The recruitment of retired nurses to promote health at schools has already started.
Health minister Dr Aaron Motsoaledi returned from a study tour to Brazil last year and announced that he was determined to revitalise the country’s primary health care system, copying some of the successes from the Latin American country.
Dr Yogan Pillay, Deputy Director General in the health department, recently said, ‘the minister has signed his life away to the President and by extension our lives’.
Motsoaledi has agreed to work to increase life expectancy, decrease the rate of maternal and child mortality, decrease the burden of disease from HIV and tuberculosis and improve the effectiveness of the health system.
‘We start from a poor base, so the question is how far we can move by 2014,’ said Pillay.
Pillay unveiled three streams of ‘re-engineering’ the health system:
– A PHC team consisting of a professional nurse supported by at least four community health workers (CHWs) will be assigned to each of the more than 4 000 electoral wards. Depending on the need of the area, an environmental health practitioner and health promotion worker will also join each team.
– School health services will be established with a nurse assigned to a group of schools. Advertisements calling on retired nurses have already appeared and Pillay said that they were finalising the hiring policy.
– The establishment of specialist teams in the health districts. Motsoaledi has announced that the ‘District specialist task teams’ will consist of an anaethetist, family physician, primary health care nurse, obstetrician, advance midwife, paediatrician and advanced paediatric nurse.
Pillay said each PHC team would initially be responsible for 8 000 people with the aim to have 35 percent of households assessed and registered within the first year of the rollout.
Fourteen teams will be up and running in the next couple of week with 54 in place by the end of the year. The teams will focus primarily on maternal and child health, HIV, TB and some chronic diseases.
Pillay said an audit of CHWs found that there were currently between 58 000 and 68 000 CHWs in the country, but said they were ‘unco-ordinated, untrained and not well supported’.
He said 5 000 CHWs would be trained or re-trained by the end of the year.
‘We are finalising the orientation programme and training materials with training starting on October 1,’ said Pillay. ‘ Health-e News Service.
In terms of the schools, Pillay said the vision was to have a health presence in each institution, but in the light of the shortage of nurses it may be more feasible to deploy nurses to a cluster of schools or target the poorer schools.
The specialist doctor teams consisting of among others obstetricians, gynaecologists, family physicians and paediatricians would target the districts and could be assigned to more than one depending on the population sizes.
‘We can’t afford to have a launch of concepts and policy. We have been tasked with getting this off the ground and when we launch it, it has to be happening already,’ said Pillay, adding that the plans had to be ‘in sync with the National Health Insurance’ plan.
Pillay said National Treasury had given the department R338-m in the current budget to make it happen. A further R400-m and R700-m has been budgeted in 2012/3 and 2013/4 for PHC and R501-m and R700-m for maternal and child health in the same periods.