Department of Health

The 2011 National Health Research Summit (Summit) was held in response to the legislative mandate of the National Health Research Committee (NHRC) to set priorities for health research, and to address the strategic priorities of the National Department of Health (DoH) and the Government of South Africa. The strategic focus of the DoH is the implementation of the 10 Point Plan for 2009 - 2014 health sector priorities, which includes ‘strengthening of research and development’ as its 10th priority. A major goal of the government in the Medium Term Strategic Framework for 2009 - 2014 is to achieve a long and healthy life for all South Africans. The Ministry of Health has entered into a Negotiated Service Delivery Agreement (NSDA) with other Ministries responsible for the social determinants of health and all 9 provincial Members of Executive Committees (MECs) for Health, toimprove the health outcomes of the population.Objectives. The objectives of the Summit were to determine what was needed to ‘strengthen research, innovation and development’ and to achieve the health outcomes of the NSDA: (1) increasing life expectancy; (2) reducing maternal and child mortality rates; (3) combating HIV/AIDS and tuberculosis; and (4) strengthening the effectiveness of the health system.

The National Department of Health (NDoH) Stra¬tegic Plan 2015 -2020. This strategic planning document articulates our vision, goals, strategies and indicatorsof achievement. It reflects our values – a commitment to excellence in healthcare that is community-centred, strategic thinking, quality, compassion, social justice, equity, diversity, innovation and a sense of urgency in overcoming the enormouschallenges we face. It is also aligned with the National Development Plan for the entire country. It builds on strengths and contributions of previous year’s efforts unique to the health system.  The Department created this Strategic Plan to ensure that the nation’s resources are working toward the same goals as articulated in the National Development Plan. This Strategic Plan establishes that direction with its five broadly defined goalswith realistic objectives that prioritise and focus the Department’s efforts towards a long and healthy life for all South Africans.

The World Health Organisation defines eHealth as “the use of information and communication technologies (ICTs) for health to, for example, treat patients, pursue research, educate students, track diseases and monitor public health.” This short definition covers a vast domain, including:• Electronic Health Records (enabling sharing of patient data between points of care),• Routine health management information (e.g. web-based surveillance systems, electronic disease registers, electronic district health information systems),• Vital Registration (the use of computerised systems for registration of death or births),• Consumer Health Informatics (access to information on health by healthy individuals or patients),• Health Knowledge Management (e.g. best practice guidelines managed and accessed electronically),• mHealth (e.g. use of mobile devices such as cell-phones to share information or to collect aggregate or patient data),• Telemedicine (e.g. use of ICTs to provide care at a distance),• Virtual Healthcare (e.g. teams of professionals working together via ICTs), and• Health Research (e.g. use of high performance computing to handle large volumes of data).This strategy adopts the above definition of eHealth and aims to comply with the resolution WHA58.28 on eHealth, adopted by the 58th World Health Assembly in 2005.

This paper describes progress and challenges in efforts to improve the health of South Africans since 1994. It reviews the state of health and the health care system, identifies major accomplishments and shortcomings, and outlines some opportunities for new gains in national health priorities. The purpose of the paper is to help inform discussion of macro health policy and planning by identifying key priorities and opportunities for consideration. Although restructuring of the public health sector post‐1994 achieved substantial improvements in terms of access, rationalisation of health management and more equitable health expenditure, fifteen years later these early gains have been eroded by a greatly increased burden of disease related to HIV/AIDS, generally weak health systems management and low staff morale. The result is poor health outcomes relative to total health expenditure. Accomplishments of the past decade are largely overshadowed by the burden of AIDS on mortality and the health system. Indeed, continuing to manage the HIV and AIDS epidemic will dominate the next decade and beyond. Efforts to sustain financing for the prevention and treatment of HIV and AIDS, while improvingservice efficiency and quality of care, will require new funding formulas such as those envisaged in a national health insurance system. But, despite the enormity of the challenge there are opportunities for significant systems improvements and progress on the major policy priorities.

This report sets out the progress achieved by the National Department of Health in the implementation of the 10 Point Plan for 2009 – 2014. The mandate of the health sector, under the stewardship of the National Minister of Health, is to co-ordinate the implementation of government’s Medium Term Strategic Framework (MTSF) for 2009 – 2014, with a specific focus on Strategic Priority 5: Improving the health profile of all South Africans. 

Workforce planning for the health service is challenging and complex. Nonetheless, workforce planning is an important process. The health, policy, legislative and economic context influence the task of visualising and implementing improvements in the health workforce. The policy context provides the framework for the development of the HRH Strategy. The Minister of Health, in his Budget Speech in May 2011, announced the re-engineering of the primary healthcare system and an overhaul of the health system. Implementing the three main streams for re-engineering Primary Healthcare is the short-term priority. These streams are: District Clinical Specialist Teams, Community Outreach PHC Teams and the School Health Programme.The problem statement: An overview of the trends and challenges in HRH for South Africa is grouped into three thematic areas. For each thematic area the key issues are highlighted and brief recommendations, which informed the HRH Strategy, are provided.

The purpose of the purpose is to provide an enabling framework for the conduct of research that improves human health and wellbeing in South Africa. The health research policy for South Africa is located in both global and local socio-economic contexts, and seeks to respond proactively to challenges of the coming millennium. It attempts to create a framework and environment for health research to contribute effectively to health development and is envisaged as an integral part of long-term health development aimed at improving the health and quality of life of all South Africans and reduces inequalities within the system.  The research system should be based on a series of shared values with clearly defined and articulated goals.An agreement on the values will lead to an improvement in quality, effectiveness and efficiency of the research system. The system needs to integrate the concerns and views of the community and policymakers, the research of basic and community based researchers and the national and global research priorities.

Health is regarded by the World Health Organisation (WHO) as a fundamental human right, and health promotion is defined as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health”.The foundations for health promotion are based upon the Alma Ata Declaration and subsequent charters as adopted by the WHO. This National Health Promotion Policy reaffirms the commitment of the Department of Health to promote the health of allSouth Africans. This policy will contribute towards achieving the national vision of a long and healthy life for all South Africans by clarifying the role of health promotion at national, provincial and district levels and service delivery relationships with otherstakeholders.The document outlines the quadruple burden of disease that South Africa is faced with, furthermore highlights the extent to which the health system struggles with four major health issues: non-communicable diseases (NCDs); communicable diseases (especially HIV and TB); maternal, neonatal and child morbidity and mortality; and deaths due to injury and violence. Health promotion has a significant role to play in reducing the burden of disease to the health system, by addressing the key social, behavioural and structural determinants of health. Improved intra and inter-departmental coordination is required to ensure that resources are applied efficiently and to create a culture based on the sharing of good practices. The Health Promotion Strategy and Policy clarifies the role of health promotionin the health sector and other non-heath sectors. The document also highlights the need for collaborative efforts between the Department of Health and all other stakeholders. 

South Africa remains in the grip of the quadruple burden of disease as we call them, namely: (a) HIV and AIDS and TB; (b) High levels of Maternal and Child Mortality; (c)Non-Communicable diseases; and (d) Injuries and trauma. Over the last 7-8 years a lot of progress has been made with regard to reducing the high levels of mortality from HIV and AIDS and related complications and co-morbidities.The roll out of Antiretroval Treatment has seen our country recording major improvements in health indicators such as life expectancy, infant and child mortality and maternal mortality.Out of the four components of the quadruple burden of disease the two components which remain stubbornly high are the Non-Communicable diseases and injuries and trauma. The rising levels of noncommunicable diseases is not a uniquely South African experience. Health scientists predict that diseases of lifestyle will cause 7 out 10 deaths in developing countries by 2020. As it has been emphasised many times before, most of the NCDs can be prevented or their morbidity and mortality reduced by a change of lifestyle. This Report reflects some of the key policy interventions and demonstrates our commitment to a public health sector that is pro-active, forward looking, focuses on prevention, and accountable to the people of South Africa. We hope you find the Report informative and, most importantly, useful. Producing this report involved the commitment of a diverse group of individuals, each of whom contributed their time and advice to ensure that the final product was representative of public health from a national perspective.