Youth, Disabled and Child Service Delivery: Departments of Health and Sports briefings

JOINT MONITORING COMMITTEE ON INVOLVEMENT OF QUALITY OF LIFE AND STATUS OF CHILDREN YOUTH AND DISABLED PERSONS
14 September 2007
YOUTH, DISABLED AND CHILD SERVICE DELIVERY: DEPARTMENTS OF HEALTH AND SPORTS BRIEFINGS

Chairperson : Ms W Newhoudt- Druchen (ANC)

Documents handed out:
Department of Health Presentation: Programmes for persons with disabilities
Department of Health Presentation: Monitoring the Quality of Life of youth and children
Department of Sports and Recreation presentation

Audio recording of meeting

SUMMARY
The Department of Health briefed the Committee on service delivery for the disabled, noting that it was necessary to concentrate on multi-sectoral programmes that aimed at improving and maintaining accessibility to quality rehabilitation. A protocol was still needed for free health care for the disabled, and there was a need to monitor the provinces more closely in terms of their awareness and service delivery. The backlog of wheelchairs and hearing aids had been lessened, but more work was needed on orientation and mobility for the visually impaired. The Department had succeeded in performing 30 000 eye cataract surgical procedures. More focus was needed on implementation, and there must be increased access, particularly in the rural areas, and better budgeting and prioritization.  Members posed questions on the need for occupational therapists and doctors at centres for the disabled, injuries at work, the criteria for free health care, the allocations for disability care, and inaccessibility of the patient charter for those with visual impairments,

The Department gave a second briefing on improving the quality of life of youth and children, noting it was trying to lessen child mortality and improve child health by promoting breast feeding. In youth areas, there was a drive to establish youth-friendly clinics and ensure that peer-educators were trained, and that life skills training was implemented, in a move to reduce the teenage pregnancy rate. In the area of youth and adolescence, she indicated that there was a drive to establish youth-friendly clinics and to ensure that more peer-educators were trained. In addition to these programmes, life-skills training took place in conjunction with the youth indaba, which was an annual week-long event aimed at tackling youth issues. This initiative, she hoped, would help to reduce the number of teenage pregnancies. Questions were posed about the breast feeding campaigns, and the links between the youth organizations. Not all questions could be answered, due to lack of time.

The Department of Sports and Recreation briefed the Committee on how it aimed to reach all disadvantaged sectors, emphasizing that access to sports was a right. There needed to be greater focus on establishing partnerships with corporates and communities. The Department stressed that sports could be done at any age, and was particularly useful in integrating juvenile offenders back into society. The Department criticized the relatively low budget allocated to disabled persons. Members posed questions around reintroduction of physical education into schools, mainstreaming of disabled sports, lack of funding for disabled sportspersons, and whether the 2010 facilities would be disability-friendly.

The Committee adopted the reports from the oversight visits to the Northern Cape and the Free State.

MINUTES
Service Delivery for the Disabled: Briefing by Department of Health (DOH)

Mrs Christelle Kotzenberg: Cluster Manager: Non-Communicable Diseases, DOH, indicated that in considering service delivery for the disabled, focus must be placed on multi sectoral programmes that aimed at improving and maintaining accessibility to quality rehabilitation and community-based rehabilitation. She highlighted that the underlying principles that guided the Department were stated in the Constitution and in the National Health Act. The strategic plan placed emphasis on the improvement of access to health care and, for persons with disabilities, free health care at hospital level. A protocol had to still be put in place. She indicated that there were varying degrees of success in the provinces in terms of service delivery, but that management and administrative staff needed to be continually monitored as some were not aware of the various programmes in place, and did not therefore always treat people with disability in appropriate manners.

Mrs Kotzenberg indicated that the backlog of wheel chairs and hearing aids has been lessened to a certain extent, and 30 000 wheel chairs and buggies and 16 000 hearing aids had been distributed. She explained that the Flemish government was funding many of the initiatives that aimed to eradicate the backlogs, but the funds only scratched the surface and much more needed to be done at grass roots level.

One sector that in her view had been previously ignored was that of orientation and mobility services for the blind. This was usually dealt with by NGOs, making it inaccessible to the majority of visually impaired persons. She hoped that soon a programme would be integrated into the Department of Health. To date 30 000 cataract eye surgeries had been done to restore sight, and this was seen as a good achievement.

Ms Kotzenberg was unhappy to report that in the past the Department had focused too much on training of nurses, and insufficiently on training of rehabilitation personnel. However, there had been a positive step in that sign-language facilities and interpreters were at most hospitals.

She indicated that the main challenges facing the Department were in the fields of implementation and human resources. There had to be significant access to services, especially in rural areas. Poor remuneration was restricting the condition of the health service.

In conclusion, Ms Kotzenberg stated that there had been significant progress but there must be an enhanced priority and budgeting at provincial and district levels and focus on specified recruitment and retention policies.

Improving the quality of life of youth and children in South Africa: DOH Briefing
Dr Sebolelo Amos, Cluster Manager: Maternal, Child, Womens' Health and Nutrition, DOH, outlined the link between infant mortality rate and the mother’s health and indicated that the Department, in considering child health issues, tried to provide a holistic approach that clustered everything into three main groups – being the Maternal Death Inquiry Programme; the Child Problem Identification Programme (CHIP) and the Perinatal Problem Identification Programme (PPIP). These programmes helped to monitor child deaths. She noted that usually children died due to poor skills, lack of human resources and lack of financial resources. She highlighted that 12% of children from 0-3 months were being exclusively be breast-fed and studies had shown that this would assist them in being more healthy. In addition to this she encouraged mothers to breast feed children for up to 60 months, due to the increased Vitamin A content in breast milk, but agreed that cultures needed to be taken into account. She indicated that 94% of children under one year were fully immunized against DPT, Hib and Polio, and 82% against measles. She outlined the key interventions for children from one to five years, which included immunization, early childhood development, vitamin A supplements, growth monitoring and school health services.

In the area of youth and adolescence, she indicated that there was a drive to establish youth-friendly clinics and to ensure that more peer-educators were trained. In addition to these programmes, life-skills training took place in conjunction with the youth indaba, which was an annual week-long event aimed at tackling youth issues. This initiative, she hoped, would help to reduce the number of teenage pregnancies.

The total budget for this sector was R28.8 million, and the programme breakdown was tabled. She concluded that there needed to be increased resource allocation, integrated planning, community involvement and participation and translation of knowledge into action.

Discussion
The chairperson commended Dr Amos for her passionate and well-reasoned presentation.

Mr M Moss (ANC) suggested to Ms Kotzenberg that disabled groups required occupational therapists and doctors at centres where disabled persons would meet during working hours. He also asked her about the backlog, or shortages of wheelchairs.

Ms Kotzenberg said that the units for people with disabilities were run by the Department of Social Services and not the Department of Health. Thus the two departments shared responsibility. She explained that the backlogs had arisen in some provinces owing to over-expenditure of the Health budget over the years.

Mr Moss asked how the Departments of Health and Labour worked together when people were injured at work.

Ms Kotzenberg responded that assistance in regard to Workmen’s Compensation was treated as a private matter and that nobody qualified under this for free treatment.

Mr Andrew Madella (ANC) asked Ms Kotzenberg how much a wheelchair cost from the Department. He said that in the marketplace it was priced at around R900 or more, which was out of the reach of most disabled persons, who would not be able then to use wheelchairs to get around.

Ms E Ngaleka (ANC) asked Ms Amos what had happened to the breast feeding campaign, which was previously held in February.

Ms Ngaleka asked what was the criterion for free health care.

Ms F Batyi (ID) inquired how much exactly was allocated to the clinics for people with disabilities. She raised concern that the patients’ charter was not visible, nor was it accessible to visually impaired persons, in many clinics and hospitals.

Dr Amos highlighted that in the youth indaba there was a provision made for people with disabilities, but the youth themselves had criticised the Department for not doing much for the visually impaired persons.

Ms Kotzenberg highlighted that the province would receive an all-inclusive budget without distinctions as to the project breakdown. Dictated budgets were not permitted by the Public Finance Management Act.

Ms Batyi asked Dr Amos whether there was a link between her Department and Love Life and whether adolescents were encouraged to use femidoms as opposed to condoms.

Mr B Mkongi(ANC) asked what the relationship was between the youth indaba and the youth commission.

The remaining questions could not be answered in the meeting, due to shortage of time, but the presenters indicated that they could be contacted for further inquiries.

Youth, children and the disabled: Department of Sports and Recreation (SRSA)
Mr Thembinkosi Biyela, Director, Mass Participation Programme, SRSA, emphasised from the outset that access to sports was a right and that his Department aimed to reach all disadvantaged sectors of the community. He also stated that the focus would be on training and supporting youth and disabled children. The only way this could be done, in his view, was through partnerships with corporates and communities to mainstream their efforts. He was impressed with the lessons learnt from Austria, that gymnastics could be done from the cradle to senior citizenship; the Austrian team comprised of members ranging from 7 to 70 years. What intrigued him most was that they were using everyday materials, such as crates, as props for their displays. Mr. Biyela highlighted the pivotal roles sports played, especially when dealing with juvenile delinquents, as they were incorporated more easily into society and learned useful life and team skills. He applauded the team of  “old magogos” in Limpopo, which comprised of elderly women who had started a soccer team.

Mr Biyela noted that the Department aimed to remove barriers to sports participation, provide opportunities to progress and develop sporting skills and expertise, train and support youth, disabled and children, establish links between schools, clubs and the wider community, improve fitness and health, reduce social problems in communities and increase employability and poverty alleviation programmes. He outlined the Junior Dipadi programme for children and caregivers. He highlighted progressive strides in his department to employ disabled persons and noted that to date SRSA had more than 2% of disabled persons working for it. Various disability structures were involved in partnerships and awareness programmes for sports for the disabled. In conclusion, he was not impressed that despite a budgetary increase from  R30 million to R194 million over three years, less than R 1 million was allocated to disabled sport.

Discussion
Mr Moss was gravely concerned with the directive that physical education should be taken out of the school curriculum. He wanted to know when it would be reintroduced.

Mr Biyela indicated that physical education would be returning to schools, but it would be part of the schools’ curriculum and not in the department’s hands. In addition to this he stated that the school’s culture, the community and the parents of the children would play a central role in determining whether the return of physical education would be a viable step for each school.

Mr A Madella (ANC) raised concern with regard to the mainstreaming of disabled sports, as there was already a backlog.  He enquired as to what portion of the budget would be allocated to that mainstreaming process.

Mr Madella was gravely concerned with the plight of young disabled sports persons, who could not take part in International Sport Competitions due to lack of funds.

Mr Biyela said that more effort was needed in engaging corporates and creating sustainable partnerships.

Mr Madella enquired into the accessibility into facilities at the 2010 World Cup, and whether these would be disability-friendly.

Mr Biyela indicated that there was a 2010 Unit that dealt with questions or concerns with regards to 2010, and that they should be contacted for further information.

The Chairperson noted that the Departments and the Committee had the responsibility of ensuring that the quality of life for all South Africans, including children and the disabled, was enhanced.

Other business
The Committee adopted the reports from the oversight visits to the Northern Cape and the Free State. Members expressed concern with the number of grammatical errors in both reports and encouraged more attention to be paid to reports and minute taking.

The meeting was adjourned.