Free State Health MEC Montsheng Tsiu is de­ter­mined to ad­dress the chal­lenges fac­ing the health sec­tor in the prov­ince

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New Free State Health MEC Montsheng Tsiu is de­ter­mined to ad­dress the chal­lenges fac­ing the health sec­tor in the prov­ince.

She aims to do this through the proper im­ple­men­ta­tion of govern­ment’s re-engi­neer­ing of the pri­mary health­care (PHC) policy, which aims to in­crease ac­cess to and im­prove the qual­ity of health ser­vices.

The re-engi­neer­ing of PHC has four out­puts: in­creas­ing life ex­pectancy, de­creas­ing ma­ter­nal and child mor­tal­ity, com­bat­ing HIV and AIDS and de­creas­ing the bur­den of dis­ease from tu­ber­cu­lo­sis (TB), and strength­en­ing the ef­fec­tive­ness of the health sys­tem.

Con­ceived by the Na­tional De­part­ment of Health in 2010, the model for re-engi­neer­ing South Africa’s PHC land­scape was sub­se­quently adopted by pro­vin­cial govern­ment.

MEC Tsiu said if the prov­ince gets the im­ple­men­ta­tion model right, its health­care sys­tem will be the best in the coun­try.

“If we im­ple­ment it cor­rectly, the de­part­ment will ul­ti­mately not need a lot of money to de­liver ser­vices. If we help our peo­ple to pre­vent dis­eases, we will be able to save money for the de­part­ment be­cause when a per­son gets sick it in­creases the bur­den on the de­part­ment to take care of that per­son,” she ex­plained.

“If our res­i­dents are em­pow­ered to pre­vent dis­eases, we will have health­ier res­i­dents who do not need to visit health­care fa­cil­i­ties of­ten. They will be able to go for check-ups while they are still healthy and in­fec­tions will be picked up early, treated and con­trolled,” she added.

MEC Tsiu was ap­pointed to the po­si­tion in May this year and be­lieves she is the right woman for the job be­cause she has worked for the health de­part­ment for over 30 years, first as a pro­fes­sional nurse in pri­mary health­care and later as the

pro­vin­cial head of nurs­ing.

Since day one, MEC Tsiu has em­pha­sised the im­por­tance of tak­ing pri­mary health­care to the peo­ple.

She said the de­part­ment will be run­ning cam­paigns across the prov­ince to pro­mote pre­ven­ta­tive health­care.

The MEC said high vol­umes of peo­ple visit the prov­ince’s health fa­cil­i­ties.

“We find that some of our fa­cil­i­ties are too small to carry the num­ber of pa­tients that come through. How­ever, they are not turned away. We help ev­ery­one who comes to our fa­cil­i­ties,” she added.

Core chal­lenges

Bud­get is one of the big­gest fac­tors con­tribut­ing to many of the de­part­ment’s chal­lenges. For this fi­nan­cial year, the de­part­ment has a bud­get of R10.4 bil­lion, which MEC Tsiu ex­plained is in­ad­e­quate. She added that most of the money goes to salaries.

How­ever, she said in­no­va­tive ways are be­ing found to make the money go fur­ther with­out com­pro­mis­ing ser­vice de­liv­ery.

The prov­ince’s pop­u­la­tion is about 2 763 024, and many of these peo­ple live in ru­ral ar­eas. Around 82 per­cent of the pop­u­la­tion does not have med­i­cal aid and makes use of pub­lic health­care ser­vices.

The de­part­ment con­stantly finds it­self hav­ing to pay for things that it did not bud­get for, such as lit­i­ga­tion and ser­vic­ing peo­ple from other prov­inces and abroad, es­pe­cially in hos­pi­tals.

The MEC said the de­part­ment is try­ing its best to en­sure that it em­ploys skilled peo­ple but ex­plained that some­times health­care work­ers end up mak­ing mis­takes be­cause of the heavy work­load, which is ex­ac­er­bated by staff short­ages.

She said that the short­age of staff at health fa­cil­i­ties is, how­ever, not unique to the Free State.

MEC Tsiu ac­knowl­edged that the coun­try has a bur­den of dis­eases, es­pe­cially in the Free State where many peo­ple are in­fected with HIV and AIDS, and TB. Ma­ter­nal deaths and neo-na­tal and in­fant mor­tal­i­ties are also high.

Re­cent re­ports have in­di­cated that the three prov­inces with the high­est HIV preva­lence are KwaZulu-Na­tal, fol­lowed by the Free State and the Eastern Cape.

MEC Tsiu said the Free State’s Le­jweleputswa, in par­tic­u­lar, which is a min­ing district, has a high level of TB.

“We also have many pa­tients liv­ing with non-com­mu­ni­ca­ble dis­eases like hy­per­ten­sion, high lev­els of trauma and men­tal health is­sues,” she said.

“We are try­ing hard to en­sure that we do not over­bur­den our health­care work­ers,” she said.

With the prov­ince be­ing at the cen­tre of the coun­try, a num­ber of na­tional roads pass through it. This means that Free State health fa­cil­i­ties are of­ten called upon to treat trav­ellers from other ar­eas who have been in­volved in ac­ci­dents in the prov­ince. The N8, N5, N6, N1 and N3 all pass through the Free State and carry high traf­fic vol­umes, es­pe­cially over hol­i­day pe­ri­ods.

Top pri­or­i­ties

Among the pri­or­i­ties that the MEC has ear­marked for this fi­nan­cial year are:

Cen­tralised Chronic Medicines Dis­pens­ing and Dis­tri­bu­tion – this will en­able peo­ple to col­lect their med­i­ca­tion from dif­fer­ent points at their own con­ve­nience.

Im­prov­ing health in­fra­struc­ture across the prov­ince – the de­part­ment re­cently opened two state-of-the-art hos­pi­tals in the ru­ral ar­eas of the Free State, namely Al­bert Nzula District Hos­pi­tal in Tromps­burg and Senorita Nt­la­bathi in Lady­brand. The Batho Clinic in Man­gaung op­er­ates as a 24-hour clinic, as do the Dr Che Gue­vara Clinic in Sa­sol­burg and the re­fur­bished Sa­sol­burg Clinic. Other clin­ics will start op­er­at­ing day and night dur­ing this fi­nan­cial year.

Im­ple­ment­ing the Health Pa­tient Regis­tra­tion Sys­tem across fa­cil­i­ties in the prov­ince – the elec­tronic regis­tra­tion of pa­tients will re­sult in bet­ter case man­age­ment. Pelonomi and Univer­si­tas hos­pi­tals have al­ready started us­ing the elec­tronic regis­tra­tion model.

TB screen­ings – the de­part­ment will in­ten­sify TB screen­ings and en­sure that in­fected peo­ple are put on treat­ment.

The dis­tri­bu­tion of con­doms – this will be in­creased and health ed­u­ca­tion will be pro­vided. Ef­forts to pre­vent mother-to-child trans­mis­sion of HIV will also be stepped up.

One of the suc­cesses that the de­part­ment has had over the years is en­rolling 130 clin­ics for as­sess­ment as Ideal Clin­ics.

“About 91 of our fa­cil­i­ties have achieved a sil­ver sta­tus, and we are work­ing to en­rol more clin­ics. We have 223 clin­ics in the Free State and in­tend en­sur­ing that they are all Ideal Clin­ics,” the MEC said.

In an ef­fort to de­crease ma­ter­nal deaths, the MEC said the de­part­ment has ap­proved some fa­cil­i­ties to do cae­sarean sec­tions while oth­ers will fo­cus on nat­u­ral births.

She said some health­care providers have been trained for ob­stet­ric emer­gen­cies. Found in clin­ics across the prov­ince, these ex­perts step in when ba­bies are un­der­weight, pre­ma­ture or face other dif­fi­cul­ties.

The MEC added that the de­part­ment has var­i­ous part­ner­ships with the pri­vate sec­tor and also works with other govern­ment de­part­ments to im­prove ser­vice de­liv­ery at health­care cen­tres.

Unique ini­tia­tives

MEC Tsiu said the de­part­ment has ini­ti­ated a num­ber of unique pro­grammes to ad­dress chal­lenges fac­ing the health sec­tor.

One of them is the Ar­rive Healthy cam­paign, which the de­part­ment ex­e­cutes dur­ing hol­i­day sea­sons. Dur­ing this pe­riod, the de­part­ment con­ducts road blocks with the po­lice and trans­port de­part­ment. It de­ploys emer­gency med­i­cal ser­vices work­ers on a num­ber of busy roads to stop trav­ellers and test them for chronic ill­nesses like high blood pres­sure, among oth­ers.

“This is be­cause it was found that dis­eases like hy­per­ten­sion con­trib­ute to road ac­ci­dents,” she said, ex­plain­ing that peo­ple may have a dis­ease they are not aware of, but which could make them a dan­ger to them­selves and oth­ers, should their con­di­tion re­sult in an ac­ci­dent.

“We also have health ed­u­ca­tion cam­paigns, es­pe­cially dur­ing

school hol­i­days. For in­stance, we visit com­mu­ni­ties and ed­u­cate young men about med­i­cal male cir­cum­ci­sion,” she said.

Re­turn of Cubantrained med­i­cal stu­dents

The MEC said the 117 Cubantrained med­i­cal stu­dents who have just re­turned to South Africa for their sixth year of study will help ad­dress chal­lenges fac­ing the prov­ince.

They will fin­ish their qual­i­fi­ca­tion in South Africa to en­sure they be­come fa­mil­iarised with South Africa’s dis­ease bur­den and are in­te­grated into the coun­try’s health­care sys­tem.

“Af­ter they com­plete their stud­ies, we are plan­ning to de­ploy them to ru­ral ar­eas.The good thing is that most of them come from ru­ral ar­eas and are pre­pared to go work there.

They are go­ing to help the coun­try a lot,” she said.

Free State Health MECMontsheng Tsiu.

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