Public Health and Health Systems

By the numbers: National Health Insurance in Mpumalanga

A Limpopo nurse was suspended after a video of her insulting a patient was leaked to the public. (File Photo).File Photo.
Written by Cynthia Maseko

It has been two years since Mpumalanga started its National Health Insurance (NHI) pilot site. Now the provincial department of health lays out progress in the pilot district.

The Central Chronic Medication Dispensing and Distribution programme is aimed at reducing wait times, overcrowding in clinics.

The Central Chronic Medication Dispensing and Distribution programme is aimed at reducing wait times, overcrowding in clinics.

In August, Health-e News reported that Mpumalanga’s National Health Insurance (NHI) pilot district showed signs of collapse.

Now, OurHealth speaks with provincial Department of Health spokesperson Dumisani Malambule who updates us on progress in the province’s NHI pilot district of Gert Sibande.

31 ward-based outreach teams

Ward-based outreach teams help take health promotion and disease prevention out of clinics and into communities. Comprised largely of community health care workers, teams go out into the community to provide basic health education and refer patients to clinic when necessary.

According to Malambule, 31 ward-based outreach teams are now operational in Gert Sibande, which has 138 wards.

Led by a professional nurse, each team is linked to a primary health car facility and should also include an enrolled or enrolled auxiliary nurse, and six community health workers. Each district should also have one health promotion practioner and environmental health officer as part of these teams.

“The communities these teams are serving are very delighted to have a nurse visiting them in their households, which also helps to reduce waiting time at our clinics,” Malambule told OurHealth.

14 school health teams

Aimed at reviving school health services, school health teams are made up of one or more nurses. To date, these teams have conducted catch-up vaccination campaigns to reach children who did not receive basic childhood immunisations last year due to national vaccine stock outs, Malambule added.

Relatedly, most of the district’s schools welcomed vaccination teams as part of the country’s HPV vaccine. However, Malambule said several schools refused to host the campaign and submitted written opposition to the campaign to the Mpumalanga Department of Health. These schools included Bethal’s Jim van Tonder and Laerskool Marietjie Van Niekerk schools, and Highveld Ridge’s Adullam Christian School.

10 private general practioners contracted

According to Malambule, only 10 of 148 the private physicians working in the district have agreed to take on additional duties within the Department of Health for pay to address doctor shortages. Malambule notes that like other rural NHI pilot sites, Gert Sibande is struggling to attract health care professionals but added that the department is looking at innovative ways to attract health care workers to the area.

52 health care facilities have decentralised chronic medication distribution  

Through the Central Chronic Medication Dispensing and Distribution programme, stable patients on chronic medication can collect their medication outside of crowded clinics at local pharmacies like Clicks and MediRite Patients then only visit the clinic every three months for check ups and consultations, reducing clinic crowding. The provincial department continues to face challenges in recruiting private facilities for the programme, Malambule told OurHealth.

One ideal clinic established

The district is home to one “ideal clinic,” part of a nationwide initiative to develop local examples of superior public health clinics.The ideal clinic in Breyten Mpumalanga has an average waiting time of about an hour, according to Malambule, who attributed the short wait time to better patient management, and monitoring and evaluation.

 7 community dialogues

In addition to a 2012 official launch of the NHI pilot district, the province recently held a community dialogue on the NHI in the Govan Mbeki Municipality. Another six community dialogues to increase communities’ understanding of the NHI are slated for neighbouring municipalities.

Computers are also being delivered to all primary health care facilities, he added. – Health-e News.

An edited version of this story was originally published in the 5 December edition of the Khanyisa Media community newspaper

About the author

Cynthia Maseko

Cynthia Maseko joined OurHealth in 2013 as a citizen journalist working in Mpumalanga. She is passionate about women’s health issues and joined Treatment Action Campaign branch as a volunteer after completing her matric. As an activist she has been involved with Equal Treatment, Planned Parenthood Association of South Africa, Prevention of Mother to Child Transmission of HIV and also with Marie Stopes Clinic’s project Blue Star dealing with the promotion of safe abortions and HIV education.

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