06 December 2010
The Department of Health would like to provide a response regarding the constant allegations leveled against our department and Honorable MEC Sokatsha in particular by DA.
We view these allegations as a concerted effort to cast doubt and aspersions in the public eye, targeted towards tarnishing our MEC’s image and standing in society as well as that of the Northern Cape Department of Health. We also want to emphasize that there is only one Department of Health in South-Africa, not 9 provincial departments and one national department operating seperately.
Statement 1.
While the past couple of years have seen achievements with regards to combating HIV and AIDS, the role the Northern Cape Department has played towards this end has been nominal.
Response
The Northern Cape has seen the HIV prevalence staying within the range of 18.5% and 16.2% in the last 5 years, seeing a marginal increase of 1% in the results of the Antenatal Survey of 2009. Second only to the Western Cape in the last many years, the Northern Cape has maintained marginal fluctuations in the prevalenve, which are indicative of a stabilization pattern in statistical terms .
It must also be remembered that prevalence is indication of patients living with the HIV virus and not the rate of new infections. Therefore as more patients are now stable on ARV’s and more young women are now able to in fact give birth to HIV-free babies , this may invariably influence prevalence rates as the Antenatal Survey samples only pregnant women and is not a cross sectional population survey.
The province has played and is continuing to play its role in HIV prevention activities which involve community outreach in the main. A comprehensive STI Plan is in place and the province’s condom distribution rate has more than doubled in the last year. The Department has ensured that there is a High Transmission Area (HTA) site in each of the 5 districts, while Frances Baard will get an additional one due to the emerging problem of sex work proliferation in the district. Frances Baard is also the only district which had an increase of HIV prevalence in the last survey, while all other districts had a decrease. Namakwa recorded 0% prevalence out of all 68 pregnant women who were sampled in the 2009 study.
The successful Ministerial Health Campaign conducted across the province during August/September 2010. The campaign kicked off in the Pixley-Ka-Seme District in the towns of Petrusville and De Aar during the week of 23-26 August 2010. The campaign then moved to the Siyanda Region during the week of 30 August to 02 September 2010 where the communities of Louisvale-Weg, Paballelo, Marchand, Alheit, Askham, Groot-Mier, Topline and Wegdraai were visited. The campaign moved to Greater Nr 2,Galeshewe-Kimberley during the week of 06-09 September 2010.The campaign ended in the John Taolo Gaetsewe District during the week of 01-04 November 2010 where the communities of Madibeng,Ga-Mopedi,7 Miles, Magajoneng and Deeerham were visited.
Campaign activities included health walks, door-to-door activities, health education sessions, exhibitions, community dialogues and Candlelight Memorial services. Services rendered included HIV Counseling and Testing (HCT),Blood pressure assessment, Blood sugar assessment, Hemoglobin assessment, Five TB screening (symptomatic screening, through five verbal questions),Male and female condom distribution, Oral Health, Eye Health,H1N1 Vaccinations and Promotion of Healthy lifestyles
According to some statistics gathered in the districts, in Pixley-Ka-seme 310, Siyanda 150 and Frances Baard 378 people tested and received counseling for HIV. In the Pixley-Ka-Seme District 19 people, the Siyanda District 13 and in the Frances Baard District 18 people tested positive for HIV. Over 316 door-to-door visits were conducted in Pixley-Ka-Seme, 616 in Siyanda and 260 in Frances Baard. Dental patients consulted were Pixley-Ka-Seme 380, Siyanda 265 and Frances Baard 79. The number of ophthalmic examinations conducted was Pixley-Ka-Seme 200, Siyanda 337 and Frances Baard 172. The number of clients screened for chronic illnesses were Pixley-Ka-Seme 441, Siyanda 1238 and Frances Baard 737. Regarding the H1N1 Campaign, the number of adults and children receiving treatment were Pixley-Ka-Seme 272 and Frances Baard 277.The number of patients screened for TB was Pixley-Ka-Seme 441, Siyanda 270 and Frances Baard 323.
The overarching challenges faced by our communities in terms of health service delivery challenges are among others insufficient human resources on facility level, long waiting times, negative staff attitudes, limited medical supplies, ineffective emergency medical services (EMS),poor access to specialized health care (eye care, dental care).Socio-Economic conditions are also posing health risks in our communities like poverty and unemployment, alcohol dependency, poor infrastructure (dilapidated dwellings),bucket systems and poor access to social support services.
MEC Sokatsha and the Northern Cape Department of Health would like to encourage communities to report any form of non compliance to District Health managers. The MEC acknowledges the challenges experienced by the department regarding the issues raised and indicated that all districts are in the process of addressing these challenges through clearly defined operational plans. MEC Sokatsha also requests all municipal councilors to assess the health needs in their areas and report it to the department as soon as possible.
Statement 2
The last couple of years have seen new policies and strategies to improve HIV counseling and testing, measures put in place to ensure that all HIV infected children and pregnant mothers have access to treatment and ensuring that people with CD4 counts of 350 become eligible for access to anti-retroviral therapy. These successes can be attributed to the National Department of Health but unfortunately not to the actions of our provincial department, which is ravished by poor strategic planning.
Response
In South Africa, the management of HIV and AIDS has, since the introduction of the Operational Plan for the Comprehensive Care Management & Treatment (CCMT) Plan in 2004, been guided by common Guidelines and Protocols from the National Department of Health. Provinces have in the main, functioned within these parameters with minimal variation as may have been necessary.
The “new policies and strategies ....” refered to in the above statement came as a result of what has now become known widely as the Presidential Mandate (dubbed across the country as “marching orders”) for the acceleration of HIV and AIDS services in the country. These “marching orders” were articulated by President Jacob Zuma in his watershed speech of World AIDS Day 2009 and were translated into the policies correctly referred to above. These include HIV Counseling & Testing, Revised PMTCT Guidelines, Provider-Initiated Counseling & Testing, New ARV Guidelines for Children and Adults, to mention but a few
These policies apply to all provinces and came into effect on 1 April 2010.
On the issue raised about “ ... poor strategic planning”, the Northern Cape was among the first few provinces to develop and complete its own Provincial Strategic Plan for HIV & AIDS following the release of the National Strategic Plan (NSP) 2007-2011. We went further, with support from UNAIDS, to develop a Monitoring & Evaluation Framework for this Plan, While the NSP had not been costed, the Northern Cape Province went ahead to cost its PSP as an attempt to employ more objective means for resource allocation for the programme going forward.
All the above 3 documents are readily available.
Statement 3.
This can be seen in the fact the Northern Cape Health Department met only 15 of their 30 targets pertaining to combating HIV/AIDS. The more worrying fact however, is that this department got an adverse opinion from the Auditor General in terms of performance. In other words, we cannot believe what this Annual Report says. What this department says it does, what it reports and what is actually on the ground, is not the same thing. Furthermore the department got a disclaimer in terms of finance. In other words, it cannot properly account for the money it gets and it might be possible that money which should have gone to HIV/AIDS, did not.
Response
The achievement of some of the targets set for HIV & AIDS depends on a multisectoral and multidisciplinary approach, and not only the Department of Health. That the Department achieved 50% the set targets indeed suggests the existence of gaps in the provincial multisectoral response to HIV & AIDS. In order ot address this, the Premier of the Province, who is also the Chairperson of the Provincial AIDS Council, put together a multisectoral AIDS Council consisting of 16 sectors last year in November.
Statement 4
This department needs to review its five year strategic plan, its Annual Performance Plan in terms of performance and the Turnaround Strategy in terms of finances. When we have a measurable, realistic overall plan in place, both in terms of performance and finances, we can look at what we as a province can do in order to reduce the HIV/AIDS infection rate amongst our people even more.
Response
The current PSP will expire at the end of 2011 and the process of reviewing the Plan is underway.
The DA suggests six things that need to be done in terms of HIV/AIDS once we have the overall framework and finances in order:
1. Locally-based research is necessary in order to understand what influences the spread of the virus in the province, the problems that people experience in terms of managing the illness, what the solution is and what the solution will cost.
2. Local stakeholders should be engaged in a way that provides clarity on what exactly it is that they have to do and what their responsibility is going to be. We honestly need to move away from these talk-shop gatherings.
3. Based on the above, localized actionable plans that are aligned and that are continuously monitored and evaluated against realistic targets, must be developed.
4. The MEC for Health should release a quarterly report on statistics, as well as the province’s plans, progress and necessary revisions to the plan that should
be made. This will keep people in the province informed and motivated about the fight against AIDS, ensuring optimal involvement from all sectors, including support groups and HIV/AIDS councils.
5. There must be more control over medication leaving the Arthur letehle Depot.
6. Lastly, we should look at innovative projects particular to the Northern Cape. In this respect, a small amount of funding can be made available for projects that test innovative ideas that may improve services on the ground. These of course should be rigorously evaluated against set criteria but if they prove cost effective they should systematically be expanded. A couple of examples include the use of technology, in the form of mobile phones, to educate, monitor and coordinate mentor caregivers. We could also look into the use of mobile phone technology to support treatment adherence, which constitutes a problem in our province.
As far as the above recommendations go, it is our view is that some may be useful, however the Department would have to strategize as a collective to ponder on these.
Enquiries:
Andrid F. Scholtz
Ministerial Spokesperson
Tel : 053 830 2000
Cell: 0824479696
Fax: 053 8331925
E-mail : This email address is being protected from spambots. You need JavaScript enabled to view it.
Issued by: Ministry of Health
Northern Cape Province