DEPARTMENT OF HEALTH
2011/12-2013/14
Annual Performance Plan
Vote 7: Health
June 2011
1
CONTENTS
PAGE
FOREWORD BY THE MEMBER OF THE EXECUTIVE COUNCIL ( MEC)
STATEMENT BY THE HEAD OF DEPARTMENT (HOD)
4.1.
OFFICIAL SIGN OFF
1. PART A: STRATEGIC OVERVIEW
4
6
7
8
8
1.1. VISION, MISSION AND VALUES
8
1.2 STRATEGIC GOALS
10
1.3 SITUATIONAL ANALYSIS
1.4 PROVINCIAL SERVICE DELIVERY ENVIRONMENT
1.5 PROVINCIAL ORGANISATIONAL ENVIRONMENT
15
28
30
1.6 LEGISLATIVE AND OTHER MANDATES
1.7 OVERVIEW OF THE 2009/10 BUDGET AND MTEF ESTIMATES
2. PART B : PROGRAME AND SUB-PROGRAMME PLANS
30
35
35
2.1 PROGRAMME 1: ADMINISTRATION
2.2 PROGRAMME 2: DISTRICT HEALTH SERVICES
2.3 PROGRAMME 3: EMERGENCY MEDICAL SERVICES
52
94
102
2.4 PROGRAMME 4: PROVINCIAL HOSPITALS
2.5 PROGRAMME 5: CENTRAL AND TERTIARY HOSPITALS
2.6 PROGRAMME 6: HEALTH SCIENCES AND TRAINING
2.7 PROGRAMME 7: HEALTH CARE SUPPORT SERVICES
2.8 PROGRAMME 8: HEALTH FACILITIES MANAGEMENT
111
118
128
135
145
3. PART C: LINKS TO OTHER PLANS
145
3.1 INFFRASTRUCTURE/CAPITAL PLANS
147
3.2 CONDITIONAL GRANTS
150
3.3 PUBLIC-PRIVATE PARTNERSHIPS (PPPs)
2
152
4. CONCLUSION
5.
153
ANNEXURES
5.1 ANNEXURE A: CHANGES TO THE TABLED FIVE YEAR STRATEGIC PLAN
5. 5.2 ANNEXURE E: DEFINITIONS AND DATA ELEMENT IN THE APP
3
153
156
FOREWORD BY THE MEMBER OF THE EXECUTIVE COUNCIL
(MEC)
The 2009 democratic elections ushered in a new administration of the African National
Congress (ANC) led government with the mandate that the provision of quality health care
services should become one of the key priority areas of government. As the Department of
Health in Limpopo, we are charged with the responsibility of providing quality health care
services in an integrated, sustainable, affordable, effective, and efficient manner. We are
required by law to ensure that the idea of a long and healthy life for all South Africans is
realised.
Understanding very well that the mandate given to the democratic government require us to
work very hard and deliver.To realize this constitutional imperative, the department commits
itself to providing sound basic health care in order to improve the lives of the people of the
province. In an endeavor to realize this noble goal, the department will always strive towards
improving access and better healthcare facilities throughout the province. Assigned with the
responsibility of looking after the health status of 5.4 million citizens particularly the poor, the
Department has identified the following crucial areas:





Improving quality health care
Maintenance of infrastructure;
Procurement of health high tech equipments;
Strengthening internal control measures in relation to risk management, procurement and
financial management; and
Implementation and adherence to the service delivery improvement plan.
It is heartening to mention that we have improved, albeit not satisfactorily, in the following areas,
where we previously experienced huge challenges:







HIV counseling and testing (HCT);
Prevention of mother to child transmission of HIV and Aids (PMTCT);
Provision of ART prophylaxis and management of opportunistic infections;
Home and Community Based care;
Integrated nutrition programme;
Integrated Management of Childhood Illnesses (IMCI) and
Quality improvement programmes.
We are re-doubling our efforts in reducing our morbidity and mortality arising from complications
of pregnancy, communicable diseases, vaccine preventable childhood diseases, diseases of life
style, HIV and TB, trauma and violence against women and children. We believe this will go a
long way in successfully pushing back the frontiers of poverty and under-development.
The 2011/12-2014 will see the Department putting more effort on the implementation of the
ministry’s Ten Point Plan namely:
 Provision of strategic leadership and creation of the social compact of better health
outcomes;
 Implementation of the National Health Insurance;
 Improving the quality of health services;
 Overhauling the health care system and improving its management;
 Improved human resources planning, development and management;
4






Revitalization of the infrastructure;
Accelerated implementation of the HIV and AIDS Strategic Plan and
increased focus on Tuberculosis (TB) and other communicable diseases;
Mass mobilization for better health of the population;
Review of the drug policy; and
Strengthening research and development.
It is therefore my pleasure to present to you this Annual Performance Plan. I also wish to
commit my office to give oversight to this plan.
……………………………………………………
………………………………
Date
Mme D.P Magadzi
Member of the Executive Council (MEC)
Department of Health and Social Development
5
STATEMENT BY THE HEAD OF THE DEPARTMENT (HOD)
In pursuit of the provision of quality health care services, the Department of Health in Limpopo,
strives to ensure that our administrative capacity, systems, policies and processes are improved
and aligned with the policy mandate of the ruling party. It is our firm believe that to achieve the
set goals and objectives as spelled out in the APP, sufficient efforts, resources, and the entire
workforce shall be required. We are duty bound to go an extra mile to realise this. The
department is bestowed with the responsibility to provide quality health care services in an
integrated, sustainable, affordable, effective, and efficient and effective manner.
The mission of the Department is to provide accessible, comprehensive, integrated, sustainable
and affordable health and social development services. Guided by the vision and mission as
reflected in this APP, plans and programmes are in place to ensure the full attainment of the
goals and objectives. To that effect, a 5 year strategic plan was developed covering 2010-2014
and currently is in the first year of the government planning circle. There is a need to maximise
efforts towards providing quality health services in line with the Limpopo Employment Growth
and Development Plan (LEGDP).
The department will be focusing mainly on the following priorities to further improve health
services in the province as outlined in the Social Cluster Programme of Action and the
Negotiated Service Delivery Agreement of the Health Sector which focuses on the following 4
strategic outcomes:




Increasing Life Expectancy
Decreasing Maternal and Child mortality
Combating HIV and AIDS and decreasing the burden of diseases from Tuberculosis
Strengthening Health System Effectiveness
The Department will aslo put special measures in place to ensure the attainment of the
aforemention outcomes. The 5 year strategic plan will serve as a guiding tool towards
managing the identified challenges.
________________________
D. Mafubelu
_______________
Date
Head of Department
Department of Health
6
OFFICIAL SIGN OFF
It is hereby certified that this Annual Performance Plan was developed by the Provincial
Department of Health in Limpopo; was prepared in line with the current strategic plan of the
Department of Health in Limpopo under the guidance of Mme D.P Magadzi, the Member of
Executive Council for Health and Social Development; and accurately reflects the performance
targets which the Provincial Department of Health in Limpopo will endeavour to achieve given
the resources made available in the budget for 2011/12 budget year.
MR P.F. MUSHWANA
...........................................................
Name: Chief Financial Officer
Signature
MR K.R. MASHABA
…………………………………..
Name: Head of strategic planning
Signature
MS D. MAFUBELU
...........................................................
Name: Accounting Officer
Signature
APPROVED BY:
MME D.P MAGADZI
...........................................................
Name: Member of the Executive Council
Signature
7
1. PART A: STRATEGIC OVERVIEW
1.1 VISION, MISSION AND VALUES
1.1.1 Vision
An optimal and sustainable health care service in Limpopo
1.1.2 Mission
The provision and promotion of a comprehensive, accessible and affordable quality health care
service to improve the life expectancy of the people
1.2.3 Values and Ethics
The Department adheres to the following values and ethics that uphold the Constitution of the
Republic of South Africa:









Caring and professionalism;
Honesty and integrity;
Fairness and equity;
Respect and dignity;
Efficiency and effectiveness;
Teamwork and partnership;
Patriotism;
Transparency; and
Innovation and quality.
1.2 STRATEGIC GOALS
The strategic goals of the Department as reflected in the five year strategic plan are indicated below:
Strategic goal
Goal statement
Rationale
Expected outcomes
1. Effective corporate
governance provided
Ensure an effective
corporate governance
system by 2014
Support the
implementation of the
Departmental plans
and programs to
improve service
delivery
Improved quality of
health services by
2014
2. Appropriate human
resources
management and
development
provided
Ensure appropriate HRM and A need to optimize the Improved realization
development services by
realization of the
of the Department’s
2014
strategic objectives of objectives
the Department
through human
resource
management and
development services
8
Strategic goal
Goal statement
Rationale
Expected outcomes
3. Sound financial
management
practice promoted
Ensure efficient and effective
financial and supply chain
management by 2014
A need to ensure
fiscal discipline and
optimisation of
resource allocation
Improved
accountability on
financial resources
resulting in wellfunded and managed
health services
4. Implementation of
comprehensive care
and management of
HIV and AIDS,TB,
STIs and other
communicable and
non communicable
diseases accelerated
Develop and implement
plans for the provincial
priority programs by 2014
A need to reduce
morbidity and
mortality related to the
burden of diseases
Reduced morbidity
and mortality
5. Strengthen district
health and hospital
services
Implement 80% of DHS
components in all districts
and sustainable outreach
programme at all levels of
care by 2014
A need to ensure
equitable access to
health care services
Improved access to
health services
6. Improve quality of
health care
Implement quality
improvement plans in the
districts and hospitals by
2014
Improve client
satisfaction and
clinical outcomes
Reduced morbidity
and mortality in the
province
Improved client
satisfaction and
patient safety
7. Improve Emergency
Medical Services
Ensure that 90% of EMS
calls are responded to within
national norm of 15 minutes
in rural areas and 40 minutes
in urban areas by 2014
A need to respond to
calls within the norm
in order to save lives
Reduce morbidity and
mortality
8. Tertiary services
developed
Tertiary/academic services
increased from 22 to 37 in
line with the Modernisation of
Tertiary Services Document
Improved and
increased access to
tertiary services in the
province
Developed teaching
platform in the
province
Reduced referrals to
other provinces
Increased access to
tertiary services
9. Improve
infrastructure
development and
maintenance
Implement a reviewed 5 year
infrastructure development
and maintenance plan by
2014
Health services provided in
accessible, safe and
maintained buildings
Health service
delivery needs for
additional
infrastructure
expansion
Improved access and
quality of health
services
9
1.3 SITUATIONAL ANALYSIS
1.3.1 POPULATION PROFILE
The Province of Limpopo is situated in the north of the Republic of South Africa. It shares borders
with the provinces of Gauteng, Mpumalanga and North West. It also shares borders with the
Republics of Mozambique in the east, Zimbabwe in the north and Botswana in the west. The province
covers an area of 123 910 km2 with an estimated population of 5.23 million.
With 5.23 million people, Limpopo accounts for 10.6% of the population in the Republic of South
Africa which is estimated at 49, 3 million. This makes Limpopo the fourth most populated province in
the country after Gauteng, KwaZulu-Natal, and Eastern Cape respectively (Stats SA, 2009). The
population of Limpopo is youthful with 35.7% (2, 5 million) being children under the age of 15 years.
Close to six out of ten people (59.6% or 3,1million) are economically active (15 – 64 years) while
elderly people are in the minority making up 4.7% of the province’s population. Females constitute
the majority, making up 52.3% (2, 73 million) of the province’s population. The age and gender
scenario described above is depicted in Figure 1 below.
Figure 1.
Age – gender structure for Limpopo
80+
75-79
70-74
Male
Female
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
-8.00
-6.00
-4.00
-2.00
0.00
2.00
4.00
6.00
8.00
Percent
From a district perspective, Limpopo consists of five districts as indicated in Table 1. The province’s
population is unevenly distributed among the districts, with 47.4% of the population concentrated in
Vhembe and Capricorn Districts. Noteworthy however, is the change in the population distribution
where Vhembe District is no longer the most populated District in the province. As indicated in Table
10
1, proportionally more people are currently found in Capricorn District than in Vhembe District. The
2009 population estimates highlight migration as a key demographic process in the explanation of the
current population distribution in Limpopo. When it comes to gender structure, districts generally
emulate the provincial picture – females outnumbering males - with the exception of Waterberg
District where males slightly outnumber the females (50.4%).
TABLE 1.
District
ESTIMATED POPULATION FOR LIMPOPO BY DISTRICT AND GENDER, 2009
Male
Female
Total
population
estimate
Percentage share of
the provincial
population
Capricorn
595 369
645 199
1 240 569
23.73
Vhembe
582 122
655 203
1 237 324
23.67
Waterberg
299 798
295 193
594 991
11.38
Mopani
510 695
555 629
1 066 324
20.40
Sekhukhune
507 116
580 876
1 087 992
20.81
Total
2 495 100
2 732 100
5 227 200
100.0
1.3.2 SOCIO-ECONOMIC PROFILE OF LIMPOPO
Approximately 80% of the population in Limpopo is rural based. This situation greatly impacts on the
population’s capacity to acquire education – particularly tertiary education - which in turn influences
the potential for employment in the formal economic sector. Available information shows that one in
three people (33.4%) aged 20 and older has had no formal education. The highest percentage of
people in this category (39%) is found in Vhembe District, while Capricorn District has the lowest
percentage (9%). According to the Department of Health and Social Development (2005) at least two
thirds (67.6%) of the population aged 20 and older with no formal education are women. Statistics
South Africa (2007) shows a significant decrease at national level in the percentage of the population
aged 20 and older with no schooling. It is reported that the percentage of people aged 20 and older
with no schooling dropped from 17.9% in 2001 to 10.3% in 2007. In 2007, 9.1% of the people aged
20 and older had completed higher education, as compared with 8.4% in 2001. While these are
national figures and, variations are invariably expected at provincial level, the expectation is that the
changes reflected at national level are mirrored at provincial level, Limpopo included.
The rate of unemployment plays a key role in depicting the employment status of the labour force in
South Africa and, to a fair extent, the functioning of the economy at large. Statistics South Africa
(Stats SA hereafter) conducts labour force surveys on a quarterly basis in an attempt at tracking
employment and unemployment patterns in the country. Results of the 2010 second quarter Labour
force survey put the national unemployment rate at 25.3%. From a provincial perspective the rate of
unemployment in Limpopo was estimated at 22.6% during the same reference period. This portrays
Limpopo as the third province in the country with the lowest unemployment rate after Western Cape
(21.8%) and KwaZulu - Natal (20.8%).
11
1.3.3 EPIDEMIOLOGICAL PROFILE/BURDEN OF DISEASES
Notifiable medical conditions
There were a few outbreaks of communicable diseases and severe emerging infectious diseases,
particularly severe acute watery diarrhoea’s (cholera) and more recently H1N1 influenza. Limpopo
reported a total of 4 634 cholera cases with 30 laboratory confirmed deaths (case fatality rate of
0.65%) from 15th November 2008 to 01 June 2009. The majority of the cases were females which
accounted for 51% (2 667) whilst children less than five years of age accounted for 14.2% (652).
Human rabies is the most fatal disease in Limpopo as it has a case fatality of 100%. Most dog bites
and confirmed human rabies cases are reported in Vhembe District. The incidence of confirmed
human rabies in Limpopo has decreased from 22 in 2006, to two in 2007, two in 2008, and one in
2009. A total of 7122 animal bites were reported from health facilities in Limpopo for the financial year
2008/2009. The large proportion of cases were reported from Vhembe (75%), followed by Mopani
(15.9%), and Capricorn (5.6%). The least number of cases were reported from Sekhukhune (2.1%)
and Waterberg (1.4%) districts.
Although malaria cases have showed a gradual decline over the past 10 years, the malaria case
fatality rate remains above the National Target of 0.5 %. Seasonal malaria increases are also
experienced during the malaria season, with upsurges experienced during the 2010/2011 financial
year.
Figure 1: Limpopo Malaria cases & case fatality rate (Cfr) 1999/2000-2010/11
Malaria Cases & Cfr per Financial Year:
Limpopo: 1999/2000 to 2010/11
12000
1.8
1.6
10000
8000
1.2
1
6000
0.8
4000
0.6
0.4
2000
0.2
0
0
Case fatality rate
12
Trendline of cases
2010/11
Financial Year
2009/10
2008/09
2007/08
2006/07
2005/06
2004/05
2003/04
2002/03
2001/02
2000/01
1999/00
Financial Year
Case Fatality Rate
# of cases
1.4
HIV and AIDS
The prevalence of HIV in South Africa has been consistently monitored through the use of the
sentinel surveillance data. This data relates to pregnant women aged 15-49 who seek antenatal care
services in public health clinics. The 2009 national prevalence rate is 29.4%. The prevalence of HIV
varies considerably at provincial level with KwaZulu Natal registering the highest prevalence of 39.5%
in 2009 and Western Cape is the lowest hit province with prevalence of 16.9%. Limpopo has been
the third lowest province since 1990 and currently with the prevalence of 21.4%
Figure 2 below compares the National HIV prevalence trend with the situation in Limpopo.
Figure 2: HIV sero- prevalence by province – 2007 - 2009
45
%
Preva
lence
40
35
30
25
20
15
10
5
0
EC
FS
GP
KZN
LP
MP
NC
NW
WC
SA
2007
28.8
31.5
30.5
38.7
20.4
34.6
16.5
30.6
15.3
29.4
2008
27.6
32.9
29.9
38.7
20.7
35.5
16.2
31
16.1
29.3
2009
28
30.9
29.7
39.5
21.4
34.6
17.7
29.9
16.9
29.4
Province
2007
2008
2009
Source: National Department of Health, 2010
Nationally, the prevalence among women in the age group 30-34 years remains the highest with
increase from 39.6% in 2007 t0 41.5% in 2009. There is a slight decrease in HIV prevalence in the
age group 15-19 years by 0.4% from 14.1% in 2008 to 13.7% in 2009. (National Department of
Health, 2010: 3)
13
Figure 3. Limpopo HIV prevalence Trends 1990-2009
25
21.5
19.3
21.4
20.6 20.4
20.7
17.5
20
15.6
14.5
%Prevalence
13.2
15
11.5
11.4
8.2
10
8
4.9
5
1.1
0.3
1.8
3
0.5
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Source: National Department of Health, 2010
The prevalence of HIV varies among districts in Limpopo and this is not a unique feature for this
particular province. Figure 4 below shows the prevalence of HIV by district in Limpopo during the
period 2006 -2010. The information in Figure 4 shows the prevalence varies not only between
districts but also within districts over time. Generally HIV prevalence is higher in Waterberg and
Mopani districts than in the remaining three districts, with Vhembe district registering the lowest
prevalence since 1990.
Figure 4. HIV prevalence among antenatal women by district in Limpopo, 2006 to 2009
35
30
% Prevalence
25
20
15
10
5
0
Capricorn
Mopani
Sekhukhune
Vhembe
Waterberg
Limpopo
Province
19.8
23.8
21.3
15.1
25.4
20.4
2008
21
25.2
21.8
14.7
23.6
20.7
2009
23.8
26.2
16.6
14.3
28.8
21.4
2007
Districts
2007
2008
Source: National Department of Health, 2010
14
2009
1.4 PROVINCIAL SERVICE DELIVERY ENVIRONMENT
1.4.1 OVERVIEW OF THE SUCCESSES AND CHALLENGES IN SERVICE DELIVERY AND HEALTH
OUTCOMES FOR THE PREVIOUS FINANCIAL YEAR
The Department has continued to implement strategies to achieve the objectives for the 2010/11
financial year.
The Department successfully implemented the Occupational Specific Dispensation (OSD) for Medical
doctors, dentists, pharmacists and EMS personnel, in the 2009/10 financial year. Two hundred and
fifty new bursaries were awarded to health professionals and 16 to medical students studying in
Cuba. However, the Department still experience a challenge of shortage of nurses.
In order to improve quality of care, the Department has conducted performance assessments of
hospitals to evaluate compliance to National Core Standards. One hundred and ten health facilities
were assessed in terms of National Core Standards by December 2010.
The Department continued to provide universal access to primary health care services.

The PHC utilisation rate has increased from 2.7 in 2008/08 to 2.9 in 2009/10 despite patients
bypassing clinics to hospitals;

Despite the increase of clinics providing a full package of PHC services from 349 in 2008/09 to
360 by December 2010 in 2009/10, the Department still experience challenges of shortage of
nurses, doctors and allied health professionals visiting clinics; and

Only Seventeen of the thirty district hospitals managed to visit clinics weekly in 2010/11.
The Department made a significant improvement in the provision of access to ARV. The number of
health facilities accredited for ARV treatment increased from 80 in 2009/10 to 345 sites in quarter
three of 2010/11 with more than 85 000 registered ART patients receiving antiretroviral therapy in
2010/11 financial year.
TB cure rate remains a challenge despite an increase from 61.7% in 2008/09 to 67% in the 2009/10
financial year. However patients with DOT support increased from 80.5% in 2008/09 to 85% by
December 2010. The Department continues to successfully manage MDR TB and XDR TB.
The PHC facilities with 60% IMCI saturation increased from 374 in 2009/10 to 411 in December
2010. Furthermore, all districts are providing school health services with 457 greenery projects
established.
Despite the implementation of Emergency Medical Services (EMS) expansion and optimisation plan,
EMS response times remain a challenge.
Inadequate IT infrastructure hampers successful implementation of telemedicine services
The Department continues to experience insufficient supply of medicines by some the suppliers.
The Department managed to complete two malaria facilities, two emergency medical services
stations, two forensic pathology facilities 157 staff accommodation units in the 2009/10 financial year.
The revitalisation of health facilities continues with two hospital revitalisation projects having been
completed at Jane Furse and Lebowakgomo hospitals in the 2009/10 financial year. Furthermore,
seven new clinics were completed and 11 upgraded.
15
Key Challenges
•
•
•
•
•
•
•
•
•
•
Shortage of health professionals;
Reaching equity target for People with Disabilities;
Poor quality of care – e.g. long queues, low EMS response times, bad staff attitude, inadequate
infection control, cleanliness, safety of staff and patients;
Infant and maternal mortality remain a challenge;
Increased burden of diseases such as non communicable diseases (cancer, hypertension etc.)
which pose a threat to the health status of the people;
Inadequate pharmaceutical supplies (inability of contracted suppliers to deliver);
Inappropriate referral system;
Inadequate and inappropriate health infrastructure;
Incomplete Health Information System; and
Poor audit outcomes for both financial and performance information.
TABLE 2.
TRENDS IN KEY PROVINCIAL SERVICE VOLUMES
Indicator
2007/08
(actual)
2008/09
(actual)
PHC headcount – Total
13.5m
14.4m
15.1m
16m
OPD Headcount - new case not
referred
No
baseline
No
baseline
No
baseline
720 000
Separations District Hospitals
253 792
332748
264 387
259 203
Separations Regional Hospitals
53 952
75 292
71 461
56 252
Separations Tertiary/ Central
Hospitals
40 324
40 775
39 281
40 572
16
2009/10
(actual)
20010/11
(estimate)
1.4.2 REVIEW OF PROGRESS TOWARDS THE MILLENNIUM DEVELOPMENT GOALS (MDGS)
The Department will accelerate progress towards the MDGs through implementation of activities as reflected below.
TABLE 3.
PROGRESS ON MILLENNIUM DEVELOPMENT GOALS
MDGs
Goal 1:
Eradicate Extreme
Poverty And Hunger
Goal 4:
Reduce Child
Mortality
Goal 5:
Improve Maternal
Health
Target
Halve, between 1990
and 2015, the
proportion of people
who suffer from hunger
Reduce by two-thirds,
between 1990 and
2015, the under-five
mortality rate
Indicator
Limpopo progress in
2004-2009
Source of data
Limpopo required
progress by 2015
Prevalence of underweight
in children (under 5 years
of age)
14.2%
South Africa
Demographic and Health
Survey (SADHS) 2003
7.1%
Incidence of severe
malnutrition in children
(under 5 years of age)
(Wasting)
3.8%
South Africa
Demographic and Health
Survey (SADHS) 2003
2%
Under-five mortality rate
43.9 per 1000 live births
South Africa
Demographic and Health
Survey (SADHS) 2003
40.9 per 1 000 live births
Infant mortality rate
34.1 per 1000 live births
SADHS 2003
31.1 per 1000 live births
Proportion of children under
1yr immunized against
Measles
83.5%
(109566 of 131217)
District Health Information
System (DHIS), 2009
90%
182.9 per 100 000 live
births
Saving Mothers report
2007
136.5 per 100 000 live
births
87.6%
SADHS 2003
95%
Reduce by threeMaternal mortality ratio
quarters, between 1990
and 2015, the maternal
Proportion of births attended
mortality rate
by skilled health personnel
17
MDGs
Target
Achieve, by 2015,
universal access to
reproductive health
Goal 6: Combat HIV
and AIDS, malaria
and other diseases
Have halted by 2015,
and begin to reverse
the spread of HIV and
AIDS, TB, malaria and
other major diseases
Indicator
Limpopo progress in
2004-2009
Source of data
Limpopo required
progress by 2015
Contraceptive prevalence
rate
58.6%
SADHS 2003
66%
Adolescent birth rate
16.8%
DHIS 2007/08
9.4%
Antenatal care coverage
93.4%
DHIS 2007/08
98%
Cervical cancer screening
coverage
16.7%
NHLS
70%
HIV prevalence among 15
to 24 year-old pregnant
women
31.9%
National HIV and Syphilis
Prevalence Survey of
South Africa 2007
15%
Proportion of tuberculosis
cases detected and cured
under directly observed
treatment, short-course
(DOTS)
85%
Electronic TB register
92%
Malaria case fatality rate
1%
Limpopo Malaria
information register
0.6%
18
1.4.3 NATIONAL HEALTH SYSTEMS (NHS) PRIORITIES FOR 2009-2014: THE 10 POINT PLAN
TABLE 4.
NATIONAL HEALTH SYSTEMS PRIORITIES FOR 2009-2014 (THE 10 POINT PLAN)
PRIORITY
KEY ACTIVITIES
1. Provision of Strategic leadership and
creation of Social compact for better
health outcomes

Ensure unified action across the health sector in pursuit of common goals

Mobilize leadership structures of society and communities

Communicate to promote policy and buy in to support government programs

Review of policies to achieve goals

Impact assessment and program evaluation

Development of a social compact

Grassroots mobilization campaign
2. Implementation of National Health
Insurance (NHI)

Finalisation of NHI policies and implementation plan

Immediate implementation of steps to prepare for the introduction of the NHI, e.g. Budgeting, Initiation of
the drafting of legislation
3. Improving the Quality of Health
Services

Focus on 18 Health districts

Refine and scale up the detailed plan on the improvement of Quality of services and directing its immediate
implementation

Consolidate and expand the implementation of the Health Facilities Improvement Plans

Establish a National Quality Management and Accreditation Body


Identify existing constitutional and legal provisions to unify the public health service;
Draft proposals for legal and constitutional reform

Development of a decentralised operational model, including new governance arrangements

Training managers in leadership, management and governance

Decentralization of management

Development of an accountability framework for the public and private sectors
4. Overhauling the health care system
and improving its management
19
PRIORITY
KEY ACTIVITIES
5. Improved Human Resources
Planning Development and
Management

Refinement of the HR plan for health

Re-opening of nursing schools and colleges

Recruitment and retention of professionals, including urgent collaboration with countries that have excess
of these professionals

Specify staff shortages and training targets for the next 5 years

Make an assessment of and also review the role of the Health Professional Training and Development
Grant (HPTDG) and the National Tertiary Services Grant (NTSG)

Manage the coherent integration and standardisation of all categories of Community Health Workers

Urgent implementation of refurbishment and preventative maintenance of all health facilities

Submit a progress report on Revitalization

Assess progress on revitalization

Review the funding of the Revitalization program and submit proposals to get the participation of the private
sector to speed up this program


Implementation of PMTCT, Paediatric Treatment guidelines
Implementation of Adult Treatment Guidelines
Urgently strengthen programs against TB, MDR-TB and XDR-TB

Intensify health promotion programs

Strengthen programmes focusing on Maternal, Child and Women’s Health

Place more focus on the programs to attain the Millennium Development Goals (MDGs)

Place more focus on non-communicable diseases and patients’ rights, quality and provide accountability

Complete and submit proposals and a strategy, with the involvement of various stakeholders

Draft plans for the establishment of a State-owned drug manufacturing entity

Commission research to accurately quantify Infant mortality

Commission research into the impact of social determinants of health and nutrition

Support research studies to promote indigenous knowledge systems and the use of appropriate traditional
medicines
6. Revitalization of infrastructure
7. Accelerated implementation of the
HIV and AIDS strategic plan and the
increased focus on TB and other
communicable diseases
8. Mass mobilisation for the better
health for the population
9. Review of drug policy:
10. Strengthening
Development
Research
and

20
1.4.4 PROVINCIAL CONTRIBUTION TOWARDS THE HEALTH SECTOR NEGOTIATED SERVICE DELIVERY AGREEMENT (NSDA)
TABLE 5. PROVINCIAL CONTRIBUTION TOWARDS THE ACHIEVEMENT OF THE FOUR NSDA OUTPUTS
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
OUTPUT 1: INCREASING LIFE EXPECTANCY
Reduce malaria incidence and Case
Fatality Rate
Implement programme for Prevention
and treatment of Chronic Disease of
Lifestyle

Indoor residual spraying of 85% structures targeted for
spraying in Malaria high risk areas Surveillance
systems with epidemic thresholds & response in place

Training of all health care providers on early diagnosis
& treatment of malaria cases, including management
of severe and complicated malaria

Increased health promotion on prevention & treatment
of malaria

Regional (cross-border) malaria control support

Strengthen community mobilisation

Implement hypertension and diabetes care model at
PHC facilities
21

990,000 structures to be sprayed

Malaria Case Fatality Rate at 0.6%

Hypertension incidence rate reduced
by 1%

Diabetes incidence rate reduced by 1%
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
OUTPUT 2: DECREASING MATERNAL AND CHILD MORTALITY
Improve access to maternal and child
health services
Increase the percentage of pregnant
women who book for antenatal care
before 13 weeks gestation from
16.6% to 35%

Implementation of the recommendations of Saving
Mothers report

Delivery rate in health facilities to be
increased to 95% by 2014

Implementation of programmes on sexual and
reproductive health

Health facility maternal mortality rate to
be reduced to 136,5/100 000 live births

Couple year protection rate to be
increased to 60% by 2014

Implementation of integrated management of
childhood illnesses (IMCI)

Reduce diarrhoea incidence for under 5
years per 1000 population to 160 by 2014

Implementation of Limpopo initiative newborn care


Implementation of the recommendations of Saving
babies report
To reduce pneumonia incidence for under
5 years per 1000 population to 56 by
2014

Provide routine immunizations against childhood
vaccine preventable diseases

Public Health facility mortality rate for
children <5 to be reduced to 8/1000 live
births

Public Health facility mortality rate for
children <1 to be reduced to 11,4/1000
live births

90% immunisation coverage for
children under one year

Antenatal care before 13 weeks
coverage to increase to 35% by 2014

Community mobilisation
22
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
Reduce mortality in HIV positive
children and pregnant women

Mainstream HCT to all programmes targeting children
and pregnant women

100% of pregnant women to receive
HCT

Provide lifelong ART to women who tested positive
and have a CD4 count of <350

100% of pregnant to receive lifelong
ART

Initiate ART to HIV positive children 1 year and below
regardless of CD4 count

100% of children to receive lifelong
ART

Provide cervical screening to women who tested
positive on annual basis

70% of cervical cancer coverage
Increase the percentage of schools
which are visited by a School Health
Nurse at least once a year
Conduct health screening of Grade R and 1 learners
especially for eyes, ears and teeth
100% of primary schools to receive phase I
school health services
OUTPUT 3: COMBATING HIV AND AIDS AND DECREASING THE BURDEN OF DISEASE FROM TUBERCULOSIS

ART expansion programme


Initiate people with HIV and AIDS
and Tuberculosis (TB )comorbidity at CD4 count of ≤ 350
on ART
Initiate lifelong ART to eligible co infected HIV/TB patients
100% of HIV/TB co-infected patients
initiated on lifelong ART
Initiate infants with HIV PCR positive on lifelong ART
98% of infants with HIV PCR positive
initiated on lifelong ART
Provide HCT to all client attending health facilities
95% HIV testing rate
Scale up access to HIV Counselling
& Testing (HCT)
Increase access to ART
Total number of patients ( adults and
children) on ART to increase from 85 000
to 247 456 by 2014
23
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
Reduce the number of TB patients
who develop MDR-TB
Implement National TB management guidelines
Reduce TB patients with MDR-TB to 2%
Reduce the TB incidence

Community mobilisation

Strengthen inter-departmental and inter-sectoral
coordination for TB Control
Improved TB Cure rate
Implement National TB management guidelines
Reduce the defaulter rate for new
smear positive Pulmonary TB cases
Reduce TB incidence rate to 110 per
100 000
Improve the cure rate from 67% to 85%
Reduce the defaulter rate from 8.1% to
<5%
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Revitalisation of Primary Health care
Increased access to PHC services

Provision of 24hrs Services in all health centres

Provision of on call service in all PHC facilities

27 Health centres providing 24 hour
services

416 clinics to provide an on call service
Improve quality of care
Implement the primary health care package

100% of PHC facilities implementing
75% of primary health care package
Improve utilisation rate

Community mobilization


Marketing of PHC services
PHC utilisation rate to increase from 2.9
to 3.5
24
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Health Care financing and Management
Plan for the implementation of the
NHI
Improved health care financing and
management systems
Readiness strategy on NHI implementation developed
Implement readiness strategy on NHI in
health facilities
Implement best practices in line with legislative prescripts
and guidelines
Unqualified financial audit opinion
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Human Resources for Health
Improve access to human resources
for health
Review the departmental HR Plan in line with the National
Human Resource Plan 2014/15

HR Plan, which reflects an appropriate
skills mix between health professionals
produced
Reduction of vacancy rate
Implement Departmental recruitment and selection
strategy

Vacancy rate of the following categories
reduced to:
-Medical Specialists- 59%
-Medical Officers- 11%
-Professional Nurses- 28%
-Pharmacists- 5%
Strengthen clinical training

Implement HRD Strategy Vision 2015


Implement Departmental Bursary Policy


25
3331 participants appointed in the
learnerships programme
1000 professional nurses category
trained
1 880 bursaries on various health
professionals awarded
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Quality of Health and the Accreditation of Health Establishments
Improve patient care and the
satisfaction levels of the users of the
health care system
Accreditation of Health facilities
Increase resolved complaints in all
the institutions to improve quality of
service

Commission provincial research study to conduct
annual Patient Satisfaction surveys


Strengthen M & E in health facilities
Prepare facilities for accreditation

Establish provincial functional call centre

Develop integrated complaints database

Implement standardised complaint mechanism
90% users of public health services
satisfied with the service received
(client satisfaction rate)
20% Percentage of health facilities
accredited annually
100% of complaints resolved within 25
days
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Health Infrastructure
Develop, upgrade and maintain
Health facilities
Primary Health Care (PHC) Facilities
Implement PHC facilities upgrade programme
Malaria Facilities
77 PHC facilities completed
Implement malaria facilities improvement programme
15 Malaria facilities completed
Hospital Revitalization Program

Limpopo Academic Hospital – National Flagship Option appraisal report
Project:
o Peer Review Processes
o PPP Feasibility Study Report
26
Provincial Priorities for 2011/ 12
Planned Provincial Strategies and activities
Target (Required provincial performance
by 2014/15
Construction of revitalisation projects
Infrastructure maintenance
6 hospitals completed
100% health facilities complying with
maintenance contracts
OUTPUT 4: STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
Information, Communication and Technology and Health Information Systems
Provincial Priorities for
Planned Provincial Strategies and activities
2011/ 12

Effective and efficient Knowledge,
records, Information
Management Systems and
Technologies (KRIMST) strategy
and policy
Target (Required provincial performance
by 2014/15




Develop and implement ICT Strategy and Policy
Develop and implement Knowledge and Information
Management Strategy and Policy
Develop and implement Records Management
Strategy and Policy




PHIS Clinical Modules
Implemented

Telemedicine Implemented
District Health Information System
(DHIS) enhanced, maintained and
supported

Implementation of all outstanding modules of PHIS
including the clinical modules


Fifteen (19 new) telemedicine ( infrastructure) sites
implemented


Data quality assessments in all health facilities
Implementation of the revised National indicator Data
Set (NIDS)



27
All facilities implementing ICT Strategy
and policy
All facilities implementing Knowledge
and Information
All facilities implementing Management
Strategy and Policy
All facilities implementing Records
Management Strategy and Policy
PHIS fully implemented in all hospitals,
clinics, medical centres and the
pharmaceutical depot
All Hospitals and PHC facilities, nursing
colleges with telemedicine infrastructure
All health facilities assessed for data
quality in terms of South African
statistics quality assurance framework
(SASAQAF)
All facilities implementing the revised
NIDS
1.5 PROVINCIAL ORGANISATIONAL ENVIRONMENT
The Department reviewed and approved the organogram that provides for adequate capacity of senior
management at head office level focusing on strategic direction and leadership, policy development,
monitoring and evaluation and institutional performance to improve service delivery. The district
organograms were also reviewed and approved with a view to creating appropriate management
capacity to strengthen district health services.
The Department strove to redress imbalances identified in the previous organisational structures in order
to maximise benefits of structuring and strengthening service delivery provision at all implementation
levels.
The Department continued to strengthen the recruitment and retention strategy for health professionals
through international and regional collaboration on recruitment and training of medical practitioners and
implementation of OSD for doctors and allied. This move has made it possible for the department to
realize an increase in the workforce of Doctors from 876 in 2006 March to 1098 March in 2010. This
shows an overall increase of 25.3% for Doctors. Nursing personnel had an increase of 15.8 % (from
12469 in 2006 March to 14442) while Pharmacists increased with 56.5% (from 170 in 2006 March to 266
in 2010 March).
It is important to note that there has been a 71% decrease in resignations by personnel at the critical
occupations levels
28
TABLE 6. PUBLIC HEALTH PERSONNEL IN 2009/10
Categories
Number
employed
% of total
employed
Number per
100,000
people
Number per
100,000
uninsured
people2
Vacancy
rate5
% of total
personnel
budget
Annual cost
per staff
member
Medical officers3
923
5.0%
18
18
64.6%
13.0%
374747
Medical specialists
83
0.5%
2
2
79.4 %
26.4%
759083
92
5.0%
2
2
67.5%
12.8%
369183
Professional nurses
7144
38.4%
136
136
48.4%
7.0%
200979
Enrolled Nurses
2782
15.0%
53
53
51.2%
3.3%
95129
Enrolled Nursing Auxiliaries
4516
24.27%
86
86
35.7%
2.6%
74017
Student nurses
770
4.14%
15
15
-
2.2%
62013
266
1.43%
5
5
52.4%
9.2%
264803
Physiotherapists
108
0.58%
2
2
67.4%
4.3%
122466
Occupational therapists
88
0.47%
2
2
72.8%
4.4%
126661
Radiographers
115
0.62%
2
2
68.8%
5.2%
149141
Emergency medical staff
1456
7.8%
28
28
51%
3.2%
92212
Dieticians/ Nutritionists
131
0.7%
3
3
60.9%
5.1%
146859
Community Care-Givers (even 131
though not part of the PDoH
staff establishment)
0.7%
3
3
-
1.3%
36000
Total
100
-
-
-
100
2873293
Dentists
3
Pharmacists
3
18775
Data Source: This table comprises of provincial health personnel. Populations are those of resident people; Interns and community service health
professionals have been included.
2011/12-2013/14 Annual Performance Plan Vote 7
29
1.6 LEGISLATIVE AND OTHER MANDATES
1.6.1 NEW LEGAL AND POLICY MANDATES

Green paper on national planning as amended by notice 101 of 2010

Improving government performance: Our approach
1.6.2 RELEVANT COURT RULINGS
Court rulings that might impact on the Department’s capacity to deliver services did not exist at
the time of the drafting of the Annual Performance Plan.
1.6.3 PLANNED POLICY INITIATIVES




Information & communication technology policy
Information, records and knowledge management policy
Communication policy
Security policy
1.7 OVERVIEW OF THE 2009/10 BUDGET AND MTEF ESTIMATES
The Department was allocated an amount of R9.3 billion in the 2009/10 financial year to deliver the
health services in the Limpopo. A total amount of R9 billion was spent which represent 96.4% of
the allocated budget.
The overall health budget increased from R6.1billion in 2007/8 financial year to R9.3 billion in
2009/10. This indicates an accumulative growth of 52% or R3.2 billion over the last three years.
The Provincial funding criteria for Health vote has also improved from 24% in 2007/8 to 26% in
2009/10 of the Provincial equitable share budget.
The budget grows from R9.3 billion in 2009/10 to R11.6 billion in the year ending 2012/13.This
represents a cumulative growth of 25.8% or R2.3 billion. The budget is used to continue funding
the strategic goals and strategic focus of the Department as per mandates.
Despite the above mentioned budget growth, the Department still experience the funding
gap in the following areas and is currently reviewing the resources trends through its
Service Transformation Plan.

Filling of critical vacant posts to reduce the vacancy rate.

Funding of the HIV and AIDS programme resulting from the new treatment guidelines as
pronounced by the President of the Republic, and

Infrastructure development and maintenance of existing infrastructure and equipment.
2011/12-2013/14 Annual Performance Plan Vote 7
30
1.7.1 EXPENDITURE ESTIMATES
TABLE 7.
EXPENDITURE ESTIMATES
Programme
R’000
2007/08
Administration
Main
Adjusted
appropriation appropriation
Audited Outcomes
2008/09
2009/10
Revised
estimate
2010/11
Medium term expenditure estimate
2011/12
2012/13
2013/14
160,618
190,641
202,314
270,721
260,721
260,721
272,902
281,733
302,562
3,303,974
4,198,649
4,913,696
5,553,689
5,644,961
5,644,961
5,987,686
6,308,530
6,846,904
Emergency Medical
Services
196,746
250,650
306,517
399,705
522,386
522,386
593,687
654,949
669,289
Provincial Hospital
Services
884,923
972,895
1,136,988
1,204,028
1,211,096
1,211,096
1,369,512
1,421,091
1,459,008
Central Hospital
Services
559,264
693,031
810,278
944,440
955,650
955,650
1,010,754
1,130,798
1,150,007
Health Sciences and
Training
210,397
325,250
344,117
418,085
400,578
400,578
440,169
453,782
487,490
Health Care Support
Services
391,677
643,479
638,207
799,897
796,904
796,904
839,938
887,531
902,908
Health Facilities
Management
423,322
685,051
666,482
942,978
910,368
790,368
1,071,755
1,044,292
1,112,468
6,130,921
7,959,646
9,018,599
10,533,543
10,533,543
10,413,543
11,240,199
11,658,016
12,240,915
719
843
1421
1,420
1,420
1,420
1,498
1,580
1,667
6,131,640
7,960489
9,020,020
10,534,963
10,704,084
10,584,084
11,587,901
12,184,286
12,932,303
District Health Services
Sub-total
Direct charges against
the National Revenue
Fund
Total
Change to 2010/11
budget estimates
16.7%
This economic classification is the same as the classification in the Department in Budget Statement No. 2.
2011/12-2013/14 Annual Performance Plan Vote 7
31
TABLE 8. SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Audited Outcomes
Economic Classification
2007/08
2008/09
Main
Adjusted
appropriation appropriation
2009/10
Current payments
5,597,245
6,884285 7,986,860
Compensation of
employees
4,044,354 4,692,208
Goods and services
1,452,981 2,182,896 2,392,516
Medium-term estimate
Revised
estimate
2010/11
2011/12
2012/13
2013/14
9,215,823
9,245,547
9,245,547
9,993,921 10,664,440 11,351,345
6,499,398
6,617,370
6,617,370
7,147,605
7,594,252
8,159,375
2,716,425
2,628,177
2,628,177
2,846,316
3,070,188
3,191,970
5,593,767
9,181
577
118,404
287,083
280,945
316,282
409,909
409,909
433,441
440,352
451,842
1
18,111
28,431
40,718
29,535
29,535
43,161
45,319
47,585
Departmental agencies
and accounts
1,1117
2,013
2,452
3,001
7,001
7,001
3,162
3,203
3,363
Non-profit institutions
79,579
113,065
119,654
129,696
230,477
230,477
238,556
229,924
230,894
Households
37,707
153,894
130,408
142,867
142,896
142,896
148,562
161,906
170,001
515,991
789,121
752,215
1,002,858
1,048,628
928,628
1,160,539
1,079,494
1,129,116
Buildings and other fixed
structures
379,371
613,933
595,304
797,794
834,956
714,956
911,198
852,022
892,037
Machinery and equipment
132,582
165,188
153,946
205,064
213,672
213,672
249,341
227,472
237,079
4,038
10,000
2,965
-
-
Financial transactions in
assets and liabilities
Transfers and subsidies
to
Provinces and
municipalities
Payments for capital
assets
Software and other
intangible assets
Total economic
classification
6,131,640 7,960,489 9,020,020
2011/12-2013/14 Annual Performance Plan Vote 7
10,534,963
32
-
-
-
-
10,704,084 10,584,084 11,587,901 12,184,286 12,932,303
1.7.2 RELATING EXPENDITURE TRENDS TO STRATEGIC GOALS
The Department has estimated R11.2 billion in the 2011/12 financial year and average of 6% nominal growth over the Medium Term
Expenditure Framework to realise the following priorities:

Effective corporate governance provided;

Appropriate human resources management and development provided;

Sound financial management practice promoted;

Implementation of comprehensive care and management of HIV and AIDS,TB, STIs and other communicable and non communicable
diseases accelerated;

Strengthen district health and hospital services;

Improve quality of health care;

Improve Emergency Medical Services;

Tertiary services developed; and

Improve infrastructure development and maintenance.
2011/12-2013/14 Annual Performance Plan Vote 7
33
TABLE 9.
Expenditure
Current prices
TRENDS IN PROVINCIAL PUBLIC HEALTH EXPENDITURE (R’000)
2007/08
Audited/actual
2008/09
2009/10
Estimate
2010/11
MTEF projection
2011/12
2012/13
2013/14
1
Total2
Total per person
Total per uninsured person
6,132
7,960
9,020
10,584
1.16
1.09
1.53
1.42
1.77
1.61
2.08
1.88
11,588
2.28
2.06
6,807
8,756
8,569
9,526
9,966
10,478
11,122
1.3
6,289
1.6
8,091
1.6
7,918
1.8
8,802
1.8
9,208
1.9
9,682
2.1
10,276
53.9%
14.4%
9.1%
59.4%
11.2%
19.5%
52.8%
12.2%
8.7%
54.0%
13.7%
21.7%
52.8%
11.8%
8.9%
52.9%
11.0%
22.1%
48.2%
9.8%
8.7%
47.9%
12.2%
24.1%
47.4%
9.4%
8.4%
43.7%
11.1%
25.8%
47.3%
9.4%
8.4%
41.6%
10.6%
26.8%
44.6%
8.9%
7.9%
39.2%
9.9%
27.9%
12,184
2.39
2.17
12,932
2.54
2.30
Constant (2008/09) prices 3
Total2
Total per person
Total per uninsured person
% Of Total spent personon:
DHS
PHS
CHS
All personnel
Capital
Health as a % of total public
expenditure
2011/12-2013/14 Annual Performance Plan Vote 7
34
2. PART B: PROGRAMME AND SUB-PROGRAMME PLANS
2.1 PROGRAMME 1: ADMINISTRATION
2.1.1 PROGRAMME PURPOSE
The purpose of the programme is to provide strategic management and overall administration of the department including rendering of
advisory, secretarial and office support services through the sub programmes of Administration and Office of the MEC.
The Head Office coordinates the work of the department by providing political and legislative interface between government, civil society and
other relevant stakeholders; it provides strategic direction and overall management and administration of the Department.

Providing overall strategic direction;

Allocating resources;

Developing policies, norms and standards, and management systems;

Manage information and records;

Providing monitoring and evaluation;

Liaison and coordination;

Overseeing cross-cutting issues such as gender and disability;

Resolving disputes that could not be dealt with at institutional or district level.
Limpopo’s network of health institutions is managed through the Head Office in Polokwane and five health districts. These districts are
required to:

Co-ordinate health districts, lead and ensure strategic support closer to delivery units;

Act as agents for decentralisation by assessing and building the capacity of healthcare institutions;

Ensure compliance with the overall strategic direction, policies, norms and standards;

Ensure delivery of provincial/ district services;

Liaise and coordinate with relevant organisations in their health districts; and

Manage and oversee the development of district health systems.
2011/12-2013/14 Annual Performance Plan Vote 7
35
The programme implements the priorities through the strategic goals of providing effective corporate governance; providing appropriate
human resources management and development and promotion of sound financial management practice. The strategic objective of providing
security management services has been added and the strategic objectives of establishment and operationalisation of knowledge, records,
information and knowledge management systems and technology have been modified to align with the provincial and national priorities.
2.1.2 PRIORITIES





Improving financial management and control
Implementation of supply chain management system
Implementation of risk management strategy
Implementation of effective and efficient monitoring and evaluation systems
Implementation of knowledge, records, information management systems and technologies
2011/12-2013/14 Annual Performance Plan Vote 7
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2.1.3 SITUATIONAL ANALYSIS AND PROJECTED PERFORMANCE FOR HUMAN RESOURCES
TABLE 10.
SITUATIONAL ANALYSIS AND PROJECTED PERFORMANCE FOR HUMAN RESOURCES
Annual indicators
Type
Data source
PERSAL/
Vulindlela/
Stats SA
population
estimates
Audited/ Actual performance
Estimated
performance
Medium-term targets
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13 2013/14
12
16
16
23
29
36
43
60
123
138
165
189
214
238
3
4
5
6
7
8
9
1. Medical officers per
100,000 people
No
2. Professional nurses per
100,000 people
No
3. Pharmacists per 100,000
people
No
4. Vacancy rate for
professional nurses
%
20
19.5
46.9
36.3
41
37
28
5. Vacancy rate for doctors
%
76
71
67.5
54.4
44
33
22
6. Vacancy rate for medical
specialists
%
81
79
80.2
75.3
71
66
60
7. Vacancy rate for
pharmacists
%
44.7
46
54.2
44.4
27
17
8
NB: This table does not include local government personnel. No district classified as rural in the Province
2011/12-2013/14 Annual Performance Plan Vote 7
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2.1.4 PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR ADMINISTRATION
STRATEGIC GOALS 1: Effective corporate governance provided
TABLE 11.
PROVINCIAL STRATEGIC OBJECTIVES FOR ADMINISTRATION
Strategic
objective
Performance
indicator
Strategic plan Means of
target
verification/
Data source
Implement
effective and
efficient
monitoring
and
evaluation
systems
Number of
performance
monitoring
reviews
conducted
Establish
effective and
efficient
monitoring and
evaluation
(M&E) systems
in the
Department by
2014
Number of
research
studies
conducted
Number of
Health facilities
certificated for
Accreditation
2011/12-2013/14 Annual Performance Plan Vote 7
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
Documented
evidence
4
4
4
4
4
4
4
Documented
evidence
No
baseline
No
baseline
No
baseline
No baseline
3 research
reports
produced
-client
satisfactio
n surveys
-Time flow
studies
-Burden of
diseases
study
commissio
ned
1 research
report
produced
on
Burden of
disease
1
research
report
produced
on
Burden of
disease
Documented
evidence
No
baseline
No
baseline
1
1
121 of 483 121 of 483
38
121 of 483
Strategic
objective
Performance
indicator
Strategic plan Means of
target
verification/
Data source
Provide risk
management
services
Number of
institutions
conducting risk
assessments
Maximise
implementation
of risk
management
strategy in the
Department by
2014
Documented
evidence
25
30
40
Provide
security
management
services
Percentage
compliance of
institutions to
departmental
security
management
plan
Improve
physical and
information
security
measures in the
department by
2014
Documented
evidence
No
baseline
No
baseline
Knowledge,
records,
information
management
systems and
technology
(KRIMST)
established
Knowledge
and
information
management
strategy and
Policy
developed and
implemented
Improve data
quality and
records
management by
2014
Documented
evidence
No
baseline
No
baseline
2011/12-2013/14 Annual Performance Plan Vote 7
Audited/ Actual performance
2007/08
39
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
46
73 of 504
100 of 504
200 of 504
No
baseline
No baseline
483 of 483 483 of 483
80 %
85 %
complianc compliance
e
483 of 483
No
baseline
No baseline
Approved
strategy
and policy
document
s
Reviewed
and
implement
ed
Reviewed
and
implemente
d
90 %
complianc
e
Strategic
objective
and
operational
Performance
indicator
Strategic plan Means of
target
verification/
Data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
Number of
facilities that
meet minimum
requirements
in terms of
National
Archives and
Records
Service Act
Documented
evidence
No
baseline
No
baseline
No
baseline
100/486
Institutions
assessed for
complying to
60% Records
Management
Legislation
40
45
50
Information
Communicatio
n Technology
Strategy and
Policy
developed and
implemented
Documented
evidence
No
baseline
No
baseline
No
baseline
No baseline
Develop
and
implement
ICT
strategy
and Policy
Reviewed
and
implement
Reviewed
and
implement
Number of
Sites with
PHIS fully
implemented
Hospital/
Facility fully
automated
Core
modules
implement
ed in all
hospitals
Core
modules
implement
ed in all
hospitals
Core
modules
implement
ed in all
hospitals
Core
modules
implemented
in all
hospitals
6
180
283
Number of
sites with
Telemedicine
infrastructure
Site
Implementati
on Signed off
No
baseline
No
baseline
No
baseline
10
29
210
(19 new)
(181 new)
381
(171 new)
2011/12-2013/14 Annual Performance Plan Vote 7
40
Strategic
objective
Performance
indicator
Strategic plan Means of
target
verification/
Data source
Number of
facilities that
meet minimum
requirements
for data quality
Provide
effective and
efficient
communicati
on services
Number of
facilities
implementing
Communicatio
n strategy
To improve
communication
services at all
levels by 2014
2011/12-2013/14 Annual Performance Plan Vote 7
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Documented
evidence
No
baseline
No
baseline
84
64
Documented
evidence
No
baseline
No
baseline
No
baseline
52
41
Medium term targets
2011/12
90 new
483 of 483
2012/13
2013/14
122
126
483 of 483
483 of 483
STRATEGIC GOALS 2 & 3: Appropriate human resources management and development provided
Strategic
objective
Provide
human
resource
management
and
development
Performance
indicator
Number of
Medical doctors
and dentists
appointed
Strategic
plan
target
Audited/Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
PERSAL
43
48
91
263
325
341
327
PERSAL
9
8
20
6
20
22
24
Number of
Professional
nurses appointed
PERSAL
152
216
950
187
400
450
500
Number of
Pharmacist
appointed
PERSAL
6
8
32
57
53
52
50
Percentage of
people with
disabilities
employed
PERSAL
0.5%
(166 of
30250)
0.5%
(166 of
30250)
0.5%
(302 of
30250)
1.5%
(453 of 30250)
2%
(776 of
38833)
2%
(955 of
47793)
2%
(1044 of
52249)
Number of
Medical
Specialists
appointed
Enhance
human
resource
availability
by 2014
Means of
verification/
Data source
2011/12-2013/14 Annual Performance Plan Vote 7
42
STRATEGIC GOALS 3: Sound financial management practice promoted
Strategic
objective
Provision of
efficient and
effective
supply chain
management
system
Performance
indicator
Percentage of
bids awarded
to Historically
disadvantaged
individual (HDI)
Strategic
plan target
Means of
verification/
Data source
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
97%
77%
66%
70%
80%
80%
80%
44%
40%
29%
30%
50%
50%
50%
Percentage of
bids awarded
to disabled
4%
1%
1%
1%
1%
1%
2%
Percentage of
bids awarded
to Youths
22%
24%
13%
15%
35%
35%
35%
Percentage of
bids awarded
to small
medium and
micro
enterprises
(SMMEs)
65%
74%
52%
60%
58%
60%
60%
No baseline
45%
(49 of 54)
96%
(52 of 54)
100%
(58)
100%
(58)
100%
(58)
100%
(58)
Percentage of
bids awarded
to women
Optimally
Documented
implement
evidence
supply chain
managemen
t system in
line with the
prescribed
prescripts
by 2014
Audited/Actual performance
Percentage of
institutions with
credible asset
registers
2011/12-2013/14 Annual Performance Plan Vote 7
Documented
evidence
43
Strategic
objective
Provide
efficient and
effective
financial
management
system
Performance
indicator
Revenue
collected
Audit opinion on
financial
management
expressed by
the Auditor
General
Strategic
plan target
Implement
sound
financial
managemen
t system in
line with the
prescribed
prescripts
by 2014
2011/12-2013/14 Annual Performance Plan Vote 7
Means of
verification/
Data source
Audited/Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
BAS
R83 million
R87
million
R111.6
million
R98 million
R107
million
R112
million
R117
million
Auditor
General
report
Qualified
Qualified
Qualified
Unqualified
Unqualifie
d
Unqualified
Unqualifie
d
44
2.1.5 QUARTERLY TARGETS FOR 2011/12 FOR ADMINISTRATION
TABLE 12.
PROVINCIAL QUARTERLY TARGETS FOR 2011/12
Performance indicator
Reporting
period
Annual target 2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Number of performance
monitoring reviews conducted
Quarterly
4
1
1
1
1
Number of research studies
conducted
Annually
2 research reports
produced

client satisfaction
surveys

Time flow studies
2 Research
proposals
developed
Commissioning 2
studies
Data collection
and analysis
phase(2 studies)
2 research reports
produced
1 burden of
diseases study
commissioned
1 burden of diseases
study commissioned
Number of Health facilities
certificated for Accreditation
Annually
121 facilities
certificated for
Accreditation
40 facilities
prepared for
certification for
Accreditation
40 facilities
prepared for
certification for
Accreditation
41 facilities
prepared for
certification for
Accreditation
121 facilities
certificated for
Accreditation
Number of institutions conducting
risk assessments
Quarterly
73 of 504
12
21
20
20
Percentage compliance of
institutions to departmental
security management plan
Quarterly
483 of 483
80 % compliance
121 of 483
142 of 483
362 of 483
483 of 483
80 % compliance
80 % compliance
80 % compliance
80 % compliance
Knowledge and information
management Strategy and Policy
developed and implemented
Quarterly
Approved strategy and
policy documents
First draft
Final draft and
approval
Implementation
Implementation
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Performance indicator
Reporting
period
Annual target 2011/12
Quarterly targets
Q1
Q2
Q3
Q4
10
20
30
40
Final draft and
approval
Implementation
Implementation
Number of Institutions that meet
minimum requirements in terms of
National Archives and Records
Services Act
Quarterly
40
Information Communication
Strategy Technology and Policy
developed and implemented
Quarterly
Develop and implement First draft
ICT strategy and Policy
Number of Sites with PHIS fully
implemented
Annually
6
Project plan
completed
Procurement
phase completed
Infrastructure
deployment
completed
6
Number of sites with
Telemedicine infrastructure
Annually
29 (19 new)
14
14
14
29 (19 new)
Number of facilities that meet
minimum requirements for data
quality
Quarterly
90 new
23 new
22 new
22 new
23 new
Number of facilities implementing
communication strategy
Quarterly
483 of 483
483 of 483
483 of 483
483 of 483
483 of 483
Number of medical doctors and
dentists appointed
Annually
325
236 posts
advertised
40 posts filled
100 posts filled
87 outstanding
posts advertised
185 post filled
Number of Medical Specialists
appointed
Annually
20
All posts
advertised
4 posts filled
8 posts filled
8 posts filled
2011/12-2013/14 Annual Performance Plan Vote 7
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Performance indicator
Number of Professional nurses
appointed
Reporting
period
Annually
Annual target 2011/12
400
Quarterly targets
Q1
Q2
Q3
Q4
All posts
advertised on
open advert
80 posts filled
100 posts filled
160 posts filled
60 posts filled
Number of Pharmacists appointed Annually
53
47 post
advertised on
open advert
10 posts filled
10 posts filled
23 posts filled
Percentage of people with
disabilities employed
Annually
2%
(776 of 38833)
0.6%
(233/38833)
1%
(388/38833)
1.5%
(582/38833)
2%
(776 of 38833)
Percentage of bids awarded to
Historically disadvantaged
individual (HDI)
Annually
80%
80%
80%
80%
80%
Percentage of bids awarded to
women
Annually
50%
50%
50%
50%
50%
Percentage of bids awarded to
disabled
Annually
1%
1%
1%
1%
1%
Percentage of bids awarded to
Youths
Annually
35%
35%
35%
35%
35%
Percentage of bids awarded to
small medium and micro
enterprises (SMMEs)
Annually
58%
58%
58%
58%
58%
Percentage of institutions with
credible asset registers
Quarterly
100% (58)
100% (58)
100% (58)
100% (58)
100% (58)
Revenue collected
Quarterly
R107 million
R11million
R40 million
R16 million
R40 million
2011/12-2013/14 Annual Performance Plan Vote 7
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TABLE 13.
NATIONAL QUARTERLY TARGETS FOR 2011/12
Performance indicator
Reporting period
Annual target
2011/12
Quarterly Targets
Q1
Q2
Q3
Q4
1. Vacancy rate for professional
nurses
Annually
41%
(5462/13473)
43%
(5462/13473)
42%
(5563/13473)
41%
(5563/13473)
41%
(5462/13473)
2. Vacancy rate for doctors
Annually
44%
(1296/2892)
55%
(1591/2892)
53%
50%
(1532/2892)
(1446/2892)
44%
(1296/2892)
71%
(289/404)
82%
81%
80%
(331/404)
(327/404)
(323/404)
27%
(153/559)
39.5%
(221/559)
35.5%
(199/559)
31.8%
(178/559)
3. Vacancy rate for medical
specialists
Annually
4. Vacancy rate for pharmacists
Annually
71%
(289/404)
27%
(153/559)
2.1.6 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 14.
EXPENDITURE ESTIMATES: ADMINISTRATION
Sub-programme
Audited outcome
2007/08
MEC’s Office
Main
appropriation
2008/09 2009/10
719
Adjusted
appropriation
Revised
estimate
2010/11
Medium term expenditure estimates
2011/12
2012/13
2013/14
843
1,421
1,420
1,420
1,420
1,498
1,580
1,667
Management
160,618 190,641
202,314
270,721
260,721
260,721
272,902
281,733
302,562
TOTAL
161,337 191,484
203,735
272,141
262,141
262,141
2011/12-2013/14 Annual Performance Plan Vote 7
48
274,400
283,313
304,229
TABLE 15.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Audited Outcomes
Main
Adjusted
appropriation appropriation
2007/08
2008/09
2009/10
158,037
185,840
198.066
264,261
249,167
Compensation of employees
90,815
119,437
136,123
190,867
Goods and services
67,222
72,661
61,366
9,181
577
1,430
2,372
1,117
Revised
estimate
2011/12
2012/13
2013/14
249,167
263,852
274,775
295,264
171,867
171,867
179,870
188,433
209,044
73,394
77,300
77,300
83,982
86,342
86,220
4,877
3,880
4,094
3,880
4,094
4,249
4,462
2,013
2,452
3,001
7,001
7,001
3,162
3,203
3,363
313
359
2,425
879
1,408
1,408
932
1,046
Payments for capital assets
1,870
2,025
792
4,000
4,565
4,565
6,454
4,289
4,503
Machinery and equipment
1,870
2,025
792
4,000
4,565
4,565
6,454
4,289
4,503
161,337
191,484
203,735
272,141
262,141
262,141
274,400
283,313
304,229
Current payments
Financial transactions in assets
and liabilities
Transfers and subsidies to
2010/11
Medium-term estimate
Provinces and municipalities
Departmental agencies and
accounts
Households
1,099
Software and other intangible
assets
Total economic classification
2011/12-2013/14 Annual Performance Plan Vote 7
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2.1.7 PERFORMANCE AND EXPENDITURE TRENDS
The objective of this Programme is to provide overall strategic management, administration, legislative and communication services through the
MEC’s office. The allocated budget has a direct impact on the achievements of targets in the following ways:

Foster the improvement of financial management and control in the department as a whole, e.g. policies and procedure manuals are developed,
implemented and monitored throughout the department.

Improvement of the effectiveness and efficiency of the supply chain management

Intensify the implementation and monitoring of the risk management strategy throughout the department.
The department has spent a total of R570.7 million in 2007/8 to 2009/10 while the 2010/11 budget amounts to R272.1 million. The proposed MTEF
from 2011/12 to 2013/14 is projected at R956.9 million which will be used to maintain and improve the current services. The funding has therefore
been aligned to the various key strategic focus of the programme.
2.1.8 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme administration and the measures to mitigate the impact of the
risks are indicated below.
Risks
Mitigating factors
Non-integrated monitoring and evaluation
systems
Development of the integrated monitoring and evaluation system
Shortage of health professionals
Awarding of bursaries as a recruitment strategy
Improvement of working environment
Inadequate internal controls
Segregation of functions
Implementation of procedure manuals
Strengthen supervision at all levels
2011/12-2013/14 Annual Performance Plan Vote 7
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2.2 PROGRAMME 2: DISTRICT HEALTH SERVICES
2.2.1 PROGRAMME PURPOSE
The purpose is to render Primary Health Care Services and District Hospital Services through the following sub- programmes.





Primary Health Care Services ( District management, Community Health Clinics, Clinics, Community Based Services, Other community services)
District hospitals;
HIV and AIDS, Sexually Transmitted Infections (STI) and Tuberculosis (TB) Control Programmes;
Mother and Child and Women’s Health (MCWH) and nutrition; and
Disease Prevention and Control
The programme is provided through strategic goals of strengthening district health and hospital services; improving quality of health care;
implementation of comprehensive care and management of HIV and AIDS, TB, STIs and other communicable and non communicable diseases;
accelerated disease prevention and control. The strategic objective of disease prevention and control has been added to align with national and
provincial priorities.
Limpopo has 30 level one hospitals with bed capacity of 5 913 beds. These are spread through the five districts within the province. The ideal
scenario is that there should be at least one district hospital in each sub-district. This is not possible due to a number of reasons including
infrastructure constraints, economies of scale, etc. Thirteen of these hospitals have dedicated TB wards for treatment of TB patients excluding MDRTB.
The general performance of the hospitals range from satisfactory to unsatisfactory for the period between 2007/2008, 2008/2009 and 2009/2010. The
Average Length of Stay (ALOS) was 4.3, 4.2 and 4.3 days, which is within the national norm of 4 days. The Bed Utilisation Rate (BUR) was 64.1,
68.1 and 67.1 from 2007/08 and this is below the national target of 80%. This suggests serious low utilisation of the usable beds. The Patient Day
Equivalence (PDE) has been rising steadily at 1 456 266, 1 490 925 and 1 572 949 from the 2007/08 financial year. A similar steady increase from
2007/08 was noted with OPD total headcount of 1 253 719, 1 395 009 and 1 397 435. Cost per Patient Day Equivalence has been steady at R1 498,
R1 318 and R1375.
2011/12-2013/14 Annual Performance Plan Vote 7
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2.2.2 PRIORITIES






Improve quality of care
Combating HIV and AIDS and decreasing the burden of diseases from Tuberculosis
Increase life expectancy
Increase access to health care services.
Reduce Maternal and Child morbidity and mortality
Strengthening health system effectiveness
2.2.3 SPECIFIC INFORMATION FOR DISTRICT HEALTH SERVICES
STRATEGIC GOALS 5& 6: Strengthen district health and hospital services and Improve quality of health care
TABLE 16.
DISTRICT HEALTH SERVICE FACILITIES BY HEALTH DISTRICT 2009/10
Health district1
Facility type
No.
Population
Population per PHC
facility5 or per hospital
bed
2,5
Waterberg District
Sekhukhune District
Non fixed clinics3
1337
Fixed Clinics4
57
CHCs
1
Sub-total clinics + CHCs
58
District hospitals
7
3
Non fixed clinics
402
Fixed Clinics4
84
CHCs
3
Sub-total clinics + CHCs
87
2011/12-2013/14 Annual Performance Plan Vote 7
52
670 646
1 041 457
-
Per capita
utilisation6
2.1
2.3
Health district1
Facility type
No.
Population
2,5
Capricorn District
Vhembe District
Mopani District
District hospitals
5
Non fixed clinics3
307
Fixed Clinics4
94
CHCs
4
Sub-total clinics + CHCs
98
District hospitals
6
Non fixed clinics3
1033
Fixed Clinics4
112
CHCs
8
Sub-total clinics + CHCs
120
District hospitals
6
Non fixed clinics3
1 394
Fixed Clinics4
93
CHCs
8
Sub-total clinics + CHCs
101
District hospitals
6
1 247 760
Population per PHC
facility5 or per hospital
bed
Per capita
utilisation6
3.1
1 295 079
3.5
1 147 961
3.0
2011/12-2013/14 Annual Performance Plan Vote 7
53
Health district1
Facility type
No.
Population
2,5
Province
1.
2.
Non fixed clinics3
4473
Fixed Clinics4
440
CHCs
24
Sub-total clinics
464
District hospitals
30
5 402 900
Populations are those of resident uninsured people. Mid-Year estimate on Population for 2009 used
Total fixed clinics includes 419 clinics and 21 gate way clinics
2011/12-2013/14 Annual Performance Plan Vote 7
54
Population per PHC
facility5 or per hospital
bed
Per capita
utilisation6
2.8
SUB-PROGRAMME 2.1: DISTRICT MANAGEMENT, COMMUNITY HEALTH CENTRES, CLINICS, HEALTH CENTRES,
COMMUNITY BASED SERVICES AND OTHER COMMUNITY SERVICES
2.1.1. SITUATIONAL ANALYSIS INDICATORS FOR SUB-PROGRAMME DISTRICT MANAGEMENT, COMMUNITY HEALTH
CENTRES, CLINICS, COMMUNITY BASED SERVICES AND OTHER COMMUNITY SERVICES
STRATEGIC GOALS 5& 6: Strengthen district health and hospital services and Improve quality of health care
TABLE 17.
SITUATIONAL ANALYSIS INDICATORS FOR DISTRICT HEALTH SERVICES
Quarterly Indicator
Data source
Type
1. Provincial PHC expenditure
per uninsured person
BAS/
Stats
SA population
estimates
R
312
284
352
251
349
339
2. PHC total headcount
DHIS
No
15 .1
3 528 519
3 318 981
2 099 916
4 712 553
1 440 027
3. PHC total headcount under
5 years
DHIS
No
3 635 686
800 371
736 988
729 302
1 027 066
341 959
4. Utilisation rate – PHC
DHIS
No
2.9
3.0
3.0
2.3
3.6
2.1
5. Utilisation rate under 5
years - PHC
DHIS
No
6.3
5.9
6.3
6.2
7.0
5.3
6. Fixed PHC facilities with a
monthly supervisory visits
rate
DHIS
%
58.2
75.5
55.7
62.8
53.9
43.3
7. Expenditure per PHC
headcount
BAS
R
116
108
122
140
99
151
2011/12-2013/14 Annual Performance Plan Vote 7
Provincial
Wide
Figure
2009/10
55
Capricorn
2009/10
Mopani
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
Waterberg
2009/10
Quarterly Indicator
Data source
Type
8. Percentage of complaints
of users of PHC Services
resolved within 25 days
Documentary
evidence
%
Annual indicators
DHIS
9. CHCs/CDCs with resident
doctor rate
Documentary
evidence
10. Number of PHC facilities
assessed for compliance
against the 6 priorities of
the core standards
Assessment
report
1.
%
Provincial
Wide
Figure
2009/10
Capricorn
2009/10
Mopani
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
Waterberg
2009/10
No baseline
-
-
-
-
-
3
2
0
1
0
0
No baseline
-
-
-
-
-
No
Fixed PHC facilities' means fixed clinics plus community health centres. 'Public' means provincial plus local government facilities. 2. Community Health Centres and Community Day
Centres
2011/12-2013/14 Annual Performance Plan Vote 7
56
2.1.2 PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISTRICT MANAGEMENT, COMMUNITY HEALTH
CENTRES, CLINICS, COMMUNITY BASED SERVICES AND OTHER COMMUNITY SERVICES
STRATEGIC GOALS 5 & 6: Strengthen district health and hospital services and Improve quality of health care
TABLE 18.
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISTRICT MANAGEMENT,
COMMUNITY HEALTH CENTRES, CLINICS, COMMUNITY BASED SERVICES AND OTHER COMMUNITY SERVICES
Strategic
objective
Performance
indicator
Strategic
plan
target
Means of
verification/
Data source
Strengthen
PHC
service
delivery
systems
Number of
districts with
functional District
Management
Teams
Increase
access of
PHC
services
Documented
evidence
Number of
districts
implementing the
District Health
Plan
Audited/ Actual performance
Medium term targets
2008/09
2009/10
No
baseline
No baseline
No baseline
5
5
5
5
Documented
evidence
5
5
5
5
5
5
5
Number of PHC
facilities
implementing
75% of PHC
package
Documented
evidence
No
baseline
No baseline
No baseline
No baseline
443 of 443
443 of 443
443 of
443
Number of PHC
facilities providing
24 hours service
Documented
evidence
324/416
308 of 416
360 of 416
365 of 416
27 of 443
27 of 443
27 of 443
2011/12-2013/14 Annual Performance Plan Vote 7
2007/08
Estimated
performan
ce 2010/11
57
2011/12
2012/13
2013/14
Strategic
objective
Performance
indicator
Strategic
plan
target
Number of PHC
facilities on call
systems
Strengthen
PHC
service
delivery
systems
Hypertension
incidence rate
reduced
Increase
access of
PHC
services
Diabetes
incidence rate
reduced
2011/12-2013/14 Annual Performance Plan Vote 7
Means of
verification/
Data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performan
ce 2010/11
Medium term targets
2011/12
2012/13
2013/14
Documented
evidence
No
baseline
No baseline
No baseline
No baseline
416 of 443
416 of 443
416 of
443
Documented
evidence
No
baseline
No baseline
No baseline
No baseline
Determine
baseline
Reduced by
0.25%
Reduced
by 0.5%
Documented
evidence
No
baseline
No baseline
No baseline
No baseline
Determine
baseline
Reduced by
0.25%
Reduced
by 0.5%
58
TABLE 19.
NATIONAL PERFORMANCE INDICATORS FOR DISTRICT MANAGEMENT, COMMUNITY HEALTH CENTRES, CLINICS,
COMMUNITY BASED SERVICES AND OTHER COMMUNITY SERVICES
Indicator
Data source
Type
Audited/ Actual performance
Estimate
MTEF Projection
National
Target
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
2014/15
N/A
1. Provincial PHC
expenditure per
uninsured person
BAS/ Stats
SA
population
estimates
R
155
253
312
469
482
492
522
2. PHC total headcount
DHIS
No
13.5m
14.4m
15.1m
16m
16.5m
17m
17.3m
3. PHC total headcount
under 5 years
DHIS
No
3 353 272
3 698 973
3 635 686
3 737 548
3 849 674
3 965 164
4 000 000
4. Utilisation rate – PHC
DHIS
%
2.6
2.7
2.9
2.9
3
3.2
3.4
3.5
5. Utilisation rate under
5 years- PHC
DHIS
%
5.2
5.9
6.3
6.5
6.8
7
7.3
5.5
6. Fixed PHC facilities
with a monthly
supervisory visits rate
DHIS
%
85
58.9
58.2
75
80
85
95
100
7. Expenditure per PHC
headcount
8. Percentage of
complaints of users
of PHC Services
resolved within 25
days
BAS/DHIS
R
95
127
124
157
165
163
170
N/A
Documented
evidence
%
No
baseline
No baseline
100
100
100
100
100
100
2011/12-2013/14 Annual Performance Plan Vote 7
59
-
Indicator
Data source
Type
Audited/ Actual performance
Estimate
MTEF Projection
National
Target
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
2014/15
Annual indicators
9. CHCs/CDCs with
resident doctor rate
Documented
evidence
%
4%(1of 27)
4% (1of 27)
4% (1of
27)
4% (1of
27)
7.4% (2 of
27)
11.1% (3
of 27)
14.8% (4
of 27)
-
10. Number of PHC
facilities assessed
for compliance
against the 6
priorities core
standards
Assessment
reports
No
No
baseline
No baseline
No
baseline
56
150
300
464
All facilities
'Fixed PHC facilities' means fixed clinics plus community health centres. 'Public' means provincial plus local government facilities
2011/12-2013/14 Annual Performance Plan Vote 7
60
2.1.3 PROVINCIAL QUARTERLY TARGETS FOR DISTRICT HEALTH SERVICES FOR 2011/12
TABLE 20. PROVINCIAL QUARTERLY TARGETS FOR DISTRICT MANAGEMENT, COMMUNITY HEALTH CENTRES, CLINICS,
COMMUNITY BASED AND OTHER COMMUNITY BASED SERVICES FOR 2011/12
Performance indicator
Reporting
period
Annual target
2011/12
Number of Districts with functional District Management
Teams
Annually
5 of 5
5
5
5
5
Number of districts implementing the District Health Plan
Quarterly
5 of 5
5
5
5
5
Number of PHC facilities implementing 75% of PHC
package
Quarterly
443 of 443
443 of 443
443 of 443
443 of 443
443 of 443
Number of PHC facilities providing 24 hours service
Quarterly
27of 443
27of 443
27of 443
27of 443
27of 443
Number of PHC facilities on call systems
Quarterly
416 of 443
416 of 443
416 of 443
416 of 443
416 of 443
2011/12-2013/14 Annual Performance Plan Vote 7
61
Quarterly targets
Q1
Q2
Q3
Q4
TABLE 21. NATIONAL QUARTERLY TARGETS FOR DISTRICT MANAGEMENT, COMMUNITY HEALTH CENTRES, CLINICS,
COMMUNITY BASED AND OTHER COMMUNITY BASED SERVICES FOR 2011/12
Indicator1
Type
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
1. Provincial PHC expenditure per uninsured person
R
Quarterly
482
120.5
120.5
120.5
120.5
2. PHC total headcount
No
Quarterly
16.5m
4m
4.25m
4.25m
4m
3. PHC total headcount under 5 years
No
Quarterly
3 849 674
962 418
962 418
962 418
962 418
4. Utilisation rate – PHC
%
Quarterly
4.0
4.0
4.0
4.0
4.0
5. Utilisation rate under 5 years- PHC
%
Quarterly
6.8
6.8
6.8
6.8
6.8
6. Percentage of fixed PHC facilities with a monthly
supervisory visit rate
%
Quarterly
80
80
80
80
80
7. Expenditure per PHC headcount
R
Quarterly
165
165
165
165
165
8. Percentage of complaints of users of PHC
Services resolved within 25 days
%
Quarterly
100
100
100
100
100
9. Number of PHC facilities assessed for
compliance against the 6 priorities of the core
standards
No
Annually
150
30
40
40
40
2011/12-2013/14 Annual Performance Plan Vote 7
62
SUB-PROGRAMME 2.2: DISTRICT HOSPITALS
2.1 SITUATION ANALYSIS INDICATORS FOR DISTRICT HOSPITALS
SITUATION ANALYSIS INDICATORS FOR DISTRICT HOSPITALS
Type
Data Source
Province
Capricorn
wide value
2009/10
2009/10
%
16.1
12.5
DHIS
1. Caesarean section rate
No
264 387
40 823
2. Separations – Total
DHIS
TABLE 22.
Indicator
Sekhukhu
ne
2009/10
14.8
Mopani
2009/10
Vhembe
2009/10
Waterberg
2009/10
National
Average
2009/10
17.9
19.9
16.1
18.8
37 394
52 800
62 621
34 063
117,382
No
1 672 949
446660
222879
328309
525806
196641
364,854
No
1 379 435
267 887
170 205
363 097
406 747
189 497
367,173
Days
4.3
4.2
4.2
3.7
4.9
4.4
4.3 days
%
67.1
60.7
69.1
63.6
74.9
63.2
65.4
BAS &
Documented
evidence
R
1,375
1,362
1,395
1,423
1,333
1,777
-
8. Percentage of complaints of users
of district hospital services
resolved within 25 days
Documented
evidence
%
100
100
100
100
100
100
9. Percentage of district hospitals
with monthly mortality and
morbidity meetings
Documented
evidence
%
100
100
100
100
100
3. Patient day equivalent – Total
DHIS
4. OPD Headcounts – Total
DHIS
5. Average length of stay
DHIS
6. Bed utilisation rate
DHIS
7. Expenditure per patient day
equivalent (PDE)
2011/12-2013/14 Annual Performance Plan Vote 7
100
-
-
63
Indicator
Data Source
Type
Province
wide value
2009/10
Capricorn
2009/10
Sekhukhu
ne
2009/10
Mopani
2009/10
Vhembe
2009/10
Waterberg
2009/10
National
Average
2009/10
No
baseline
No
baseline
No
baseline
No
baseline
No
baseline
No
baseline
-
No
baseline
No
baseline
No
baseline
No
baseline
No
baseline
-
Annual indicators
10. District Hospital Patient
Satisfaction Rate
DHIS: Patient
Satisfaction
Module
11. Number of District Hospitals
assessed for compliance against
the 6 priorities of the core
standards
2011/12-2013/14 Annual Performance Plan Vote 7
Assessment
Reports
%
No
No
baseline
64
2.2 PROVINCIAL STRATEGIC OBJECTIVES AND PROVINCIAL PERFORMANCE INDICATORS FOR DISTRICTHOSPITALS
STRATEGIC GOALS 5 & 6: Strengthen District health and hospital services and Improve quality of health care
TABLE 23.
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISTRICT HOSPITALS
Strategic
objective
Performance
indicators
Strategic
plan target
Means of
verification/
Data source
Provide district
hospital services
package
Number of hospitals
complying with 75%
of district hospital
service package
Increase
from 20 to
30 by 2014
Assessment
Reports
23 of 30
28 of 30
23 of 30
25 of 30
Strengthen
Primary Health
Care service
delivery systems
Percentage of fixed
PHC facilities
supported by a
doctor at least once
a week
Increase
access to
PHC
services
Documented
evidence
57%
237 of
416
59%
245/416
56.6%
255/451
58%
257/443
2011/12-2013/14 Annual Performance Plan Vote 7
Audited/ Actual performance
2007/08
65
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
30 of 30
30 of 30
30 of 30
60%
266/443
62%
275/443
64%
284/443
TABLE 24.
NATIONAL PERFORMANCE INDICATORS FOR DISTRICT HOSPITALS
Indicator
Data
source
Type
Audited/ Actual performance
2007/08
2008/09
Estimate
2010/11
2009/10
Medium-term targets
2011/12
2012/13
National
target
2014/15
2013/14
15.5
14.9
16.1
15
15
15
15
15 or above
235 792
332 748
264 387
259 203
264 387
270 435
278 545
-
1 456 266
1 490 925
1 672 949
1 640 146
1 672 949
1 754 400
1 807 032
-
1 253 719
1 395 009
1 397 435
1 370 034
1 397 435
1 435 345
1 478 405
-
Days
4.3
4.2
4.3
4
4
3.9
3.8
3.5 days
%
64.1
68.1
67.1
70
71
72
75
75 or above
R1,498
R1,318
R1,375
R1,457
R1,500
R1,650
No
baseline
No
baseline
100
100
100
100
100
-
76.6
(23 of 30)
80
(24 of 30)
100
(30 of 30)
100
100
100
100
100
1. Caesarean section rate
DHIS
%
2. Separations - Total
DHIS
No
3. Patient Day
Equivalents – Total
DHIS
No
4. OPD Headcounts Total
DHIS
No
5. Average length of stay
DHIS
6. Bed utilisation rate
DHIS
7. Expenditure per patient
day equivalent (PDE)
BAS/DHIS
8. Percentage of
complaints of users of
District Hospital
Services resolved
within 25 days
Documente
d evidence
9. Percentage of District
Hospitals with monthly
Mortality and Morbidity
Meetings
Documente
d evidence
R
%
%
2011/12-2013/14 Annual Performance Plan Vote 7
66
R1,700
Indicator
Data
source
Type
Audited/ Actual performance
2007/08
2008/09
Estimate
2010/11
2009/10
Medium-term targets
2011/12
2012/13
National
target
2014/15
2013/14
Annual indicators
10. District Hospital Patient
Satisfaction rate
DHIS:
Patient
Satisfaction
Module
%
No
baseline
No
baseline
No
baseline
65
70
75
80
-
11. Number of District
Hospitals assessed for
compliance against the
6 priorities of the core
standards
Assessmen
t Reports
No
No
baseline
No
baseline
No
baseline
10
15
25
30
-
2.3 QUARTERLY TARGETS FOR DISTRICT HOSPITALS FOR 2011/12
TABLE 25.
PROVINCIAL QUARTERLY TARGETS FOR DISTRICT HOSPITALS FOR 2011/12
Performance indicator
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Number of hospitals complying with 75% of district Quarterly
hospital service package
30 of 30
25 of 30
30 of 30
30 of 30
30 of 30
Percentage of fixed PHC facilities supported by a Quarterly
doctor at least once a week
60%
266 of 443
60%
266/443
60%
60%
60%
266/443
266/443
266/443
2011/12-2013/14 Annual Performance Plan Vote 7
67
TABLE 26.
NATIONAL QUARTERLY TARGETS FOR DISTRICT HOSPITALS FOR 2011/12
Indicator
All indicators modified
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
1. Caesarean section rate
Quartely
15%
15%
15%
15%
15%
2. Total Separations –Total
Quartely
264 387
66 097
66 097
66 097
66 098
3. Patient Day Equivalents –Total
Quartely
1 672 949
418 237
418 237
418 237
418 236
4. OPD Total Headcounts –Total
Quartely
1 397 435
349 359
349 359
349 359
349 358
5. Average length of stay
Quartely
4 days
4 days
4 days
4 days
4 days
6. Bed utilisation rate
Quartely
71%
71%
71%
71%
71%
7. Expenditure per patient day equivalent
Quartely
R1,500
R1,5 00
R1,5 00
R1,5 00
R1,5 00
8. Percentage of complaints of users of
District Hospital Services resolved within
25 days
Quarterly
100%
100%
100%
100%
100%
9. Percentage of District Hospitals with
monthly Mortality and Morbidity Meetings
Quarterly
100%
100%
100%
100%
100%
10. Number of District Hospitals assessed for
compliance against the 6 priorities of the
core standards
Quarterly
15
4
4
4
3
2011/12-2013/14 Annual Performance Plan Vote 7
68
SUB-PROGRAMME 2.3: HIV & AIDS, STI & TB CONTROL (HAST)
2.3.1 SITUATIONAL ANALYSIS FOR HIV AND AIDS AND TB CONTROL
TABLE 27.
Quarterly Indicator
SITUATION ANALYSIS INDICATORS FOR HIV & AIDS, STIS AND TB CONTROL
Data
source
Type
Province wide
value
2009/10
1. Total number of
patients
(Children and
Adults) on ART
2. Male condom
distribution rate
DHIS
No
64 636
DHIS
No
14.4
3. New smear
positive PTB
defaulter rate
ETR.net
%
4. PTB two month ETR.net
smear
conversion rate
%
5. Percentage of TB
HIV-TB
Co- registers
infected patients
placed on ART
6. HCT
rate
Testing DHIS
Capricorn
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
Waterberg
2009/10
9080
17 143
14.4
19.3
13.2
13
8.1%
711 of 8 738
5.2
94 of 1 836
6.9
9.5
148 of 2 150
182/170 of 1 791
7.1
131 of
1 842
63.3
5 880 of 9 164
63.3
1 162 of 1 836
64.2
1 380 of 2
1510
56.2
1 006 of
1 791
77.3
1 425 of
1 842
57.3
934 of
629
%
No baseline
No baseline
No baseline
No baseline
No baseline
No baseline
New
indicator
%
83.6
83.9
88.4
84.6
78.9
81.0
New
indicator
69
8814
National
Average
2009/10
1 063 644
18251
2011/12-2013/14 Annual Performance Plan Vote 7
13 700
Mopani
2009/10
13.2
10.5
113
212 of 1 629
7.4
1
Quarterly Indicator
Data
source
Type
Province wide
value
2009/10
Capricorn
2009/10
Mopani
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
Waterberg
2009/10
National
Average
2009/10
Annual indicators
7. New
smear ETR.net
positive
PTB
cure rate
%
2011/12-2013/14 Annual Performance Plan Vote 7
67.0
5 858/8 738
72.3
1 043/ 1 442
70
69.3
1 328/ 1 917
59.9
1199/2 001
75
1 323/1
763
58.7
792/ 1 498
66%
2.3.2 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR HIV & AIDS, STIs AND TB CONTROL
STRATEGIC GOAL 4: Implementation of comprehensive care and management of HIV and AIDS, TB, STIs and other communicable and non
communicable diseases accelerated
TABLE 28.
Strategic
objective
Increase access
to
comprehensive
HIV and AIDS,
STIs, Care,
treatment,
management
and support
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HIV & AIDS, STIs AND TB CONTROL
Performance
indicators
Proportion of
HIV exposed
babies testing
positive
Percentage of
HIV exposed
infants who
are PCR
positive
initiated on
ART
Strategic
plan target
Expand
access to
appropriate
treatment,
care and
support to
95% of all
HIV positive
people and
their
families
Percentage of
pregnant
women who
are tested for
HIV
2011/12-2013/14 Annual Performance Plan Vote 7
Means of
verification/
Data source
Audited/ Actual performance
Estimated
performance
Medium term targets
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
DHIS
20%
2 082/10
411
18%
2 192/12
107
10.4%
1114 of
10926
5%
<5%
<5%
<5%
DHIS
27%
572/2 702
33%
721/ 2 192
70%
797/1144
90%
95%
96%
98%
DHIS
78%
120053/145
002
82%
121702/14
6588
91%
137623/1
50993
95%
95%
95%
95%
71
Strategic
objective
Performance
indicators
Strategic
plan target
Means of
verification/
Data source
Audited/ Actual performance
Estimated
performance
Medium term targets
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
Documented
evidence
49
64
80
241
483
483
483
Expand
access to
appropriate
treatment,
care and
support to
95% of all
HIV positive
people and
their
families
DHIS
No Baseline
1 240
1 156
3 500
4 000
4 800
6 000
Improve
cure rate on
new smear
positive
PTB from
67% to
85%
ETR.net
80.9%
(5 513 of
6 815)
80.5%
(6 012 of
7 468)
84%
(8 117 of
9 663)
85%
(7 188 of
456)
87%
(6 768
of
7
780)
89%
(6 370
of
7
158)
90%
5 926 of
6 585
ART service
points
registered
Reduce mortality Number of
and morbidity
newly
due to TB
diagnosed
eligible HIV
positive
patients
starting INH
Prophylactic
Treatment
[IPT]
Percentage of
TB patients
with a DOT
supporter
(DOT
Coverage)
2011/12-2013/14 Annual Performance Plan Vote 7
72
8
Strategic
objective
Performance
indicators
Means of
verification/
Data source
Audited/ Actual performance
Estimated
performance
Medium term targets
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
ETR.net
67.0
4 566 of 6
815
71.7%
5 354 of 7
468
73.6%
74%
6 431 of 8 6 257 of 8 456
738
75%
5 835 of
7 780
77%
5 512 of
7 158
79%
5 202 of
6 585
HIV testing
rate among
TB patients
ETR.net
48.5%
(3 305 of 6
815)
77.3%
(5 773 of
7 468)
87%
(5 129 of
5 859)
100%
100%
100%
100%
Percentage of
MDR-TB
patients
started on
ARVs
TB registers
No baseline
No
baseline
50.4
25 0f 48
100%
100%
100%
100%
Percentage of
XDR-TB
patients
started on
ARVs
TB registers
No baseline
No
baseline
100%
2 of 2
100%
100%
100%
100%
Percentage of
TB patients
with MDR-TB
ETR.net
No
baseline
No
baseline
No
baseline
0.25%
1%
1.2%
1.8%
TB incidence
rate
ETR.net
143/100
000
181/100
000
141/
100 000
130/ 100
000
125/
100
000
120/10
0 000
115/100
000
Treatment
Success Rate
(Cure Rate
plus
Completion
Rate)
Strategic
plan target
Reduce TB
defaulter
rate from
8.1% to less
than 5.0%
2011/12-2013/14 Annual Performance Plan Vote 7
73
TABLE 29.
Quarterly Indicator
NATIONAL PERFORMANCE INDICATORS FOR HIV & AIDS, STIS AND TB CONTROL
Data
Type
Audited/ actual performance
Estimate
MTEF projection
source
2007/08
2008/09
National
Target
2009/10
2010/11
2011/12
2012/13
2013/14
2014/15
64 636
102 400
148 970
198 130
247 663
3.2 million
1. Total number of
patients
(Children and
Adults) on ART
2. Male condom
distribution rate
DHIS
No
31 800
43 625
DHIS
No
13
13
14.4
16
17
18
19
60
3. New smear
positive PTB
defaulter rate
ETR.net
%
8
545 of
6 815
7.9
590 of
7 468
8.1
711 of 8730
7.5
(634 of
8 456)
7.2
(560 of
7 780)
6.5
(465 of 7
158)
5.5
362 of 6
585
<5
4. PTB two month
smear
conversion rate
ETR.net
%
54.4
2 937 of
5 401
58.5
5 113 of
8 743
63.3
5 800 of
9 164
63.5
5 369 of
8 456
65
5 057 of
7 780
67
4 796 of
7 158
68
4 478 of
6 585
75
5. Percentage
of TB
HIV-TB
Co- register
infected patients
placed on ART
%
No
baseline
No
baseline
No baseline
40
100
100
100
100
6. HIV Testing rate
DHIS
%
74.5
88.8
83.6
90
95
95
95
ETR.net
%
56.5
3 850 of
6 815
61.7
4 504 of
7 468
67.0
5 858 of
8 738
67.2
5 682 of
8 456
67.5
5 252 of
7 780
73
5 225 of
7 158
80
5 268 of
6 585
Annual indicators
7. New smear
positive PTB
cure rate
85
# The target is to distribute 1 billion condoms, and there are about 16.5m males 15 years and older (StatsSA 2009 midyear estimates). This equates to
approximately 60 condoms per male 15 years and older
2011/12-2013/14 Annual Performance Plan Vote 7
74
2.3.3 QUARTERLY TARGET FOR HIV & AIDS, STIS AND TB CONTROL
TABLE 30.
PROVINCIAL QUARTERLY TARGETS FOR HIV & AIDS, STI AND TB CONTROL FOR 2011/12
Performance indicators
Reporting
period
Annual target
2011/12
Proportion of HIV exposed babies
testing positive
Quarterly
Percentage of HIV exposed
infants who are PCR positive
initiated on ART
Quarterly Targets
Q1
Q2
Q3
Q4
<5%
<5%
<5%
<5%
<5%
Quarterly
95%
95%
95%
95%
95%
Percentage of pregnant women
who are tested for HIV
Quarterly
95%
95%
95%
95%
95%
ART service points registered
Quarterly
483
483
483
483
483
Number of newly diagnosed
eligible HIV positive patients
starting IPT
Quarterly
4 000
1000
1000
1000
1000
Percentage of TB patients with a
DOT supporter (DOT Coverage)
Quarterly
87%
(6 768 of 7 780)
87%
(6 768 of 7 780))
87%
(6 768 of 7 780)
87%
(6 768 of 7
780)
87%
(6 768 of 7 780)
Treatment Success Rate (Cure
Rate plus Completion Rate)
Quarterly
75%
(5 835 of 7 780)
75%
(1 459 of 1 945)
75%
(1 459 of 1 945)
75%
(1 459 of 1
945)
75%
(1 459 of 1945)
HIV testing rate among TB
patients
Quarterly
100%
100%
100%
100%
100%
2011/12-2013/14 Annual Performance Plan Vote 7
75
Performance indicators
Reporting
period
Annual target
2011/12
Percentage of MDR-TB patients
started on ARVs
Quarterly
Percentage of XDR-TB patients
started on ARVs
Quarterly Targets
Q1
Q2
Q3
Q4
100%
100%
100%
100%
100%
Quarterly
100%
100%
100%
100%
100%
Percentage of TB patients with
MDR-TB
Quarterly
1%
1%
1%
1%
1%
TB incidence rate
Quarterly
125/
000
TABLE 31.
100
125/
100 000
125/
100 000
125/
000
100
125/
000
100
NATIONAL QUARTERLY TARGETS FOR HIV & AIDS, STI AND TB CONTROL FOR 2011/12
Performance indicator
Reporting
period
2011/12
1. Total number of patients (Children and
Adults) on ART
2. Male condom distribution rate
Quarterly
3. New smear positive PTB defaulter rate
Q1
Q2
Q3
Q4
148 970
112 480
124 100
136 270
148 970
Quarterly
17
17
17
17
17
Quarterly
7.2%
7.2%
(140 of 1 945)
7.2%
(140 of 1 945)
7.2%
(140 of 1 945)
7.2%
(140 of 1 945)
65%
5 057 of 7 780
65%
65%
65%
5 057 of 7 780
5 057 of
( 560 of 7 780)
4. PTB two month smear conversion rate
2011/12-2013/14 Annual Performance Plan Vote 7
Quarterly targets
Quarterly
65%
5 057 of 7 780
76
7 780
5 057 of 7 780
Performance indicator
Reporting
period
2011/12
5. Percentage of HIV-TB Co-infected
patients placed on ART
6. HIV Testing rate
Quarterly
7. New smear positive PTB cure rate
Quarterly targets
Q1
Q2
Q3
Q4
100%
100%
100%
100%
100%
Quarterly
95%
95%
95%
95%
95%
Annually
67.5%
67.5%
67.5%
67.5%
67.5%
SUB-PROGRAMME 2.4: MATERNAL, CHILD AND WOMEN’S HEALTH AND NUTRITION
2.4.1 SITUATION ANALYSIS FOR MCWH & N
TABLE 32.
SITUATION ANALYSIS INDICATORS FOR MCWH & N
Quarterly Indicator
Data source
Type
1. Immunisation coverage
under 1 year
DHIS
%
2. Vitamin A coverage 12-59
months
DHIS
%
3. Measles 1st dose under 1
year coverage
DHIS
%
4. Pneumococcal
Vaccine(PCV) 3rd Dose
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Province
wide value
2009/10
District
Capricorn
2009/10
District
Mopani
2009/10
District
Sekhukhune
2009/10
District
Vhembe
2009/10
District
Waterberg
2009/10
National
Average
2009/10
102.8
99.2
97.6
102
102.8
95.5
32.8
32.6
31.9
44
27.1
27.1
36.6
107.3
111,9
100,5
104,4
100,2
99,8
No baseline
No baseline
No
baseline
No baseline
No
baseline
No baseline
99.2
%
77
98.8
Quarterly Indicator
Data source
Type
Province
wide value
2009/10
District
Capricorn
2009/10
No baseline
No baseline
District
Mopani
2009/10
District
Sekhukhune
2009/10
District
Vhembe
2009/10
District
Waterberg
2009/10
National
Average
2009/10
coverage
%
5. Rota Virus (RV) 2ndt
Dose Coverage
DHIS
6. Cervical cancer screening
coverage
DHIS
%
8.3
7. Antenatal visits before 20
weeks rate
DHIS
%
42.9
8. Baby tested PCR Positive DHIS
six weeks after birth as a
proportion of babies tested
at six weeks
%
10.4
No
baseline
No baseline
No
baseline
No baseline
7.3
7.2
12.4
8.6
6.6
42.4
41.9
43.3
43.5
43
34.5
7.9
17.3
17
4.5
11
29.1
24.6
25.1
20.1
31.7
-
-
-
-
New
indicator
5.7
47.6
Annual indicators
9. Couple year protection rate DHIS
%
24.4
21.9
10. Public Health Facility
maternal mortality rate
DHIS
No per
100000
11. Delivery rate for women
under 18 years
DHIS
%
8.4
7.9
8.4
8.0
9.3
8.3
8.2
12. Public Health Facility Infant
mortality rate(under 1) rate
DHIS
No per
1000
13.4
14
15
20.6
9.4
14.2
9.9
13. Public Health Facility Child
mortality (under 5) rate
DHIS
No per
1000
9.2
9.7
11.5
9.7
8.3
8.4
6.4
2011/12-2013/14 Annual Performance Plan Vote 7
No baseline
-
78
2.4.2 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR MCWH&N
STRATEGIC GOALS 4, 5 & 6 : Implementation of comprehensive care and management of HIV and AIDS,TB, STIs and other communicable and
non communicable diseases accelerated; Strengthen District health and hospital services and Improve quality of health care
TABLE 33. PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR MCWH&N
Strategic
objective
Strengthen
programmes on
maternal, child,
woman, youth
and adolescent
health
Performance
indicators
Strategic
plan target
Means of
verification/
data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
Percentage ante Reduce
natal care before maternal
13wks
deaths from
182.9 to
Percentage of
100 per
institutions
136.5 per
(CHCs and
100 000 live
hospitals)
births
implementing
80% of
recommendation
s from the
saving mothers
report
DHIS
No
baseline
No
baseline
16.6%
20%
25%
30%
35%
Documented
evidence
No
baseline
63.2%
39 of 62
77%
48 of 62
100%
64of 64
100%
61 of 61
100%
61 of 61
100%
61 of 61
Number of PHC
facilities with
60% IMCI
saturation
Documented
evidence
311 of
416
351/416
374/416
391/416
416/464
416/464
416/464
Child
mortality
from 43.9 to
40.9 per
2011/12-2013/14 Annual Performance Plan Vote 7
79
Strategic
objective
Performance
indicators
Number of PHC
facilities
implementing
Community
Component of
IMCI
Strategic
plan target
1000 live
births
Means of
verification/
data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Documented
evidence
65/416
82/416
134/416
200/416
Percentage of
primary schools
receiving phase
1 of school
health services
DHIS
53%
(1382 of
2591)
82%
2126 of
2591
95%
(2461 of
2591)
Proportion of
births attended
by skilled health
professionals
DHIS
86%
87.6%
98%
2011/12-2013/14 Annual Performance Plan Vote 7
80
Medium term targets
2011/12
300/443
2012/13
2013/14
443/443
443/443
95%
97%
(2461 of 2591) (2513 of
2591)
99%
(2 565 of
2 591)
100%
(2591/259
1)
90%
90%
90%
90%
TABLE 34.
Indicator
1. Immunisation
coverage under 1
year
Data
source
NATIONAL PERFORMANCE INDICATORS FOR MCWH & N
Type
DHIS
Audited/ Actual performance
2009/10
Estimate
2010/11
MTEF projection
2011/12
2012/13
National
target
2007/08
2008/09
2013/14
2014/15
%
79.5
10 431 of
131 217
83.5
109 566 of
131 217
99.2
130 167 of
131 217
90
118 095 of
131 217
90
118 095
of 131
217
90
118 095 of
131 217
90
118 095
of 131
217
90
80
2. Vitamin A
coverage- 12 -59
months
DHIS
%
24
84 847 of
353 530
36.7
129 745 of
353 530
32.8
146 290 of
353 530
45
159 088 of
353 530
50
176 765
of 353
530
55
194 441 of
353 530
60
3. Measles 1st dose
coverage under 1
year
DHIS
%
90
118 095 of
131 217
85
111 534 of
131 217
107.3
140 795 of
131 217
103.7
136 072 of
131217
90
118 095
of 131
217
90
118 095 of
131 217
90
90
118 095 of
131 217
4. Pneumococcal
(PCV) 3rd Dose
Coverage
DHIS
No
baseline
No baseline
No baseline
90
(118 095 of
131 217)
90
(118 095
of 131
217)
90
(118 095 of
131 217)
90
(118 095
of 131
217)
90
5. Rota Virus (RV) 2nd
Dose Coverage
DHIS
%
No
baseline
No baseline
No baseline
90
(118 095 of
131 217)
90
(118 095
of 131
217)
90
(118 095 of
131 217)
90
(118 095
of 131
217)
90
6. Diarrhoea incidence
under 5years
DHIS
Per
1000
203/1000
209/1000
200/1000
180/1000
170/1000
160/1000
-
%
2011/12-2013/14 Annual Performance Plan Vote 7
197.60/10
00
81
Indicator
Data
source
Type
Audited/ Actual performance
2007/08
2008/09
Estimate
2009/10
2010/11
MTEF projection
2011/12
2012/13
National
target
2013/14
2014/15
7. Pneumonia
incidence under 5
years
DHIS
Per
1000
62.9/1000
60/1000
65/1000
62/1000
60/1000
58/1000
56/1000
8.
DHIS
%
4.7
42 134 of
1 027 665
6.7
68 854 of
1 027 665
8.3
85 287 of
027 665
18
184 980 of
1 027 665
60%
616599 of
1027665
65
667982 of
1 027 665
70
719365 of
1 027 665
32
No
baseline
40.1
No baseline
43.7
50
60
70
80
20
2 082/10
411
18
2 192/12
107
10.4
114 of 10926
5
<5
<5
<5
<5
Cervical cancer
screening coverage
9. Ante natal visit
before 20 weeks
rate
DHIS
10. Baby tested PCR
Positive six weeks
after birth as a
proportion of babies
tested at six weeks
DHIS
%
%
1
-
70
70
Annual indicators
11. Couple year
protection rate
DHIS
%
No
baseline
23.6
24.4
35
40
45
50
75
12. Public Health
Facility Maternal
mortality rate
DHIS
No per
100000
182.9/
100 000
182.9/
100 000
182.9/
100 000
182.9/
100 000
171.4/
100 000
159.9/
100 000
148.4/
100 000
Provincial
13. Delivery rate for
women under 18
years
DHIS
%
8.5
9.1
8.4
7.5
7
6.5
6
2011/12-2013/14 Annual Performance Plan Vote 7
82
Indicator
Data
source
Type
Audited/ Actual performance
2007/08
2008/09
Estimate
2009/10
MTEF projection
2010/11
2011/12
2012/13
National
target
2013/14
14. Public Health
Facility Infant
mortality rate(under
1) rate
DHIS
No per
1000
13.6
13.1
13.4
12.6
12
11.6
10
15. Public Health
Facility Child
mortality (under 5)
rate
DHIS
No per
1000
9.8
9.1
9.2
8.8
8.6
8.4
8
2.4.3 QUARTERLLY TARGETS FOR MCWH & N
TABLE 35.
PROVINCIAL QUARTERLY TARGETS FOR MCWH & N FOR 2011/12
Performance indicator
Reporting
period
Percentage ante natal care before 13wks
Quarterly
Percentage of institutions (CHCs and
hospitals) implementing 80% of
recommendations from the saving mothers
report
Quarterly
Number of PHC facilities with 60% IMCI
saturation
Quarterly
2011/12-2013/14 Annual Performance Plan Vote 7
Annual target
2011/12
QUARTERLY TARGETS
Q1
Q2
Q3
Q4
25%
25%
25%
25%
25%
100%
61 of 61
100%
61 of 61
100%
61 of 61
100%
61 of 61
100%
61 of 61
396 of 464
406 of 464
411 of 464
416 of 464
416/464
83
2014/15
Performance indicator
Reporting
period
Annual target
2011/12
QUARTERLY TARGETS
Q1
Q2
Q3
Q4
Number of PHC facilities implementing
Community Component of IMCI
Quarterly
300 of 443
210 of 443
230 of 443
250 of 443
300 of 443
Percentage of primary schools receiving
phase 1 of school health services
Quarterly
97%
(2513 of 2591)
24%
628 of 2 591
48%
1 256 of 2 591
72%
1 884 of 2 591
97%
2 513of 2 591
Proportion of births attended by skilled
health professionals
Quarterly
90%
90%
90%
90%
90%
TABLE 36.
Performance indicator
NATIONAL QUARTERLY TARGETS FOR MCWH & N FOR 2011/12
Reporting
period
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
1. Immunisation coverage
under 1 year
Quarterly
90%
118 095/ 131 217
90%
118 095/ 131 217
90%
118 095/ 131 217
90%
118 095/ 131 217
90%
118 095/ 131 217
2. Vitamin A coverage- 12
-59 months
Quarterly
50%
(176 765 of 353
530)
50%
(176 765 of 353 530)
50%
(176 765 of 353 530)
50%
(176 765 of 353 530)
50%
(176 765 of 353
530)
3. Measles 1st dose
coverage under 1 year
Quarterly
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
2011/12-2013/14 Annual Performance Plan Vote 7
84
Performance indicator
Reporting
period
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
4. Pneumococcal (PCV) 3rd
Dose Coverage
Quarterly
90
(118 095 of 131
217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
5. Rota Virus (RV) 2nd Dose
Coverage
Quarterly
90
(118 095 of 131
217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
90%
(118 095 of
131 217)
6. Diarrhoea incidence under Quarterly
5years
180/1000
population
195/1000 population
190/1000 population
185/1000 population
180/1000
population
7. Pneumonia incidence
under 5 years
Quarterly
60/1000
population
61.5/1000 population
61/1000 population
60.5/1000 population
60/1000 population
Cervical cancer screening Quarterly
coverage
60%
616599 of
1027665
55%
565216 of
1027665
57%
60%
60%
60%
8.
9. Ante natal visit before 20
weeks rate
Quarterly
10. Baby tested PCR Positive
six weeks after birth as a
proportion of babies
tested at six weeks
Quarterly
2011/12-2013/14 Annual Performance Plan Vote 7
<5
<5
585769 of
1027665
<5
85
<5
59%
606322 of
1027665
60%
616599 of
1027665
60%
60%
<5
SUB-PROGRAMME 2.5: DISEASE PREVENTION AND CONTROL
2.5.1 SITUATION ANALYSIS FOR DISEASE PREVENTION AND CONTROL
TABLE 37.
SITUATION ANALYSIS INDICATORS FOR DISEASE PREVENTION AND CONTROL
Data source
Type
Province
2009/10
Annual Indicator
Capricorn
2009/10
Mopani
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
Waterberg
2009/10
Malaria surveillance
programme
%
1.09
2842 cases & 31
deaths
5.88
0.67
0
1.19
1.59
2. Cholera fatality
rate
Documented
evidence
%
0.65
0,63
1 of 159
0
8,5
4 of 47
0
0
3. Cataract
surgery
DHIS
No per
million
population
3607
2372
195
348
692
0
1. Malaria fatality
rate
2011/12-2013/14 Annual Performance Plan Vote 7
86
National
Average
2009/10
2.5.2 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR DISEASE PREVENTION
AND CONTROL
STRATEGIC GOAL 4: Implementation of comprehensive care and management of HIV and AIDS, TB, STIs and other communicable and non
communicable diseases accelerated
TABLE 38.
PROVINCIAL PERFORMANCE INDICATORS FOR DISEASE PREVENTION AND CONTROL
Strategic
objective
Performance
indicators
Strategic
plan target
Means
of
verification/
Data source
Audited/ Actual performance
2007/08
2008/09
Reduce
Malaria
Incidence
Number of
dwellings
sprayed
Reduce
malaria fatality
to 0.5 % in
2014
Documented
evidence
955 000
980 000
2011/12-2013/14 Annual Performance Plan Vote 7
87
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
928 236
918 000
990 000
990 000
990 000
TABLE 39.
NATIONAL PERFORMANCE INDICATORS FOR DISEASE PREVENTION AND CONTROL
Indicator
Data source
Type
1. Malaria fatality
rate
Documented
evidence
%
2. Cholera fatality
rate
Documented
evidence
%
3. Cataract surgery
rate
Documented
evidence
No/ million
population
Audited/ actual performance
2009/10
Estimate
(target)
2010/11
MTEF projection
2011/12
2007/08
2008/09
2012/13
2013/14
0.9
0.74
1.09
2842 cases &
31 deaths
0.96
0.6
0.55
0.5
0
0.46
25/5 448
0.65
0
0
0
0
953
953
3607
1000
>1000
>1000
>1000
National
target
2014/15
2.5.3 QUARTERLY TARGETS FOR DISEASE PREVENTION AND CONTROL
TABLE 40.
PROVINCIAL QUARTERLY TARGETS FOR DISEASE PREVENTION AND CONTROL FOR 2011/12
Performance indicators
Number of dwellings sprayed
2011/12-2013/14 Annual Performance Plan Vote 7
Reporting
period
Annual target
2011/12
Quarterly
990 000
88
Quarterly Targets
Q1
No
spraying
during 1st
quarter
Q2
Q3
Q4
225 000
606 000
159 000
2.2.4 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 41.
DISTRICT HEALTH SERVICES
Sub-programme
Audited outcome
Main
appropriation
Adjusted
appropriation
Revised
estimate
Medium term expenditure
estimates
R’ thousand
2007/08
2008/09
District Management
132,025
313,643
362,465
430,223
763,990
763,990
752,295
723,244
679,106
Clinics
805,312
993,218
1,181,590
1,571,364
1,250,616
1,250,616
1,350,384
1,425,434
1,595,733
Community Health Centres
147,449
176,867
207,701
228,754
201,470
201,470
217,551
247,429
266,000
Community-based Services
98,137
109,791
159,013
151,403
105,459
105,459
123,389
130,053
139,066
Other Community Services
141,900
183,629
202,273
135,784
326,491
326,491
277,228
251,964
267,562
HIV and AIDS
205,137
257,154
413,645
524,896
525,951
525,951
624,909
733,963
884,146
Nutrition
19,313
16,789
19,031
24,610
25,148
25,148
26,087
27,391
28,761
Coroner Services
(Currently provided under
forensic pathology services)
34,164
48,834
2,062
84,878
N/A
N/A
N/A
N/A
N/A
District Hospitals
1,720,537 2,098,724
2,365,916
2,401,777
2,445,836
2,445,836
2,615,843
2,769,052
2,986,530
TOTAL
3,303,974 4,198,649
4,913,696
5,553,689
5,644,961
5,644,961
5,987,686
6,308,530
6,846,904
2011/12-2013/14 Annual Performance Plan Vote 7
2009/10
2010/11
89
2011/12
2012/13
2013/14
TABLE 42.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Audited Outcomes
2007/08
2008/09
Main
Adjusted
Revised
appropriation appropriation estimate
2009/10
2010/11
Medium-term estimate
2011/12
2012/13
2013/14
Current payments
3,108,156
3,930,724 4,660,077
5,278,023
5,233,074 5,233,074
5,581,078
5,910,257
6,454,751
Compensation of employees
2,495,401
2,951,098 3,454,128
4,048,909
4.086,673 4.086,673
4,351,926
4,596,807
4,988,888
612,755
979,626 1,205,949
1,229,114
1,146,401 1,146,401
1,229,152
1,313,450
1,465,863
Goods and services
Transfers and subsidies to
90,555
153,413
166,842
185,274
274,872
274,872
298,330
298,604
303,005
Provinces and municipalities
1
18,111
28,431
40,718
29,535
29,535
43,161
45,319
47,585
Non-profit institutions
79,579
113,065
119,654
129,696
230,477
230,477
238,556
229,924
230,894
Households
10,975
22,237
18,757
14,860
14,860
14,860
16,613
23,361
24,527
105,263
114,512
86,777
90,392
137,015
137,015
108,278
99,669
89,148
Buildings and other fixed
structures
29,396
28,761
5,565
-
40,000
40,000
18,000
Machinery and equipment
71,834
75,751
78,247
90,392
97,015
97,015
90,278
85,669
4,033
10,000
2,965
-
-
-
-
-
4,198,649 4,913,696
5,553,689
5,644,961 5,644,961
5,987,686
6,308,530
Payments for capital assets
Software and other intangible
assets
Total economic classification
3,303,974
2011/12-2013/14 Annual Performance Plan Vote 7
90
14,000
89,148
6,846,904
2.2.5 PERFORAMNCE AND EXPENDITURE TRENDS
The objective of this Programme is to render District Health Services through various budget sub-programmes as indicated in table 26 above.
The funding has therefore been aligned to the various key strategic focus of the programme. The allocated budget has a direct impact on the
achievements of targets in the following ways:

Acceleration of the comprehensive primary health care services package

Improve quality of care at District hospital level, e.g. reduction of patient waiting time and conducting doctors’ visits to clinics

Intensify the rendering of MCWH and nutrition programme, e.g. increased immunisation rate, reduction in maternal death and increase in
greenery projects

intensify the rendering of prevention and disease control programme, e.g. the coverage of provision of health services at ports is
increasing, whist malaria fatality rate is decreasing

Improve the rendering of a comprehensive HIV and AIDS, STI and TB programme, e.g. the treatment coverage of people with HIV/AIDS
and TB is increasing as the funding increases
The department has spent a total of R12.4 billion in 2007/8 to 2009/10 while the 2010/11 budget amounts to R5.6 billion. The proposed MTEF
from 2011/12 to 2013/14 is projected at R18.4 billion which will be used to maintain and improve the current services.
2011/12-2013/14 Annual Performance Plan Vote 7
91
2.2.6 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme District Health Services and the measures to mitigate the
impact of the risks are indicated below.
Risks
Mitigating factors

Missed opportunity (vaccination of children at any given
time: presentation of road to health card with each
consultation)

Establish a forum for strengthening monitoring and evaluation at
hospitals

Late bookings by pregnant women

Strengthen community outreach through media, door to door
campaigns

Shortage of equipment to implement the full District hospital
package

Contracts, standardization of equipment and motivate for
appointment of clinical engineers and vetting of contractors

Infection due to poor disposal of human tissue at PHC
facilities

Strengthen monitoring of the Service Level Agreement; provide
refrigerators to all clinics

Lack of patient information management system (HIV)

Motivate for the development of patient information system
2011/12-2013/14 Annual Performance Plan Vote 7
92
2.3 PROGRAMME 3: EMERGENCY MEDICAL & PATIENT TRANSPORT SERVICES
2.3.1 PROGRAMME PURPOSE
The aim of the program is to render pre-hospital Emergency Medical Services including Inter-hospital transfers and Planned Patient Transport through
the sub-programmes of Emergency transport and planned patient transport.
The programme is provided through the strategic goal of improving emergency medical services and supported by strategic objective of improving
emergency medical services.
The Emergency Medical Services are being rendered by basic, intermediate and advanced trained Emergency Care Practitioners (ECP) from 47 EMS
stations of which 14 are purpose built and two newly built control centres. Planned Patient Transport is currently rendered at hospitals. There are 31
rescue vehicles, 16 operational response units (rapid response vehicles) manned by paramedics and 500 ambulances covering the entire Province.
Furthermore the Province has an Air Ambulance service providing EMS services for obstetric and critically ill patients across the Province. However the
Department still experience challenges of shortage of EMS practitioners and rescue vehicles at stations and control centres.
EMS currently responds to approximately 80% of all calls within the national norms of 15 Minutes in urban areas and 40 minutes in rural areas. EMS in
Limpopo responds to all medical and trauma related incidents where the critically injured and sick are treated, stabilised and transported to appropriate
facilities. EMS engages in disaster planning sessions at local, district and provincial levels. However the extent of the responses and preparedness is
limited by the current limited resources.
2.3.2 PRIORITIES





Improve quality of care
Strengthening implementation of Planned Patient Transport transfer within EMS
Provision of Custom built stations
Recruit, train and retain skilled personnel
Digitalization of EMS ICT systems
2011/12-2013/14 Annual Performance Plan Vote 7
93
2.3.3 SITUATIONAL ANALYSIS FOR EMERGENCY MEDICAL AND PATIENT TRANSPORT
TABLE 43.
SITUATION ANALYSIS INDICATORS FOR EMS AND PATIENT TRANSPORT
Quarterly Indicator
1. Rostered Ambulances
2. P1 calls with a response of time
<15 minutes in an urban area
3. P1 calls with a response time of
<40 minutes in a rural area
4. All calls with a response time
within 60 minutes
2011/12-2013/14 Annual Performance Plan Vote 7
Data
Source
Type
Province
wide value
2009/10
450
Capricorn
2009/10
90
90
90
90
90
National
Average
2009/10
1,546
DHIS
DHIS
No
%
65
73.1
63.4
65.2
62.6
59.9
50.4
DHIS
%
81
93.5
50.0
90.4
88.3
83.1
DHIS
%
92
92.2
90.3
93.4
93.1
90.0
Waterberg
2009/10
Mopani
2009/10
Sekhukhune
2009/10
Vhembe
2009/10
55.1
67.7
94
2.3.4 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR EMERGENCY MEDICAL
SERVICES AND PATIENT TRANSPORT
STRATEGIC GOAL 1: Improve emergency medical services
TABLE 44.
Strategic
objective
Improve
Emergency
Medical
Services
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR EMS AND PATIENT TRANSPORT
Performance
indicator
Strategic
Plan target
Means of
verification
/ Data
Source
Audited/ actual performance
2007/08
2008/09
2009/10
Medium term targets
Estimated
performa
nce
2010/11
2011 /12
2012/13
2013/14
1:30000
1:25000
1:20000
1:18000
1:15000
1:13000
1:12000
25
23
20
20
20
20
18
45
43
40
40
40
40
40
Documente
d evidence
8
10
14
15
19
(4 new)
21
24
Number of Emergency
Care Practitioners
providing EMS
Documente
d evidence
1526
1505
1505
2053
2503
2953
3403
Number of Planned
Patients Transported
Documente
d evidence
No
Baseline
No
Baseline
Ratio of ambulance per Ensure that
90% of
population
EMS calls
EMS response times in are within
Urban and Rural areas the national
norm by
2014
Number of stations
established
2011/12-2013/14 Annual Performance Plan Vote 7
Norms &
Standards
DHIS
95
No
Baseline
No
Baseline
140 000
140 000
140 000
TABLE 45.
NATIONAL PERFORMANCE INDICATORS FOR THE EMS AND PATIENT TRANSPORT
Indicator
1. Rostered Ambulances
2. P1 calls with a response time of
<15 minutes in an urban area
3. P1 calls with a response time of
<40 minutes in a rural area
4. All calls with a response time
within 60 minutes
2011/12-2013/14 Annual Performance Plan Vote 7
Data
Source
DHIS
DHIS
Type
Audited/ actual performance
Estimate
2010/11
per 10000
population
MTEF projection
2011/12
2012/13
National
target
2014/15
2007/08
0.35
2008/09
0.4
2009/10
0.08
0.55
0.66
0.76
2013/1
4
0.83
1 per
10000
population
70%
55.5%
65%
55%
60%
65%
70%
80%
70%
70%
81%
55%
60%
65%
70%
80%
84%
94%
92%
60%
70%
80%
90%
100%
%
DHIS
%
DHIS
%
96
2.3.5 QUARTERLY TARGETS FOR EMERGENCY MEDICAL SERVICES AND PATIENT TRANSPORT
TABLE 46.
PROVINCIAL QUARTERLY TARGETS FOR EMS FOR 2011/12
Performance Indicators
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
1. Ratio of Ambulance per population
Quarterly
1: 15 000
1:15000
1: 15000
1:15000
1: 15000
2. EMS Response times in urban and rural
areas
Quarterly
20
20
20
20
20
40
40
40
40
40
3. Number of stations established
Annually
19 (4 new)
15
16
16
19 (4 new)
4. Number of Emergency Care Practitioners
Annually
2503 (450 new)
450 ECPs
posts
advertised
Applications
processed
450 ECPs
appointed
2503 (450 new)
Quarterly
140 000
35 000
35 000
35 000
35 000
providing EMS
5. Number of Planned Patients Transported
2011/12-2013/14 Annual Performance Plan Vote 7
97
TABLE 47.
NATIONAL QUARTERLY TARGETS FOR EMS FOR 2011/12
Performance indicator
Reporting
period
QUARTERLY TARGETS
Annual target
2011/12
Q1
1. Rostered Ambulances per 10000
population
2. Percentage P1 (red calls) calls with a
response time of <15 minutes in an
urban area
3. Percentage P1 (red calls) calls with a
response time of <40 minutes in a
rural area
4. % of all calls with a response time
within 60 minutes
Q2
Q3
Q4
Quarterly
0.66%
0.66%
0.66%
0.66%
0.66%
Quarterly
60%
55%
60%
60%
60%
Quarterly
60%
55%
60%
60%
60%
60%
70%
70%
70%
Quarterly
70%
2.3.6 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 48.
EXPENDITURE ESTIMATES: EMERGENCY MEDICAL SERVICES AND PATIENT TRANSPORT
Sub-programme
Audited outcome
2007/08
2008/09
Main
Adjusted
appropriation appropriation
2009/10
Revised
estimate
2010/11
Medium term expenditure
estimates
2011/12
2012/13
2013/14
R’ thousand
Emergency Transport
196,746
250,650
306,517
399,705
522,386
522,386
593,687
654,949
669,289
TOTAL
196,746
250,650
306,517
399,705
522,386
522,386
593,687
654,949
669,289
2011/12-2013/14 Annual Performance Plan Vote 7
98
TABLE 49.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Audited Outcomes
2007/08
2008/09
Main
Adjusted
appropriation appropriation
2009/10
Revised
estimate
2010/11
Medium-term estimate
2011/12
2012/13
2013/14
Current payments
175,627
213,334
268,139
348,532
471,213
471,213
527,043
605,574
617,445
Compensation of employees
144,340
168,234
240,457
297,030
419,711
419,711
434,431
497,153
504,354
31,287
45,100
27,682
51,502
51,502
51,502
92,612
108,421
113,091
19
171
11
169
169
169
179
193
203
19
171
11
169
169
169
179
193
203
21,100
37,145
38,367
51,004
51,004
51,004
66,465
49,182
51,641
21,100
37,145
38,367
51,004
51,004
51,004
66,465
49,182
51,641
196,746
250,650
306,517
399,705
522,386
522,386
593,687
654,949
669,289
Goods and services
Transfers and subsidies to
Provinces and municipalities
Households
Payments for capital assets
Buildings and other fixed
structures
Machinery and equipment
Total economic
classification
2.3.7 PERFORMANCE AND EXPENDITURE TRENDS
The objective of this Programme is to render pre-hospital Emergency Medical Services including Inter-hospital transfers and Planned Patient
Transport. The allocated budget has a direct impact on the achievements of the targets in the following ways:

Improve the functioning of Planned Patient Transport services, e.g. the acquisition of vehicles to transport patients between hospitals.

Improve quality of care at pre-hospital level, e.g. reduction of response times and recruitment of qualified staff, purchase of ambulances and
communication equipments
The department has spent a total of R753.9 million in 2007/8 to 2009/10 while the 2010/11 budget amounts to R399.7 million. The proposed MTEF
from 2011/12 to 2013/14 is projected at R1.3 billion which will be used to maintain and improve the current services.
2011/12-2013/14 Annual Performance Plan Vote 7
99
2.3.8 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme Emergency Medical services and the measures to mitigate
the impact of the risks are indicated below.
Risks
Underfunding of EMS
Inadequate EMS practitioners and Staff turnover
Inadequate EMS vehicles
Inadequate infrastructure
Inadequate information and communication technology
2011/12-2013/14 Annual Performance Plan Vote 7
Mitigating factors
Analysis and identifications of financial resources
Recruitment of staff and provision of training for all EMS categories
Implementation of the EMS optimization plan
Fast-track infrastructure development
Provide appropriate Information and Communication Technology
100
2.4 PROGRAMME 4: PROVINCIAL HOSPITALS (REGIONAL AND SPECIALISED)
2.4.1 PROGRAMME PURPOSE
The purpose is delivery of hospital services, which are accessible, appropriate, and effective and provide general specialist services, including a
specialized rehabilitation service, as well as a platform for training health professionals and research through the sub-programmes General (regional)
hospitals and specialised hospitals.
The programme is provided through the strategic goals of strengthening district health and hospital services and improving quality of health care. There is no
change of objectives in the five year strategic plan.
There are five regional hospitals in the Province. The hospitals are located as follows: Mokopane Hospital in Waterberg District, Tshilidzini hospital in
Vhembe District, Letaba Hospital in Mopani and St Ritas and Philadelphia hospitals in Sekhukhune. Capricorn District has no level 2 hospital and as a
result Polokwane and Makweng hospitals render that level of care.
The performance of the five hospitals range from satisfactory to unsatisfactory depending on the key performance indicator over the 3 year period
(2007/08 – 2009/10). The Patient Day Equivalence (PDE) for the three financial years was 304 527, 529 892 and 517 365 respectively. An increase in
the OPD total headcounts for the three year period: 276 860,422 180 and 429 329. The average length of stay (ALOS) was 5.5, 4.9 and 5.0 days
respectively. Bed Utilisation rate was at 64%, 65% and 67%. The expenditure per patient day equivalence was R1294, R1182 and R1305.
The province has three specialised hospitals, namely: Thabamoopo in Capricorn District, Evuxakeni in Mopani District and Hayani in Vhembe District.
This leaves Sekhukhune and Waterberg Districts without psychiatric hospitals. The following services are only rendered at Thabamoopo hospital:
observation, acute psychiatric ward and forensic psychiatric services. Hayani hospital renders maximum security services.
Average Length of Stay (ALOS) for acute patients was 20, 33.5 and 3.5 days for the 3 financial years (2007/08, 2008/09, 2009/10). ALOS for sub-acute
was 50, 38, and 46.5 days respectively. The usable bed utilisation rate (UBUR) was 85.2%, 85.5% and 88%. Percentage of mental health care users
(MHCU) was 4.8%, 6.2% and 6.8% respectively.
2.4.2 PRIORITIES




Expansion of secondary hospital services
implement quality improvement programmes in all provincial hospitals
Implement a sustainable outreach programme
Develop and implement the provincial nursing strategy
2011/12-2013/14 Annual Performance Plan Vote 7
101
2.4.3 SUB-PROGRAMME 4.1 GENERAL (REGIONAL) HOSPITALS
PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR GENERAL (REGIONAL)
HOSPITALS
STRATEGIC GOAL 6: Strengthen District health and hospital services and Improve quality of health care
TABLE 50.
Strategic
objective
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR SUB-PROGRAMME GENERAL (REGIONAL) HOSPITALS
Performance
indicators
Strategic
target
plan Data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Estimated
performance
2010/11
Medium term targets
2011/12
2012/13
2013/14
Expand
secondary
hospital
services
Transfer rate to
tertiary hospitals
Increase the
number of
secondary
services from
four (4) to eight
(8) by 2014
Documented
evidence
4%
4%
4.96%
4
4
3
2
Strengthen
District
Health
Services
Number of
regional
hospitals
conducting
outreach
programs
monthly
Implement a
sustainable
outreach
programme by
2014
Documented
evidence
4
4
5
5
5
5
5
Improve
quality of
nursing
practice
Number of
hospitals
implementing
75% of the
basic nursing
care package
Develop and
implement the
Quality
improvement
programmes by
2014
Documented
evidence
No baseline
No
baseline
20
40
40
40
2011/12-2013/14 Annual Performance Plan Vote 7
102
40
TABLE 51.
Quarterly Indicators
NATIONAL PERFORMANCE INDICATORS FOR SUB-PROGRAMME GENERAL (REGIONAL) HOSPITALS
Data Source
Type
Audited /actual performance
Estimate
MTEF projection
2008/09
21.9
2009/10
22,9
2010/11
23
2011/12
24
2012/13
24
2013/14
25
National
target
2012/13
>25
1. Caesarean section
rate
2. Separations - Total
DHIS
%
2007/08
22.3
DHIS
No
53 952
75 292
71 461
73 604
75 812
78 086
80 428
Provincial
3. Patient Day
Equivalents - Total
4. OPD Headcount Total
5. Average length of
stay
6. Bed utilisation rate
7. Expenditure per
patient day
equivalent (PDE)
8. Percentage of
complaints of users
of Regional Hospital
Services resolved
within 25 days
9. Percentage of
Regional Hospitals
with monthly
Mortality and
Morbidity Meetings
DHIS
No
304 527
529 892
517 365
532 885
548 871
565 337
582 297
Provincial
DHIS
No
276 860
422 180
429 329
442 208
455 474
469 138
483 212
Provincial
DHIS
Days
5.5
4.9
5
5
5
5
5
4.8
DHIS
BAS
%
R
64
R 1,294
65.6
R 1,182
67
R 1,305
70
R 1,383
70
R 1,465
70
R 1,552
70
R 1,645
75
Documented
evidence
%
No
baseline
No
baseline
100
100
100
100
100
Docemented
evidence
%
100
100
100
100
100
100
100
2011/12-2013/14 Annual Performance Plan Vote 7
103
Quarterly Indicators
Annual indicators
10. Percentage of users
of regional hospital
services satisfied
with the services
received (Regional
hospitals patient
satisfaction rate)
11. Number of Regional
Hospitals assessed
for compliance with
the 6 priorities of the
core standards
Data Source
Type
Audited /actual performance
Estimate
MTEF projection
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
Survey
reports
%
No
baseline
75%
(manual)
No
baseline
73.4%
(manual)
64.6%
65%
70%
75%
80%
Assessments
reports
No
No
baseline
No
baseline
No
baseline
2
5
5
5
National
target
2012/13
QUARTERLY TARGETS FOR GENERAL (REGIONAL) HOSPITALS
TABLE 52.
PROVINCIAL QUARTERLY TARGETS FOR GENERAL (REGIONAL) HOSPITALS
Performance indicators
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Transfer rate to tertiary hospitals
Quarterly
4
4
4
4
4
Number of regional hospitals conducting outreach programs
monthly
Quarterly
5
5
5
5
5
Number of hospitals implementing 75% of the basic nursing care
package
Quarterly
40
40
40
40
40
2011/12-2013/14 Annual Performance Plan Vote 7
104
TABLE 53.
NATIONAL QUARTERLY TARGETS FOR GENERAL (REGIONAL) HOSPITALS FOR 2011/12
Quarterly Indicators
Reporting
period
Annual target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
1. Caesarean section rate
Quartely
24%
24%
24%
24%
24%
2. Separations - Total
Quartely
75 812
18 953
18 953
18 953
18 953
3. Patient Day Equivalents – Total
Quartely
548 871
137 218
137 218
137 218
137 218
4. OPD Headcounts – Total
Quartely
455 474
113 868
113 868
113 868
113 868
5. Average length of stay
Quartely
5 days
5 days
5 days
5 days
5 days
6. Bed utilisation rate
Quartely
70%
70%
70%
70%
70%
7. Expenditure per patient day (PDE)
Quartely
R1,465
R1,465
R1,465
R1,465
R1,465
8. Percentage of complaints of users of Regional
Hospital Services resolved within 25 days
Quarterly
100%
100%
100%
100%
100%
9. Percentage of Regional Hospitals with monthly
Mortality and Morbidity Meetings
Quarterly
100%
100%
100%
100%
100%
10. Number of Regional Hospitals assessed for
compliance with the 6 priorities of the core standards
Quarterly
5
2
1
1
1
2011/12-2013/14 Annual Performance Plan Vote 7
105
2.4.4 SUB-PROGRAMME 4.2: SPECIALISED HOSPITALS
PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR GENERAL (REGIONAL)
HOSPITALS
STRATEGIC GOAL 6: Strengthen district health and hospital services and improve quality of health care
TABLE 54.
Strategic
Objective
Implement
quality
improvement
programme in
Provincial
hospitals
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR SUB-PROGRAMME (SPECIALISED) HOSPITALS
Performance
indicator
Average length of
stay (acute)
ALOS (Sub-Acute)
Bed utilisation
Rate
Percentage of
Mental Health
Care Users
(MHCU) on leave
of absence
Strategic
plan target
Implement
quality
improvemen
t
programme
s in three
(3)
specialized
hospital by
2014
Number of
specialised
hospitals
assessed for
compliance with
the 6 priorities of
the core standards
2011/12-2013/14 Annual Performance Plan Vote 7
Means of
verification/
Data source
Audited/ Actual performance
Estimated
performance
2007/08
2008/09
2009/10
DHIS
20
33.2
33.5
20
20
20
20
DHIS
50 days
38 days
46.5
days
40 days
40 days
40 days
40 days
DHIS
85.2%
85.5%
88%
80%
80%
80%
80%
Documented
evidence
4.8%
53 of 1
114
6.2%
69 of 1
114
6.18%
10%
10%
10%
10%
Assessment
reports
No
baseline
No
baseline
No
baseline
No baseline
3
3
3
106
2010/11
Medium-term targets
2011/12
2012/13
2013/14
QUARTERLY TARGETS FOR SPECIALISED HOSPITALS
TABLE 55.
QUARTERLY TARGETS FOR SUB-PROGRAMME SPECIALISED HOSPITALS FOR 2011/12
Performance indicator
Reporting
period
Quarterly targets
Annual target
2011/12
Q1
Q2
Q3
Q4
Average length of stay
(acute)
Quarterly
20
20
20
20
20
ALOS (Sub-Acute)
Quarterly
40 days
40 days
40 days
40 days
40 days
Bed utilisation rate
Quarterly
80%
80%
80%
80%
80%
Percentage of MHCU on
leave of absence
Quarterly
10%
10%
10%
10%
10%
Number of specialised
hospitals assessed for
compliance with the 6
priorities of the core
standards
Quarterly
3
Training
conducted
1
1
1
2011/12-2013/14 Annual Performance Plan Vote 7
107
2.4.5 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 56.
EXPENDITURE ESTIMATES: PROVINCIAL HOSPITAL SERVICES
Sub-programme
Audited outcome
2007/08
2008/09
Main
Adjusted
appropriation appropriation
2009/10
Revised
estimate
Medium term expenditure
estimates
2010/11
2011/12
2012/13
2013/14
R’ thousand
General (regional) hospitals
729,050
783,618
913,416
953,609
970,913
970,913
1,078,126
1,112,071
1,146,135
Psychiatric hospitals
155,873
189,277
223,572
250,419
240,183
240,183
291,386
309,020
312,873
TOTAL
884,923
972,895
1,136,988
1,204,028
1,211,096
1,211,096
1,369,512
1,421,091
1,459,008
Tuberculosis hospitals
TABLE 57.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Current payments
Compensation of employees
Goods and services
Transfers and subsidies to
Provinces and municipalities
Households
Payments for capital assets
Buildings and other fixed
structures
Machinery and equipment
Total economic
classification
2007/08
876,305
767,928
108,377
2,581
Audited Outcomes
2008/09
2009/10
963,065
1,128,245
823,329
976,158
139,736
152,087
3,968
4,205
Main
appropriatio
n
Adjusted
appropriatio
n
1,189,639
1,017,951
171,688
4,174
Medium-term estimate
1,197,367
1,021,742
175,625
3,674
Revised
estimate
2010/11
1,197,367
1,021,742
175,625
3,674
2011/12
1,353,307
1,158,470
194,837
3,686
2012/13
1,403,589
1,178,466
225,123
3,981
2013/14
1,440,631
1,267,321
173,310
4,180
2,581
6,037
3,968
5,862
4,205
4,538
4,174
10,215
3,674
10,215
3,674
10,215
3,686
12,519
3,981
13,521
4,180
14,197
-
-
-
-
-
-
-
-
-
6,037
5,862
4,538
10,215
10,055
10,055
12,519
13,521
14,197
884,923
972,895
1,136,988
1,204,028
1,211,096
1,211,096
1,369,512
1,421,091
1,459,008
2011/12-2013/14 Annual Performance Plan Vote 7
108
2.4.6 PERFORMANCE AND EXPENDITURE TRENDS
The purpose of the programme is to deliver secondary level hospital services to be accessible, appropriate, and effective. This includes provision of
general specialist services, specialised services, as well as a platform for training health professionals and research. The allocated budget has a direct
impact on the achievements of targets in the following ways:

Expand the secondary hospital services, e.g. referrals to the tertiary hospital will drop as secondary services are performed at regional hospitals

Improve quality of care at regional and specialised hospital level, e.g. reduction in patient waiting time due the availability of health professionals and
implementation of nursing care package.
The department has spent a total of R3.0 billion in 2007/8 to 2009/10 while the 2010/11 budget amounts to R1.2 billion. The proposed MTEF from
2011/12 to 2013/14 is projected at R3.8 billion which will be used to maintain and improve the current services.The funding has therefore been aligned to
the various key strategic focus of the programme.
2.4.7 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme: Provincial hospitals services and the measures to mitigate the
impact of the risks are indicated below.
Risks
Poor quality of mental health care
Cost per patient day equivalent due to delayed patient
recovery
2011/12-2013/14 Annual Performance Plan Vote 7
Mitigating factors
Strengthen Mental Health Review Boards

Motivate for the establishment of Mental Health Care institutions in
each district with emphasis on child psychiatry
Motivate for appointment of more specialists

109
2.5 PROGRAMME 5: CENTRAL & TERTIARY HOSPITALS
2.5.1 PROGRAMME PURPOSE
The purpose of the programme is to provide tertiary health services and create a platform for training of health professionals and research.
The programme is provided through the strategic objective of development of tertiary services. The objectives in the five strategic plan have not changed.
There are 2 Tertiary Hospitals (Polokwane and Mankweng hospitals that operate as a Complex). They are located in the Capricorn District. They also
offer level 2 hospital services for Capricorn District. They provide a teaching platform for health professionals and this extended to the 5 Regional
hospitals.
The performance on key indicators for the 3 year period starting in 2007/08 is outlined below: The Patient Day Equivalence (PDE) has been increasing
steadily at 310 184, 338 207 and 341 586 respectively. OPD total health counts were 211 776, 258 221 and 253 549 respectively. The Average Length
of Stay (ALOS) stands at 5.9, 6.1 and 6.4 days which is within the norm of 4 to 8 days. Bed utilisation rate is below the norm of 80% at 65.4, 70.6 and
72.5. The expenditure per Patient Day Equivalence (expenditure/PDE) was R1736, R1707 and R2543 respectively.
2.5.2 PRIORITIES




Improve quality of care
Increase access to tertiary services
Reduce referrals outside the Province
Implement sustainable outreach programme
2011/12-2013/14 Annual Performance Plan Vote 7
110
2.5.3 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR TERTIARY HOSPITALS
STRATEGIC GOAL 8: Tertiary services developed
TABLE 58.
Strategic
Objective
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR TERTIARY HOSPITALS
Performance
indicator
Strategic
Plan target
Means of
verification
/ Data
source
Audited/ Actual performance
2007/08
Strengthen
Tertiary/
academic
services
Strengthen
secondary
Hospital
services
2008/09
Estimated
performance
2009/10
2010/11
Medium-term targets
2011/12
2012/13
2013/14
Number of tertiary 34
disciplines
provided
NTSG
report
17
23
26
28 of 50
32 of 50
33 of 50
34 of 50
Transfer rate
outside the
province
15%
Register
5.4 %
(1816)
5.4%
(1630)
5.1%
(1 884)
5%
4%
4%
4%
Number of
registrars
appointed
Increase
number of
registrars
by 10%
Persal
Reports
Number of
clinical disciplines
conducting
outreach
programmes
Increase
number of
disciplines
conducting
outreach by
10%
89
Number of
institutions using
Telemedicine
Clinical
Reports
Clinical
Reports
No
baseline
20
22
No
baseline
4 pilot
sites
NB: Telemedicine includes implementation of Tele-Consultation, Tele-radiology, Tele-dermatology, Tele-dentistry
2011/12-2013/14 Annual Performance Plan Vote 7
No
baseline
111
31
34
64
70
77
19
22 of 38
30 of 38
35 of 38
38 of 38
0
10
29
49
69
TABLE 59.
NATIONAL PERFORMANCE INDICATORS FOR TERTIARY HOSPITALS
Quarterly Indicators
Data Source Type
Audited/ actual performance
2007/08
25.4
2009/10
DHIS
No
40 324
40 775
39 281
40 459
49 117
50 590
52 107
3. Patient Day Equivalents - Total
DHIS
No
310 184
338 207
341 586
351 833
362 387
373 258
384 455
4. OPD Headcount - Total
DHIS
No
211 776
258 211
253 549
261 155
268 989
277 058
285 369
5. Average length of stay
DHIS
6. Bed utilisation rate
DHIS
7. Expenditure per patient day
equivalent (PDE)
DHIS & BAS
R
8. Percentage of complaints of users
of the Hospital’s Services resolved
within 25 days
Survey
reports
%
R 1,736
No
Baseline
% 100
30
2013/14
2. Separations – Total
65.4
30
2012/13
%
%
28
2011/12
DHIS
Days 5.9
27.1
2010/11
MTEF projection
1. Caesarean section rate
9. Percentage of tertiary hospitals with Clinical
Monthly Mortality and Morbidity
Reports
Meetings
24.3
2008/09
Estimated
performance
30
6.1
6.4
6
6
6
6
70.6
72.5
73
74
75
75
R 1,707
No
Baseline
R 2,543
100
R 2,695
100
R 2,856
100
R 3,027
100
National
target
2014/15
R 3,208
100
100
100
100
100
100
100
86
47
55
65
70
75
No
baseline
No
baseline
No baseline 2
Annual indicators
10. Percentage of users of Tertiary
Survey
Hospital Services satisfied with the reports
services received (Tertiary hospitals
patient satisfaction rate)
11. Number of Tertiary Hospitals
assessed for compliance with the 6
priorities of core standards
2011/12-2013/14 Annual Performance Plan Vote 7
Assessment
report
%
No
88
No
baseline
112
2
2
90
2
2.5.4 QUARTERLY TARGETS FOR TERTIARY HOSPITALS
TABLE 60.
PROVINCIAL QUARTERLY TARGETS FOR TERTIARY HOSPITALS
Performance indicator
Reporting
period
Annual
target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Number of tertiary disciplines provided
Quarterly
32 of 50
28
29
30
32
Number of clinical disciplines conducting outreach programmes
Quarterly
30 of 38
22
25
28
30
Number of registrars appointed
Annually
64 (6 new)
58
60
62
64
Transfer rate outside the province
Quarterly
4%
4%
4%
4%
4%
Number of institutions using Telemedicine
Quarterly
29 (15 new)
14
14
14
29
TABLE 61.
NATIONAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR TERTIARY HOSPITALS
Quarterly Indicator
Type
1.
2.
3.
4.
5.
6.
7.
Caesarean section rate
Separations - Total
Patient Day Equivalents – Total
OPD -Headcounts – Total
Average length of stay
Bed utilisation rate
Expenditure per patient day equivalent (PDE)
8. Percentage of complaints of users of the hospital’s
services resolved within 25 days
9. Percentage of tertiary hospitals with monthly mortality
and morbidity meetings
10. Number of tertiary hospitals assessed for compliance
with 6 priorities of core standards
2011/12-2013/14 Annual Performance Plan Vote 7
%
No
No
No
Days
%
R
Reporting
period
Quartely
Quartely
Quartely
Quartely
Quartely
Quartely
Quartely
Annual target
2011/12
30
49 117
362 387
268 989
6
74
R 2,856
Quarterly targets
Q1
Q2
30
30
12 279
12 279
90 569
90 569
67 247
67 247
6
6
74
74
R 2,856
R 2,856
Q3
30
12 279
90 569
67 247
6
74
R 2,856
Q4
30
12 279
90 596
67 247
6
74
R 2,856
%
Quartely
100
100
100
100
100
%
Quartely
100
100
100
100
100
Quarterly
2
Training
conducted
1
1
2
113
2.5.5 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 62.
EXPENDITURE ESTIMATES: CENTRAL AND TERTIARY SERVICES
Sub-programme
Audited outcome
2007/08
2008/09
Main
appropriation
2009/10
Adjusted
appropriation
Revised
estimate
2010/11
Medium term expenditure
estimates
2011/12
2012/13
2013/14
R’ thousand
Tertiary Hospitals
559,264
693,031
810,278
944,440
955,650
955,650
1,010,754
1,130,798
1,150,007
TOTAL
559,264
693,031
810,278
944,440
955,650
955,650
1,010,754
1,130,798
1,150,007
2011/12-2013/14 Annual Performance Plan Vote 7
114
TABLE 63.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Audited Outcomes
Main
appropriation
Medium-term estimate
Revised
estimate
2007/08
2008/09
2012/13
2013/14
Current payments
540,092
669,037
789,572
918,799
930,009
930,009
980,858
1,097,910
1,115,875
Compensation of employees
417,721
509,580
597,338
717,791
690,246
690,246
742,469
848,383
888,403
Goods and services
122,371
159,457
192,234
201,008
239,763
239,763
238,389
249,527
227,472
Transfers and subsidies to
1,178
1,795
837
976
976
976
1,035
1,118
1,174
Provinces and municipalities
-
-
-
-
-
-
-
-
-
1,178
1,795
837
976
976
976
1,035
1,118
1,174
Payments for capital assets
17,994
22,199
19,869
24,665
24,665
24,665
28,861
31,770
32,958
Machinery and equipment
17,994
22,199
19,869
24,665
24,665
24,665
28,861
31,770
32,958
559,264
693,031
810,278
944,440
955,650
955,650
1,010,754
1,130,798
1,150,007
Households
Total economic classification
2009/10
Adjusted
appropriation
2010/11
2011/12
2.5.6 PERFORMANCE AND EXPENDITURE TRENDS
The purpose of the Tertiary Hospital is to provide tertiary health services and create a platform for training of health professionals and research. The
funding has been aligned to the key strategic objective of the programme and targets. The allocated budget has a direct impact on the achievements of
targets in the following ways:
 Reduction of referrals outside the province, e.g. tertiary services are being increased in the hospital through the current budget and MTEF and this
reduces the referrals outside the province.
 Improve quality of care at tertiary hospital level, e.g. reduction in patient waiting time due the availability of health professionals.
 Modernisation of the tertiary services, e.g. the purchase of highly technical equipment to render the tertiary services is done using the allocation
under this programme
The department has spent a total of R2.1 billion in 2007/8 to 2009/10 while the 2010/11 budget amounts to R944.4 million. The proposed MTEF from
2011/12 to 2013/14 is projected at R3.1 billion which will be used to maintain and improve the current services.
2011/12-2013/14 Annual Performance Plan Vote 7
115
2.5.6 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives for the budget programme tertiary hospitals and the measures to mitigate the impact of the
risks are indicated below.

Risks
Inappropriate and inadequate skills development program 

Inadequate infrastructure



Mitigating factors
Conduct skills audit
Develop recruitment and retention strategy
Provide needs based human resource development and training
Fast-track infrastructure development e.g. Limpopo Academic Hospital

Inadequate health technology

Provide appropriate Health Technology

Inadequate information and communication technology

Provide appropriate Information and Communication Technology
•
Inefficient Supply Chain Management
•
Strengthen and streamline efficiency of the supply chain management
2011/12-2013/14 Annual Performance Plan Vote 7
116
2.6 PROGRAMME 6:– HEALTH SCIENCES AND TRAINING
2.6.1 PROGRAMME PURPOSE
The purpose of the programme is to render training and development opportunities for actual and potential employees of the Department through sub
programmes human resource development (bursaries, PHC training and other training); nurse training colleges; and EMS training colleges.
The programme is provided through the strategic goal of providing appropriate human resources management and development. Strategic objectives have not
changed. However there are objective statements of strategic objectives for training and development of nurse professionals and provision of training for
emergency care personnel have been added in order to align with national and provincial priorities.
The human resource development programme provides for re-designing of training programmes to develop employees on the spectrum of management
and leadership programs. The objective is to ensure that competent and capable workforce is available thus achieving the departmental strategic
priorities. Bursaries are awarded to Limpopo citizens to pursue studies in health science related professions to overcome the vacancy challenges on
scarce and critical skills.
Nursing education includes training of nurses in basic nursing certificate, basic diploma, and post basic diploma and certificate programmes. Training
includes continuous professional development of nurses of all categories. The formal training programs take place in the Limpopo College of Nursing
with three campuses and the twenty four accredited nursing schools located in the hospitals. Two new college campuses are awaiting accreditation. The
college campuses accommodate 980 students per annum
The following programmes are offered:








Diploma in Ophthalmic nursing ;
Diploma in Clinical Nursing Science, Health Assessment, Treatment and Care (PHC);
Diploma in Advanced Midwifery and Neonatal Nursing Science;
Diploma in Medical and Surgical Nursing Science (OT, Critical Care nursing (ICU), Orthopaedic, Trauma and Emergency care);
Diploma in Midwifery Nursing science;
Diploma in Nursing (General community, psychiatric) and Midwifery Diploma in General Nursing (community, psychiatric) and Midwifery ;
Diploma in General nursing (Bridging course);
Diploma in Psychiatric nursing science;
2011/12-2013/14 Annual Performance Plan Vote 7
117



Diploma in Child Nursing science;
Enrolled nursing; and
Enrolled nursing auxiliary (Poverty Alleviation Program)
Currently there is only one accredited Provincial EMS college resulting in vast restrictions to increase training capacity. The college has trained 143
intermediate life support practitioners since 2005. The province has commenced implementation of Emergency Care Technician Programme in 2010 with
15 practitioners on training.
2.6.2 PRIORITIES


Provide health professional training and other categories
Continuing professional development programme
2011/12-2013/14 Annual Performance Plan Vote 7
118
2.6.3 PROVINCIAL STRATEGIC OBJECTIVES AND NATIONAL PERFORMANCE INDICATORS FOR HEALTH SCIENCES AND
TRAINING
STRATEGIC GOAL 1: Appropriate human resources management and development provided
SUB PROGRAMME 6.1: HUMAN RESOURCE DEVELOPMENT
TABLE 64.
Strategic
objective
Provide human
resource training
and
development
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HUMAN RESOURCE DEVELOPMENT
Performance
indicator
Number of new
bursaries awarded
Strategic
plan target
Strengthen
the skills and
human
resource base
Means
of
verification/
Data Source
Documented
evidence
Number of new
participants
appointed in the
internship
programme
Documented
evidence
Number of new
participants
appointed in the
learnership
programme
Documented
evidence
2011/12-2013/14 Annual Performance Plan Vote 7
119
Audited/ Actual performance
2007/08
2008/09
2009/10
495
1219
229
971
1043
24
35
Medium term targets
Estimated
performance
2010/11
2011/12
2012/13
2013/14
266
375
475
515
373
699
391
481
571
37
45
397
397
397
QUARTERLY TARGETS FOR HUMAN RESOURCE DEVELOPMENT
TABLE 65.
PROVINCIAL QUARTERLY TARGETS FOR HUMAN RESOURCE DEVELOPMENT FOR 2011/12
Performance indicator
Reporting
period
Annual
target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Number of new bursaries awarded
Bi-annually
375
190
175
10
375 student
progress
monitored
Number of new participants appointed in the internship
programme
Annually
391
Applications
processed
391
391 interns
inducted
391 interns
inducted
Number of new participants appointed in the
learnership programme
Bi-annually
397
37
360
397
learners
inducted
397 learners
inducted
SUB-PROGRAMME 6.2: NURSE TRAINING COLLEGES
TABLE 66.
Strategic
objective
Train and
develop nurse
professionals
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR NURSE TRAINING COLLEGES
Performance
indicator
Number of
post basic
nurse
professionals
trained
Strategic
plan target
Train 340
nurses by
2014
2011/12-2013/14 Annual Performance Plan Vote 7
Means
verification/
Source
of
Data
Documented
evidence/
College records
120
Audited/ Actual performance
2007/08
2008/09
237
248
2009/10
248
Medium term targets
Estimated
performanc
e
2010/11
310
2011/12
310
2012/13
310
2013/14
310
Strategic
objective
Performance
indicator
Number of
professional
nurses trained
Strategic
plan target
Train 2 500
nurses y
2014
Means
verification/
Source
of
Data
Documented
evidence/
College / campus
records
Audited/ Actual performance
2007/08
2008/09
566
443
2009/10
2010/11
800
783
Medium term targets
Estimated
performanc
e
2011/12
800
2012/13
800
2013/14
800
QUARTERLY TARGETS FOR NURSE TRAINING COLLEGES
TABLE 67.
PROVINCIAL QUARTERLY TARGETS FOR NURSE TRAINING COLLEGES FOR 2011/12
Performance indicator
Reporting period
Annual
target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
Number of post basic nurse professionals trained
Quarterly
310
Applications
processed
270
40
310
Number of professional nurses trained
Quarterly
800
210
120
190
220
2011/12-2013/14 Annual Performance Plan Vote 7
121
SUB-PROGRAMME 6.3: EMS TRAINING COLLEGE
SPECIFICATION OF MEASURABLE OBJECTIVES AND PERFORMANCE INDICATORS
TABLE 68.
Strategic
objective
PROVINCIAL OBJECTIVES AND PERFORMANCE INDICATORS FOR SUB-PROGRAMME EMS COLLEGE
Performance
indicator
Train and
develop
Emergency
Care
Technicians
(ECT)
Number of personnel
trained as ECT
TABLE 69.
Performance indicator
Number of personnel
trained as Emergency
Care Technicians (ECT)
Strategic
Plan
target
180
Means of
verification
Course audit
report
Audited/ actual performance
Estimated
performan
ce
Medium term targets
2007/08
2008/09
2009/10
2010/11
2011 /12
2012/13
2013/14
No
baseline
No
baseline
15
30
60
60
90
QUARTERLY TARGETS FOR HEALTH SCIENCES AND TRAINING FOR 2011/12
Reporting period
Quarterly
2011/12-2013/14 Annual Performance Plan Vote 7
Annual target 2011/12
60
122
Quarterly targets
Q1
Q2
Q3
Q4
30
Applications
processed
30
Applications
processed
TABLE 70.
Annual indicators
NATIONAL PERFORMANCE INDICATORS FOR HEALTH SCIENCES AND TRAINING
Data Source
Audited / actual performance
Type
2007/08
2008/09
2009/10
Estimate
2010/11
Medium term goals
2011/12
2012/13
2013/14
1. Intake of nurse
students
Documented
evidence
No
860
982
998
1 300
1 500
1 600
1 700
2. Students with
bursaries from the
province
Documented
evidence
No
1 298
2 287
2216
250
350
450
490
3. Basic nurse
students
graduating
Documented
evidence/
Certificates
No
566
443
783
800
800
800
800
2011/12-2013/14 Annual Performance Plan Vote 7
123
National
target
2014/15
2.6.4 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 71.
EXPENDITURE ESTIMATES: HEALTH SCIENCES AND TRAINING
Sub-programme
Audited outcome
2007/08
Main
appropriation
2008/09
2009/10
Adjusted
appropriation
Revised
estimate
2010/11
Medium term expenditure
estimates
2011/12
2012/13
2013/14
R’ thousand
Nursing Training Colleges
8,7592
117,103
147,584
130,644
150,661
150,661
151,482
151,339
168,704
EMS Training Colleges
3,099
3,505
661
14,185
1,477
1,477
3,036
3,269
4,084
Bursaries
6,546
98,372
83,959
100,558
100,558
100,558
103,591
106,271
111,585
Primary Health Care Training
3,529
-
-
6,866
5,564
5,564
6,278
6,642
7,024
Other Training
109,631
106,270
111,913
165,832
142,318
142,318
175,782
186,261
190,378
TOTAL
210,397
325,250
344,117
418,085
400,578
400,578
440,169
463,782
487,490
2011/12-2013/14 Annual Performance Plan Vote 7
124
TABLE 72. SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Main
Adjusted
Revised
appropriation appropriation estimate
Audited Outcomes
2007/08
2008/09
2009/10
Current payments
179,009
186,442
230,050
285,095
266,095
Compensation of employees
111,763
125,607
157,928
201,722
Goods and services
67,246
60,835
72,122
Transfers and subsidies to
22,494
124,757
Households
22,494
Payments for capital
assets
Buildings and other fixed
structures
Machinery and equipment
Total economic
classification
2011/12-2013/14 Annual Performance Plan Vote 7
2011/12
2012/13
2013/14
266,095
303,115
314,605
340,415
190,722
190,722
218,123
221,103
231,845
83,373
75,373
75,373
84,992
93,502
108,570
104,173
120,066
121,559
121,559
124,270
130,212
136,724
124,757
104,173
120,066
121,559
121,559
124,270
130,212
136,724
8,894
14,051
9,894
12,924
12,924
12,924
12,784
8,965
10,351
-
-
2,059
-
-
-
-
-
-
8,894
14,051
7,835
12,924
12,924
12,924
12,784
8,965
10,351
210,397
325,250
344,117
418,085
400,578
400,578
440,169
453,782
487,490
125
2010/11
Medium-term estimate
2.6.5 PERFORAMANCE AND EXPENDITURE TRENDS
The purpose of the programme is to render training and development opportunities for actual and potential employees of the Department.
The allocated budget has a direct impact on the achievements of targets in the following ways:

Reduction of shortage of doctors. E.g. the department offers bursaries to students for medical related qualifications with an agreement to
recruit them after their completion of studies.

Reduction in the shortage of nursing professionals, e.g. the department trains the post basic nursing professionals using the budget and
MTEF provided.

Implementation of the learnership programme. The funding for this experience giving programme is funded through the current budget and
MTEF.

Reduction in the shortage of EMS practitioners, e.g. the department utilises the current budget and MTEF to train the required EMS
practitioners at different categories.

Reduction in the shortage of nursing staff, e.g. nursing colleges are funded to train the potential nurses that after completion of their studies
work to improve quality of care.
The department has spent a total of R879.8 million in 2007/8 to 2009/10 while the 2010/11 budget amounts to R418.1 million. The proposed
MTEF from 2011/12 to 2013/14 is projected at R1.4 billion which will be used to maintain and improve the current services.
2.6.7 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme: Health sciences and training and the measures to mitigate
the impact of the risks are indicated below.
Risks
Mitigating factors
High staff turnover rate of trained personnel.
Assessment of current training policy.
Breach of bursary/ training contractual service obligation.
Quarterly returns on the status of employees who have got bursary
service obligations and implementation of debt recovery policy.
Ill-informed training programmes.
Alignment of the work place skills plan with individual competency
based development plan.
Release of privileged information to outside companies for
bidding of training tenders.
Vetting of service providers and officials.
2011/12-2013/14 Annual Performance Plan Vote 7
126
2.7 PROGRAMME 7: HEALTH CARE SUPPORT SERVICES
2.7.1 PROGRAMME PURPOSE
The purpose of the programme is to render support services as required by the Department to realise its aim and incorporating all aspects of
rehabilitation through sub-programmes

Medicine trading account (Pharmaceutical Services);

Orthotic and Prosthetic ( Allied Health Care Support Services);

Oral health services; and

Forensic Pathology Services.
The programme is provided through strategic goals of strengthening district health and hospital services and improving quality of health care;
implementation of comprehensive care and management of HIV and AIDS, TB, STIs and other communicable and non communicable diseases
and accelerated disease prevention and control. Strategic objectives of development of forensic pathology services have been added to align with
national and provincial priorities.
Pharmaceutical services are rendered from the Depot responsible for effective and efficient procurement, storage and supply of medicines and
surgical sundries to all health facilities. The procurement of medicines and surgical sundries is done using mainly national tenders awarded by
National treasury. The pharmacies and the Depot are required to meet the minimum standards determined by the Pharmacy Council and
Medicines Control Council. The procurement, warehousing and distribution are outsourced.
The medicines and surgical sundries are kept and distributed from a central Depot which also pre-packs bulk medicines for distribution. The Depot
distributes medicines directly to all hospitals and primary health care facilities. All primary healthcare facilities and the Depot do not meet the
minimum legislative requirements determined by the Pharmacy Council and Medicines Control Council. The essential drug lists are used as
standard treatment guidelines but Provincial and institutional drug and therapeutic committee develop additional standard treatment guidelines.
Functionality of hospitals’ Drug and Therapeutics Committees is at 95%. Stock availability in the Province is as follows: Depot at 87.33%, hospitals
at 87.1% and clinics at 83.5%.
Clinical health care support services are being provided within the allieds profession of Physiotherapy, Speech and Hearing, Occupational
Therapy, Medical Orthotic and Prosthetic, Dietician, Optometry, Radiography and Medical Social work focusing on rehabilitation and clinical
support services. This service is a developing service within the Department characterised by lack of appropriate physical facilities and equipment
and inadequate outreach services. However progress has been made, 29 of 40 hospitals are implementing a full complement of clinical support
services.
2011/12-2013/14 Annual Performance Plan Vote 7
127
The Medico-legal mortuaries were transferred from the South African Police Service (SAPS) with effect from the 1 st of April 2006. Only one
forensic mortuary was transferred to the Department along with four SAPS personnel in the province. The Department ensures that all unnatural
causes of death are fully evaluated and investigated through post mortem examinations. The establishment of forensic pathology facilities is
underway with 11 completed and one under construction. The Department has assigned forensic pathology services administrative and
management responsibility to the chief specialist (Forensic Path) of Polokwane–Mankweng complex from 2007. The National Department of
Health has promulgated regulations pertaining to Forensic Pathology Services.
2.7.2 PRIORITIES



Availability of medicine and medical sundries at the depot, hospitals and PHC facilities
Increase facilities with full complement of Health Care support services
Strengthen Forensic Pathology Services
2011/12-2013/14 Annual Performance Plan Vote 7
128
2.7.3 PROVINCIAL STRATEGIC OBJECTIVES FOR HEALTH CARE SUPPORT SERVICES
STRATEGIC GOAL 1: Strengthen District health and hospital services, Improve quality of health care and Implementation of comprehensive care and
management of HIV and AIDS, TB, STIs and other communicable and non communicable diseases accelerated
TABLE 73.
Strategic
objective
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HEALTH CARE SUPPORT SERVICES
Performance
indicator
Strategic
plan target
Means of
verification/
Data source
Audited/ Actual performance
2007/08
2008/09
2009/10
Medium term targets
Estimated
performance
2010/11
2011/12
2012/13
2013/14
SUB-PROGRAMME: MEDICINE TRADING ACCOUNT (PHARMACEUTICAL SERVICES)
Provide all
essential
medicines
Percentage
availability of
Essential
Medicines in
Depot
95%
95%
95%
85%
91.3%
87.33%
95%
95%
92%
88%
87.1%
95%
95%
95%
95%
92%
89%
85%
83.5%
92%
92%
92%
95%
2011/12-2013/14 Annual Performance Plan Vote 7
129
Hospitals
Clinics
95%
Documented
evidence
Strategic
objective
Performance
indicator
Strategic
plan target
Means of
verification/
Data source
Audited/ Actual performance
2007/08
2008/09
Medium term targets
Estimated
performance
2009/10
2010/11
2011/12
2012/13
2013/14
SUB-PROGRAMME: ORTHOTIC AND PROSTHETIC ( ALLIED HEALTH CARE SUPPORT SERVICES)
Provide
healthcare
support
services
Number of
hospitals with
full
complement
of clinical
health support
services
Provide full
complement
of clinical
healthcare
support
services in
all health
facilities by
2014
Documented
evidence
SUB-PROGRAMME: FORENSIC PATHOLOGY SERVICES
Documented
Develop
Number of
13
evidence
forensic
forensic
pathology
pathology
services
facilities
developed
2011/12-2013/14 Annual Performance Plan Vote 7
23 of 40
7
130
27 of 40
9
29 of 40
30 of 40
12
12
32 of 40
13
40 of 40
-
40 of 40
-
2.7.4 QUARTERLY TARGETS FOR HEALTH CARE SUPPORT SERVICES
TABLE 74.
QUARTERLY TARGETS FOR HEALTH CARE SUPPORT SERVICES FOR 2010/11
Performance indicator
Reporting
period
Percentage availability of Essential Medicines in
Depot
Hospitals
Clinics
Quarterly
Number of hospitals with full complement of clinical health support
services
Quarterly
Annual
target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
95%
95%
92%
95%
95%
92%
95%
95%
92%
95%
95%
92%
95%
95%
92%
32 of 40
30 0f 40
30 of 40
31 of 40
32 of 40
2.7.5 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 75.
EXPENDITURE ESTIMATES: HEALTH CARE SUPPORT SERVICES UPDATE FOR 2013/14
Sub-programme
Audited outcome
2007/08
2008/09
Main
Adjusted
Revised
appropriation appropriation estimate
2009/10
2010/11
Medium term expenditure
estimates
2011/12
2012/13
2013/14
R’ thousand
Forensic services
49,764
56,012
34,656
39,913
39,913
39,913
42,308
44,423
44,645
5,249
10,350
7,443
13,016
9,443
9,443
13,797
14,487
15,210
336,664
577,117
596,108
746,968
747,548
747,548
783,833
828,621
841,053
391,677
643,479
638,207
799,897
799,604
799,604
839,938
887,531
900,687
Orthotic and prosthetic
services
Medicines trading account
TOTAL
2011/12-2013/14 Annual Performance Plan Vote 7
131
TABLE 76.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION UPDATE FOR 2013/14
Main
Adjusted
Revised
appropriation appropriation estimate
Audited Outcomes
2007/08
Current payments
2008/09
2009/10
2010/11
Medium-term estimate
2011/12
2012/13
2013/14
391,665
641,250
627,765
782,543
779,670
779,670
821,543
873,665
888,695
13,840
6,975
29,315
34,409
32,909
32,909
53,074
54,203
59,136
377,825
634,275
598,450
748,134
746,761
746,761
768,469
819,462
829,559
Transfers and subsidies to
-
607
1,743
1,743
1,743
1,847
1,995
2,094
Provinces and municipalities
-
-
-
-
-
-
-
-
Households
-
607
1,743
250
250
1,847
1,995
2,094
12
1,622
10,442
15,611
15,611
15,611
16,548
11,871
12,119
-
-
9,375
11,627
13,000
13,000
12,325
6,940
6,941
12
1,622
1,067
3,984
3,984
3,984
4,223
4,931
5,178
391,677
643,479
638,207
799,897
799,904
799,904
839,938
887,531
902,908
Compensation of employees
Goods and services
Payments for capital assets
Buildings and other fixed structures
Machinery and equipment
Total economic classification
2.7.6 PERFORMANCE AND EXPENDITURE TRENDS
The purpose is to render health care support services to the entire Health Care Services. The allocated budget has a direct impact on the achievements of
targets in the following ways:

Provision of all essential medicines. The allocated budget is used to purchase all these medicines and the MTEF will ensure availability.

Provision of forensic pathology services.

Provision of orthotic and prosthetic services. E.g. the purchase assistive devices are done using this allocation.
The department has spent a total of R1.7 billion in 2007/8 to 2009/10 while the 2010/11 budget amounts to R799.9 million. The proposed MTEF from
2011/12 to 2013/14 is projected at R2.6 billion which will be used to maintain and improve the current services.The Department ensure achievement of
this programme’s strategic objectives and targets through effective and economic utilization of the resources, regular monitoring of the programme
performance and stakeholders participation.
2011/12-2013/14 Annual Performance Plan Vote 7
132
2.7.7 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme: Health Care Support Services and measures to mitigate the
impact of the risks are indicated below.
Risks
Mitigating factors
Inappropriate and inadequate skills



Conduct skills audit
Develop recruitment and retention strategy
Provide needs based human resource development and training
Inadequate infrastructure
Fast-track infrastructure development e.g. Big bang
Inadequate health technology

Provide appropriate Health Technology
Inadequate information and communication technology

Provide appropriate Information and Communication Technology
Inefficient Supply Chain Management
Strengthen and streamline efficiency of the supply chain management
2011/12-2013/14 Annual Performance Plan Vote 7
133
2.8 PROGRAMME 8: HEALTH FACILITIES MANAGEMENT
2.8.1 PROGRAMME PURPOSE
The purpose of the programme is to plan, provide and equip new facilities/assets, and upgrade, rehabilitate and maintain hospitals, clinics and other
facilities.
The programme is provided through strategic goals of improving infrastructure development and maintenance. There is no change in five year strategic
objectives.
A review of various maps reflecting the relationship between the burden of disease and the social and economic circumstances of the population of
Limpopo shows clearly that physical facilities are not the most urgent requirement for an improvement of health delivery in the province, although the
provision of basic infrastructure still needs to be given urgent attention. In line with national objectives, the priority focus in health services should shift to
the preventative health rather than curative interventions. This renewed focus on preventative rather than curative medicine will place greater emphasis
on the Primary Health Care (PHC) system to ensure that patients are seen at the right point of entry to the health system. While some Occupational
Patient Departments (OPD) has fairly high patient headcounts there are many that are comparatively low. The report on the PHC system shows the need
for more clinics and Community Health Centres (CHC) and for the full package of PHC services to be offered at these facilities. Continued construction of
new facilities in priority areas remains a high priority, but we need to look at providing longer opening hours at existing facilities as well as spreading the
patient visiting patterns over longer hours.
Our analysis indicates that there are more than enough beds for 2020 but that the beds are not necessarily correctly located geographically or at the
right level (1, 2 or 3). In addition, at this stage, beds located at clinics and CHCs have not yet been included in level one or district bed counts. Beds
therefore need to be redistributed according to population requirements and all level one
beds must be counted.
There are a number of hospitals with bed counts of less than 100 and with low occupancy rates. Population projections show that these occupancy rates
will decline even further. These hospitals need to be evaluated and reclassified as CHCs where there is currently a great shortage of facilities of this
category of service. This will also contribute to effective personnel and funding allocations, while offering a broader based service to the community.
In general most facilities are in reasonable ‘maintain” condition and in need of adequate funding for renovations or maintenance. In addition, if facilities
can be right-sized, savings can be made on upgrading as only the required areas need to be renovated. Subsequently maintenance will also be
minimized, and facility utilization will increase.
In catchments areas where bed numbers need to be increased, it is necessary to ensure that the coverage in terms of population is taken into account
which may result in beds being better placed in existing and new CHCs and not at existing hospitals.
2011/12-2013/14 Annual Performance Plan Vote 7
134
2.8.2 PRIORITIES










Upgrade of PHC facilities
Upgrade of hospitals
Provide new academic Hospital
New malaria facilities
New EMS facilities
Upgrade of Forensic Pathology Services facilities
Provide staff accommodation
Upgrade nursing college and nursing schools
Provide suitable Pharmaceutical Depot
Provide water, sanitation and electrical services (new and upgrade)
2011/12-2013/14 Annual Performance Plan Vote 7
135
2.8.3 PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HEALTH FACILITIES MANAGEMENT
STRATEGIC GOAL 9: Improve infrastructure development and maintenance
TABLE 77.
PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HEALTH FACILITIES MANAGEMENT
Strategic
objective
Develop, upgrade
and maintain
Health facilities
Performance
indicator
Strategic
Plan target
Means
of
verification/
Data Source
Audited/ actual performance
Estimated
performa
nce
Medium term targets
2007/08
31
2008/09
20
2009/10
18
2010/11
17
2011 /12 2012/13
27
15
2013/14
15
Number of new and
upgraded PHC
facilities completed
77
IRM
(Infrastructur
e Reporting
Model)
Number of EMS
facilities completed
20
IRM
3
4
2
4
4
6
13
IRM
2
0
0
7
2
2
2
Number of hospitals
on revitalization
under construction
IRM
4
6
6
4
4
4
5
Number of hospitals
on revitalization
completed
IRM
1
0
0
1
2
1
1
Number of hospitals
on revitalization preplanning
2011/12-2013/14 Annual Performance Plan Vote 7
6 hospitals
revitalised
136
Strategic
objective
Performance
indicator
Strategic
Plan target
Means
of
verification/
Data Source
2007/08
5
2008/09
2
2009/10
2
No
baseline
None
No
baseline
IRM
Number of Forensic
Pathology Services
(FPS) facilities
completed
2
IRM
Number of Malaria
facilities completed
15
IRM
Malaria Head
Office’s upgrade
completed
Number of new staff 68 units
accommodation
units / rooms
completed per
annum (18 ten
bedroom blocks -180
rooms)
Audited/ actual performance
Medium term targets
Estimated
performa
nce
2010/11
2
2011 /12 2012/13
1
None
2013/14
None
2
2
10
2
1
No
baseline
No
baseline
None
1
None
None
87
None
157
94
18 (180)
18 (180)
17 (170)
Develop, upgrade Number of health
and
maintain institutions provided
with own source of
Health facilities
water
150
IRM
50
50
49
35
30
30
30
Number of health
institutions provided
with pollution free
sanitation units
150
IRM
114
70
10
30
30
30
30
Number of health
institutions with
upgraded electrical
supply
22
IRM
29
27
2
10
3
3
3
2011/12-2013/14 Annual Performance Plan Vote 7
137
Strategic
objective
Performance
indicator
Percentage of health
facilities complying
with maintenance
contracts
TABLE 78.
Annual Indicator
Strategic
Plan target
Means
of
verification/
Data Source
Implement
Documented
planned
evidence
maintenanc
e at health
facilities
Audited/ actual performance
Estimated
performa
nce
2007/08
No
baseline
2010/11
Determine
baseline
2008/09
No
baseline
2009/10
No
baseline
Medium term targets
2011 /12
100%
2012/13
2013/14
100%
100%
NATIONAL PERFORMANCE INDICATORS FOR HEALTH FACILITIES MANAGEMENT
Data Source
Type
Audited/ actual performance
2007/08
2008/09
Medium term targets
Estimated
performance
2009/10
2010/11
2011/12
2012/13
4.46
4.46
2013/14
1. Equitable share
capital programme as
% of total health
expenditure
BAS
%
4.46
4.46
4.46
2. Number of hospitals
currently unfunded
on revitalisation
programme
IRM
No
0
0
0
0
0
0
0
3. Expenditure on
facility maintenance
as % of total health
expenditure
BAS
%
1.92
1.92
1.92
1.92
1.92
1.92
1.92
4. Average backlog of
service platform in
fixed PHC facilities
Documented
evidence
R
5. Level 1 beds per
1000 uninsured
population1
Documented
evidence
No
2011/12-2013/14 Annual Performance Plan Vote 7
6,403
1.3
6,915
1.3
138
4.46
7,468
1.3
8,065
1.3
8,710
1.3
9,501
1.3
National
target
2014/15
4.46
0
10,364
1.3
90
Annual Indicator
6. Level 2 beds per
1000 uninsured
population1
Data Source
Documented
evidence
Type
No
Audited/ actual performance
2007/08
0.5
2008/09
0.5
2009/10
0.5
Medium term targets
Estimated
performance
2010/11
0.5
2011/12
0.5
2012/13
0.5
National
target
2013/14
0.5
¹Summarised from the provincial service transformation plan
2.8.4 QUARTERLY TARGETS FOR HEALTH FACILITIES MANAGEMENT FOR 2011/12
TABLE 79.
QUARTERLY TARGETS FOR HEALTH FACILITES MANAGEMENT FOR 2011/12
Performance indicator
Number of new and
upgraded PHC facilities
completed
Reporting
period
Annual
target
2011/12
Quarterly targets
Q1
Q2
Q3
Q4
3
4
4
16
10
10
5
10
10
5
27
Annually
Number of health
institutions provided with
own source of water
Quarterly
30
Number of health
institutions provided with
pollution free sanitation
units
Percentage of health
facilities complying with
maintenance contracts
Quarterly
30
Quarterly
100%
2011/12-2013/14 Annual Performance Plan Vote 7
5
(Boreholes Drilled,
Equipped, Tested and
Commissioned)
5
100%
100%
139
100%
100%
2014/15
60
Performance indicator
Reporting
period
Annual
target
2011/12
Number of health
institutions with
upgraded electrical
supply
Annually
3
Number of EMS facilities
completed
Annually
Number of hospitals on
revitalization preplanning
Quarterly targets
Q1

Q2
One health facility at
75% electrical supply
upgrade
2 health facilities at
25% electrical supply
upgrade

4
One at 75% construction
progress
Annually
2
Number of hospitals on
revitalization under
construction
Annually
Number of hospitals on
revitalization completed
Q3
Q4
2 health
facilities at
75% electrical
supply
upgrade
2 health facilities
completed – 100%
1
1
2
10% IPIP development
30% IPIP
development
80% peer
review
National approval
4
4 hospitals under
construction
4 hospitals under
construction
4 hospitals
under
construction
4 hospitals under
construction
Annually
2
0
0
0
2 complete.
Number of Forensic
Pathology Services
(FPS) facilities
completed
Annually
1
25% construction
progress
50% construction
progress
75%
construction
progress
One FPS facility
completed -100%
Number of Malaria
facilities completed
Annually
10
2
6 at 75%
construction
progress
6
2
Malaria Head Office’s
upgrade completed
Annually
1
25% construction
progress
50% construction
progress
75%
construction
progress
100% completed

2011/12-2013/14 Annual Performance Plan Vote 7
140

One health
facility completed
– 100%
2 health facilities
at 25% electrical
supply upgrade
Performance indicator
Number of new staff
accommodation units /
rooms completed per
annum (18 ten bedroom
blocks -180 rooms)
Reporting
period
Annual
target
2011/12
Annually
18
Quarterly targets
Q1
Q2
18 ten-bedroom blocks’
tenders awarded
35% construction
progress
Q3
Q4
70%
construction
progress
18 ten-bedroom blocks’
completed - 100%
2.8.5 RECONCILING PERFORMANCE TARGETS WITH EXPENDITURE TRENDS
TABLE 80.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Sub-programme
R’ thousand
Audited outcome
2007/08
2008/09
Main
appropriation
2009/10
Adjusted
appropriation
Revised
estimate
2010/11
Medium term expenditure
estimates
2011/12
2012/13
2013/14
Community Health facilities
110,760 145,077
172,091
202,894
228,105
228,105
257,625
250,660
275,290
District hospitals
169,693 266,657
225,617
368,191
321,888
321,888
420,324
442,416
422,159
Provincial hospitals
12,871
15,230
30,176
27,289
19,444
19,444
34,226
35,937
37,734
9,186
10,287
35,825
18,333
17,506
17,506
20,633
22,665
24,798
Other facilities
120,812 247,800
292,988
326,271
323,425
203,425
338,947
292,614
352,487
TOTAL
423,322 685,051
756,697
942,978
910,368
790,368
1,071,755
1,044,292
1,112,468
Central hospitals
2011/12-2013/14 Annual Performance Plan Vote 7
141
TABLE 81.
SUMMARY OF PROVINCIAL EXPENDITURE ESTIMATES BY ECONOMIC CLASSIFICATION
Main
Adjusted
Revised
appropriation appropriation estimate
Audited Outcomes
Current payments
Compensation of employees
Goods and services
Transfers and subsidies to
Households
2010/11
Medium-term estimate
2007/08
2008/09
2009/10
2011/12
2012/13
2013/14
68,354
93,346
117,029
148,931
118,952
118,952
163,125
184,065
198,269
2,546
2,140
5,507
8,719
3,500
3,500
9,242
9,704
10,384
65,808
91,206
111,522
140,212
115,452
115,452
153,883
174,361
187,885
147
147
Payments for capital assets
354,821
591,705
639,668
794,047
791,416
671,416
908,630
860,227
914,199
Buildings and other fixed
structures
349,975
585,172
631,788
786,167
781,956
661,956
880,873
831,082
885,096
4,841
6,533
7,880
7,880
9,460
9,460
27,757
29,145
29,103
685,051
756,697
942,978
910,368
790,368
1,071,755
1,044,292
1,112,468
Machinery and equipment
Software and other intangible
assets
Total economic classification
5
423,322
2.8.6 PERFORAMNCE AND EXPENDITURE TRENDS
The purpose of the programme is to plan, provide and equip new facilities/assets, and upgrade, rehabilitate and maintain hospitals, clinics and other
facilities. The allocated budget has a direct impact on the achievements of targets in the following ways:

Maintenance of health facilities .e.g. boilers and equipments at hospitals and other institutions.

Building and upgrading of health facilities. E.g. clinics, health centres, forensic pathology, nursing colleges and hospitals as well as the building of
new malaria, new academic hospital and EMS stations are provided for in the budget and MTEF.
The department has spent a total of R1.8 billion in 2007/8 to 2009/10 while the 2010/11 budget amounts to R943.0 million. The proposed MTEF from
2011/12 to 2013/14 is projected at R3.5 billion which will be used to maintain and improve the current services.The Department ensure achievement
of this programme’s strategic objectives and targets through effective and economic utilization of the resources, regular monitoring of the programme
performance and stakeholders participation.
2011/12-2013/14 Annual Performance Plan Vote 7
142
2.8.7 RISK MANAGEMENT
The key risks that may affect the realisation of the objectives of the budget programme: Health facilities management and measures to mitigate the
impact of the risks are indicated below.
Risks
Mitigating factors
Lack of norms and standards
Development of national norms and standards by the National Health Task team
Inability to spend the infrastructure budget
Plan, document, advertise and award bids a month prior to the start of the new
financial year
Inability of contractors to deliver projects within Strengthen contract management and on site supervision
contractual time frame
Delays in the procurement systems
Explore alternative ways to fast track procurement
Lack of preventative maintenance
Introduction of 3 year maintenance term contracts
2011/12-2013/14 Annual Performance Plan Vote 7
143
3. PART C: LINKS TO OTHER PLANS
3.1 INFRASTRUCTURE/CAPITAL PLANS
INFRASTRUCTURE/CAPITAL PLANS
TABLE 82.
Main
appropriation
OUTCOME
NO
PROJECT NAME
PROGRAMME

New and replacement
assets
1
(R’ thousand)
(additional)

(R’ thousand)
(additional)
3
Upgrades and
additions
4
Rehabilitation,
renovations and
refurbishments
2007/08
2008/09
138,842
221,284
2010/11
342,914
260,473
46,448
42,455
66,546
97,005
240,529
392,649
305,149
537,321

2011/12







Capital
(R’ thousand)
(additional)
Source: Tables B.5, Limpopo Budget Statements 2010/11
2011/12-2013/14 Annual Performance Plan Vote 7
2009/10

Capital

Medium-term estimates
2012/13
2013/14

Current

Revised
Estimate
OUTPUTS
Capital
Maintenance and
repairs
2
MUNICIPALITY
Adjusted
appropriation
144
435,486
370,141
295,233
102,825
107,966
113,364
482,723
470,707
558,155


3.1.1
FACTORS INFLUENCING THE DEPARTMENT’S ABILITY TO DELIVER ON INFRASTRUCTURE /CAPITAL PLANS

Turnaround in the completion and/or implementation of projects by implementing agent

Integrated infrastructure plans

Turnaround time in the procurement process
2011/12-2013/14 Annual Performance Plan Vote 7
145
3.2 CONDITIONAL GRANTS
TABLE 83.
Name of
conditional grant
1. Hospital
revitalization
Programme
CONDITIONAL GRANTS
Purpose of the grant
To revitalize hospitals around infrastructure
development, health technology, quality
improvement and organizational
development)
Performance indicators
(extracted from the Business Cases
prepared for each Conditional Grant)
Indicator targets for 2011/12

Number
of
projects
in
hospital
revitalization program completed

2 hospitals completed

2 business cases approved

Number of business cases approved for
the hospital revitalization program

4 IPIP’s approved

Number of IPIP approved for the hospital
revitalization program

6 hospitals under construction

Feasibility Study for the Academic
Hospital National Flagship Program
completed

Seventy seven (27) PHC facilities
completed

Theatre Air Conditioners

Thirty (30) PHC facilities provided
with pollution free sanitation units

Thirty (30) health facilities provided
with own source of water

Number of projects in construction in the
hospital revitalization program

Number of hospitals in planning phase in
the hospital revitalization program

Feasibility Study for the Academic
Hospital National Flagship Program
completed
Number PHC facilities completed
2. .Infrastructure

As per Division of Revenue Act (DORA):

Grant for
Provinces

The Provincial Infrastructure Grant set
out in Schedule 4 supplements the
funding of infrastructure programmes
funded from provincial budgets to enable
Provinces



to address backlogs in provincial
infrastructure
Participate in the Infrastructure
Development Improvement Programme
(IDIP) facilitated by the National
2011/12-2013/14 Annual Performance Plan Vote 7

Number of hospitals with critical
equipments replaced

Number of health facilities provided with
pollution free sanitation units

Number of health facilities provided with
own water source
146
Name of
conditional grant
Purpose of the grant
Treasury, unless the National Treasury
exempts any such Department from
participation.


3. Forensic
Pathology
Service Grant
where a receiving provincial department
lacks capacity designate a percentage
not exceeding four percent of the
allocation for acquiring such capacity
Performance indicators
(extracted from the Business Cases
prepared for each Conditional Grant)

Number of health facilities with electrical
supply upgraded

Number of health facilities provided with
new water purification plants

Number of health facilities provided with
new waste treatment plants
Indicator targets for 2011/12

Five (3) health facilities’ electrical
supply upgraded
To provide funding for infrastructure
development: new, upgrade,
replacement of equipment, electrification,
sanitation, water and maintenance.
For establishment and development Forensic
Pathology services in the province
4. HIV and AIDS Increase access to comprehensive HIV and
AIDS, STIs Care, treatment, management and
support
Number of new and upgraded Forensic
Pathology facilities completed

Percentage of clients tested for HIV

95% testing rate

Number of patients on ART - total

148 970 patients on ART

Number of CD4 tests done

300 000 CD4 count test done

Number of PCR HIV tests done

12 150 PCR HIV tests done

Number of Viral Load tested done

80 000 Viral Loads test done

No. of CHW(Lay counsellor, Mentors,
Peers educators and Carers receiving
stipend)

Lay Counsellors 900 Mentors 82

2011/12-2013/14 Annual Performance Plan Vote 7
One Forensic Pathology facility
completed
Percentage of post filled against the plan
147
Peer educators 200, Carers 6845

80% of staff appointed against the
plan
Name of
conditional grant
5. Health
Professions
training &
Development
grant
6. National
Tertiary
Services
Grant
Purpose of the grant
Performance indicators
(extracted from the Business Cases
prepared for each Conditional Grant)
Indicator targets for 2011/12
•
Division of Revenue Act 12 of 2009
•
•
To support provinces to fund costs
associated with training of health
professionals; development and
recruitment of medical specialists in
under-served provinces; and support
and strengthen under graduate and
post graduate teaching and training
processes in health facilities
Number and composition of health
sciences students by province and
training institution (Under graduate)
348 students in various categories
undergoing training
•
Number of registrars per discipline
and per institution (post graduate

63 registrars appointed
•
Number of specialist per discipline

90 specialists in various disciplines
providing teaching in TertiaryRegional hospitals
•
Expanded specialist and teaching
infrastructure in target provinces

50 specialists providing expanded
teaching.

Teaching aids available in TertiaryRegional hospitals
To compensate tertiary facilities for the
additional costs associated with spill over
effects to ensure the adequate provision of
tertiary health services for all South African
citizens.
2011/12-2013/14 Annual Performance Plan Vote 7
Number of tertiary health services provided
148
32 of 50 tertiary services
3.3 PUBLIC-PRIVATE PARTNERSHIPS (PPPs)
TABLE 84.
Name of PPP
PPPS
Purpose
Outputs
Current annual budget
(R’thousand)
1. Limpopo
Renal Dialysis
Unit
2.
Phalaborwa
Hospital
To Form partnership for
financing, constructing,
equipping, maintaining,
operating and co-staffing
an enlarged and
refurbished renal facility;
and
•
High quality serviced health
facility delivered
•
Facilities and management
service consistent with the
ethos, goals and values of the
Department provided
Provide full range of
haemodialysis and
provision of support to the
peritoneal outpatients
services by private parties
•
Acquire full PPP for
financing, designing,
upgrading, and
refurbishment of the
Phalaborwa Health
Centre as a private
hospital facility
Private hospital established
through PPP
2011/12-2013/14 Annual Performance Plan Vote 7
R14 million
Date of
termination
Measures to ensure
smooth transfer of
responsibilities
November 2016
Project Steering Committee
established to ensure:
High quality renal services
consistent with the international
standards provided
R200 000
December 2025

Compliance to service
level agreement

skills transfer to the
project team by the
private partner

that funding for the
project is available

decision to re- advertise
or perform internally to
be taken three years
prior to termination
(2013)
Project Steering Committee
established to ensure:

Compliance to service
level agreement

decision to re- advertise
or perform internally to
be taken three years
prior to termination
(2022)
15 years Agreement signed
149
Name of PPP
Purpose
Outputs
Current annual budget
(R’thousand)
3.
Big bang
project
4. Limpopo
Academic
Hospital
To explore the
construction, upgrade,
equipping and
maintenance of all
hospitals and Primary
Health Care (PHC)
facilities in a limited,
conceded time frame to
ensure fit for purpose built
facilities in which health
care can be rendered
Acquire full PPP for
financing, designing and
building the academic
hospital
Hospitals and PHC facilities
constructed, upgraded, equipped
and maintained to benefit the total
population of Limpopo in which
quality health care will be provided
High quality academic hospital
services consistent with the
international standards provided
R 20 million
Date of
termination
Measures to ensure
smooth transfer of
responsibilities
March 2012/13
(Feasibility
Study Report)
Project Steering Committee
established to ensure:

terms of reference for
the feasibility study are
completed

transactional advisor is
appointed

feasibility study report is
completed

decision by the
Department based on
the recommendations of
the feasibility study
report is recorded
R10 million
-
Achievement of milestones
as per PPP manual
R3 million
-
Achievement of milestones
as per PPP manual
Transactional Advisor appointed in
5. Laundry
Acquire full PPP for
financing, designing,
upgrading, and
refurbishment and
building of the laundry
2011/12-2013/14 Annual Performance Plan Vote 7
High quality serviced health facility
delivered
High quality renal services
consistent with the international
standards provided
150
4. CONCLUSION
Given that the development of the Annual Performance Plan (APP) was an inclusive
process, it is therefore reasonable to conclude that all the Department’s employees
proudly take ownership of this strategic document. Meanwhile, Government’s priorities in
general and those of the health sector in particular have carefully been incorporated into
the APP.
The following resource documents and priorities, interalia, were considered in the
development of the APP: Medium Term Strategic Framework (MTSF), the 10 Point Plan
for the health sector, Government outcomes (Negotiated Delivery Agreement),
Limpopo’s Employment Growth and Development Plan (LEGDP), State of the Nation
Address (SONA), State of the Province Address (SOPA) and the Minister’s Programme
of Action for 2010/11 National Health Priorities. In addition, the APP has been developed
using the format customised for the health sector and approved by Treasury. It is also
important to note that a great effort has been made in setting targets that will see to the
achievement of the Department’s strategic objectives.
The Department hereby commit itself to implement the Annual Performance Plan (APP)
for 2011/12 – 2013/14 (MTEF).
2011/12-2013/14 Annual Performance Plan Vote 7
151
5. ANNEXURES
5.1 ANNEXURE A: CHANGES TO THE TABLED FIVE YEAR STRATEGIC PLAN
The vision, mission and the following strategic objectives and objective statements have been added or modified to align with the
national and provincial priorities.
PART A: CHANGES OF VISION AND MISSION
Old Vision
New vision
Old mission
A health promoting and
developmental service to the
people in Limpopo
An optimal and
sustainable health care
service in Limpopo
The Department is committed to
providing accessible,
comprehensive, integrated,
sustainable and affordable health
and social development services
TABLE 85: PART B: CHANGES IN STRATEGIC OBJECTIVES
BUDGET
STRATEGIC STRATEGIC
OBJECTIVE
PROGRAMME GOAL
OBJECTIVE
STATEMENT
Programme 1:
Administration
Effective
corporate
governance
provided
Provide
integrated
planning
2011/12-2013/14 Annual Performance Plan Vote 7
New mission
Develop and
implement
integrated strategic
plan and annual
performance plan by
2014
BASELINE
(FOR THE
OBJECTIVE
(2008/09)
2005/09-2010
strategic plan
available
152
The provision and promotion of a comprehensive,
accessible and affordable quality health care service
to improve the life expectancy of the people
JUSTIFICATION
(RATIONALE
EXPECTED
OUTCOMES
CHANGES IN
STRATEGIC
PLAN
Ensure
implementation of
national,
provincial and
departmental
priorities with key
stakeholders
National ten
point plan,
PGDS, MTSF
Improved
strategic
leadership and
management
Strategic
objective
removed
TABLE 85: PART B: CHANGES IN STRATEGIC OBJECTIVES
BUDGET
STRATEGIC STRATEGIC
OBJECTIVE
PROGRAMME GOAL
OBJECTIVE
STATEMENT
Provide security
management
services
Knowledge,
Records,
Information and
management
systems
technology
(KRIMST)
established and
operational
Programme 2:
District Health
Services
Strengthen
district health
and hospital
services
Strengthen
programmes on
maternal, child,
woman, youth,
adolescent
health and
nutrition
Provide nutrition
services
2011/12-2013/14 Annual Performance Plan Vote 7
BASELINE
(FOR THE
OBJECTIVE
(2008/09)
Improve physical
Security
and information
management
security measures in plan available
the Department by
2014
JUSTIFICATION
(RATIONALE
EXPECTED
OUTCOMES
CHANGES IN
STRATEGIC
PLAN
Ensure
compliance with
security
measures
Secured and
safe
departmental
environmental
assets
New Strategic
objective
Develop, implement
and review KRIMST
strategy and Policy
by 2014
Standalone
policies
available.
Records and
information
management
units available
and operational
PHIS and DHIS
available
Reduce maternal
591 (18.9)
deaths from 182.9 to reported
136.6 per 100 000
maternal
live
deaths for 3
years (2005Mortality under five
2007) and
reduced from 43.9
43.9/1000 live
to 40.9 per 1000
births for under
live births by 2014
5 years
mortality rates
To provide and
implement and
integrated
KRIMST strategy
and Policy
Improved
accountability on
resources
resulting in wellfunded and
managed health
services
Strategic
objective
modified
Implement
programmes on
MCWH and
nutrition to
reduce morbidity
and mortality
rates
Improved child
survival
Strategic
objective
statement
target changed
Increase number of
greenery projects
from 506 to 756
Reduce
malnutrition
Improved
nutritional status
Strategic
objective
removed
506
153
TABLE 85: PART B: CHANGES IN STRATEGIC OBJECTIVES
BUDGET
STRATEGIC STRATEGIC
OBJECTIVE
PROGRAMME GOAL
OBJECTIVE
STATEMENT
Programme 5
Central and
Tertiary
Services
Tertiary
services
developed
Strengthen
secondary
hospital services
BASELINE
(FOR THE
OBJECTIVE
(2008/09)
JUSTIFICATION
(RATIONALE
Increase number of
registrars by 10 %
by 2014
31 Registrars
Improve quality
and access to
care
Increase number of
clinical disciplines
conducting outreach
by 10% by 2014
22
Reduce referrals to
other provinces by
15% by 2014
5.3%
4 Pilot sites
Improve the
quality of tertiary
services
Response to
medico legal and
diagnosis
requirements
Improved quality
of care
417 staff
Part of the
accommodation strategy to attract
constructed
and retain health
staff
Improved quality
of care
Programme 7:
Health care
support
services
Strengthen
district health
and hospital
services
Develop forensic
pathology
services
Increase number of
telemedicine from 3
pilot sites to 89
Increase health
research projects by
8% by 2014
Develop 13 forensic
pathology facilities
by 2014.
Programme 8
Health facilities
management
Improved
infrastructure
development
and
maintenance
Develop,
upgrade and
maintain health
facilities
Construct 68 new
staff
accommodation
units by 2014
Promote health
research
2011/12-2013/14 Annual Performance Plan Vote 7
104
11 forensic
pathology
facilities
established
154
EXPECTED
OUTCOMES
CHANGES IN
STRATEGIC
PLAN
Improved quality
of care
Strategic
objective
modified
New strategic
objective
statement
Improved access
to forensic
pathology
services
Strategic
objective
removed
New strategic
objective
Strategic
objective
statement
target changed
5.2 ANNEXURE E - DEFINITIONS OF INDICATORS AND DATA ELEMENTS IN THE APP
5.2.1 SITUATION ANALYSIS
TABLE 2: TRENDS IN KEY PROVINCIAL SERVICE VOLUMES
Indicator
Title
Short Definition
Purpose/
Importance
Source
Total PHC
Headcount
in PHC
facilities
Number of PHC
patients seen
during the
reporting period in
PHC facilities
(Clinics and
CHCs)
Tracks the
uptake of
PHC
services at
each PHC
facility for
the
purposes of
allocating
staff and
other
resources.
DHIS
Each patient is
counted once for
each day they
appear at the
facility, regardless
of the number of
services provided
on the day(s) they
were seen
2011/12-2013/14 Annual Performance Plan Vote 7
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
PHC total
headcount
Accuracy of
headcount
depends on
the reliability
of PHC
record
management
at facility
level
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Programme
Manager
155
OPD
General
clinic new
case not
referred
rate”
Number of
General OPD
clinic new cases
(seeking medical
attention for a
condition for the
first time) that
report to the
General OPD
department
without being
referred from a
PHC facility or
doctor during the
reporting period in
all Hospitals
(district, regional,
tertiary and
central) as a
percentage of the
OPD General
headcount new
visits total.
Tracks the
utilisation of
Hospitals
by patients
to access
PHC
services,
which in
fact should
be
accessed at
PHC
services.
This could
also points
to the
needs for
PHC
services or
gaps in
PHC
service
delivery
Patients with
General OPD
follow-up visits,
visiting specialised
OPD clinics and
Emergency
patients are not
counted in
denominator,
because this is not
regarded as PHC
level of care.
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Numerator:
OPD
General
clinic
headcount new case not
referred.
Denominator
= OPD
General
clinic
headcount
new casetotal
Accuracy of
headcount
depends on
the reliability
of district
hospital
record
management
at facility
level
Sum of :


OPD
General
clinic
headcou
nt-new
case
referred
OPD
General
clinic
headcou
nt -new
case not
referred
156
Output
Percentage
Quarterly
Yes
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Programme
Manager
Total
Hospital
Separations
Recorded
completion of
treatment and/or
the
accommodation of
a patient in all
hospitals (district,
regional, tertiary
and central)
Separations
include inpatients
who were
discharged,
transferred out to
other hospitals or
who died and
includes Day
Patients.
Monitoring
the service
volumes
DHIS
Sum of:




Inpatient
deaths
Inpatient
discharg
es
Inpatient
transfer
out
Day
patient
Accuracy
dependant
on quality of
data from
reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
All Hospital
Programmes
TABLE 3: MILLENIUM DEVELOPMENT GOALS
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Prevalence
of
underweight
(children
under 5)
A child under 5
years identified
as being
BELOW the
third centile but
EQUAL TO or
OVER 60% of
Estimated
Weight for Age
(EWA) on the
Road-to-Health
chart. Include
any such child
irrespective of
the reason for
the underweight
malnourishment,
premature birth,
genetic
disorders etc.
Essential
for growth
monitoring
in children
DHIS
Numerator
Accuracy
dependent
on quality
of data from
reporting
facility
Outcome
Percentage
Quarterly
No
Lower levels
of
Health
Information,
Epidemiology
2011/12-2013/14 Annual Performance Plan Vote 7
Number of
children
underweight
for age
during the
reporting
period
prevalence of
underweight
(children
under 5)
are desired
Denominator
and Research
Programme
Nutrition
Programme
Maternal, Child
and Women’s
Health
Programme
Number of
children
weighed
during the
reporting
period
157
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Incidence of
severe
malnutrition
in children
(under 5
The number of
children who
weigh below
60% Expected
Weight for Age
(new cases per
month) per
1000 children in
the target
population
Essential
for growth
monitoring
in children
DHIS
Numerator
Accuracy
dependent
on quality
of data from
reporting
facility
Outcome
Number per
1000
Quarterly
No
Lower levels
of
Health
Information,
Epidemiology
years of age)
The number
of children
who weigh
below 60%
Expected
Weight for
Age during
the reporting
period
(Indicator
must be
annualised)
prevalence of
underweight
(children
under 5)
are desired
and Research
Programme
Nutrition
Programme
Maternal, Child
and Women’s
Health
Programme
Denominator
Children
under 5
years
x 1000
Infant
mortality rate
Number of
children less
than one year
old who die in
one year, per
1000 live births
during that year
Monitors
trends in
infant
mortality
South
African
Demographic
And Health
Surveys
(SADHS)
Numerator
Number of
children less
than one
year old who
die in one
year
Denominator
Data are
not
frequently
available.
Empirical
data are
available
from the
SADHS,
which is
conducted
every 5
years
Total
number of
live births
during that
year x 1000
2011/12-2013/14 Annual Performance Plan Vote 7
158
Outcome
Number per
1000 (rate)
Empirical
data are
provided by
the SADHS
every 5
years
No
Lower Infant
Mortality
Rates are
desired
Maternal, Child
and Women’s
Health
Programme
Indicator
Title
Short Definition
Purpose/
Importance
Source
Measles
coverage
under 1
Percentage of
children under 1
year who
received their
first measles
dose
Monitors
measles
coverage
DHIS
Method of
Calculation
Numerator:
Measles 1st
dose before
1 year
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Reliant on
under 1
population
estimates
from
StatsSA
Output
Percentage
Quarterly
No
Higher
proportions of
children
immunised
against
measles are
desired.
Expanded
Programme
on
Immunisation
(EPI)
Denominator:
Manager
Population
under 1 year
Maternal
mortality
ratio
Number of
women who die
as a result of
childbearing,
during
pregnancy or
within 42 days of
delivery or
termination of
pregnancy in
one year, per
100,000 live
births during that
year
Monitors trends
in maternal
mortality
SADHS
Numerator
Number of
women who
die as a
result of
childbearing,
during
pregnancy or
within 42
days of
delivery or
termination
of pregnancy
in one year
Data are
not
frequently
available.
Empirical
data are
available
from the
SADHS,
which is
conducted
every 5
years
Outcome
Data are
not
frequently
available.
Empirical
data are
available
from the
Output
Number per
100,000
Empirical
data are
provided
by the
SADHS
every 5
years
No
Lower
Maternal
Mortality
Ratios are
desired
Lower
Health
Information,
Epidemiology
and Research
Programme
MCWH
Programme
Denominator
Total number
of live births
during that
year x
100,000
Proportion
of births
attended
by skilled
health
personnel
Percentage of
women who
gave birth in the
5 years
preceding the
South African
Demographic
Survey (SADHS)
Monitors trends
in maternal
mortality
2011/12-2013/14 Annual Performance Plan Vote 7
SADHS
Numerator
Number of
women who
gave birth in
the 5 years
preceding
the survey
who reported
159
Empirical
data are
provided
by the
SADHS
every 5
years
No
Higher levels
of skilled
births
attended by
skilled health
personnel are
desired
Health
Information,
Epidemiology
and Research
Programme
Indicator
Title
Short Definition
Purpose/
Importance
who reported
that medical
assistance at
delivery from
either a doctor,
nurse or midwife
Source
Method of
Calculation
Data
Limitations
that medical
assistance at
delivery from
either a
doctor,
nurse or
midwife
SADHS,
which is
conducted
every 5
years
Denominator
Total number
of women
who gave
birth in the 5
years
preceding
the survey
2011/12-2013/14 Annual Performance Plan Vote 7
160
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
MCWH
Programme
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
HIV and
AIDS
prevalence
among 15-19
year old
group
Percentage of
women aged
15-19 years
surveyed
testing
positive for
HIV
Tracks
prevalence of
HIV and AIDS
in younger
women of
reproductive
age, and the
success of
efforts to
combat HIV
and AIDS in
South Africa
Annual
Antenatal
and HIV
Survey
Numerator:
Women aged
15 – 19
years who
tested HIV
positive
during the
survey;
Denominator:
Women aged
15 – 19
years who
were tested
for HIV
during the
survey
Reflects
prevalence
in surveyed
women, not
entire
population.
Outcome
Percentage
Annual
No
Lower levels
of HIV and
AIDS
prevalence
are desired
Health
Information,
Epidemiology
Tracks
prevalence of
HIV and AIDS
in young adult
women of
reproductive
age, and the
success of
efforts to
combat HIV
and AIDS in
South Africa
Annual
Antenatal
and HIV
Survey
Numerator:
Women aged
20– 24 years
who tested
HIV positive
during the
survey;
Denominator:
Women aged
20 – 24
years who
were tested
for HIV
during the
survey
Reflects
prevalence
in surveyed
women, not
entire
population
Track the
extent of the
use of
contraception
(any method)
amongst
women of
child bearing
age
SADHS
(antenatal)
HIV and
AIDS
prevalence
among 20-24 year old
group
(antenatal)
Contraceptive
Prevalence
Rate
Percentage of
women aged
20-24 years
surveyed
testing
positive for
HIV
Percentage of
women of
reproductive
age (15-44)
who are using
(or whose
partner is
using) a
modern
contraceptive
2011/12-2013/14 Annual Performance Plan Vote 7
and Research
Programme
HIV and AIDS
Programme
Outcome
Percentage
Annual
No
Lower levels
of HIV and
AIDS
prevalence
are desired
Health
Information,
Epidemiology
and Research
Programme
HIV and AIDS
Programme
Data are
not
frequently
available.
Empirical
data are
available
from the
SADHS,
which is
161
Output
Percentage
Empirical
data are
provided
by the
SADHS
every 5
years
No
Higher
Contraceptive
prevalence
levels are
desired
Health
Information,
Epidemiology
and Research
Programme
MCWH&N
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
method.
Contraceptive
methods
include
female and
male
sterilisation,
injectable and
oral
hormones,
intrauterine
devices,
diaphragms,
spermicides
and
condoms,
natural family
planning
lactational
amenorrhoea.
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
conducted
every 5
years
Indicator
Responsibility
Programme
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
New
smear
positive
PTB cure
rate
Percentage of
patients who
are proved to
be cured using
smear
microscopy at
the end of the
treatment
(bacteriological
proof)
Tracks the
success of
efforts to
combat
Tuberculosis in
South Africa
ETR.net
Numerator:
Accuracy
dependent
on quality
of data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicate
better cure
rate for the
province
TB Programme
Manager
(TB
information
system)
2011/12-2013/14 Annual Performance Plan Vote 7
New smear
positive
cured
Denominator:
New smear
positive
newly
registered
162
5.2 PROGRAMMES AND SUB-PROGRAMMES
PROGRAMME 1: ADMINISTRATION
TABLES 6, 10 & 13: NATIONAL PERFORMANCE INDICATORS FOR HUMAN RESOURCES
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Medical
officers per
100,000
people
Medical
officers in
posts on
last day of
March per
100 000
people.
Tracks the number
of filled Medical
officer’s posts as
part of monitoring
availability of Human
Resources for
Health
Persal
Medical
Officers in
posts
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
Annual
No
Increase in
the number
of medical
officers
contributes to
improving
access to
and quality
of clinical
care
HRM
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
100 000
population
Annual
No
Increase in
the number
of medical
officers in
rural districts
i contributes
to improving
access to
and quality of
clinical care
in rural
district.
HRM
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
100 000
population
Annual
No
Increase in
the number
of
professional
nurses
contributes to
improving
access to
and quality
of health
services
HRM
----------------
100 000
population
Total
population
X 100 000
Medical
officers per
100,000
people
in
rural
districts
Professional
nurses per
100,000
people
Medical
officers in
posts
employed in
the Rural
districts on
last day of
March per
100 000
people.
Professional
Nurses in
posts on
last day of
March per
100 000
people.
Tracks the number
of filled Medical
officer employed in
the rural districts, as
part of monitoring
availability of Human
Resources for
Health in Rural
Districts. This
indicator also assists
in assessing urban
/rural equity.
Persal
Tracks the number
of filled Professional
Nurses posts , as
part of monitoring
availability of Human
Resources for
Health
Persal
Medical
Officers in
posts- Rural
---------------Total
population
in Rural
Districts
X 100 000
Professional
Nurses in
posts
---------------Total
population
X 100 000
2011/12-2013/14 Annual Performance Plan Vote 7
163
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Professional
nurses per
100,000
people
in
rural
districts
Professional
Nurses in
posts
employed in
rural
districts on
last day of
March per
100 000
people.
Tracks the number
Professional Nurses
posts filled in rural
districts, as part of
monitoring
availability of Human
Resources for
Health in Rural
Districts. This
indicator also assists
in assessing urban
/rural equity.
Persal
Professional
Nurses in
posts- Rural
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
100 000
population
Annual
No
Increase in
the number
of
professional
nurses in
rural districts
contributes to
improving
access to
and quality
of health
services rural
districts
HRD
Tracks the number
of filled Pharmacists
posts to monitor
availability of Human
Resources
Persal
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
100 000
population
Annual
No
Increase in
the number
of
Pharmacists
lead to better
quality of
care
HRD
Dependant
on
accuracy of
Persal
system.
Input
Ratio per
100 000
population
Annual
No
Increase in
the number
of
Pharmacists
in rural
districts lead
to better
quality of
care in these
rural districts
HRD
Pharmacists
per 100,000
people
Pharmacists
in posts on
last day of
March per
100 000
people.
---------------Total
population
in Rural
Districts
X 100 000
Pharmacists
in posts
---------------Total
population
X 100 000
Pharmacists
per 100,000
people
in
rural
districts
Pharmacists
in posts
employed in
rural
districts on
last day of
March per
100 000
people.
Tracks the number
Pharmacists posts
filled in rural districts,
as part of monitoring
availability of Human
Resources for
Health in Rural
Districts. This
indicator also assists
in assessing urban
/rural equity
Persal
Pharmacists
in posts Rural
---------------Total
population
in Rural
Districts
X 100 000
2011/12-2013/14 Annual Performance Plan Vote 7
164
Vacancy
rate
for
professional
nurses
Percentage
of funded
vacant
professional
Nurses
posts on the
last day of
the
reporting
period
Tracks the number
of funded vacant
Professional Nurses
posts to monitor
availability of Human
Resources
Persal
Dependant
on
accuracy of
Persal data
Process
Ratio per
100 000
population
Quarterly
No
Increase in
the number
of
professional
nurses lead
to better
quality of
care
HRD
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Process
Percentage
Quarterly
No
Total
Number of
funded
vacant
Dependant
on
accuracy of
Persal data
Decrease in
the vacancy
rate lead to
better quality
of care
Human
Resources
Total
Number of
funded
vacant
Professional
Nurses
posts
---------------Total
number of
funded
professional
nurse posts
in the
province
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Vacancy
rate
for
doctors
Percentage
of funded
vacant
doctors
posts on
the last day
of the
reporting
period
Tracks the number of
funded vacant
Doctors posts to
monitor availability of
Human Resources
Persal
Doctors
posts on the
last day of
the
reporting
period
---------------Total
number of
doctors
funded
posts in the
province
2011/12-2013/14 Annual Performance Plan Vote 7
165
Management
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Vacancy
rate
for
medical
specialists
Percentage
of funded
vacant
medical
specialists
posts on
the last day
of the
reporting
period
Tracks the number of
funded vacant
medical specialists
posts to monitor
availability of Human
Resources
Persal
Method of
Calculation
Total
Number of
funded
vacant
medical
specialists
posts on the
last day of
the
reporting
period
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Process
Percentage
Quarterly
No
Decrease in
the vacancy
rate lead to
better quality
of care
Human
Resources
Decrease in
the vacancy
rate lead to
better quality
of care
Human
Resources
Dependant
on
accuracy of
Persal data
Management
---------------Total
number of
medical
specialists
funded
posts in the
province
Vacancy
rate
for
pharmacists
Percentage
of funded
vacant
pharmacists
posts on
the last day
of the
reporting
period
Tracks the number of
funded vacant
pharmacists posts to
monitor availability of
Human Resources
Persal
Process
Total
Number of
funded
vacant
Dependant
on
accuracy of
Persal data
Pharmacists
posts on the
last day of
the
reporting
period
---------------Total
number of
funded
pharmacists
posts in the
province
2011/12-2013/14 Annual Performance Plan Vote 7
166
Percentage
Quarterly
No
Management
TABLE 11 AND 12: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR ADMINISTRATION
Indicator Title
Short Definition
Purpose/
Importance
Source
Number of
performance
monitoring
reviews
conducted
Examination and
assessment of
performance
against set
targets
Track
performance
of programs or
projects
Monitoring
and
Evaluation
Method of
Calculation
Numerator
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
None
Output
Sum total
Quarterly
No
Output
reflect
progress
monitoring
Monitoring
and
Evaluation
Number of
performance
review
conducted
Denominator
Number of
performance
review
targeted
Number of
research studies
commissioned
Formal study
conducted
through rigorous
process to
measure
satisfaction rates
of clients
To improve
quality of
services
Monitoring
and
Evaluation
Study
completed
outsourci
ng
output
Sum total
annual
yes
improved
quality of
services
Monitoring
and
Evaluation
Number of
Health facilities
certificated for
Accreditation
‘Certification
To provide
quality of
health
services
Compliance
Reports
Numerator
outsourci
ng
output
Sum total
annual
yes
improved
quality of
services
Monitoring
and
Evaluation
Misunder
standing
of risk
manage
ment
output
Basic
maths
quarterly
No
Risk culture
consciousn
ess
Risk
Management
and all
employees.
Number of
institutions
conducting risk
assessments
for Accreditation’
shall mean the
determination by
the Accreditation
body that an
eligible Health
facilities is
certificated in
compliance with
applicable
predetermined
standards
All institutions
should conduct a
risk assessment.
Number of
facilities
certificated for
accreditation
Denominator
Total number
of facilities
In order to
have a risk
profile that
keeps us
aware of all
operational
2011/12-2013/14 Annual Performance Plan Vote 7
PFMA
Impact X
Likelihood=
Inherent risk
exposure-–
(minus)
control
167
Indicator Title
Short Definition
Purpose/
Importance
Source
surprises that
have an
adverse effect
towards
achievement
of objectives
Number of
institutions
implementing
security
management
plan
Percentage
compliance of
institution
Compliance
include the
following:
Monitoring of
service level
agreement,
conforming to
the provisions of
minimum
information on
security
standards
Provide safe
and secure
environment
for
Departmental
assets –
property and
information
Minimum
information
Security
Standards
Method of
Calculation
Data
Limitatio
ns
effectiveness=
residual risk.
content
Numerator
Complian
ce
depends
on
credible
security
report
Number of
institutions
Denominator
Total number
of targeted
institutions
The identification
of physical
security
measures that
can be applied at
institutions to
safeguard or
protect
departmental
assets – people,
property and
information
2011/12-2013/14 Annual Performance Plan Vote 7
168
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
process
Number
Quarterly
No
Secure and
safe
environmen
t for
department
al assets
Security
management
directorate
Indicator Title
Short Definition
Purpose/
Importance
Source
Knowledge
management
Strategy and
Policy developed
and
implemented
Knowledge
management
Strategy and
Policy available
Departmental
Knowledge
should be
retained and
managed
Documented
evidence
Number of
facilities that
meet minimum
requirements in
terms of
National
Archives and
Records Service
Act
Number of all
health facilities
with appropriate
record keeping
To
provide
good
record
keeping
for
decision
making
and
planning
National
Archives and
record
services Act
Method of
Calculation
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
Document
availability
N/A
Process
N/A
Annually
Yes
Strategy
and Policy
implemente
d and
reviewed
GITO
Numerator
Complian
ce
depends
on
manage
ment of
records
at the
Institutio
ns.
Outcome
Number
Quarterly
No
Good
quality
record
keeping in
all
Institutions
is desired
GITO
N/A
Process
N/A
Annually
Yes
Information
Communica
tion
Technology
Strategy
and Policy
implemente
d and
reviewed
GITO
Accuracy
of
calculatin
g core
modules
Process
Number
Quarterly
Yes
All core
modules
implemente
d
GITO
Number of
health
facilities
inspected for
good Record
keeping
Denominator
Total number
of health
facilities in
the Province
Information
Communication
Technology
Strategy and
Policy developed
and
implemented
Information
Communication
Technology
Strategy and
Policy available
Number of sites
with PHIS fully
implemented
The total number
of site wherein
all the PHIS core
modules are
implemented
and functional
ICT strategy
and policy
need to be in
place to
support line
function
2011/12-2013/14 Annual Performance Plan Vote 7
Documented
evidence
PHIS
Document
availability
Total number
of core
modules
169
Indicator Title
Short Definition
Purpose/
Importance
Number of sites
with
telemedicine
infrastructure
The total number
of health sites
that are
equipped with
telemedicine
infrastructure
To ensure all
sites have
telemedicine
infrastructure
for improved
patient
management
Number of
facilities that
meet minimum
requirements for
data quality in
terms of South
African Statistics
Quality
Assurance
Framework
(SASQAF)
Number of
hospitals, PHCs
and District
offices with data
that is accurate,
reliable,
complete,
relevant and
timeous.
To provide
credible
information for
informed
decision
making and
planning
Number of
health
professionals
appointed
20 specialists,
340 medical
offices, 37
dentists, 1417
professional
nurse, 55
pharmacists &
312 Emergency
care
Practitioners
appointed
Tracks the
appointment
of the core
health
professionals
to reduce the
vacancy rate
Source
DHIS
Documented
evidence
Method of
Calculation
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
Number of site
telemedince
infrastructure
Only
infrastruc
ture is
measure
d
Output
Number
Quarterly
Yes
Availability
of
infrastructur
e in
telemedicin
e sites
GITO
Numerator
Complian
ce
depends
on
quality of
data from
the
Institutio
ns.
Outcome
Number
Quarterly
No
High quality
data in all
Institutions
is desired
GITO
Appointm
ent not
yet
captured
are not
reflected
Output
Number
Quarterly
No
Reaching
the target
Human
Resource
Management
Number of
Institutions
assessed for
data quality
Denominator
Total number
of all Health
Institutions
within the
Province
2011/12-2013/14 Annual Performance Plan Vote 7
Persal &
Vulindlela
(HRM
information
System)
Returns on
appointments
Headcount
Job
offers
reported
as
appointm
ents
170
Reduction
of vacancy
rate
Indicator Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
Percentage of
people with
disabilities
employed
Equity targets of
People with
Disability
Implementatio
n of affirmative
action at the
work place
Equity Act
People with
Disability
appointed
---------------
Accessibi
lity to the
work
place
Output
Ratio
Bi annual
No
Equity
achieved.
Human
Resource
Planning and
Research
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Address the
imbalances
of the past
Supply Chain
Management
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Address the
imbalances
of the past
Supply Chain
Management
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Address the
imbalances
of the past
Supply Chain
Management
Total number
of personnel X
100.
Percentage of
bids awarded to
Historically
disadvantaged
individual (HDI)
Percentage of
bids awarded to
Historically
disadvantaged
individual (HDI)
Bring the
historically
disadvantaged
to the
mainstream
economy
Consolidated
procurement
report
Numerator
Number of
bids awarded
to HDI
Denominator
Total bids
awarded by
100%
Percentage of
bids awarded to
Women
Percentage of
bids awarded to
Women
Improve
participation of
women in
economic
activities
Consolidated
procurement
report
Numerator
Number of
bids awarded
to women
Denominator
Total bids
awarded by
100%
Percentage of
bids awarded to
Disabled
Percentage of
bids awarded to
Disabled
Improve
participation of
disabled in
economic
activities
Consolidated
procurement
report
Numerator
Number of
bids awarded
to Disabled
Denominator
Total bids
awarded by
2011/12-2013/14 Annual Performance Plan Vote 7
171
Indicator Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Improved
youth
participation
in economic
activities
Supply Chain
Management
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Stimulate
economic
growth
within the
local
communitie
s
Supply Chain
Management
Depende
d on the
accuracy
of data
by end
users
Process
Percentage
Quarterly
and
annual
No
Sustainabilit
y and job
creation
Supply Chain
Management
100%
Percentage of
bids awarded to
Youths
Percentage of
bids awarded to
Youths
Economic
empowerment
to the youth
Consolidated
procurement
report
Numerator
Number of
bids awarded
to youths
Denominator
Total bids
awarded by
100%
Percentage of
bids awarded to
Locality
Percentage of
bids awarded to
Locality
Support local
economic
growth
Consolidated
procurement
report
Numerator
Number of
bids awarded
to locality
Denominator
Total bids
awarded by
100%
Percentage of
bids awarded to
small medium
and micro
enterprise
(SMME)
Percentage of
bids awarded to
small medium
and micro
enterprise
(SMME)
Empower
small medium
and micro
enterprise
(SMME) to
sustain
themselves
and create
jobs
2011/12-2013/14 Annual Performance Plan Vote 7
Consolidated
procurement
report
Numerator
Number of
bids awarded
to SMMEs
Denominator
Total bids
awarded by
100%
172
Indicator Title
Short Definition
Purpose/
Importance
Source
Percentage of
institutions with
credible asset
registers
Percentage of
institutions with
credible asset
registers
Proper
recording
assets
Excel asset
register
BAS
Method of
Calculation
Data
Limitatio
ns
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibilit
y
Numerator
Depende
d on the
accuracy
of data
by
institution
s
Process
Percentage
Annual
No
Account for
all
government
assets
Supply Chain
Management
Amount
collected
against the set
target
Rely on
payment
by
patients
process
Amount
Annual
No
Improved
funding for
delivering of
services to
the
community
Financial
budgeting and
revenue
Audited
annual
financial
statement
Financial
controls
and
complian
ce with
financial
prescript
s
Process
N/A
Annual
Yes
Accountabili
ty and value
for money
CFO
Number of
institutions
with credible
asset register
Denominator
Total number
of institutions
by 100%
Revenue
collected
Amount of
revenue
collected for the
year
Supplement
resources to
implement
government
programmes
BAS
Audit opinion on
financial
management
expressed by the
Auditor General
Financial
statement fairly
presented
without any
reservations
To obtain
unqualified
audit report
Auditor
General’s
report
2011/12-2013/14 Annual Performance Plan Vote 7
173
PROGRAMME 2; DISTRICT HEALTH SERVICES
TABLES 17, 19 AND 21: NATIONAL PERFORMANCE INDICATORS FOR DISTRICT HEALTH SERVICES
Indicator
Title
Short Definition
Purpose/
Importance
Source
Provincial
PHC
expenditure
per
uninsured
person
Total expenditure
by the Provincial
DoH on PHC
services
To monitor
adequacy of
funding
levels for
PHC
services
BAS
Method of
Calculation
Data
Limitations
Numerator
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Input
Annual
Annul
No
Higher levels
of expenditure
reflect
prioritisation of
PHC services
DHS
Programme
Manager
Total
expenditure
of the
Province on
PHC
services
(Programme
2)
Financial
Management
Officials
Denominator
Number of
uninsured
people in the
Provinces as
indicated in
STATSSA or
Council for
Medical
Scheme data
PHC total
headcount
Number of PHC
patients seen
during the
reporting period.
Each patient is
counted once for
each day they
appear at the
facility, regardless
of the number of
services provided
on the day(s) they
were seen
Tracks the
uptake of
PHC
services at
each PHC
site for the
purposes of
allocating
staff and
other
resources.
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Sum total of
PHC
headcounts
during the
reporting
period
Accuracy of
headcount
depends on
the reliability
of PHC
record
management
at facility
level
174
Output
Sum
Quarterly
No
Higher levels
of uptake may
indicate an
increased
burden of
disease, or
greater
reliance on
public health
system
DHS
Programme
Manager
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
PHC total
headcount
– under 5
years
Number of PHC
patients under the
age of 5 years
seen during the
reporting period.
Each patient is
counted once for
each day they
appear at the
facility, regardless
of the number of
services provided
on the day(s) they
were seen
Tracks the
children
under 5
uptake of
PHC
services at
each PHC
site for the
purposes of
allocating
staff and
other
resources.
DHIS
Sum of PHC
headcount
under 5
years during
the reporting
period
Accuracy of
headcount
depends on
the reliability
of PHC
record
management
at facility
level
Output
Sum
Quarterly
No
Higher levels
of uptake may
indicate an
increased
burden of
disease
amongst
children, or
greater
reliance on
public health
system
DHS
Programme
Manager
Utilisation
rate - PHC
Rate at which
services are
utilised by the
target population,
represented as
the average
number of visits
per person per
period in the
target population.
Tracks the
uptake of
PHC
services at
each PHC
site for the
purposes of
allocating
staff and
other
resources.
DHIS -
Numerator:
Output
No
PHC total
headcount
Annualised
rate
Quarterly
PHC Total
Headcount
Denominator:
Total
Population
Total
Population
Higher levels
of uptake may
indicate an
increased
burden of
disease, or
greater
reliance on
public health
system
Programme
Manager
StatsSA -
Dependant
on the
accuracy of
estimated
total
population
from
StatsSA
Rate at which
services are
utilised by the
target population
under 5 years,
represented as
the average
number of visits
per person per
period in the
target population.
Tracks the
uptake of
PHC
services at
each PHC
site for the
purposes of
allocating
staff and
other
resources.
DHIS -
Numerator:
Output
No
PHC
headcount
under 5
years
Annualised
rate
Quarterly
PHC
headcount
under 5
years
Dependant
on the
accuracy of
estimated
population 5
years an
under from
StatsSA
Higher levels
of uptake may
indicate an
increased
burden of
disease, or
greater
reliance on
public health
system
Programme
Manager
Utilisation
rate - PHC
under 5
years
2011/12-2013/14 Annual Performance Plan Vote 7
Denominator:
StatsSA Population
under 5
years
Population
under 5
years
175
Indicator
Title
Short Definition
Purpose/
Importance
Source
Percentage
of fixed
PHC
facilities
that were
visited by a
supervisor
at least
once every
month
Percentage of
fixed PHC
facilities that were
visited by a
supervisor at
least once every
month (official
supervisor report
completed)
Tracks the
supervision
rate of all
PHC
facilities.
DHIS
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Numerator:
Dependant
on the
reporting the
purpose of
the visit by
the
supervisor to
the PHC
facility.
Quality
Percentage
Quarterly
No
Higher levels
indicate better
support to the
PHC facility
QA
Programme
Manager
Accuracy of
headcount
depends on
the reliability
of PHC
record
management
at facility
level and
accuracy of
Efficiency
Rate
Quarterly
No
Lower
expenditure
could indicate
DHS
Programme
Manager
Number of
fixed PHC
facilities that
were visited
by a
supervisor
Denominator:
Total number
of fixed PHC
facilities
Expenditure
per
PHC
Headcount
Expenditure per
PHC headcount
by provincial DoH
at provincial PHC
facilities.
Tracks the
cost to
provincial
DoH for
every visit to
provincial
PHC facility.
DHIS –
Numerator:
PHC Total
Headcount
Expenditure
on PHC by
provincial
DoH
BAS –
Expenditure
on PHC by
provincial
DoH
Denominator:
PHC Total
Headcount
efficient use of
financial
resources, or
incomplete
provision of
the
comprehensive
PHC package
expenditure
depends on
the accuracy
of correct
expenditure
allocation
Community
Health
Centres
(CHCs)
and
Community
Day
Centres
(CDCs)
with
resident
Percentage of
CHCs and CDCs
with at least one
resident Doctor.
Tracks the
national
norms of the
PHC
package
2011/12-2013/14 Annual Performance Plan Vote 7
QA
Numerator:
Total number
of CHCs and
CDCs with at
least one
resident
Doctor.
Accuracy
dependant
on the
quality of
data from
the reporting
facility
Input
Percentage
Quarterly
Yes
Higher
percentage
indicates
better
compliance to
the national
norms
Human
Resources
Management
Districts and
Development
176
Indicator
Title
Short Definition
Purpose/
Importance
Source
doctor rate
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Process
Sum
Annual
Yes
Higher number
indicates
better
compliance
with the core
standards
Quality
Assurance
Denominator:
Total number
of CHCs and
CDCs in the
province
Number of
PHC
facilities
assessed
for
compliance
against the
6 priorities
of the core
standards
Total number of
PHC facilities
assessed for
compliance
against the core
standards
Tracks the
levels of
compliance
against the
core
standards
2011/12-2013/14 Annual Performance Plan Vote 7
QA
Total number
of PHC
facilities
assessed
against the
core
standards.
177
TABLES 18 AND 20: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISTRICT HEALTH SERVICES
Indicator Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculati
on Type
Reporting
Cycle
New
Indica
tor
Desired
Performance
Indicator
Respons
ibility
Number of
Districts with
functional District
Management
Teams
Total quantity of
Districts with
management
teams
Support
efficiency of
the District
Health
Services
DHIS
N/D-total number of
Districts that are
having management
teams over total
number of district that
exist in the Province
Accuracy of
the quality of
data
Output
Numeric
al
Quarterly
no
All Districts
DEM
Number of
districts
implementing the
District Health
Plan
Total quantity of
Districts who are
implementing DHP
Accelerating
service
delivery at
District level
DHIS
N/D-number of
districts who are
implementing district
health plan over the
existing number of
district in the Province
Data subject
to
manipulation
Output
Numeric
al
Quarterly
No
All Districts
DEM
Percentage
supervision of
PHC facilities
Number of visits by
the supervisor to
PHC facilities
To monitor
and evaluate
the
implementatio
n of PHC
service
delivery
DHIS
N/D- number of visits
done to PHC facilities
by the supervisor over
total number of visits
to the existing PHC
facilities
Data collected
subject to
manipulation
Output
Percenta
ge
Quarterly
No
All PHC
facilities to be
honestly
supervised
Percentage of
PHC facilities
implementing full
PHC package
Percentage of PHC
facilities that are
implementing PHC
package fully
Access PHC
facilities that
provide all
services that
are mend for
PHC level
DHIS
N/D-number of PHC
facilities that
implement PHC
package over the total
number of PHC
facilities in the
Province
Data collected
subject to
manipulation
output
Percenta
ge
Quarterly
No
All PHC
facilities
DEM
Percentage of
facilities
providing 24
hours service
Percentage of PHC
facilities that are
providing 24hours
service
Access PHC
services
DHIS
Numerical
Manipulation
of data
Output
Percenta
ge
Quarterly
No
All PHC
facilities to
provide 24
hours service
DEM
Number of NPOs
supporting
provision of PHC
package
NPOs are mainly
HBC who are
funded to support
deliver of PHC
package
Community
Home based
Care services
reports
Additional :
Waterberg: 26
Capricorn:79
Vhembe :120
Mopani:58
Total= 370
Process
Addition
¼
none
Target 400
Senior
Manager
NPO
funding
2011/12-2013/14 Annual Performance Plan Vote 7
178
SUB PROGRAMME: DISTRICT HOSPITALS:
TABLES 22, 24 AND 26: INDICATORS FOR DISTRICT HOSPITALS
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Caesarean
section rate
in district
hospitals
Caesarean
section
deliveries in
hospitals
expressed as a
percentage of all
deliveries in
hospitals.
Track the
performance
of obstetric
care of the
district
hospitals
DHIS
Numerator:
Accuracy
dependant on
quality of data
from reporting
facility
Output
Percentage
Quarterly
No
Higher
percentage of
Caesarean
section
indicates
higher
burden of
disease,
and/or poorer
quality of
antenatal
care.
MCWH&N
Programme
Manager
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
District Health
Services
Number of
Caesarean
sections
performed
Denominator:
Total number
of deliveries
in facility
Total
separations
in District
Hospitals
Recorded
completion of
treatment and/or
the
accommodation
of a patient in
district hospitals.
Separations
include
inpatients who
were
discharged,
transferred out
to other
hospitals or who
died and
includes Day
Patients.
Monitoring
the service
volumes
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Sum of:




Inpatient
deaths
Inpatient
discharg
es
Inpatient
transfer
out
Day
patient
179
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Patient Day
Equivalent in
District
Hospitals
Patient day
equivalent is
weighted
combination of
inpatient days,
day patient
days, and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Monitoring
the service
volumes
DHIS
Sum of:
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
District Health
Services
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
District Health
Services




OPD
Headcount
total = sum
of:


OPD
Headcount Total in
district
hospitals
A headcount of
all outpatients
attending an
outpatient clinic.
Inpatient
days total
1/2 Day
patients
1/3 OPD
headcou
nt -total
1/3
Emergen
cy
Headcou
nt
Monitoring
the service
volumes
DHIS
Sum of:


2011/12-2013/14 Annual Performance Plan Vote 7
OPD
specialist
clinic
headcou
nt +
OPD
general
clinic
headcou
nt
OPD
specialist
clinic
headcou
nt
OPD
general
clinic
headcou
nt
180
Indicator
Title
Short Definition
Purpose/
Importance
Source
District
hospitals
with monthly
Maternal
Mortality and
Morbidity
Meetings
Percentage of
district hospitals
having monthly
Maternal
Mortality and
Morbidity
Meetings (3 per
quarter)
To monitor
the quality of
hospital
services, as
reflected in
levels of
diseases
adverse
events; and
proportion of
deaths
Quality
Assurance
(QA)
Method of
Calculation
Numerator:
Number of
district
hospitals
having
Maternal
Mortality and
Morbidity
every month
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Quality
Percentage
Quarterly
No
Higher
percentage
suggests
better clinical
governance
Quality
Assurance
Accuracy of
information is
dependent on
the accuracy of
time stamp for
each complaint
Quality
Higher
percentage
suggest
better
management
of complaints
in District
Hospitals
Quality
Assurance
(QA)
Denominator:
Total number
of district
hospitals
Percentage
of
complaints
of users of
District
Hospital
Services
resolved
within 25
days
Percentage of
complaints of
users of District
Hospital
Services
resolved within
25 days
To monitor
the
management
of the
complaints in
District
Hospitals
Quality
Assurance
Numerator:
Total number
of complaints
resolved
within 25
days during
the quarter
Denominator:
Total number
of complaints
during the
quarter
2011/12-2013/14 Annual Performance Plan Vote 7
181
Percentage
Quarterly
Yes
Indicator
Title
Average
length of
stay in
district
hospitals
Short Definition
Purpose/
Importance
Source
Average number
of patient days
that an admitted
patient in the
district hospital
before
separation.
To monitor
the efficiency
of the district
hospital
DHIS
Method of
Calculation
Numerator:
Inpatient
days + 1/2
Day patients
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
High levels of
efficiency y
could hide
poor quality
Efficiency
Ratio
Quarterly
No
A low
average
length of stay
reflects high
levels of
efficiency.
But these
high
efficiency
levels might
also
compromise
quality of
hospital care
District Health
Services
Accurate
reporting sum
of daily usable
beds
Efficiency
Percentage
Quarterly
No
Higher bed
utilisation
indicates
efficient use
of bed
utilisation
and/or higher
burden of
disease
and/or better
service levels
District Health
Services
Denominator:
Separations
Bed
utilisation
rate (based
on usable
beds) in
district
hospitals
Patient days
during the
reporting period,
expressed as a
percentage of
the sum of the
daily number of
usable beds.
Track the
over/under
utilisation of
district
hospital
beds
DHIS
Numerator:
Inpatient
days + 1/2
Day patients
Denominator:
Number of
usable bed
days
2011/12-2013/14 Annual Performance Plan Vote 7
182
Indicator
Title
Short Definition
Purpose/
Importance
Source
Expenditure
per patient
day
equivalent
(PDE) in
district
hospitals
Expenditure per
patient day
which is a
weighted
combination of
inpatient days,
day patient
days, and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Track the
expenditure
per PDE in
district
hospitals in
the province
BAS /
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Method of
Calculation
Data
Limitations
Numerator:
Total
Expenditure
in district
hospitals
Denominator:
Patient Day
Equivalent
(PDE)*
183
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Efficiency
Rate
Quarterly
No
Lower rate
indicating
efficient use
of financial
resources.
District Health
Services.
Indicator
Title
Short Definition
Purpose/
Importance
Source
Percentage
of users of
District
Hospital
Services
satisfied with
the services
received
The percentage
of users that
participated in
the District
Hospital
Services survey
that were
satisfied with the
services
Tracks the
service
satisfaction
of the District
Hospital
users
QA
Method of
Calculation
Numerator:
Total number
of users that
were
satisfied with
the services
rendered in
District
Hospitals
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Generalizability
depends on
the number of
users
participating in
the survey.
Output
Percentage
Annual
Yes
Higher
percentage
indicates
better levels
of satisfaction
in District
Hospital
services
Quality
Assurance
Process
Sum
Annual
Yes
Higher
number
indicates
better
compliance
with the core
standards in
District
Hospitals
Quality
Assurance
Denominator:
Total number
of users that
participated
in the Client
Satisfaction
Survey (in
District
Hospitals)
Percentage
of
District
Hospitals
facilities
assessed
for
compliance
against the 6
priorities of
the
core
standards
Percentage of
District Hospitals
assessed for
compliance
against the core
standards
Tracks the
levels of
compliance
against the
core
standards
QA
Numerator:
Total number
of District
Hospitals
assessed
against the 6
priority areas
of the core
standards.
Denominator:
Total number
of District
hospitals in
the province.
2011/12-2013/14 Annual Performance Plan Vote 7
184
TABLES 23 AND 25: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISTRICT HOSPITALS
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitation
s
Type of
Indicato
r
Number of
hospitals
complying
with service
package
Number of hospitals
which attain 80% in
the District hospitals
package Norms and
Standards tool
(NDOH)
Track extent
of provision of
District
Hospital
services.
Hospital
Survey
Sum of all hospitals
which attain 80% or
more in the District
hospitals Norms and
Standards tool
Accuracy
Quality
dependant on
quality of data
from reporting
facility
Calculati
on Type
Report
ing
Cycle
New
Indicat
or
Desired
Performance
Indicator
Responsibi
lity
Sum
Annual
No
Higher
performance
indicates
better
compliance
with Package
District
Health
Services
SUB PROGRAMME: HIV AND AIDS, TB AND STI CONTROL:
TABLES 27, 29 AND 31. SITUATION ANALYSIS INDICATORS FOR HIV & AIDS, STIS AND TB CONTROL
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Total
number of
patients
(Children
and Adults)
on ART
Number of
patients on
an ARV
regimen
Track the
number of
patients on
ARV
Treatment
CCMT
Cumulative total of
Number of patients
on an ARV regimen
Male
condom
distribution
rate
Number of
male
condoms
distributed
within the
province at
public health
facilities per
male
population 15
years and
over
Track the
contraceptive
measures
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Male condoms
distributed within
province
Data
Limitations
Indicator
reliant on
accuracy of
population
estimates
from
StatsSA
Denominator:
Male population 15
and over
185
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Input
Cumulative
total
Quarterly
No
Higher total
indicates a
larger
population on
ART
treatment
HIV/AIDS
rate
Quarterly
Higher rate
indicates
better
contraceptive
measures
which should
lead to
decrease in
HIV/AIDS
incidence.
HIV/AIDS
Programme
manager
Process
No
Programme
Manager
Indicator
Title
Short
Definition
New smear
positive
PTB
defaulter
rate
Percentage
of smear
positive PTB
cases who
interrupted
(defaulted)
treatment
Purpose/
Importance
Source
ETR
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Output
Percentage
Quarterly
No
Lower levels
of interruption
reflect
improved
case holding,
which is
important for
facilitating
successful
TB treatment
Accuracy of
capturing
the
date/time
sampled
dispatched
and/or
received
Quality
Percentage
Quarterly
No
Higher
percentage
indicate
faster
turnaround
TB Programme
manager
Dependant
on the
accuracy of
the
Electronic
TB
Register.
Output
Percentage
Quarterly
Yes
Higher
percentage
indicate
better
coverage
TB Programme
Manager
Numerator:
All smear positive
defaulted
Denominator:
All smear positive
newly registered
Smear
result turnaround
time under
48 hours
rate
Percentage
of TB sputa
tests
completed
with
turnaround
time of less
than 48
hours
Monitor the
turnaround
times of the
sputa
samples
DHIS
Numerator:
TB sputa
specimens with
turnaround time
less than 48 hours
Indicator
Responsibility
Denominator:
All TB sputa
specimens
Percentage
of HIV-TB
Co-infected
patients
placed on
ART
Percentage
of HIV and
TB coinfected
patients
placed on
Ante
retrovirus
Treatment
(ART)
Monitors the
coverage of
ART among
co-infected
population
ETR.
Net
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Total number of HIV
and TB co-infected
people placed on
ART
Denominator:
Total number of coinfected people with
a CD4 count of 350
or less.
186
Indicator
Title
Short
Definition
Purpose/
Importance
Source
HCT
testing rate
Percentage
of clients
tested to
those
counselled.
Monitors the
number of
people
convinced for
testing
DHIS
Method of
Calculation
Numerator:
Total number clients
of HCT clients
tested for HIV
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Dependant
on the
accuracy of
tick and
tally sheets
Process
Percentage
Quarterly
Yes
Higher
percentage
indicates
increased
population
knowing their
HIV status.
HIV/AIDS
Accuracy
dependant
on quality
of data from
reporting
facility
Outcome
Higher
percentage
indicate
better cure
rate for the
province
TB Programme
Manager
Programme
Manager
Denominator:
Total number of
HCT clients pre-test
counselled
New smear
positive
PTB cure
rate
Percentage
of new smear
positive PTB
cases cured
at first
attempt
Monitor the
TB Cure rate
ETR
Numerator:
New smear positive
cured
Denominator:
New smear positive
newly registered
2011/12-2013/14 Annual Performance Plan Vote 7
187
Percentage
Annual
No
TABLE 28 AND 30: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR HIV & AIDS, STIS AND TB
CONTROL
Indicator Title
Short
Definition
Purpose/impo
rtance
Source
Proportion of
HIV exposed
babies testing
positive
Babies born to
known HIV
positive
mothers who
were tested
for HIV and
found to be
positive
Measures
transmission of
HIV
DHIS
Method of Calculation
Numerator:
Data
Limitation
Type of
indicator
Calculation
Type
Reporting
Cycle
New
indicator
Desired
Performance
Indicator
Responsibi
lity
None
Output
%
Quarterly
No
Less positive
babies reduce
transmission
rate
PMTCT
Programme
Manager
No yet
aggregated
on the DHIS
Output
%
Quarterly
Yes
All antenatal
clients to be
tested for HIV
PMTCT
Programme
Manager
Not yet
incorporated
on DHIS for
collection
Output
%
Quarterly
Yes
All antenatal
clients to be
tested for HIV
PMTCT
Programme
Manager
None
Input
%
Quarterly
No
Higher ART
services points
indicate
adequate
accessibility of
services
HIV/AIDS
Baby PCR test positive
around 6 weeks & Baby
HIV antibody test
positive at 18 months
Denominator:
Baby PCR test around 6
weeks & Baby antibody
test at 18 months
Percentage of
HIV exposed
infants who are
PCR positive
initiated on ART
% of pregnant
women who are
tested for HIV
ART service
points registered
Percentage of
HIV positive
children below
one year
initiated on
ART
Measure if all
children who
are HIV
positive below
one year are
initiated on
treatment
DHIS
The proportion
of pregnant
women tested
for HIV for the
first time
during their
current
pregnancy
Measures
women testing
for HIV during
the current
pregnancy
DHIS
Hospitals &
PHC facilities
accredited as
ART services
Measures
competence in
initiating
HAART on
pregnant
women
DHIS
Numerator:
number of PCR positive
initiated on ART
Denominator:
Number of exposed
babies testing PCR
positive
Numerator: Antenatal
clients HIV test
Denominator:
Antenatal clients eligible
for HIV test (clients with
unknown status)
2011/12-2013/14 Annual Performance Plan Vote 7
No of hospitals & PHC
NGOs, correctional
services facilities
offering ART long life
treatment
188
Programme
Manager
Indicator Title
Short
Definition
Purpose/impo
rtance
Source
Number of newly
diagnosed
eligible HIV
positive patients
starting INH
Prophylactic
Treatment
HIV positive
antenatal
clients who
are medically
eligible for
HAART, who
were initiated
on HAART
therapy during
the pregnancy
Measures
competence in
initiating
HAART on
pregnant
women
DHIS
Percentage of
TB patients with
a DOT
supporter (DOT
Coverage)
Percentage of
TB patients
with a DOT
supporter
(DOT
Coverage)
Monitor directly
observed
treatment
TB
Register
and ETR
Method of Calculation
Antenatal clients initiated
on HAART
Antenatal clients eligible
for HAART
Numerator:
TB patients with a DOT
Supporter
Denominator:
Data
Limitation
Type of
indicator
Calculation
Type
Reporting
Cycle
New
indicator
Desired
Performance
Indicator
Responsibi
lity
Clients
initiated on
HAART is
sourced
from ART
Data file
Output
%
Quarterly
No
All eligible
pregnant
women
initiated on
HAART
PMTCT
Programme
Manager
Accuracy
dependent
on quality of
data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicates better
DOT coverage
TB
Programme
Manager
Accuracy
dependant
on quality of
data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicate better
success rate
TB
Programme
Manager
Accuracy
dependent
on quality of
data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicate better
testing rate for
HIV
TB
Programme
Manager
Accuracy
dependent
on quality of
data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicates better
ARV uptake
TB
Programme
Manager
All TB Patients
Treatment
Success Rate
(Cure Rate plus
Completion
Rate)
HIV testing rate
among TB
patients
Cure Rate
(proven with
smear
microscopy at
the end) plus
Completion
Rate ( not
proven to be
cured)
Monitor
success of
treatment
Percentage of
TB patients
tested for HIV
Monitor testing
rate for HIV
ETR
Numerator:
New smear positive
cured plus cases who
completed treatment
Denominator:
All PTB cases
ETR
Numerator:
Number tested for HIV
Denominator:
All PTB cases
Percentage of
MDR-TB
patients started
on ARVs
Percentage of
co-infected
MDR-TB
patients
started on Arts
Monitor rate of
initiation of
ARVs on coinfected MDRTB patients
EDR
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Number of co-infected
MDR-TB patients
initiated on ARVs
189
Indicator Title
Short
Definition
Purpose/impo
rtance
Source
Method of Calculation
Data
Limitation
Type of
indicator
Calculation
Type
Reporting
Cycle
New
indicator
Desired
Performance
Indicator
Responsibi
lity
Accuracy
dependent
on quality of
data from
reporting
facility
Outcome
Percentage
Quarterly
No
Higher
percentage
indicates better
ARV uptake
TB
Programme
Manager
Errors in
reporting
Outcome
Percentage
Quarterly
No
Less than 2%
Recording
and
reporting
manager
Errors in
reporting
Outcome
Number
Annual
No
½ by 2015
Snr
Manager
TB
Denominator:
All co-infected MDR-TB
cases
Percentage of
XDR-TB patients
started on ARVs
Percentage of
co-infected
XDR-TB
patients
started on
ARVs
Monitor rate of
initiation of
ARVs on coinfected XDRTB patients
EDR
Numerator:
Number of co-infected
XDR-TB patients
initiated on ARVs
Denominator:
All co-infected XDR-TB
cases
Percentage of
TB Patients with
MDR-TB
Percentage of
patients with
Drug
resistance out
of a total of TB
patients
Proper
management
of drug
susceptible TB
ETR.net
Numerator:
Number of MDRTB
patients x 100
Denominator
Total number of TB
patients
TB incidence
rate
New cases of
TB per
100,000
Access &
Quality of TB
services
Notificatio
n Register
2011/12-2013/14 Annual Performance Plan Vote 7
Numerical
190
SUB PROGRAMME: MATERNAL, CHILD AND WOMAN HEALTH & NUTRITION
TABLES 32, 34 AND 36: NATIONAL PERFORAMANCE INDICATORS FOR MCWH & N
Indicator Title
Short
Definition
Purpose/
Importance
Source
Immunisation
coverage
under 1 year
Percentage of
all children in
the target area
under one
year who
complete their
primary
course of
immunisation
during the
month
(annualised).
A Primary
Course
includes BCG,
OPV 1,2 & 3,
DTP-Hib 1,2 &
3, HepB 1,2 &
3, and 1st
measles at 9
month
Monitor the
implementation
of Extended
Programme in
Immunisation
(EPI)
DHIS
Percentage of
children 12-59
months
receiving
vitamin A
200,000 units
twice a
year.(The
denominator is
therefore the
target
population 1-4
years
multiplied by
2.)
Monitor the
Vitamin A
coverage of
children
Vitamin A
coverage
under 12 – 59
months ( OR
1-4 years)
Method of Calculation
Numerator:
Immunised fully under
1 year
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Reliant on
under 1
population
estimates
from
StatsSA
Output
Percentage
Annualised
Quarterly
No
Higher
percentage
indicate better
immunisation
coverage
EPI
Programme
manager
Reliant on
Child
population
estimates
from
StatsSA
Output
Percentage
Annualised
Quarterly
No
Higher
percentage
indicate better
Vitamin A
coverage, and
better
nutritional
support to
children
Nutrition
Programme
manager
Denominator:
Population under
1-year
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Vitamin A supplement
to 12-59 months child
Denominator:
Target population 1-4
years x 2
191
Indicator Title
Short
Definition
Purpose/
Importance
Source
Measles
coverage
under 1 year
Percentage of
children under
1 year who
received
measles dose
Monitor the
measles
coverage
DHIS
Method of Calculation
Numerator:
Measles 1st dose
before 1 year
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Reliant on
under 1
population
estimates
from
StatsSA
Output
Percentage
Quarterly
No
Higher
percentage
indicate better
Measles
EPI
Programme
manager
Reliant on
under 1
population
estimates
from
StatsSA
Output
Reliant on
under 1
population
estimates
from
StatsSA
Output
Reliant on
population
estimates
from
StatsSA for
women in
age
category 3059 years
Output
Annualised
coverage
Denominator:
Population under 1
year
Pneumococcal
3st dose
coverage
under 1 year
Percentage of
children under
1 year who
received
Pneumococcal
3st dose
Monitor the
Pneumococcal
coverage
DHIS
Numerator:
Pneumococcal 3rd
doses before 1 year
Percentage
Annualised
Quarterly
No
Higher
percentage
indicate better
Pneumococcal
EPI
Programme
manager
coverage
Denominator:
Population under 1
year
Rota Virus 2nd
dose coverage
under 1 year
Percentage of
children under
1 year who
received Rota
Virus 2nd dose
Monitor the
Rota Virus
coverage
DHIS
Numerator:
nd
Rota Virus 2 doses
before 1 year
Percentage
Quarterly
No
Higher
percentage
indicate better
Rota Virus
EPI
Programme
manager
coverage
Denominator:
Population under 1
year
Cervical cancer
screening
coverage
Percentage of
women from
30 years and
older who
were screened
for cervical
cancer
Monitor
cervical cancer
screening
coverage
DHIS
Numerator:
Cervical smear in
woman 30-years and
older screened for
cervical cancer
Denominator:
Female population 3059 years
2011/12-2013/14 Annual Performance Plan Vote 7
192
Percentage
Annualised
Quarterly
No
Higher
percentage
indicate better
cervical
cancer
coverage
MNCWH
Programme
Manager
Indicator Title
Short
Definition
Purpose/
Importance
Source
Antenatal
visits before
20 weeks rate
The
percentage of
women who
have a
booking visit
(first visit)
before they
are 20 weeks
(about half
way) into their
pregnancy.
Utilisation of
ANC services
DHIS
Percentage of
women of
reproductive
age (15-44)
who are using
(or whose
partner is
using) a
modern
contraceptive
method.
Contraceptive
methods
include female
and male
sterilisation ,
injectable,
and oral
hormones,
intrauterine
devices,
diaphragms,
spermicides
and condoms
Track the
extent of the
use of
contraception
(any method)
amongst
women of child
bearing age
Percentage of
deliveries
where the
mother is
under 18
years on the
day of
Monitor the
percentage of
deliveries
among
teenagers
Couple Year
Protection
Rate
Delivery rate
for women
under 18
years
Method of Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Numerator:
Reliant on
accuracy of
number of
weeks the
client is
pregnant
Process
Percentage
Quarterly
No
Higher
percentage
indicates
better access
to antenatal
care.
MNCWH
programme
Manager
Reliant on
accuracy of
data
collection
Output
Percentage
Annual
No
Higher
Health
Information,
Epidemiology
st
Antenatal 1 visits
before 20 weeks
Denominator:
Antenatal 1st visits
DHIS
SADHS
Couple year protection
rate:
Numerator
protection
levels are
desired
Contraceptive years
equivalent = Sum:
 Male sterilisations x
20
 Female sterilisations
x10
 Medroxyprogesterone
injection /4
 Norethisterone
enanthate injection /6
 Oral pill cycles /13
 IUCD x 4
 Male condoms /500
and Research
Programme
MCWH&N
Programme
Denominator: Female
target population 15-44
years
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Outcome
Total number of
Deliveries in province
to woman under 18
years
193
Percentage
Annual
No
Higher
percentage
indicates
increase in the
number
deliveries
among
MCWH
Programme
manager
Indicator Title
Short
Definition
Purpose/
Importance
Source
delivery.
Method of Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Denominator:
Desired
Performance
Indicator
Responsibility
teenagers.
Total Deliveries in
province
facility
Maternal
Mortality Ratio
(MMR)
Facility Infant
mortality
(under 1
years) rate
Number of
maternal
deaths in
facility
expressed per
100 000 live
births. . A
maternal
death is the
death of a
woman while
pregnant or
within 42 days
of termination
of pregnancy,
irrespective of
the duration
and the site of
the
pregnancy,
from any
cause related
to or
aggravated by
the pregnancy
or its
management,
but not from
accidental or
incidental
causes (as
cited in ICD
10).
Confidential
enquiry into
maternal
deaths report
only released
every 3-5
years, so
monitoring of
maternal
deaths on a
routine basis is
very important
to monitor
progress
towards MDG
target.
Mortality and
causes of
death report
does not give
exact figures
for maternal
deaths.
DHIS
The number of
children who
have died in a
health facility
between birth
and their first
birthday,
Monitoring of
infant deaths
on a routine
basis is very
important to
monitor
progress
DHIS
Numerator:
Maternal death in
facility
Reliant on
accuracy of
classification
of inpatient
death
Outcome
Ratio per
100 000 live
births
Annual
No
Lower
institutional
rate indicate
fewer
avoidable
deaths.
MNCWH
programme
manager
Reliant on
accuracy of
in facility
live births
reporting
Outcome
Rate
Annual
No
Lower infant
mortality rate
N/A
Denominator:
Live births in facility
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Total number of
inpatient death under
one year
194
Indicator Title
Facility child
mortality
(under 5
years) rate
Short
Definition
Purpose/
Importance
expressed per
thousand live
births in facility
towards MDG.
The number of
children who
have died in a
health facility
between birth
and their fifth
birthday,
expressed per
thousand live
births in facility
Monitoring of
children
deaths on a
routine basis is
very important
to monitor
progress
towards MDG.
Source
Method of Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Reliant on
accuracy of
in facility
live births
reporting
Outcome
Rate
Annual
No
Lower children
mortality rate
N/A
Denominator:
Inpatients separations
under 1 year (Sum of
Inpatient discharge < 1
year and Inpatient
transfer out < 1)
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Numerator:
Total number of
inpatient deaths under
5 years
Denominator:
Inpatients separations
under 5 year (Sum of
Inpatient discharge < 5
year and Inpatient
transfer out < 5)
195
TABLE 33 AND 35 PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR MCWH&N
Indicator
Title
Short Definition
Purpose/
Importance
Source
Ante natal
care before
13wks
The percentage of
women who have a
booking visit (first
visit) before they
are 13 weeks.
HIV positive
mother with
advanced HIV
should be on
HAART for as long
as possible before
delivery to bring
the viral load down
and reduce risk of
mother to child
transmission.
DHIS
Monitors the
implementation of
IMCI at PHC
facilities
DHIS
Number of
PHC facilities
with 60% IMCI
saturation
Number of facilities
with 60% of trained
professional nurses
in IMCI
Method of Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsibil
ity
Numerator:
Reliant on
accuracy of
number of
weeks the
client is
pregnant
Process
Percentage
Quarterly
No
Higher
percentage
indicates
better
access to
antenatal
care.
PMTCT
programme
Manager
Reliant on
accuracy of
number of the
data base of
trained
professional
nurses
Process
Per number
trained
Quarterly
No
Higher
percentage
indicates
better
access to
IMCI
services.
MNCWH
programme
Manager
Reliant on
accuracy of
the reports
Process
Per number
implemente
d
Quarterly
No
Higher
number
indicates
better
access to
new born
care
services.
MNCWH
programme
Manager
Reliant on
accuracy of
the availability
of the school
outcome
Per number
trained
Quarterly
No
Higher
percentage
indicates
better
MNCWH
programme
Manager
st
Antenatal 1 visits
before 13 weeks
Denominator:
Antenatal 1st visits
Numerator:
number of PHC
facilities managing
children under 5 years
Denominator:
MNCWH
Programme
Manager
Number of PHC
facilities with 60% of
trained professional
nurses in IMCI
Number of
PHC
institutions
implementing
Community
Component of
IMCI
Number of clinics
with CHWs
implementing
household
community
component of IMCI
Monitors the
implementation of
household
community
component at
facility and
community level
Reports
Numerator:
number of PHC
facilities providing
household community
component of IMCI
Denominator:
Number of all PHC
facilities in the province
Percentage of
primary
schools
receiving
Percentage of
schools receiving
schools health
services
Monitors
implementation of
school health
services
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Numerator:
number of Primary
schools
196
Indicator
Title
Short Definition
Purpose/
Importance
Source
school health
services
Method of Calculation
Denominator:
Number of Primary
schools receiving
schools health services
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
health
register.
Desired
Performan
ce
Indicator
Responsibil
ity
access
schools
health
services
services
Percentage of
recommendati
ons from the
saving
mothers report
in all
institutions
Percentage of
facilities
implementing 8 out
of 10
recommendations
from the saving
mothers report
Monitors
implementation of
8 out of 10
recommendations
from the saving
mothers report
Reports
Numerator:
number of hospitals
providing maternity
care
Reliant on
accuracy of
the reports
from
institutions
Denominator:
Number of hospitals
implementing 8 out of
10 recommendations
from the saving
mothers report
2011/12-2013/14 Annual Performance Plan Vote 7
197
Process
Percentage
Quarterly
No
Higher
percentage
indicates
better
access
quality
maternal
health
services
MNCWH
programme
Manager
SUB PROGRAMME: DISEASE CONTROL AND PREVENTION
TABLES 38 AND 40: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR DISEASE CONTROL AND
PREVENTION
Indicator Title
Number of
dwellings
sprayed
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculati
on Type
Reporting
Cycle
New
Indicator
Desired
Performan
ce
Indicator
Respons
ibility
Total quantity of
dwellings
sprayed with an
insecticide by
the malaria
control spray
teams
A
measurement
of the
implementatio
n of the main
malaria
control
intervention
Malaria
Information
system
Numerical
Accuracy
dependant on
quality of data
from malaria
spray teams
Output
Numeric
al
Quarterly
No
Higher
levels
indicates
better
prevention
against
malaria in
communitie
s at risk
Senior
Manager:
Malaria
TABLES 37 AND 39: NATIONAL PERFORMANCE INDICATORS FOR DISEASE CONTROL AND PREVENTION
Indicator Title
Short
Definition
Purpose/
Importance
Malaria fatality
rate (annual)
Deaths from
malaria as a
percentage of
the number of
cases reported
Monitor the
number
deaths
caused by
Malaria
Source
Method of
Calculation
Numerator:
Deaths from
malaria
Denominator:
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant
on quality
of data from
health
facilities
Outcome
Rate
Annual
No
Lower
percentage
indicates a
decreasing
burden of
malaria
Communicable
Diseases
Total number of
Malaria cases
reported
2011/12-2013/14 Annual Performance Plan Vote 7
198
Indicator Title
Short
Definition
Purpose/
Importance
Cholera fatality
rate (annual)
Deaths from
cholera as a
percentage of
the number of
cases reported
Monitor the
number
deaths
caused by
Cholera
Source
Method of
Calculation
Numerator:
Deaths from
Cholera
Denominator:
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant
on quality
of data from
health
facilities
Outcome
Rate
Annual
No
Lower
percentage
indicates a
decreasing
burden of
cholera
Communicable
Diseases
Accuracy
dependant
on quality
of data from
health
facilities
Outcome
Rate per
Annual
No
Higher levels
reflects a
good
contribution
to sight
restoration,
especially
amongst the
elderly
population
Non
communicable
Diseases
Total number of
cholera cases
reported
Cataract surgery
rate (annual)
Cataract
operations
completed per
1,000,000
population
Monitor the
number of
cataract
surgery
Numerator:
Cataract
operations
completed
Denominator:
Total population
2011/12-2013/14 Annual Performance Plan Vote 7
199
1mil
population
EMERGENCY MEDICAL & PATIENT TRANSPORT SERVICES
TABLES 44, 46 AND 49: NATIONAL PERFORAMNCE INDICATORS FOR EMS AND PATIENT TRANSPORT
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Rostered
Number of
all rostered
ambulances
per 10 000
people in the
province
Track the
availability of
rostered
ambulances
EMS
Information
Systems
ambulances
per 10 000
population
Method of
Calculation
Data
Limitations
Numerator:
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Input
Sum
Quarterly
No
Higher
number of
roistered
ambulances
may lead to
faster
response
time her
EMS Manager
Quality
Percentage
Quarterly
No
Higher
percentage
indicate
better
response
times in the
urban area
EMS Manager
Total number of
roistered
ambulances
Denominator:
Total
population in
the province
(divided by 10
000)
P1 calls with a
response of
time <15
minutes in an
urban area
Percentage
of P1 call
outs to urban
locations
with
response
times within
national
urban target
(15 mins)
Monitor
Response
times within
national
urban target
EMS
Information
Systems
Numerator:
No priority 1
urban calls
where
Response times
within national
urban target
Accuracy
dependant
on quality
of data from
reporting
EMS
station
Denominator:
All priority 1
urban Call outs
2011/12-2013/14 Annual Performance Plan Vote 7
200
Indicator
Title
Short
Definition
Purpose/
Importance
Source
P1 calls with a
response time
of <40 minutes
in a rural area
Percentage
of P1 call
outs to rural
locations
with
response
times within
national rural
target (40
mins)
Monitor
EMS
Information
Systems
Response
times within
national
rural target
Method of
Calculation
Numerator:
No priority 1 rural
calls where
Response times
within national
rural target
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant
on quality
of data from
reporting
EMS
station
Quality
Percentage
Quarterly
No
Higher
percentage
indicate
better
response
times in the
rural areas
EMS Manager
Accuracy
dependant
on quality
of data from
reporting
EMS
station
Quality
Percentage
Quarterly
No
Higher
percentage
indicate
better
response
times
EMS Manager
Denominator:
All priority 1 rural
Call outs
All calls with
response time
within 60
minutes
Percentage
of all call
outs with
response
times within
60min
Monitor
Response
times
EMS
Information
Systems
Numerator:
No of calls where
Response times
within 60min
Denominator:
All Call outs
2011/12-2013/14 Annual Performance Plan Vote 7
201
TABLE 44 AND 46 PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR EMS
Number of
stations
established
Percentage
of P1 call
outs to rural
locations
with
response
times within
national
rural target
(40 mins)
Monitor
Response
times within
national rural
target
EMS
Informati
on
Systems
Numerator:
No priority 1
rural calls where
Response times
within national
rural target
Accuracy
dependant on
quality of data
from reporting
EMS station
Quality
Percentag
e
Quarterl
y
No
Higher
percentag
e indicate
better
response
times in
the rural
areas
EMS
Manager
Reliance on
accuracy of
population
estimates by
stats SA
Quality
Sum
Quarterl
y
no
Reporting
of
improved
response
times may
lead to
improved
EMS
service
delivery
EMS
Manager
Reliance on
accuracy of
population
estimates by
stats SA
Quality
Sum
Quarterl
y
no
Higher
number of
recruited
staff may
lead to
improved
response
times and
EMS
services
EMS
Manager
Denominator
:
All priority 1 rural
Call outs
Number of
emergency
care
practitioners
providing
Number of
all
operational
EMS
Stations
(46)
Improve
response
times in all
areas of
operations
EMS
Optimiza
tion Plan
(52)
Numerator:
Total number of
rostered
ambulances per
station
Denominator:
Total number of
rostered
ambulances per
district
Number of ECPs
providing EMS
Number of
available
practitioners
(1505)
Improve
Emergency
Medical
Services
response
times
EMS
Optimiza
tion Plan
(3200)
Numerator:
Total number of
available
Operational staff
Denominator:
Total number of
all calls serviced
2011/12-2013/14 Annual Performance Plan Vote 7
202
Number of
planned patients
transported
All patients
transported
from one
facility to the
other
Monitoring
total number
of patients
moved from
facility to
facility
EMS
Informati
on
system
Numerator:
No of patients
transported
Accuracy
dependant on
quality of data
from reporting
EMS station
Quality
Number
Quarterl
y
New
Reduced
number of
transferre
d patients
EMS
Manager
SUB PROGRAMME: REGIONAL HOSPITALS:
TABLE 51 AND 53: NATIONAL PERFORMANCE INDICATORS FOR REGIONAL HOSPITALS
Indicator
Title
Short Definition
Purpose/
Importance
Source
Caesarean
section rate
in regional
hospitals
Caesarean
section
deliveries in
hospitals
expressed as a
percentage of all
deliveries in
hospitals.
Track the
performance
of obstetric
care of the
regional
hospitals
DHIS
Method of
Calculation
Numerator:
Number of
Caesarean
sections
performed
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Output
Percentage
Quarterly
No
Higher
percentage of
Caesarean
section
indicates
higher
burden of
disease,
and/or poorer
quality of
antenatal
care.
Hospital
Denominator:
Total number
of deliveries
in regional
hospitals
2011/12-2013/14 Annual Performance Plan Vote 7
203
Indicator
Title
Short Definition
Purpose/
Importance
Source
Total
Separations
in regional
hospitals
Recorded
completion of
treatment and/or
the
accommodation
of a patient in
district hospitals.
Separations
include
inpatients who
were
discharged,
transferred out
to other
hospitals or who
died and
includes Day
Patients.
Monitoring
the service
volumes
DHIS
2011/12-2013/14 Annual Performance Plan Vote 7
Method of
Calculation
Sum of:




Inpatient
deaths
Inpatient
discharg
es
Inpatient
transfer
out
Day
patient
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Output
Cumulative
totals
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services
204
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Patient Day
Equivalent in
Regional
Hospitals
Patient day
equivalent is
weighted
combination of
inpatient days,
day patient
days, and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Monitoring
the service
volumes
DHIS
Sum of:
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services




OPD
Headcount
total = sum
of:



2011/12-2013/14 Annual Performance Plan Vote 7
Inpatient
days total
1/2 Day
patients
1/3 OPD
headcou
nt -total
1/3
Emergen
cy
Headcou
nt
OPD
specialist
clinic
headcou
nt +
OPD
general
clinic
headcou
nt +
205
Indicator
Title
Short Definition
Purpose/
Importance
Source
OPD
Headcount Total in
Regional
hospitals
A headcount of
all outpatients
attending an
outpatient clinic.
Monitoring
the service
volumes
DHIS
Method of
Calculation
Sum of:

OPD
specialist
clinic
headcou
nt
OPD
general
clinic
headcou
nt

Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services
Accuracy
dependant on
quality of data
from reporting
facility
Efficiency
Ratio
Quarterly
No
A low
average
length of stay
reflects high
levels of
efficiency.
But these
high
efficiency
levels might
also
compromise
quality of
hospital care
Hospital
Services

Average
length of
stay in
Regional
Hospitals
Average number
of patient days
that an admitted
patient in the
regional hospital
before
separation.
To monitor
the efficiency
of the district
hospital
DHIS
Numerator:
Inpatient
days + 1/2
Day patients
Denominator:
Separations
Sum of:




2011/12-2013/14 Annual Performance Plan Vote 7
Inpatient
deaths
Inpatient
discharg
es
Inpatient
transfer
out
Day
patient
206
Indicator
Title
Bed
utilisation
rate (based
on usable
beds) in
Regional
Hospitals
Expenditure
per patient
day
equivalent
(PDE) in
Regional
Hospitals
Short Definition
Purpose/
Importance
Source
Patient days
during the
reporting period,
expressed as a
percentage of
the sum of the
daily number of
usable beds in
regional
hospitals
Track the
over/under
utilisation of
regional
hospital
beds
DHIS
Expenditure per
patient day
which is a
weighted
combination of
inpatient days,
day patient
days, and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Track the
expenditure
per PDE in
regional
hospitals in
the province
Method of
Calculation
Numerator:
Inpatient
days + 1/2
Day patients
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accurate
reporting sum
of daily usable
beds
Efficiency
Percentage
Quarterly
No
Higher bed
utilisation
indicates
efficient use
of bed
utilisation
and/or higher
burden of
disease
and/or better
service levels
Hospital
Services
Efficiency
Rate
Quarterly
No
Lower rate
indicating
efficient use
of financial
resources.
Hospital
Services.
Denominator:
Number of
usable bed
days
2011/12-2013/14 Annual Performance Plan Vote 7
BAS /
DHIS
Numerator:
Total
Expenditure
in district
hospitals
Denominator:
Patient Day
Equivalent
(PDE)*
207
Indicator
Title
Short Definition
Purpose/
Importance
Source
Regional
hospitals
with monthly
Maternal
Mortality and
Morbidity
Meetings
Percentage of
Regional
hospitals having
monthly
Maternal
Mortality and
Morbidity
Meetings (3 per
quarter)
To monitor
the quality of
hospital
services, as
reflected in
levels of
diseases
adverse
events; and
proportion of
deaths
Quality
Assurance
(QA)
Method of
Calculation
Numerator:
Number of
Regional
hospitals
having
Maternal
Mortality and
Morbidity
every month
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Quality
Percentage
Quarterly
No
Higher
percentage
suggests
better clinical
governance
Quality
Assurance
Accuracy of
information is
dependent on
the accuracy of
time stamp for
each complaint
Quality
Higher
percentage
suggest
better
management
of complaints
in Regional
Hospitals
Quality
Assurance
(QA)
Denominator:
Total number
of Regional
hospitals
Percentage
of
complaints
of users of
Regional
Hospital
Services
resolved
within 25
days
Percentage of
complaints of
users of
Regional
Hospital
Services
resolved within
60 days
To monitor
the
management
of the
complaints in
Regional
Hospitals
Quality
Assurance
Numerator:
Total number
of complaints
resolved
within 25
days during
the quarter
Denominator:
Total number
of complaints
during the
quarter
2011/12-2013/14 Annual Performance Plan Vote 7
208
Percentage
Quarterly
Yes
Indicator
Title
Short Definition
Purpose/
Importance
Source
Regional
Hospital
Patient
Satisfaction
rate
The percentage
of users that
participated in
the Regional
Hospital
Services survey
that were
satisfied with the
services
Tracks the
service
satisfaction
of the
Regional
Hospital
users
QA
Method of
Calculation
Numerator:
Total number
of users that
were
satisfied with
the services
rendered in
Regional
Hospitals
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Generalizability
depends on
the number of
users
participating in
the survey.
Output
Percentage
Annual
Yes
Higher
percentage
indicates
better levels
of satisfaction
in Regional
Hospital
services
Quality
Assurance
Process
Sum
Annual
Yes
Higher
number
indicates
better
compliance
with the core
standards in
Regional
Hospitals
Quality
Assurance
Denominator:
Total number
of users that
participated
in the Client
Satisfaction
Survey (in
Regional
Hospitals)
Percentage
of Regional
and
specialist
Hospitals
assessed
for
compliance
against
6
priority
areas of the
core
standards
Percentage of
Regional and
specialised
Hospitals
assessed for
compliance
against the core
standards
Tracks the
levels of
compliance
against the 6
priority areas
of the core
standards
QA
Numerator:
Total number
of Regional
and
specialised
hospitals
assessed
against the
core
standards.
Denominator:
Total number
of Regional
and
specialised
hospitals in
the province
2011/12-2013/14 Annual Performance Plan Vote 7
209
TABLE 50 AND 52: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR REGIONAL HOSPITALS
Percentage
reduction in
referrals to
tertiary level
Reduction in
number of
patients
transferred from
facilities to
tertiary
To improve
access to
tertiary
services
Informatio
n
managem
ent
Numerator
Number of patients
transferred
Denominator
Inaccuracie
s
Outcom
e
Percentag
e
Quarterl
y
No
To improve
access to
tertiary
services
Process
Number
quarterly
No
To strengthen
tertiary
services
Hospital
Service
Reliability
Total number of
patients admitted
Number of
hospitals
conducting
outreach
programs
weekly
Number of
hospitals and
disciplines that
provide visits for
teaching and
patient care
support to other
hospitals
To
strengthen
Clinical care
services at
district level
Informatio
n
Managem
ent
Number of
health facilities
implementing
75% of the
basic nursing
care package
Essential nursing
service package
that should be
provided to every
individual in need
of patient care
To monitor
implementati
on of the
Basic
Nursing Care
Package by
all the health
care facilities
in Limpopo
Legally
mandated
by the
Nursing
Act No 33
of 2005
and
Regulation
2598 as
amended
Sum of
Programmes
submitted
Inaccuracie
s
Hospital
Service
Reliability
2011/12-2013/14 Annual Performance Plan Vote 7
Number of health
facilities
implementing 90%
of the Basic Nursing
Care Package
Improve
d quality
of
nursing
care
210
Number
Quarterl
y
Yes
All 40
hospitals and
416 PHC
facilities must
provide
quality
clients/patient
s care by
implement
90% and
more of the
Basic Nursing
Care Package
Nursing
Services
Directorate
SUB PROGRAMME: SPECIALISED HOSPITALS:
TABLE 54 AND 55: NATIONAL PERFORMANCE INDICATORS FOR SPECIALISED HOSPITALS
Indicator
Title
Average
length of stay
in specialised
hospitals
(acute)
Short
Definition
Purpose/
Importance
Source
Average
number of acute
patient days
that an admitted
patient in this
hospital spends
in hospital
before
separation.
To monitor
the efficiency
of the district
hospital
DHIS
Method of
Calculation
Numerator:
Acute
Inpatient days
+ 1/2 Day
patients
Data
Limitations
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicato
r
Desired
Performance
Indicator
Responsibilit
y
Accuracy
dependant on
quality of data
from reporting
facility
Efficienc
y
Ratio
Quarterly
No
A low
average
length of stay
reflects high
levels of
efficiency.
But these
high
efficiency
levels might
also
compromise
quality of
hospital care
Hospital
Services
Accuracy
dependant on
quality of data
from reporting
facility
Efficienc
y
Ratio
Quarterly
No
A low
average
length of stay
reflects high
levels of
efficiency.
But these
high
efficiency
levels might
also
Hospital
Services
Denominator:
Separations
Sum of:




Average
length of stay
in specialised
hospitals
(sub-acute)
Average
number of subacute patient
days that an
admitted patient
in this hospital
spends in
hospital before
separation.
To monitor
the efficiency
of the district
hospital
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Acute
Inpatient
deaths
Acute
Inpatient
discharge
s
Acute
Inpatient
transfer
out
Day
patient)
Numerator:
Sub-acute
Inpatient days
+ 1/2 Day
patients
211
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicato
r
Denominator:
Desired
Performance
Indicator
Responsibilit
y
compromise
quality of
hospital care
Separations
Sum of:




Bed utilisation
rate (based
on usable
beds) in
specialised
hospitals
Percentage of
mental Health
Care users
(MHCU) on
leave of
absence
Patient days
during the
reporting period,
expressed as a
percentage of
the sum of the
daily number of
usable beds in
specialised
hospitals
Track the
over/under
utilisation of
specialised
hospitals
beds
Mental Health
Care users
(MHCU) on
leave of
absence
expressed as
percentage of
all mental health
care users in
hospital
Track the
ability of the
mental health
care users to
adapt to
community
environment
and their
readiness to
be integrated
DHIS
Sub-acute
Inpatient
deaths
Sub-acute
Inpatient
discharge
s
Sub-acute
Inpatient
transfer
out
Day
patient)
Numerator:
Inpatient days
+ 1/2 Day
patients
Accurate
reporting sum
of daily usable
beds
Efficienc
y
Percentage
Quarterly
No
Higher bed
utilisation
indicates
efficient use
of bed
utilisation
and/or higher
burden of
disease
and/or better
service levels
Hospital
Services
Accuracy
dependant on
quality of data
from reporting
facility
Output
Percentage
Quarterly
No
Higher
number of
mental health
care users
rehabilitated
Hospital
services
Denominator:
Number of
usable bed
days
2011/12-2013/14 Annual Performance Plan Vote 7
Hospital
records
Numerator:
Number of
mental health
care users on
leave of
absence in
specialised
hospitals
212
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reportin
g Cycle
New
Indicato
r
Desired
Performance
Indicator
Responsibilit
y
Process
Sum
Annual
Yes
Higher
number
indicates
better
compliance
with the core
standards
specialised
hospitals
Quality
Assurance
Denominator:
Total number
of mental
health care
users in
specialised
hospitals
Percentage of
specialised
hospitals
assessed for
compliance
against
6
priority areas of
the
core
standards
Percentage of
specialised
hospitals
assessed for
compliance
against the core
standards
Tracks the
levels of
compliance
against the 6
priority areas
of the core
standards
QA
Numerator:
Total number
of specialised
hospitals
assessed
against the
core
standards.
Denominator:
Total number
of specialised
hospitals in
the province
2011/12-2013/14 Annual Performance Plan Vote 7
213
PROGRAMME 5: CENTRAL/TERTIARY HOSPITALS
TABLE 59 AND 61: NATIONAL PERFORMANCE INDICATORS FOR TERTIARY HOSPITALS
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Caesarean
section rate for
Central /
Tertiary
hospitals
Caesarean
section
deliveries in
hospitals
expressed as a
percentage of
all deliveries in
central and
tertiary
hospitals
Track the
performance
of obstetric
care of the
central and
tertiary
hospitals
DHIS
Method of
Calculation
Numerator:
Number of
Caesarean
sections
performed in
central and
tertiary
hospitals
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Output
Percentage
Quarterly
No
Higher
percentage of
Caesarean
section
indicates
higher
burden of
disease,
and/or poorer
quality of
antenatal
care.
Hospital
Accuracy
dependant on
quality of data
from reporting
facility
Output
Cumulative
totals
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services
Denominator:
Total number
of deliveries
in central and
tertiary
hospitals
Total
Separations in
Central/Tertiary
Hospitals
Recorded
completion of
treatment
and/or the
accommodation
of a patient in
district
hospitals.
Separations
include
inpatients who
were
discharged,
transferred out
to other
hospitals or
who died and
includes Day
Patients. (in
central and
tertiary
Monitoring
the service
volumes
2011/12-2013/14 Annual Performance Plan Vote 7
DHIS
Sum of:




Inpatient
deaths
Inpatient
discharg
es
Inpatient
transfer
out
Day
patient
(All above in
central and
tertiary
hospitals)
214
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
DHIS
Sum of:
Accuracy
dependant on
quality of data
from reporting
facility
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services
hospitals)
Patient Day
Equivalent in
Central/Tertiary
Hospitals
Patient day
equivalent is
weighted
combination of
inpatient days,
day patient days,
and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Monitoring
the service
volumes




OPD
Headcount
total = sum
of:


2011/12-2013/14 Annual Performance Plan Vote 7
Inpatient
days total
1/2 Day
patients
1/3 OPD
headcoun
t -total
1/3
Emergen
cy
Headcou
nt
OPD
specialist
clinic
headcoun
t +
OPD
general
clinic
headcoun
t+
215
Output
Indicator
Title
Short
Definition
OPD
Headcount Total in
Central/Tertiary
hospitals
A headcount of
all outpatients
attending an
outpatient clinic.
Purpose/
Importance
Monitoring
the service
volumes
Source
Method of
Calculation
DHIS
Sum of:

OPD
specialist
clinic
headcoun
t
OPD
general
clinic
headcoun
t

Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Output
Sum
Quarterly
No
Higher levels
of uptake
may indicate
an increased
burden of
disease, or
greater
reliance on
public health
system
Hospital
Services
Accuracy
dependant on
quality of data
from reporting
facility
Efficiency
Ratio
Quarterly
No
A low
average
length of stay
reflects high
levels of
efficiency.
But these
high
efficiency
levels might
also
compromise
quality of
hospital care
Hospital
Services

Average
length of stay
in central and
tertiary
hospitals
Average number
of patient days
that an admitted
patient in this
hospital spends
in hospital
before
separation.
To monitor
the efficiency
of the district
hospital
DHIS
Numerator:
Inpatient
days + 1/2
Day patients
Denominator:
Separations
Sum of:




2011/12-2013/14 Annual Performance Plan Vote 7
Inpatient
deaths
Inpatient
discharge
s
Inpatient
transfer
out
Day
patient)
216
Indicator
Title
Bed utilisation
rate (based
on usable
beds) in
Central and
tertiary
hospitals
Expenditure
per patient
day
equivalent
(PDE) in
central and
tertiary
hospitals
Short
Definition
Purpose/
Importance
Patient days
during the
reporting period,
expressed as a
percentage of
the sum of the
daily number of
usable beds in
central and
tertiary hospitals
Track the
over/under
utilisation of
central and
tertiary
hospital
beds
Expenditure per
patient day
which is a
weighted
combination of
inpatient days,
day patient days,
and
OPD/Emergency
total headcount,
with inpatient
days multiplied
by a factor of 1,
day patient
multiplied by a
factor of 0.5 and
OPD/Emergency
total headcount
multiplied by a
factor of 0.33. All
hospital activity
expressed as a
equivalent to
one inpatient
day
Track the
expenditure
per PDE in
regional
hospitals in
the province
Source
DHIS
Method of
Calculation
Numerator:
Inpatient
days + 1/2
Day patients
Data
Limitations
Accurate
reporting sum
of daily usable
beds
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Efficiency
Percentage
Quarterly
No
Higher bed
utilisation
indicates
efficient use
of bed
utilisation
and/or higher
burden of
disease
and/or better
service levels
Hospital
Services
Efficiency
Rate
Quarterly
No
Lower rate
indicating
efficient use
of financial
resources.
Hospital
Services.
Denominator:
Number of
usable bed
days
2011/12-2013/14 Annual Performance Plan Vote 7
BAS /
DHIS
Numerator:
Total
Expenditure
in district
hospitals
Denominator:
Patient Day
Equivalent
(PDE)*
217
Indicator
Title
Short
Definition
Central /
Tertiary
hospitals with
monthly
Maternal
Mortality and
Morbidity
Meetings
Percentage of
Central / Tertiary
hospitals having
monthly
Maternal
Mortality and
Morbidity
Meetings (3 per
quarter)
Purpose/
Importance
To monitor
the quality of
hospital
services, as
reflected in
levels of
diseases
adverse
events; and
proportion of
deaths
Source
Quality
Assurance
(QA)
Method of
Calculation
Numerator:
Number of
Central /
Tertiary
hospitals
having
Maternal
Mortality and
Morbidity
every month
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Accuracy
dependant on
quality of data
from reporting
facility
Quality
Percentage
Quarterly
No
Higher
percentage
suggests
better clinical
governance
Quality
Assurance
Accuracy of
information is
dependent on
the accuracy of
time stamp for
each complaint
Quality
Higher
percentage
suggest
better
management
of complaints
in Central /
Tertiary
Hospitals
Quality
Assurance
(QA)
Denominator:
Total number
of Central /
Tertiary
hospitals
Percentage of
complaints of
users of
Central /
Tertiary
Hospital
Services
resolved within
25 days
Percentage of
complaints of
users of Central
/ Tertiary
Hospital
Services
resolved within
25 days
To monitor
the
management
of the
complaints in
Central /
Tertiary
Hospitals
Quality
Assurance
Numerator:
Total number
of complaints
resolved
within 60
days during
the quarter
Denominator:
Total number
of complaints
during the
quarter
2011/12-2013/14 Annual Performance Plan Vote 7
218
Percentage
Quarterly
Yes
Indicator
Title
Short
Definition
Central
and
Tertiary
Hospital
Patient
Satisfaction
rate
The percentage
of users that
participated in
the Central and
Tertiary Hospital
Services survey
that were
satisfied with the
services
Purpose/
Importance
Tracks the
service
satisfaction
of the
Regional
Hospital
users
Source
QA
Method of
Calculation
Numerator:
Total number
of users that
were satisfied
with the
services
rendered in
Central and
Tertiary
Hospital
Data
Limitations
Generalizability
depends on
the number of
users
participating in
the survey.
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Output
Percentage
Annual
Yes
Higher
percentage
indicates
better levels
of
satisfaction
in Central
and Tertiary
Hospital
services
Quality
Assurance
Process
Sum
Annual
Yes
Higher
number
indicates
better
compliance
with the core
standards in
Central and
Tertiary
Hospitals
Quality
Assurance
Denominator:
Total number
of users that
participated
in the Client
Satisfaction
Survey (in
Central and
Tertiary
Hospitals)
Percentage of
Central
and
Tertiary
Hospitals
assessed for
compliance
against
6
priority areas of
the
core
standards
Percentage of
Central and
Tertiary Hospital
assessed for
compliance
against the core
standards
Tracks the
levels of
compliance
against the 6
priority areas
of the core
standards
QA
Numerator:
Total number
of Central
and Tertiary
Hospitals
assessed
against the
core
standards.
Denominator:
Total number
of Central
and Tertiary
Hospitals in
the province
2011/12-2013/14 Annual Performance Plan Vote 7
219
TABLE 58 AND 60: PROVINCIAL STRATEGIC OBJECTIVES AND ANNUAL TARGETS FOR TERTIARY HOSPITALS
Indicator
Title
Short Definition
Purpose/
Importance
Source
Method of Calculation
Data
Limitations
Type of
Indicator
Calculati
on Type
Reportin
g Cycle
New
Indicator
Desired
Performan
ce
Indicator
Responsib
ility
Number of
tertiary
services
provided
Number of tertiary
services provided
according to
Modernisation of
Tertiary Services
document
To improve
access to
Tertiary
services
Information
Manageme
nt
Sum of Tertiary services
Inaccuracies
Output
Number
Quarterly
No
To improve
access to
tertiary
services
Tertiary/cen
tral Hospital
Service
Number of
disciplines
conducting
outreach
programmes
Number of Clinical
disciplines that
conduct visits for
teaching and
patient care
support to other
hospitals
To strengthen
Tertiary
services at
Regional and
district level
Information
Manageme
nt
Process
Number
Quarterly
No
To
strengthen
tertiary
services
Percentage
referrals
outside of
province
(reduction)
Reduction in
number of patients
transferred outside
of Province
To improve
access to
Tertiary
services
Information
Manageme
nt
Reliability
DHIS
Sum of Programmes
submitted yearly
Inaccuracies
Reliability
DHIS
Numerator
Number of patients
transferred
Inaccuracies
Tertiary/cen
tral Hospital
Service
Outcome
Percenta
ge
Quarterly
No
To Provide
tertiary
services
Tertiary/cen
tral Hospital
Service
Reliability
Process
Number
Quarterly
Yes
To improve
access to
tertiary
services
Tertiary/cen
tral Hospital
Service
Inaccuracies
Output
Number
Quarterly
Yes
To
strengthen
tertiary
services
Tertiary/cen
tral Hospital
Service
Reliability
Denominator
Total number of patients
admitted
Number of
institutions
using Telemedicine
Number of
institutions using
Tele-medicine to
access tertiary care
and capacitate
health workers in
peripheral facilities
To improve
access to
Tertiary
services
Clinical
Records
Sum of institutions using
tele-medicine
Number of
registrars
appointed
Number of
registrars in
training for
various specialities
To increase
training of
specialists to
provide
tertiary
services
HR
Records
Sum of registrars
appointed
2011/12-2013/14 Annual Performance Plan Vote 7
Reliability
220
PPROGRAMME 6: HEALTH SCIENCES AND TRAINING
TABLE 64-69 AND 73: PROVINCIAL PERFORMANCE INDICATORS FOR HEALTH SCIENCES AND TRAINING
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicato
r
Calculatio
n Type
Reportin
g Cycle
New
Indicato
r
Desired
Performance
Indicator
Responsibili
ty
Number of
new
bursaries
awarded
Financial
assistance to
students
pursuing
Health
Science
Related
qualifications
To increase the
production of
Health
professional for
effective and
efficient Health
Care Service
Delivery
HRP and
HRD
Implementat
ion strategy
Population size of
the district X
Total Number of
grants per field
Data reliability
depends on the
availability of
automated
system
Output
Sum Total
Quarterly
No
Bridging of
the skills
shortages
within the
department
Human
Resource
Development
and Training
Number of
new
participants
appointed in
the
internship
programme
Workplace
Experiential
Learning
Empower youth
to gain
experience of
work and
prepare them to
contribute to the
economy
Human
Resource
PLAN and
HRD
Implementat
ion strategy
Percentage of
total staff
establishment
Budget
constraints
Output
Percentag
e
Quarterly
No
Experienced
and
appointable
graduates
Human
Resource
Development
and Training
Number of
new
participants
appointed in
the
learnership
programme
Workplace
Learning
Empower the
youth to Acquire
a registered
qualification on
the National
Qualification
framework and
prepare them to
contribute to the
economy
Human
Resource
PLAN
Percentage of
total staff
establishment
Budget
constraints
Output
Percentag
e
Quarterly
No
Qualified
learners on
NQF Level
qualification
Human
Resource
Development
and Training
Number of
post basic
nurse
professional
s trained
Number of
professional
nurses trained
on post-basic
nursing
programmes
Professional
nurses trained
for development
of all levels of
care
Human
Resource
Developmen
t
Dependent on
study leave and
availability of
posts
output
Sum total
Annual
No
Desired pass
rate on all
programmes
Nursing
Education
-----------------Total population
of the province
2011/12-2013/14 Annual Performance Plan Vote 7
No of post basic
nurses trained
221
Indicator
Title
Short
Definition
Purpose/
Importance
Source
No
of
professional
nurse
trained
Number of
basic four
year diploma,
bridging
course,
midwifery and
psychiatry
professional
nurses trained
Professional
nurses trained
for development
of all levels of
care
Learner
records
Number of
personnel
trained in
ECT (
Emergency
Care
Technician)
Number of
Emergency
personnel
entering the
ECT
programme
Tracks the
training of
Emergency
Care personnel
Human
Resources
Developmen
t
2011/12-2013/14 Annual Performance Plan Vote 7
Method of
Calculation
Data
Limitations
Type of
Indicato
r
Calculatio
n Type
Reportin
g Cycle
New
Indicato
r
Desired
Performance
Indicator
Responsibili
ty
Number of
professionals
trained
Dependent on
study leave and
availability of
posts
Output
Sum total
Annual
No
Desired pass
rate on all
programmes
Nursing
education
No denominator
Data quality
depends on
good record
keeping by both
the Provincial
DoH and EMS
College
Input
Sum total
Annual
No
Higher levels
of intake are
desired, to
increase the
availability of
ILS
Practitioners
in future
Human
Resources
Development
222
TABLE 70: NATIONAL PERFORMANCE INDICATORS FOR HEALTH SCIENCES AND TRAINING
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Intake of
nurse
students
Number of
nurses
entering the
first year of
nursing
college
Tracks the
training of
nurses
Human
Resources
Development
No
denominator
Data quality
depends on
good record
keeping by
both the
Provincial
DoH and
nursing
colleges
Input
Sum total
Annual
No
Higher levels
of intake are
desired, to
increase the
availability of
nurses in
future
Human
Resources
Development
Students
with
bursaries
from the
province
Number of
students
provided with
bursaries by
the provincial
department of
health
Tracks the
numbers of
health
science
students
sponsored by
the Province
to undergo
training as
future health
care
providers
Human
Resources
Development
No
denominator
Data quality
depends on
good record
keeping by
both the
Provincial
DoH and
Health
Science
Training
institutions
Input
Sum total
Annual
No
Higher
numbers of
students
provided with
bursaries are
desired, as
this has the
potential to
increase
future health
care
providers
Human
Resources
Development
Basic
nurse
students
graduating
Number of
students who
graduate from
the basic
nursing course
Tracks the
production of
nurses
Human
Resources
Development
No
denominator
Data quality
depends on
good record
keeping by
both the
Provincial
DoH and
nursing
colleges
Output
Sum total
Annual
No
Desired
performance
level is that
higher
numbers of
nursing
students
should be
graduating
Programme
2011/12-2013/14 Annual Performance Plan Vote 7
223
Programme
PROGRAMME 7: HEALTH CARE SUPPORT SERVICES
TABLE 73 AND 74 PROVINCIAL PERFORMANCE INDICATORS FOR HEALTH CARE SUPPORT SERVICES
Indicator Title
Short
Definition
Purpose/
Importance
Source
Percentage
availability of
essential
medicines
This is the
percentage of
essential
medicines and
surgical
sundries
monitored at
the depot,
hospitals and
clinics
To ensure
that
essential
medicines
and surgical
sundries
are
available at
the depot,
hospitals
and clinics
PDSX
information
system,
hospital and
clinic data
collection
tool.
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Data quality
from
hospitals
and clinics
depend on
good record
keeping by
hospital
Pharmacies.
Outcome
Percentage
Quarterly
No
High percentage
indicates the
availability of
ordered
medicines and
surgical sundries
from the
suppliers
Pharmaceutical
services
Number hospitals with
full complement over
the total number of
hospitals
High
turnover of
Personnel
Input
Numerical
Quarterly
No
When all
hospitals are
covered access
to services is
increased
Clinical Health
support
Manager and
Hospital CEOs
Numerator
Whether
completion
is defined
as practical
completion
or final
handover
Output
Sum total
Annual
No
Higher numbers
reflect progress
with completion
and provision of
FPS facilities
Health
Facilities
Management
Programme
Numerator:
Totals number of
medicines available at
depot, Hospitals and
clinics.
Denominator:
Total number of
medicines to be
monitored. Total for
Depot= 683
Hospitals= 101
Clinics= 273
Number of
Hospitals with full
complement of
clinical health
support services
The hospital
should have all
eight Clinical
health support
disciplines
To provide
access to
services
Hospitals
Number of
Forensic
Pathology
Services (FPS)
facilities
completed
FPS facilities
that have been
built to
completion
Tracks the
number of
FPS
facilities
that have
been built
to
completion
Health
Facilities
Management
Programme
Number of FPS
facilities completed
during reporting
period
Denominator
Total number of FPS
facilities targeted for
completion during
reporting period
2011/12-2013/14 Annual Performance Plan Vote 7
Completed
within or
above the
contractual
period (time
and value)
224
PROGRAMME 8; HEALTH FACILITIES MANAGEMENT
TABLE 77 AND 78 NATIONAL PERFORMANCE INDICATORS FOR HEALTH FACILITIES MANGEMENT
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Equitable
share
capital
programme
as % of total
health
expenditure
Expenditure
on buildings
and
equipment
from the
provincial
equitable
share
allocation
(I.e.
excluding
conditional
grants) as a
percentage
of total
provincial
health
expenditure
Tracks
expenditure
on health
infrastructur
e and
equipment
Health Facility
Maintenance
Number of
hospitals
with funding
from the
Revitalisatio
n Grant from
2003
Tracks
progress
with the
revitalisation
of hospitals
to improve
service
delivery
Number of
Hospitals
funded from
the
revitalisation
programme
Programme
BAS
Method of
Calculation
Data
Limitations
Type of
Indicato
r
Calculatio
n Type
Reportin
g Cycle
New
Indicato
r
Desired
Performanc
e
Indicator
Responsibilit
y
Numerator
Data quality
is reliant on
accurate
costing and
assessment
of the
condition of
health
facilities
Quality
Expenditur
e in Rands
Annual
No
Higher
average
backlog of
service
platform
reflects poor
condition of
health
facilities. In
some
instances, it
might even
be more
cost-effective
to replace
than to repair
the facility
Health Facility
Maintenance
Focus
should be
on hospitals
that have
been
actually
funded for
planning or
construction
, or both,
but not on
approved
business
cases that
have not
been funded
Input
Higher
percentages
of hospitals
funded
reflect
progress with
the
revitalisation
of hospitals
Health Facility
Maintenance
Expenditure
on buildings
upgrade
renovation
and
construction
Denominator
Total
Expenditure
by provincial
DoH
(equitable
share)
Health Facility
Maintenance
Programme
2011/12-2013/14 Annual Performance Plan Vote 7
No
Denominator
225
Sum
Annual
No
Programme
Programme
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Expenditure
on facility
maintenanc
e as % of
total health
expenditure
Expenditure
on health
buildings
maintenance
in the
Province as
a
percentage
of total
provincial
health
expenditure
Tracks
expenditure
on the
maintenanc
e of health
facilities
Health Facility
Maintenance
Expenditure
required to
bring all
fixed
provincial
health clinics
and CHCs
up to a
standard
requiring
routine
maintenance
(NHFA
condition 4 that is all
systems and
components
fully
operational
and fit for
purpose) as
a
percentage
of total
Tracks the
quality
(condition)
of health
facilities and
expenditure
required to
render them
Average
backlog of
service
platform in
fixed PHC
facilities
Programme
Method of
Calculation
Data
Limitations
Type of
Indicato
r
Calculatio
n Type
Reportin
g Cycle
New
Indicato
r
Desired
Performanc
e
Indicator
Responsibilit
y
Numerator
Data quality
is reliant on
accurate
costing of
maintenanc
e
expenditure
Input
Expenditur
e in Rands
Annual
No
Expenditure
on facility
maintenance
is desired to
be about 4%
of total
health
expenditure,
but no
Province has
reached this
target
Health Facility
Maintenance
Data quality
is reliant on
accuracy of
costing and
assessment
of the
condition of
health
facilities
Quality
Higher
average
backlog of
service
platform
reflects poor
condition of
health
facilities. In
some
instances, it
might even
be more
cost-effective
to replace
than to repair
the facility
Health Facility
Maintenance
Expenditure
on Buildings
maintenance
expenditure
Denominator
Total
expenditure
by Provincial
DoH
Health Facility
Maintenance
Programme
BAS
Numerator
Expenditure
required for
fixed PHC
facilities to
reach
maintenance
standard
‘fit for
purpose’
2011/12-2013/14 Annual Performance Plan Vote 7
Denominator
Replacemen
t cost for all
PHC
facilities
226
Expenditur
e in Rands
Annual
No
Programme
Programme
District Health
Services
Indicator
Title
Short
Definition
Purpose/
Importance
Source
Level 1
beds per
1000
uninsured
population
Level 1 beds
in all
hospitals per
1,000
uninsured
population
Tracks the
provision
and
availability
of Level 1
beds in the
Province
Integrated
Health
Planning
Framework
Provincial
Service
Transformation
Plan
Comprehensiv
e Service Plan
Level 2
beds per
1000
uninsured
population
Level 2
beds in all
hospitals per
1,000
uninsured
population
Tracks the
provision
and
availability
of Level 2
beds in the
Province
Integrated
Health
Planning
Framework
Provincial
Service
Transformation
Plan
Comprehensiv
e Service Plan
2011/12-2013/14 Annual Performance Plan Vote 7
Method of
Calculation
Data
Limitations
Type of
Indicato
r
Calculatio
n Type
Reportin
g Cycle
New
Indicato
r
Desired
Performanc
e
Indicator
Responsibilit
y
Numerator:
Depends on
accuracy of
population
data
Outcome
Number
per 1000
Annual
No
Higher
numbers of
Level 1 beds
suggest that
the need for
Level 1 beds
is being met.
But bed
occupancy
rates must
also be
assessed to
develop an
informed
judgement
Health Facility
Maintenance
Depends on
accuracy of
population
data
Outcome
Higher
numbers of
Level 2 beds
suggest that
the need for
Level 2 beds
is being met.
But bed
occupancy
rates must
also be
assessed to
develop an
informed
judgement
Health Facility
Maintenance
Level 1 beds
in all
hospitals
Denominator
:
Total
uninsured
population x
1000
Numerator:
Level 2
beds in all
hospitals
Denominator
:
Total
uninsured
population x
1000
227
Number
per 1000
Annual
No
Programme
Programme
TABLES 80 AND 81 PROVINCIAL PERFORMANCE INDICATORS FOR HEALTH FACILITIES MANAGEMENT
Indicator Title
Short
Definition
Purpose/
Importance
Source
Number of Primary
Health Care (PHC)
facilities completed
Fixed PHC
facilities that
have been built
to completion
Tracks the
number of PHC
facilities that
have been built
to completion
Health
Facilities
Management
Programme
Method of
Calculation
Numerator
Number of
Fixed PHC
facilities
completed
during reporting
period
Denominator
Total number of
fixed PHC
facilities
targeted for
completion
during reporting
period
Number of new
Emergency Medical
Services (EMS)
facilities completed
Fixed new EMS
facilities that
have been built
to completion
Tracks the
number of new
EMS facilities
that have been
built to
completion
Health
Facilities
Management
Programme
Numerator
Number of
EMS facilities
completed
during reporting
period
Denominator
Total number of
EMS facilities
targeted for
completion
during reporting
period
2011/12-2013/14 Annual Performance Plan Vote 7
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Whether
completion is
defined as
practical
completion or
final handover
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion and
provision of
PHC facilities
Health
Facilities
Management
Programme
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion and
provision of
EMS facilities
Health
Facilities
Management
Programme
Completed
within or above
the contractual
period (time
and value)
Whether
completion is
defined as
practical
completion or
final handover
Completed
within or above
the contractual
period (time
and value)
228
Indicator Title
Short
Definition
Purpose/
Importance
Source
Number of hospitals
on revitalisation on
preplanning
Hospitals that
are taken from
the priority list
to start with
revitalization
programme
Track hospital
hospitals that
are revitalized
Provincial
Hospital
Revitalization
Priority list
Number of hospitals
on revitalization
completed
Hospitals on
revitalization
wherein all
construction
projects have
been
completed
Tracks the
number of
hospitals on
revitalization
which have
been upgraded
/ built to
completion
Health
Facilities
Management
Programme
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
NPHF Model
Revised
annual using
indicators
provided in the
Project
Implementation
Manual from
National
Department of
health
output
NPHF
Model
Quarterly
No
Approved
Business cases
Health
Facilities
Management
Programme
Numerator
Whether
completion is
defined as
practical
completion or
final handover
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion of
hospital on
revitalization
program
Health
Facilities
Management
Programme
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion and
provision of
FPS facilities
Health
Facilities
Management
Programme
Number of
hospitals on
revitalization
program
completed
during reporting
period
Denominator
Total number of
hospitals on
revitalization
program
targeted for
completion
during reporting
period
Number of Forensic
Pathology Services
(FPS) facilities
completed
FPS facilities
that have been
built to
completion
Tracks the
number of FPS
facilities that
have been built
to completion
2011/12-2013/14 Annual Performance Plan Vote 7
Health
Facilities
Management
Programme
Numerator
Number of FPS
facilities
completed
during reporting
period
Completed
within or above
the contractual
period (time
and value)
Whether
completion is
defined as
practical
completion or
final handover
229
Indicator Title
Short
Definition
Purpose/
Importance
Source
Method of
Calculation
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion and
provision of
Malaria
facilities
Health
Facilities
Management
Programme
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
completion and
provision of
staff
accommodation
units
Health
Facilities
Management
Programme
Denominator
Number of Malaria
facilities completed
Malaria
facilities that
have been built
to completion
Tracks the
number of
Malaria
facilities that
have been built
to completion
Health
Facilities
Management
Programme
Total number of
FPS facilities
targeted for
completion
during reporting
period
Completed
within or above
the contractual
period (time
and value)
Numerator
Whether
completion is
defined as
practical
completion or
final handover
Number of
Malaria
facilities
completed
during reporting
period
Denominator
Total number of
Malaria
facilities
targeted for
completion
during reporting
period
Number of staff
accommodation units
completed
Staff
accommodation
units that have
been built to
completion
Tracks the
number of staff
accommodation
units that have
been built to
completion
Health
Facilities
Management
Programme
Numerator
Number of staff
accommodation
units completed
during reporting
period
Completed
within or above
the contractual
period (time
and value)
Whether
completion is
defined as
practical
completion or
final handover
Denominator
Total number of
staff
accommodation
units under
construction
during reporting
period
2011/12-2013/14 Annual Performance Plan Vote 7
Completed
within or above
the contractual
period (time
and value)
230
Indicator Title
Short
Definition
Purpose/
Importance
Source
Number of health
facilities provided
with own source of
water
Health facilities
that have
access to own
source of water
Tracks the
provision of
own source of
water services
to health
facilities
Health
Facilities
Management
Programme
Method of
Calculation
Numerator
Health facilities
provided with
access to own
source of water
during reporting
period
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Dependent on
availability of
underground
water and
boreholes
drying up
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
provision of
own source of
water to health
facilities
Health
Facilities
Management
Programme
Whether
completion is
defined as
practical
completion or
final handover
Output
Sum total
Annual
No
Higher
numbers reflect
progress with
provision of
pollution free
sanitation
services to
PHC facilities
Health
Facilities
Management
Programme
Denominator
Total number of
health facilities
targeted to be
provided with
own water
during reporting
period
Number of health
facilities provided
with pollution free
sanitation units
PHC facilities
with access to
pollution free
sanitation units
Tracks the
provision of
pollution free
sanitation
services to
PHC facilities
Health
Facilities
Management
Programme
Numerator
Fixed PHC
facilities
provided with
access to
pollution free
sanitation units
during reporting
period
Denominator
Completed
within or above
the contractual
period (time
and value)
Total number of
fixed PHC
facilities
targeted to be
provided with
pollution free
sanitation
services during
reporting period
2011/12-2013/14 Annual Performance Plan Vote 7
231
Indicator Title
Short
Definition
Purpose/
Importance
Source
Number of health
facilities with
upgraded electrical
supply
Health facilities
that have
access to
electricity as
per required
quantity
Tracks the
provision of
electricity
services as per
required
quantity to
health facilities
Health
Facilities
Management
Programme
Method of
Calculation
Numerator
Health facilities
with upgraded
electrical
supply during
reporting period
Data
Limitations
Type of
Indicator
Calculation
Type
Reporting
Cycle
New
Indicator
Desired
Performance
Indicator
Responsibility
Completed
within or above
the contractual
period (time
and value)
Output
Sum total
Quarterly
No
Higher
numbers reflect
progress with
provision of
upgraded
electricity
supply to health
facilities
Health
Facilities
Management
Programme
availability of
norms and
standards for
maintenance
term contracts
Output
Sum total
Quarterly
Yes
Higher
numbers
progress
towards
compliance
Denominator
Total number of
health facilities
targeted for
electrical
upgrading
during reporting
period
Percentage of health
facilities complying
with maintenance
contracts
Compliance of
health facilities
with
maintenance
term contracts
available
Tracks
compliance of
maintenance
term contracts
within the
Health
Department
Health
Facilities
Management
Programme
& hospitals
Numerator
Number of
health facilities
complying with
maintenance
term contracts
during reporting
period
Denominator
Total number of
health facilities
during reporting
period
2011/12-2013/14 Annual Performance Plan Vote 7
232
Health
Facilities
Management
Programme