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PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH. THE DISTRICT HEALTH SYSTEM AND LOCAL GOVERNMENT DR YOGAN PILLAY (ACTING CLUSTER MANAGER: DHS & DEVELOPMENT). WHAT IS THE DHS?. TARIMO (1991)

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PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH

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PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH

THE DISTRICT HEALTH SYSTEM AND LOCAL GOVERNMENT

DR YOGAN PILLAY (ACTING CLUSTER MANAGER: DHS & DEVELOPMENT)


WHAT IS THE DHS?

TARIMO (1991)

A DHS BASED ON PHC IS A MORE OR LESS SELF-CONTAINED SEGMENT OF THE NHS. IT COMPRISES A WELL DEFINED POPULATION LIVING WITHIN A CLEARLY DELINEATED ADMINISTRATIVE AND GEOGRAPHIC AREA AND INCLUDES ALL HEALTH ACTIVITIES IN THE AREA, BOTH PUBLIC AND PRIVATE

Parliamentary.Portfolio Committee_June2003


DHS:RATIONALE

  • PART OF THE NATIONAL HEALTH SYSTEM

  • VEHICLE TO DELIVER PHC IN INTEGRATED AND NON-FRAGMENTED MANNER

Parliamentary.Portfolio Committee_June2003


RATIONALE CONTD

UNGER & CRIEL (1995)

DISTRICT CONCEPT DERIVES FROM TWO RATIONALES…THE IMPLEMENTATION OF THE PHC STRATEGY, REQUIRING DECENTRLAISED MANAGEMENT, (AND) THE ORGANISATION OF INTEGRATED SYSTEMS WHICH IMPLIES THAT ONE SINGLE TEAM MANAGES THE DISTRICT HOSPITAL AND CLINICS

Parliamentary.Portfolio Committee_June2003


PRINCIPLES

  • EQUITY

  • OVERCOME FRAGMENTATION

  • ELIMINATE DUPLICATION

  • COMPREHENSIVE SERVICES

  • EFFECTIVENESS & EFFICIENCY

  • QUALITY

  • IMPROVED ACCESS

  • LOCAL ACCOUNTABILITY & COMM PARTICIPATION

  • DEVELOPMENTAL AND INTERSECTORAL

  • SUSTAINABILITY

Parliamentary.Portfolio Committee_June2003


STRATEGY

  • A POLICY FOR THE DISTRICT HEALTH SYSTEM FOR SOUTH AFRICA (DECEMBER 1995)

  • NATIONAL DHS COMMITTEE

  • PROVINCIAL DHS COMMITTEES

  • REGIONS (ALIGNED WITH LG)

  • DISTRICTS (ALIGNED WITH LG)

Parliamentary.Portfolio Committee_June2003


IMPLEMENTATION (BY 2000)

  • ALL PROVINCES ESTABLISHED HEALTH REGIONS WITH REGIONAL MANAGEMENT

  • 174 HEALTH DISTRICTS ESTABLISHED

  • MANY PROVINCES APPOINTED DISTRICT MANAGERS (OTHERS INTERIM/ACTING MX)

Parliamentary.Portfolio Committee_June2003


IMPLEMENTATION CONTD

  • OPERATIONAL PLANS DEVELOPED

  • SOME FUNCTIONAL INTEGRATION WITH LG FACILITIES

  • ANNUAL DHS COMPETITION COMMENCED IN 1998

  • ISRDP – R 30 M CONTRACT

  • UR – AUDIT OF SERVICES

  • CROSS BOUNDARY MUNICIPALITIES

Parliamentary.Portfolio Committee_June2003


CURRENT STATUS & NEXT STEPS (2000 - )

  • LOCAL GOVERNMENT REORGANISED IN DECEMBER 2000 (BOUNDARIES, NEW COUNCILS)

  • HEALTH DISTRICTS REALIGNED WITH METROS AND DISTRICT MUNICIPALITIES

  • MUNICIPAL HEALTH SERVICES DEFINED – ENVIRONMENTAL HEALTH SERVICES (FUNCTION OF METROS AND Cs)

Parliamentary.Portfolio Committee_June2003


DISTRICT DEVELOPMENT: PROGRESS ON SELECTED ISSUES – APRIL 2003

Parliamentary.Portfolio Committee_June2003


Parliamentary.Portfolio Committee_June2003


TABLE: PHC FACILITIES BY TYPE PER PROVINCE, DHIS

Parliamentary.Portfolio Committee_June2003


Parliamentary.Portfolio Committee_June2003


CURRENT ACTIVITIES

  • STATUS QUO REMAINS RE: SERVICE PROVISION AND FUNDING

  • DISCUSSION WITH NT RE: R1,5 B

  • SINGLE PUBLIC SERVICE

  • FUNCTIONAL INTEGRATION WITH SLAs AS TRANSITION MEASURE

  • DISTRICT HEALTH PLANNING

Parliamentary.Portfolio Committee_June2003


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