sakhe in War rooms. Services to OVCs are ongoing hence
numbers will be accumulative
Intervention Area : Coordination, Monitoring & Evaluation
INDICATOR
Q1
Q2
Q3
DAC meetings held as scheduled
1
1
0
DAC meeting chaired by designated Chairperson
1
1
0
70% of designated DAC members attended meeting
1
1
0
DAC minutes to PCA
1
1
0
Number of LACs submitting reports to DAC
4
6
6
Number of WACs submitting reports to LACs
0
0
20
DAC functioning well. Good participation of stakeholders, including sector
departments. Programme linked with OSSP. Integrated reporting in place and
reports regularly forwarded to PCA
Operation Sukuma Sakhe
TOTAL NO OF
WARDS
NO OF
FUNCTIONAL
WARROOMS
NO OF
OUTSTANDING
WARDS
Vulamehlo
10
10
0
Umdoni
10
9
1
Umzumbe
19
12
7
Hibiscus Coast
29
13
16
Izinqoleni
6
6
0
Umuziwabantu
10
10
0
TOTAL
84
60
24
Improvement noted ,though 24 wards are still outstanding due to
clustered wards in HCM . LTTs in place ,though there are some
challenges of delays in reporting. Matter receiving attention .
Other Planned Interventions and WAY forward
•To strengthen collaboration
• Continue to enroll above to take ownership
• Bring the Faith Based organizations on board
• Enroll other NGOs Working in HIV, AIDS,TB and behavioral
change programmes
• Pursue involvement of ward champions
• Other collaborating partners include : Broad Reach HC, Match,
Thuthuzela Centre, Red Cross, South Coast Hospice, DramAIDE, AIDS
foundation ,EPWP, Ugu Health Forum, PLWA ,Senior Citizen’s forum
and Business Sector
• Review our targets (increase in other areas)