Minister of Health briefing on Social Cluster Programme of Action for 2009
09 Mar 2009
The Minister of Health focussed on comprehensive social security, comprehensive health care, housing and human settlements, food security and nutrition, access to and the quality of education and comprehensive anti-poverty interventions, in her briefing.
The Minister of Health stressed that cholera in
The Minister of Water Affairs and Forestry answered questions regarding water supply and floods, and talked to the issue of climate change and its effects. The Director-General of the Department of Social Development discussed the Social Relief of Distress Grant and its benefits for unemployed people.
Q: A journalist asked for the number of people receiving antiretroviral drugs (ARVs) and whether they were received from the public or private sector.
A: The Minister of Health, Ms Barbra Hogan, said that the public sector was being referred to. Monitoring and evaluation had been difficult in the private sector. Regarding joint public and private health initiatives, the Department was planning to host a major workshop the following week to look at ways to better effect monitoring in the private sector. The Minister said that she did not have the figures on drug resistant tuberculosis (TB) at that briefing, but could make them available.
Q: A journalist enquired about drug resistant TB, and asked if there was a rough idea about the numbers which were cases of concern. The journalist also asked if the Department had any viewpoints regarding the Médecins Sans Frontières (MSF) in Khayalitsha, running experimental programmes on treating people with Extensively Drug Resistant (XDR) TB and Multi-Drug Resistant (MDR) TB.
A: Minister Hogan responded that in terms of the combined treatment of XTR TB and HIV in Khayalitsha, the Department was very impressed with the innovative ways the people in Khayalitsha were using the service being delivered there. This set a standard which could be used in other sites and the Department was very supportive of the initiatives in Khayalitsha.
Q: A journalist asked what a “Credible Indigent Policy Assessment Framework’ was, (under the “Comprehensive anti-poverty interventions” in the briefing report), as opposed to an ‘incredible…framework’; and what was ‘Shova Kalula’ (in the same document referred to above).
A: Mr Thami Mseleku, Department of Health Director-General, explained that ‘Shova Kalula’ literally meant ‘pedal easily’. This concept was used to promote the use of bicycles in the rural areas to provide access to a variety of places like schools and workplaces, and therefore the ‘Shova Kalula Project was the non-motorised transport project that the Department had been working on.
A: Mr Mseleku said that the ‘Credible Indigent Policy Assessment Framework’ referred to a framework based on scientific tools to allow for a credible methodology of determining indigent persons.
Q: A journalist asked if more light could be shed on the National Health Insurance Scheme (NHIS), how it would be funded and what the Department envisaged for the Chronic Health Grant.
A: Minister Hogan replied that she was unable to provide more detail on the National Health Insurance Scheme, but the Department was working intensively on the matter at the moment. The Department was assessing costing and looking at models to determine exactly what the scheme would entail, until it was satisfied that the required standards had been met. Health funding had serious challenges, and all of the nine provinces had overspent on their budgets. There was a need to examine what was happening and assess whether the National Health Insurance Scheme could possibly provide the best funding passage to people in the health sector.
A: Mr Mseleku said that the Chronic Health Grant came about from a concern raised by various people who were impacted upon by their HIV positive status and were put into the Disability Grant scheme temporarily. Once they were better they had to be taken out of the scheme, but the consequences, as was the case with TB as well, made it necessary for the Department to investigate whether this Chronic Health Grant could be extended to other chronic illnesses to look at support and developing tools for making appropriate determinations for those situations. This grant was still under discussion and the details needed to be finalised before the proper determinations could be made for persons in need.
Q: A journalist enquired whether there was certainty regarding the control of cholera in
A: Minister Hogan said that there was a decline in the number of persons infected with cholera. In the last week, the available figures showed that 21 cases were reported in
About meningitis, Minister Hogan stated that the report that she had received the previous day, about the nine year old child who had died, proved to be unrelated to meningitis, and therefore at this stage the Department was not of the opinion that an outbreak of meningitis was a significant threat.
Q: A journalist directed a question to the Minister of Water Affairs and Forestry, Ms Lindiwe Hendricks, and asked about the flash floods seen especially in
A: Minister Hendricks said that the change in weather and the effect of climate change were the kinds of problems envisaged for different parts of the whole country. This was why the response to climate change was part of the broader responsibility of the Department; to develop tools to enable municipalities to identify areas of high risk, and to take advice where development should be avoided in areas that were prone to flooding. This work was ongoing including that of assessing the need for infrastructural changes. The Department of Water Affairs and Forestry needed the authority to demarcate areas that did not have resources.
Q: A journalist sought clarity on whether the decision by the Minister of Home Affairs to close down the Messina showgrounds and house all the Zimbabwean refugees there, was a wise or just decision given the possibility of the impact on cholera in that area.
A: Minister Hogan said that the enrolling of asylum seekers by the Department of Home Affairs was continuing. The Department of Home Affairs had however stopped the provision of additional welfare services at the showgrounds. Women and children had been taken to a better site for more protection. What was important was that a disused army base, located two kilometers away from that site, was in good condition and available for use. The army and police had agreed that the facility could be used as it was better equipped. The army and police were still in the process of dealing with matters related to the movement to their site, and it was hoped that it would be available for the use of asylum seekers as soon as possible.
A: Minister Hendricks said that the situation at the
Q: A journalist asked about the National Conference on building a caring nation, and what was the motivation for such a conference.
A: Mr Mseleku said that the plan was to bring all South Africans together across all sectors at the national level to begin to further deepen the national dialogue about South Africans and promote cohesion, especially in the context of the xenophobic attacks which had become prevalent in society.
Q: A journalist enquired about the latest cholera fatalities and if therefore the possibility existed that less people would come across the border from
A: Minister Hogan said that cholera was a result of general living conditions and an unsafe water supply. Cholera was not imported; it came as a result of a decline in living conditions. The Department of Water and Forestry and the Department of Health had been working very hard to manage the epidemic and improve access to water. Programmes were in place to assist people to protect themselves against cholera. Health care professionals were now able to identify suspicious areas related to cholera, and this was leading to a decrease in the cholera statistics.
Q: A journalist asked for comment on an article in the Sunday Times the previous day, which said that one of the health professionals had discharged Schabir Shaik.
A: Minister Hogan said that the allegations regarding the case at
Q: A journalist asked for information about social assistance for unemployed persons.
A: Mr Vusimuzi Madonsela, Department of Social Development Director-General, said that government’s primary intervention in this regard was essentially the creation of work opportunities as a priority exercise. There was a skills training programme being undertaken at present and a collaborative effort between the Department of Labour and the Deparment of Public Works to assist unskilled people to gain entry into the labour market. Other interventions were being undertaken to assist people facing hardships like the rolling out of the Social Relief of Distress Grant. This grant was not only for unemployed people, but also for those facing other hardships like food insecurity, unemployment or other forms of social distress. The Department of Social Development and the Department of Health were engaged in a collaborative effort on a food security and nutrition programme, which aimed to reach out to the unemployed and assist them to find work. Mr Madonsela said that ultimately a sustainable solution was the attainment of full employment and decent work.
Q: A journalist referred to the report on the television programme Carte Blanche about the medical emergency. It highlighted
A: Mr Mseleku replied that this was an issue that existed and definitely related to emergency medical services. The problem had been discussed with the Quality Assurance Board and the need to begin training workers at mid-level had been highlighted. A number of people were in colleges at the moment for this purpose, and an agreement existed with neighbouring states to assist in dealing with medical emergencies.
Q: A journalist referred to the fact that Minister Hendricks had consistently denied that there was a water crisis. He added that last week however, there had been ‘elements of a recognition’ of such a crisis, and asked what had changed.
A: Minister Hendricks said that she did not think that the media were listening to her, and repeated her assertion that a crisis did not exist regarding the supply of water in
Ms Hendricks said that where resource water quality was concerned, municipalities had not used their budgets adequately. This pointed to the issue of security of the supply of water. The Department was in the process of using R10.1 billion to improve infrastructure for water supply and was assessing consumption patterns for this purpose. There was no crisis regarding the security of the supply of water.
Q: A journalist asked if the Minister could provide the latest figures for the number of cholera deaths and number of infections.
A: Minister Hogan replied that there had been 59 deaths and 12 334 reported cases since the outbreak of cholera in November. The case fatality rate was the amount of people who had died in relation to number of people who had contracted the disease. This figure was at 0.49%, which was considered a good rate according to the WHO standards.
The media briefing was concluded.
SOCIAL CLUSTER SECTOR MEDIA BRIEFING DOCUMENT:
09 MARCH 2009
Good morning ladies and gentlemen. On behalf of the Social Cluster Ministers I would like to present some highlights of the achievements of the Cluster.
In presenting this report this morning, I will be focusing on the following key areas as they relate to the Departments constituting the Social Cluster.
· Comprehensive social security
· Promotion of national identity and social cohesion
· Comprehensive health care
· Housing and human settlements
· Food security and nutrition
· Access to and quality of education
· Comprehensive anti-poverty interventions
Comprehensive Social Security
Social security plays a very critical role in the lives of millions of our people given the twin challenges of poverty and underdevelopment that we are still faced with.
On the issue of the implementation of a common tool to assess disabilities, the implementation of this tool has been put on hold pending the amendment of the Social Assistance Act in the 2009 Parliamentary cycle. In the meantime though, the Department of Social Development has appointed a 40 member panel of Tribunals to deal with appeals submitted for all grants. In addition, the South African AIDS Council has been exploring the issue of a grant for chronic diseases. Let me say that whilst the need for support for people with chronic diseases is clear – as many people with chronic diseases are poor and that having a chronic disease often pushes people further into poverty much more work and further consultation is needed before a proposal can be tabled to Cabinet.
Access to health services as well as affordability and equity between the private and public health sectors are all matters that we are considering in our discussion of the form and shape of a national health insurance system (NHI). The Department of Health is currently preparing a discussion document on determining the costed alternatives for a basic benefits package that could be covered under the NHI, following the presentation to Cabinet in August last year.
On our interventions to reach vulnerable children over the age of 14 years and to increase the age of child support grant beneficiaries to 15 years, Cabinet has approved the extension of the Child Support Grant from 14 – 18 years and implementation will be phased in during 2009/10 starting with 15 year old children. The Department of Social Development has established an Intersectoral Child Care and Protection Forum. One of whose functions is to address the gaps in service delivery to children of all ages, including children in the age cohort of 14 to 18 years.
As you may know Government allocated R500 million towards the Social Relief of Distress (SRD) grant in November last year. The monies paid out for the SRD increased from R13,6 million in November 2008 to R57,2 million in January 2009.
The total number of beneficiaries for all types of grants is 12,6 million. The total number of recipients per grant type is: Old Age grant – 2 344 595; War Veterans grant – 1 611; Disability grant – 1 370 195; Foster Care grant – 474 012; Care Dependency grant – 106 073; Child Support grant – 8 523 741. Due to the age extension from 14 to 15 years the number of children receiving grants aged 14-15 years is 75 591. Since July 2008 the number of older men aged 63 and 64 years that are in receipt of the older persons grant is 72 635 as at February 2009.
Promotion of national Identity and Social Cohesion
National identity and social cohesion constitute a crucial pillar of our state.
A national conference with the theme “Building a caring nation” which will look amongst others into aspects of social cohesion and nation-building is being planned for 2009. There are also plans to implement Social Mobilisation Campaigns aimed at building solidarity, improve safety of communities and strengthen social cohesion. This campaign will be piloted in
Regarding the intensification of the installation of flags in schools and other public buildings, we are happy to announce that the project is now in its second phase. 2000 flags were installed in all provinces in the first phase. And a further 1250 will be installed this year.
On the matter of a synchronized process to create a base slate to change geographic and place names, public hearings were held in
A revised draft version of the National Schools Pledge has been produced, taking into account comments made during the process of public comment. The revised draft Pledge will soon be presented to Cabinet for discussion and approval.
In relation to developing a plan on the prevention of and treatment of substance abuse (illegal drug use and alcohol abuse), the Prevention of and Treatment for Substance Abuse Bill was presented to the National Council of Provinces and to the Portfolio Committees of Health and Social Welfare in all provinces. In addition, Substance Abuse Awareness Raising Campaign was conducted through different forms of media.
On the issue of improving programmes aimed at rehabilitating communities in line with TRC recommendations, a Draft Policy on Exhumations has been developed.
The Department of Sports and Recreation has engaged national sports federations, including SA Rugby and SAFA, regarding the use of the King Protea as the sole national sports emblem. This was done with a view to unite South African sport behind one emblem for all sports federations to contribute to nation building. Consensus was also reached with SA Rugby regarding the use of the Springbok emblem.
The 2010 Mass Mobilisation campaign has been initiated to galvanise communities around the hosting of the 2010 FIFA World Cup. This programme is complemented by the social legacy campaign that aims to increase the capacity of local youth. This programme aims to use sport to improve the social environment through the use of sport as a development tool.
The launch of the 2010 Mass Mobilisation road show took place on 27 January 2009 at Galeshewe Stadium in
Comprehensive Health Care
This component of our Programme of Action entails a number of critical elements but in the interest of time we would like to focus on only a few of these.
A task team has finalized a draft government-wide integrated comprehensive programme on health promotion targeting the youth. This will be processed through the Cluster system and taken to Cabinet for discussion and adoption so that we have greater coherence across government of programmes that target the health of our youth.
We are encouraged by the fact that all provinces have adopted the Health Lifestyles initiative. Peer educators are working under supervision of professional nurses to ensure that all public health facilities are Youth Friendly.
Regarding the expanding the number of health promoting schools from 3500 to 5000, by the end of this financial year there will be 4100 health promoting schools. In addition all our schools are now implementing tobacco control policies within the context of national legislation geared at curbing tobacco use especially amongst the youth.
With respect to progress in strengthening our interventions on non-communicable diseases I can report that the implementation framework for the long-term care service model for people with non-communicable diseases is targeted for publication in the 09/10 financial year and the Diabetes Declaration implementation plan will be used by 9 of the 18 priority health districts during 2009/10 to strengthen the management of diabetes.
HIV and AIDS continue to be amongst the biggest public health challenge facing us. Among our targets is to increase the percentage of adults who have ever had an HIV test from 25% to 35%. To expand access to voluntary counseling and testing 93% of our primary health facilities provide counseling and testing. However, we wish to encourage everyone to ‘know your status’. This will contribute to risk avoidance as well as improving treatment seeking behavior. The number of people tested for HIV (excluding pregnant women) is 2 430 300.
In terms of people on treatment (ARV programme), more than 690 775 patients have been initiated on ARVs since the commencement of the programme. The
Prevention of HIV especially amongst the youth is very important to decrease the incidence of HIV in
TB remains another public health challenge and this has further been complicated by drug resistant TB. In terms of reducing the defaulter, we are encouraged by the fact that we been able to decrease our defaulter rate from 10% to 7.9%. In addition our TB cure rates have increased from just over 50% to over 60%.
A total of 844 health workers have been trained on Drug Resistant TB Management infection control, 567 on electronic TB register and data management and 4279 have been trained on TB management, leading to a total 6441 health personnel trained to help us manage TB in our country.
Since November last year we have seen a significant increase in the number of cholera cases especially in Limpopo and
Housing and Human Settlement
Despite the many challenges that we continue to experience in this area, we are encouraged by the strong collaboration that we see between government and our financial institutions. As far as the monitoring of the use of the R42 billion committed by Financial Institutions, to date, over R40,5 billion has been released for financing housing development and/or ownership.
We are also encouraged by the work being done around the transformation of the NHFC and the increase in lending to lower income groups. The final steps in the transformation of this body (NHFC) are being implemented within the context of a government-wide review of the Development Finance Institutions.
On the introduction of measures to ensure affordable and sustainable home ownership, well over 100 000 units are planned in mixed income and multiple use projects. The subsidy voucher system design for building materials in rural areas to support the self-build initiative is complete pending policy decision and is due for implementation this year.
The housing delivery programme for 2008/09 has yielded over 133 000 units of the planned 265 000 units to house occupants of informal settlements and backyard dwellers.
Just over 3 million housing subsidies were approved and just over 2 million units have been completed. This brought homes to 9.9 million citizens.
As most of us would know, sanitation is another critical element is far as housing and human settlement is concerned. A total of 906 bucket sanitation units were removed, reducing the backlog to 10 395 at the end of December 2008. The water delivery target for 2008/09 is 450 000 households and by December last year a total of 771 884 households were serviced.
During the current term of government we have provided additional 1.465m households with basic access to water supply thus increasing access from 80% to 91% measured against the 2004 base. With regard to sanitation we can report that and additional 1.16m households were served with basic sanitation thereby increasing access from 66% to 74% measured against the 2004 benchmark.
We have also increased the number of electricity connections to households within the same period by an additional 727 777 connections. There are currently 6.7m households are currently receiving have their refuse removed once a week throughout the country.
The schools programme has served 51 schools with water facilities and 125 with sanitation in the last financial year. Though implementation was slow initially, progress has improved and the remaining 3035 schools are to have been addressed by December 2010. This will mean that all schools in this country will have basic access to water and sanitation.
Whilst acknowledging the significant progress we have made with regard to the provision of basic access to water and sanitation, electricity, collection of refuse from households; government is still concerned about the number of households who still do not have access to these basic services and Cabinet decided in January 2008 to integrate all the targets and work towards Universal access by 2014.
Government is fully committed to the 2014 universal access target and as the social cluster we are working across departments and other spheres of towards the achievement of this target. Some departments, like the Department of Water Affairs and Forestry have decided to allocate an additional budget to the current Municipal Infrastructure Grant and the Bulk Infrastructure Grant. DWAF will be providing an additional R 500m in 09/10 in order to deal with some of the immediate challenges we face in the provision of water and sanitation.
Food Security and Nutrition
This is one of the critical areas of our work as the Cluster and a number of interventions have been introduced to strengthen food security. With the exception of the
The household food production programme which provides seedlings, seeds, fertiliser, pesticides and other production inputs to beneficiaries has benefited about 30 000 households this year. In the 2008 supplementary budget the household food production programme was expanded by an additional R76 million which will assist us in reaching the targeted 70 000 households.
At the school level, 6 503 schools in our country have vegetable gardens. We have also trained school communities on tree planting as well as planting fruit trees in schools as part of “Plant Million Trees Campaign”.
The National School Nutrition Programme supports about 5,6 million learners in approximately 18 000 schools. The minimum norm is to feed learners in quintiles 1, 2 and 3 on all school days at an average cost of R1.50 per learner per day. This programme has received an additional R4 billion for the new financial year to enhance sustainability of the programme.
The issue of high food prices has been discussed and addressed at the Inter-Ministerial Committee (IMC). To further probe for workable solutions in this regard, the IMC held a symposium on High Food Price to open dialogue with all industry players and consumer representatives to develop common strategies that will address this issue.
Access to and quality of education
Access to quality education and training remain the key drivers of our economy and skills. As a cluster, we have increases the allocation of resources to provide financial assistance to trainees in FET colleges to help us expand the availability of scarce skills.
560 298 learners wrote the first National Senior Certificate examinations in 2008 with a 62.5% pass rate nationally.
Mathematics is one subject that we identified as being key to achieving some of the goals we have set ourselves and you will recall that we committed ourselves to doubling the number of matric maths passes to 50 000 by 2009. A total of 63 038 learners passed mathematics at a higher grade level in 2008. A total of 15 038 passes were learners from our Dinaledi schools. This therefore indicates that the Dinaledi schools contributed 24% of the high level passes in mathematics in 2008.
In line with our campaign to improve literacy, the Kha Ri Gude campaign was officially launched in April last year and the current rate of participation indicates that the campaign will reach 100% of its learner targets.
We are also continuing to work closely with universities to double the output of universities in priority sectors by aligning the NSFAS and subsidy funding with scarce skills. To this effect, the Department of Education has allocated R439 million to improve facilities at disadvantaged institutions for the support of key skills areas including the faculties of engineering and technology.
We are aware that fees in our schools continue to be a challenge. We have committed ourselves to eliminating compulsory school fees in 60% of primary and secondary schools. As of January this year, 60% of learners are attending no-fee schools.
In order to popularise and implement measures for the prevention and management of Learner Pregnancy, tools for the Prevention and Management of Learner Pregnancy have been made available to all public schools. In September and October 2008, the first two of a three series insert to the Teacher newspaper called Genderations were published. Genderations focuses on providing support to teachers in managing and preventing learner pregnancy.
To popularise and implement Guidelines on Sexual Harassment and violence in Public Schools, the Guidelines for the Prevention and Management of Sexual Violence and harassment in public schools have been finalized and printed, and are currently being distributed to schools.
Comprehensive anti-poverty interventions
Poverty remains one of the key challenges facing our people. It undermines our democracy. As a Government therefore, we have in place a number of interventions geared at minimizing its impact on our people. By the end of 2008, government had formulated a draft anti-poverty strategy and a national plan to implement this strategy as part of fast tracking our efforts to lift more people out of poverty.
A draft poverty matrix has been drafted through the identification of key projects in the social and economic clusters. This matrix will be completed once the development of the national database of households living in poverty has been completed.
A ‘Credible Indigent Policy Assessment Framework’ has been developed and is being used by the Department of Provincial and Local Government to assess the credibility of municipal indigent policies and registers. By the end of this month, we will have completed the Indigent Policy and Register Assessment workshops in all 39 targeted municipalities to help accelerate household targeting and indigent support initiatives.
In linking up 10 000 unemployed graduates with economic opportunities, 1050 unemployed graduates trained through the Graduate Development Programme. A total of 447 unemployed youth were placed in employment opportunities through the JOBS Programme. In order to Intensify the National Youth Service Programme, since Jan 2008 12,785 unemployed and unskilled young people participate in NYS Category 1 projects.
On the issue of expand the reach of enterprise development initiatives such as business support and microfinance services resulting in sustainable economic opportunities for about 65 000 youth.
In relation to expanding access to Early Childhood Development by doubling the number of children enrolled in Early Childhood Development to over 600 000 through 1 000 new sites with more than 3 500 practitioners trained and employed, and increasing the number of care-givers. For the period April to September 2008 nationally 595 new ECD sites have been registered bringing 32 185 new children into the system.
With regard to Implementing the Rural Transport Strategy for
Generally, the Cluster is encouraged by the progress made in the implementation of government’s PoA.
Despite this progress though, we are mindful of the many shortcomings that we continue to experience, some of them have to do with resources (financial and human) and others that relate to system challenges.
Minister Barbara Hogan, MP
Minister of Health and Co-Chair of the Social Sector Cluster
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