ANNUAL REPORT
JANUARY - DECEMBER 2013
South Africa
UNDP Support to the
Limpopo Health Sector
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Contents
Executive summary ................................................................................................................................. 3
1.
Background & Context..................................................................................................................... 6
2.
Overall progress overview ............................................................................................................... 7
2.1
Sub-programme: Health Professionals Volunteerism and Capacity Development ................ 7
2.1.1 Recruitment and placement of volunteers ................................................................................ 7
2.1.3 Registration of pharmacists and nurses ..................................................................................... 8
2.1.4 Volunteer well-being .................................................................................................................. 8
2.1.4 Knowledge enhancement of the volunteers ......................................................................... 10
2.1.5 Contribution of the volunteer programme to the health sector .......................................... 10
Figure 6: Number of Repatriated Doctors in 2013 ........................................................................ 13
3.
4.
5.
6.
General Administration and Management .......................................................................... 14
Implementation Strategy Review .................................................................................................. 14
4.1
Participatory/Consultative processes .................................................................................... 14
4.2
Quality of Partnerships .......................................................................................................... 14
Management Effectiveness Review .............................................................................................. 15
5.1
Quality of Monitoring ............................................................................................................ 15
5.2
Timely delivery of outputs ..................................................................................................... 15
5.3
Resource allocation ............................................................................................................... 15
5.4
Project Risks and Actions ....................................................................................................... 18
Implementation challenges ........................................................................................................... 21
6.1
Programme funding ............................................................................................................... 21
Annexure1: Phase III Alignment to Provincial and National Priorities .................................................. 21
2
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Executive summary
This is the fourth and last year of implementation for the UNDP Support to the Health Sector in
Limpopo programme. The major focus in 2013 has been to execute the activities as agreed upon in
the programme document, within the relative scope reviews during the course the year. During the
reporting period, not much progress was made due to financial constraints as a result of
organisational changes within the Department, and being placed under administration for several
months. Since activities in the three sub-programmes, namely; Health planning support programme,
Knowledge Management and Leadership Development as well as MDGs, Monitoring and Evaluation
System were suspended in 2012, no implementation progress can be reported over this period. The
sub-programmes were suspended at the request of the Department, which included the suspension
of the recruitment of UNVs.
By December 2013, the programme retained 17 volunteer doctors, whilst 11 had been repatriated.
From July 2013, the Health Professions Council of South Africa (HPCSA) revised its previous
regulation, which gave provision for volunteers practicing in the country for a period longer than six
months to practise without following various confirmation processes. The new regulation requires
that foreign qualifications be verified by the Educational Commission for Foreign Medical Graduates
(ECFMG). Due to this development, the volunteers may not be registered with HPCSA in order to
practice until these requirements have been fulfilled. The recruitment of nurses and pharmacists
could not resume not only because of the financial situation, but most importantly, due to the strict
requirements of registration, as reported in the 2012 annual report.
The current programme cycle will end in September 2014. Terms of reference for the final evaluation
of the programme have been developed for the appointment of an evaluation team. The process of
developing a framework for new project cycle has been discussed and agreed upon. Based on the
establishment of the focus areas of the programme, the draft of the document will be presented by
UNDP in early 2014.
The Steering Committee convened during the first quarter of 2013, at which the department
committed to funding the recruitment and placement of doctors, whilst the other sub-programmes
remain suspended due to financial constraints. In December 2013, the Department re-assigned the
programme to a different directorate, designating the current discussions of the new programme
document to a new Focal person.
The programme had an opening balance of US$136 216.87 in January 2013. An income of R7,500,000
(US$ 1,196,211. 45) was received in August 2013. The total programme expenditure in 2013 is
R 9,969,792 (US$ 1,084,852.25), with an opening balance of (US$ 249,320.24) in January 2014.
3
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Programme contribution to the provincial and national strategic goals
In the various areas of specialization, the UNV volunteers in 13 hospitals distributed across the five
districts of the province have made extraordinary and dedicated contribution to the South African
medical system in the province of Limpopo. Whilst the implementation of programmes for combating
HIV and AIDS, STI, TB and other communicable diseases has been enhanced in the largely rural areas
of the province, the service volunteers have contributed towards the following three MDGs,
(i)
(ii)
(iii)
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
The Department of Health Limpopo has recorded an improvement in the TB treatment success rate
from 75% to 77.8% between 2010 and 2012. Access to tertiary services has improved through the
increase of tertiary disciplines from 75% in 2010 to 77.8% in 2012. The anti-retro viral treatment
service points have been increased from 483 to 493 (Annual Performance Plan, 2013/2014).
The programme retained 28 doctors in January 2013, of which 67% of them are specialists, serving in
13 hospitals within the 5 districts of the province. The average number of cases handled have
increased significantly, with the doctors contributing 0.05 % towards the overall service volumes
provided by the health institutions in the province. The average number of hours served by each
doctor per hospital is 151 per month. Over time, the doctor to patient ratio has decreased from
18:100,000 in 2011/12 to 16:100,000 in 2012/13, due to the increased service volumes.
The department has reported a percentage increase in patients using regional hospitals services,
varying from 64% in 2009/10 to 65% in 2010/11. This can be attributed to the placement of volunteer
specialists in regional and district hospitals, evidenced by the increased the number of cases
attended within the districts themselves. Additionally, the assignment of volunteer doctors in the
management of HIV/AIDS clinics has added value in the provision of services to patients. This is
demonstrated by the upward access to comprehensive HIV and AIDS, STIs, care, treatment,
management and support of patients from 10.4% in 2009/10 to 49.5% in 2011/12
4
Programme contribution to provincial and national strategies
UNDP Support
DoHSD Strategic Goals 2010/11
National Department of Health
Ten Point Plan
National Government
Outcome No. 2
Immediate Outcomes
Intermediate Outcomes
Final Outcomes
Strategic Impact
 Increased culture of
volunteerism

Effective corporate governance is
provided

Strategic leadership and creation
of a social compact for better
health outcomes;
 Improved hospital
performance vis-ὰ-vis
organizational management
and development

Appropriate human resource
management and development is
provided

National Health Insurance (NHI)
implemented;

Sound financial management
practice is promoted

Improved quality of health
services;

Comprehensive HIV and AIDS, TB,
STI and other communicable
diseases programmes are
implemented

Overhauled healthcare system

Improved human resources,
planning, development and
management;

Revitalized infrastructure

Accelerated implementation of
programmes for HIV and AIDS,
STIs, TB and associated diseases;

Mass mobilization for better
health for the population;

Reviewed Drug Policy; and

Strengthened research and
development
 Improved Doctor-patient
ratio
 Improved knowledge and
access to health related
information
 Diversification and increase in
the number of health
professionals

Districts Health Services and
Primary health Care services are
strengthened

Quality of health care is improved

Emergency medical services are
improved

Tertiary services are developed

Infrastructure development and
maintenance is improved
A long and healthy life for
all South Africans”.
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
1. Background & Context
UNDP Support to the Health Sector programme is a partnership with the Department of Health in
Limpopo, with the objective to support the Department in its effort to improve health care service
delivery in the province. Since the inception of the partnership in 2002, UNDP has assisted the
Government of Limpopo in addressing the shortage of health personnel caused by brain-drain; and
building capacity of local health professionals to improve service delivery and management of health
care in the province. During the first 2 phases of programme implementation, the programme
focused on the recruitment and placement of doctors. In the current phase (Phase III), which began
in 2009 October, in addition to the recruitment and placement of volunteers, the scope of the
programme expanded to include 3 additional complementary sub-programmes:



Health Planning Support Programme (Health economics)
Knowledge management and leadership development; and
Monitoring and evaluation, which includes the domestication of MDGs.
The programme made a contribution in addressing the 4 key challenges as identified in the Annual
Performance Plan, Vote 7, 2010 /11- 2013/14. These challenges are:




Mismatch between health service demands and available resources;
Shortage of skilled health professionals;
Inadequate evidence-based decision making, planning, and resource allocation; and
Inadequate management skills at some key level of the department.
The province is largely rural with an estimated population of 5, 404, 868 people which constitutes
10.4 % of the South African total population. Being a rural province, the resultant brain drain creates
a huge shortage of health professionals in the province as health professionals leave the province for
better opportunities locally and internationally. The province currently has 40 hospitals, 22 health
centres and 416 clinics.
6
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
2. Overall progress overview
2.1 Sub-programme:
Development
Health
Professionals
Volunteerism
and
Capacity
The mobility of medical professionals from the most rural to the tertiary hospitals within the province
is an old phenomenon. Local and international migration of South African doctors for better
remuneration and better working conditions remains very high. Similarly, the willingness and ability
of certain expatriates to work in difficult conditions where local health professionals are reluctant to
serve is low. The option of private practice for those doctors who remain becomes attractive because
of its smaller workload as opposed to the very high demand in the public sector. As much as the
workload for experienced doctors in rural hospitals may be reduced in the presence of Community
Service doctors, the demand for their supervision may not always be effective.
This sub-programme provides the much needed assistance to the Department to alleviate the impact
of the scarcity of doctors through the recruitment of United Nations Volunteers who serve in mostly
rural hospitals and Community Health Centres for duration of one year.
2.1.1 Recruitment and placement of volunteers
A total of 28 doctors were retained into 2013. The programme did not recruit new doctors during this
reporting period, however, the Terms of Reference were revised and adopted in late September
2013. Amongst the 11 doctors repatriated in 2013, two had served for the maximum 6 years
permissible within the UN system.
Following a Project Steering Committee meeting held in March 2013, the recruitment was set to
begin upon receipt of resources. A transfer of funds was received by UNDP in August 2013, after
which the programme identified five candidates for possible recruitment. On an on-going basis,
potential candidates continue to be solicited.
A decision to waive the interview process, taken in 2011 in order to expedite the recruitment process
has been reviewed. This arose from feedback received from hospitals regarding the inadequate skills
of some of the volunteer doctors recruited during this period. From 2013, all candidates whose
profiles have been submitted to the department for screening would undergo interviews, enhanced
through the Skype technology in order to mitigate identity concerns.
2.1.2 Registration on volunteer doctors
In July 2013, the Health Professions Council of South Africa (HPCSA) enacted a new regulation,
recognising the registration of volunteer services to exceed six months. Alongside other volunteers in
the country, the UNVs have been thus been re-classified as long-term assignments, requiring them to
initiate the verification of qualifications to HPCSA through the Educational Council of Foreign Medical
7
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Graduates (ECFMG). Whilst the new policy has been communicated to the Department, the
registration of the doctors has not been renewed. Due to the length of this process, by December
2013, only four doctors whose reports have been transmitted to HPCSA.
2.1.3 Registration of pharmacists and nurses
Despite the consultations made in 2012 regarding a possible provision for volunteer registration of
nurses and pharmacists, no further progress was made in advancing their recruitment during this
reporting period.
2.1.4 Volunteer well-being
The monitoring of living conditions of volunteers is a standard activity conducted by the PMU, UNV
Field Unit as well as the UN Security Service. A number visits to the doctors were conducted in 13
hospitals where the volunteers are assigned. Feedback has been received from the hospital and
clinical management personnel through solicited meetings. A close relationship between the PMU
and the hospitals is crucial, considering the movement of hospital management, in order to provide a
better understanding of UN Volunteers conditions of service. Although one incident of harassment
outside hospital premises was reported, however, volunteers are constantly reminded to be discreet
and vigilant for any potential threat to their security in an outside the hospital premises.
(i)
Living conditions
Whilst accommodation provided by the hospitals within their premises varies according
to locality and availability, there are isolated incidents where preference is given to
community service doctors, allied medical practitioners and doctors recruited through
other government programmes. As such, the volunteers have either been relocated to
smaller or vacated from their apartments. Although a single maintenance related matter
was received from one of the rural hospitals. Where no similar reports were received,
living conditions of the volunteers have generally met the expectation.
(ii)
Treatment of volunteers by local health professionals
Constant engagement and reports from the hospitals and the respective supervisors
regarding performance issues and professional support of the volunteers is very crucial.
Although most of the district hospitals have continued to renew contracts of the
volunteers, more negative feedback has been received post-repatriation. There is thus a
growing need for the PMU to actively involve the clinical management of the hospitals to
solicit accurate progress reports of the doctors in order to take appropriate action. On
the other hand, following their exit, doctors who have served in the tertiary hospital have
raised issues ranging from misalignment and displacement by the hospital.
8
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
As much as most of the volunteers are also viewed as committed, having adapted to the
culture of their institutions, the fact that they are employed under relatively modest
salary conditions leaves a perception of them as inferior.
(iii)
Workload and compensatory time-off (CTO)
Flexible working schedules for some of the doctors placed at the tertiary hospital are still
a challenge to achieve. In this institution, mobility of specialist is high, resulting in high
workload levels for the volunteers to absorb. New managers refuse to adopt and
accommodate the practice of CTO in order to crises created by the shortfall of specialists
at the institution. One specialist was suspended after a series of disagreements with the
supervisor related to CTO.
Figure 1: Average number of hours and cases attended in 2013
1200
1000
800
600
400
200
0
(iv)
Jan
Feb
Mar
April May
June
Jul
Aug
Sep
Oct
Nov
Dec
Cases attended 612
840
453
496
645
403
270
429
429
398
404
312
Hours worked
167
174
201
231
239
191
189
136
204
276
169
154
UNV workload
The workload of volunteers continues to reflect an outlook of their contribution at their
duty stations. As captures in Figure 1 above, the average hours worked per month among
the doctors changed significantly from the second quarter as large number of volunteers,
mainly assigned in the periphery were gradually being repatriated.
9
UNDP Support to the Health Sector in Limpopo
2.1.4
Annual Report (January –December 2013)
Knowledge enhancement of the volunteers
Training and academic exposure are highly recognized in volunteer acknowledgement, motivation
and ultimately, retention. Particularly in South Africa, volunteers are mostly deployed to serve in
various hospitals, unfamiliar with local epidemiology, the practice of health care and the organization
of the health system in the country. Workshops and conferences have been used as tools for
development and competence enhancement. During this reporting period, volunteers have attended
various conferences relevant to their areas of specialization to keep abreast of developments in
medicine.
2.1.5
Contribution of the volunteer programme to the health sector
The recruitment and placement UNV volunteers have been invaluable in maintaining the quality of
health care service delivery in Limpopo. Across the five districts of the province, 13 hospitals have
benefited. The volunteers continue to support the attempt by the department to foster the Primary
Health Care approach to healthcare. Their participation in community outreach, serving the local
clinics and community health centres has assisted in health promotion and preventive activities,
timely diagnosis and advance a team approach to healthcare services.
Whilst providing specialist care within the tertiary, regional and district hospitals, their skills have
been useful managing the rate of transfer of patients within and outside the province with reduced
costs. Most importantly, volunteers have filled the difficult void due to their willingness to work in
difficult and rural conditions, where local health professionals are difficult to retain in similar
circumstances.
Figure 2: Volunteers per Area of Specialization
10
3
2
2
3
2
2
2
1
1
10
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Figure 3: Number of Volunteers per Hospital
7
4
3
3
2
2
1
1
1
1
1
1
1
Figure 4: Distribution of Volunteers per District
Sekhukhune, 6
Capricon, 10
Mopani, 8
Vhembe, 4
11
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Table 1: List of volunteers in the programme in 2013
Name and Surname
Area of Specialization
Hosting Hospital
Status of UNV
1. Bautista, Jose
Family Medicine
Mecklenburg
In service
2. Thomas Kaung
Family Medicine
Mecklenburg
3. Tawheed Emam
Surgery
St Ritas
4. Ebrima Jarra
Family Medicine
Elim
Repatriated
5. Karchenko Andriy
Anesthesiology
Philadelphia
Repatriated
6. Sharonova Tatiana
Pediatrics
Lebowakgomo
Repatriated
7. Nuzhat Sultana Ahmed
Family Medicine
Zebediela
In service
8. Serguei Nikiforov
Surgery
Letaba
In service
9. Lioudimila Nikiforova
Obstetrics and Gynecology
Letaba
In service
10. Zhyrnyi Sergii
Surgery
Letaba
In service
11. Iryna Danylenko
Internal Medicine
Polokwane
In service
12. Akeem Adedolapo
Family Medicine
Botlokwa
In service
13. Misra Rajeev
Cardiology
Polokwane
In service
14. Kapoor Pardeep Kumar
Cardiology
Polokwane
Repatriated
15. Sergiy Bocharov
Anesthesiology
Polokwane
Repatriated
16. Ivantchenko Nikolaevitch
Neurology
Polokwane
Repatriation pending
17. Jerome Hubahib
Internal medicine
Polokwane
In service
18. Delinikaytis Sergey
Orthopedic Surgery
Polokwane
In service
19. Shahid Mehmood
Family Medicine
Siloam
In service
20. Patrick Mulindwa
Obstetrics & Gynaecology
Sekororo
In service
21. Khan Inamullah
Family Medicine
Sekororo
In service
22. Abu Minah
Family Medicine
Sekororo
In service
23. Godwin Attamah
Family Medicine
Dilokong
In service
24. Narendra Kumar Sharma
Ophthalmology
Polokwane/Mankweng
Repatriated
25. Dieudonne Takam
Family Medicine
Maphutha-Malatji
Repatriated
26. Pyai Win Gaung
Paediatrics
Letaba
Repatriated
27. Benicio Torralba
Ophthalmology
Elim
Repatriated
28. Azmi Ahmed
Internal Medicine
St. Ritas
Repatriated
Repatriated
In service
12
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Figure 5: Number of Years in Service per Volunteer in 2013
7
6
5
4
3
2
1
0
1
2
3
4
5
6
Years of service
6
5
4
3
2
1
No of volunteers
2
0
0
1
4
3
Figure 6: Number of Repatriated Doctors in 2013
Series1
Q1
0
Q2
5
Q3
3
Q4
3
13
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
3. General Administration and Management
The persistent resource constraints and the suspension of other sub-programmes have maintained
the PMU under the operations of the Programme and Administration Coordinator with support and
oversight from UNDP. The Knowledge Management Programme Officer and Programme Manager
vacated the positions in September and November 2012 respectively.
4. Implementation Strategy Review
The Steering Committee (PSC), co-chaired and represented by UNDP and the Department, still
assumes the policy and advisory role on strategic issues and ongoing oversight. The disbursement of
resources by the department, at the representation of the PSC guided the essential activities which
had to be sustained, that the Programme Management Unit (PMU) planned to implement for the
period in review.
4.1
Participatory/Consultative processes
The Steering Committee convened during the first quarter to streamline and harmonize the 2013
deliverables as the current phase of the programme nears its end in September 2014. The
department committed to an allocation of R15.4 million for 2013 to fund the recruitment and
retention of doctors, however, other sub-programmes remain suspended due to inadequate
resources.
New discussions about the review of the programme as well as the development of the project
document for the next phase resumed and will be completed before the September 2014. More
focus has been placed on the contractual arrangements of the volunteers in 2013.
4.2
Quality of Partnerships
The partnership between UNDP and the Department has been effective in the provision of high level
supervisory and technical support to the programme. As the donor and beneficiary of the
programme, the Department has been actively involved in the planning of activities and programme
activities, through representation and participation in PSC engagements. Several challenges relating
to health institutions have been effectively dealt with. Whilst resource constraints have been a great
test to the achievements of results, the programme has adapted to ensure that the available funds
are disbursed effectively.
14
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
5. Management Effectiveness Review
5.1 Quality of Monitoring
Although the Steering Committee had one seating during this reporting period, meetings between
the focal points have been held to discuss implementation challenges, resource constraints and the
future of the programme as it nears its end in 2014. During the course of 2013, quarterly progress
reports provided insight on challenges presented at the level of health institutions in the field,
resource utilization, risks and other issues in the implementation of the programme.
5.2 Timely delivery of outputs
Since the funds were received in August 2013 and the recruitment profile approved in October 2013,
the recruitment process could not yield new recruits at the end of the financial year. By December
2013, the programme had 17 volunteers, a number reduced from 28.
5.3 Resource allocation
The opening balance of funds as at January 2013 was US$ 136,216. 87 An income of R7,500,000
(US$ 1,196,211) was received in August 2013. The total programme expenditure in 2013, as depicted
in Table 2, is R 9,969,792 (US$ 1,084,852.25), with an opening balance of (US$ 249,320.24)
in January 2014
15
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Table 2: Financial expenditure report per sub-programme: January - December 2013
16
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
17
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
5.4 Project Risks and Actions
RISK TYPE
DESCRIPTION
IMPACT
SUGGESTED MANAGEMENT RESPONSE
RESPONSIBLE PARTY
Organizational
Non-provision of UNDP or UNV inputs to
ensure efficient/effective programme
deliverables.
Ineffective scope management of programme
may disrupt continuity of UNV assignments,
affecting delivery levels.
Regular Project Steering Committee
meetings and bilaleral consultations.
UNV PO / PMU
Project Evaluation
Limited capacity of the UNV Programme
office in supporting UNV volunteers.
Retention strategies through ongoing
training and enhancement of UNV
skills.
UNDP/ DOH
Regular interaction and appropriate
segregation of responsibilities between
the PMU and the UNV PO.
Financial
Irregular funding schedules
Insufficient commitment that allows for
appropriate administration of contracts
of volunteers and programme staff
Over expenditure and intermittent accounting
affects monitoring and proper planning
Voluntary separation of volunteers due to
uncertainty and lack of security.
Provide regular progress and
expenditure reporting to expedite
continued funding
PMU/ UNDP/ DOH
Align Annual Workplans to available
resources
PMU
18
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
RISK TYPE
DESCRIPTION
IMPACT
SUGGESTED MANAGEMENT RESPONSE
RESPONSIBLE PARTY
Operational
Voluntary separation of programme staff.
Delivery levels affected negatively due to
insufficient capacity.
Efficient management of operational
processes and information
PMU / UNDP
Security of the office premises
Loss or damage to property
Political
Change in political/ administrative
leadership
Negative impact on continued leadership,
strategic and financial support of the
programme
Regular consultations and PCS meetings
to concretize long-term commitment.
UNDP / DOH / PSC
Regulatory
Change in country regulations for clinical
practice
Lack of compliance by the volunteers due to
additional requirements required by
regulatory institutions disallows UNV practice.
Constant engagement of the
department for additional support to
ensure attainment of the requirement
documentation for compliance.
Regulatory
Amendment of regulations for foreign
citizenship by the government
Non-provision of HPCSA registration and
work permits has occupational risks and
could render the work and stay of UNVs
illegal
Lack of valid work permits, Diplomatic ID Cards
render the work and stay of UNVs illegal
Timely processing of contract
extensions to expedite renewal of work
permits
19
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
RISK TYPE
DESCRIPTION
IMPACT
SUGGESTED MANAGEMENT RESPONSE
RESPONSIBLE PARTY
Security
Ineffective monitoring and security and
safety of UNVs at duty stations
Injury to UNVs and loss or damage to property
may weaken retention capacity of the
programme.
Regular security visits of PMU, UNDSS
and UNV teams to duty station
UNDP/ PMU
Security alerts and information
regarding potential threats
disseminated to UNVs
PMU
UNVs encouraged to report threats of
potential danger to the PMU for
immediate action
20
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
6. Implementation challenges
6.1 Programme funding
The impact of financial resource shortage has had an impact on achieving deliverables for the 2013
financial year. The late receipt of funds made it difficult to expedite the recruitment of doctors.
Annexure1: Phase III Alignment to Provincial and National Priorities
Relevant National Outcome
 A long and healthy life for all South Africans
 Objective: To increase the life expectancy of our citizens and ensure that all people have
access to health care.
Relevant National Activities (RSA)
 Ensure a well-coordinated roll-out of antiretrovirals (ARVs) with a specific emphasis on
effective roll-out of the preventative mother to child treatments;
 Integrate HIV and tuberculosis (TB) services;
 Strengthen maternal health services;
 Develop a national strategy for chronic diseases;
 Conduct hospital audit process in 2010, with the view to improving hospitals.
Relevant National outputs
 Reduce the mortality rate;
 Reduce the impact and prevalence of HIV and AIDS and Tuberculosis, and
 Ensure an effective healthcare system.
Medium Term Strategic Framework (Relevant to Health)
 Transform the public health system so as to reduce inequalities (National Health Insurance)
in the health system, improve quality of care and public facilities, boost human resources
and step up the fight against HIV and AIDS, TB and other communicable diseases as well as
lifestyle and other causes of ill-health and mortality.
21
UNDP Support to the Health Sector in Limpopo
Annual Report (January –December 2013)
Department of health and Social Development (Limpopo province)
Vision: A health promoting and developmental to the people of Limpopo
Mission: The department is committed to provide sustainable Health and Developmental services
through a comprehensive and integrated system
Department Health and Social Development Strategic goals
 Implement comprehensive HIV and AIDS care, treatment and management, Tuberculosis
(TB), Sexual Transmitted Infections (STIs) and other communicable diseases programmes
 Strengthen Districts Health Services and Primary health Care services
 Human Resources management issues
Relevant Millennium Development Goals (MDGs)
 Reduce child mortality
 Improve maternal health
 Combat HIV/AIDS, Malaria and other diseases
Relevant UNDAF Outcome
 Democracy, good governance and administration
Envisaged Programme Outcomes
 Improved healthcare service delivery in Limpopo Province
 Increased culture of volunteerism
 Improved hospital performance vis-ὰ-vis organizational management and development
 Integration of health economics in health service planning
 Improved knowledge and access to health related information
 Improved monitoring and evaluation capacity
Expected Programme Outputs
 Recruitment of PMU staff: 1 Programme Manager; 2 Programme Officers; 1 Programme
Assistant and 1 Programme Driver
 Recruit and place 75 UNV medical doctors, 8 UNV Clinical Engineers, 30 UNV Pharmacists,
and 15 UNV special Nurses
 Develop a framework for a mentorship programme strategy
 Develop and implement a leadership development seminar series programme targeting
senior management of health facilities and health managers
 Develop guidelines and frameworks for effective health services planning
 Develop a concept document for the establishment of a health knowledge management
centre in Limpopo province
 Develop and implement monitoring and evaluation system
22