SA DEPARTMENT OF HEALTH: Positive Future Prognosis After Pandemic Turmoil

Time have never been tougher for the National Department of Health. Following the Covid-19 pandemic, and re-emergence of the economy after some of the world’s strictest lockdowns, there is a hangover, with the virus still in circulation (South Africa faced the largest share of infections on the continent), vaccine issues, and a wave of new challenges hitting the front lines each month.

Against the backdrop of a stretched budget as the Department tries to push its rollout of the National Health Insurance, loadshedding plaguing all industries, and with economic conditions weak, when the country needs stability from somewhere, it should come from healthcare. South Africa’s Department of Health is responsible for a plethora of health and medical care issues. Its reach covers all provinces and several public entities, statutory bodies, and various institutions. Represented in Government by Minister Joe Phaahla, the Department’s mission is ‘To improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the healthcare delivery system by focusing on access, equity, efficiency, quality and sustainability’.

Foster Mohale, Spokesperson for the Department, tells Enterprise Africa more about driving progress through difficult conditions which are not conducive for growth and expansion.

“There is not enough money in the public health system to address all the needs while catching up with the services and infrastructure backlogs (the collective public sector budget has been reduced year-on-year),” he begins.

“Staffing remains a challenge (and there are many facets to this) but without any increase in funds allocated for Conditions of Employment (COE), and no allowance for increasing posts in the sector, this is likely to be a continued challenge.

“The cost of private health care has rocketed and as a result many who insure themselves are downgrading packages of cover and increasing their vulnerability. This is a concern as those who cannot afford the Out-of-Pocket payments will move to the public sector which is already stretched.

“All health departments have heightened attention to pandemic preparedness and watch the effects of climate change. This can add a burden to budgets,” he details.

However, there are a number of initiatives underway to bolster and improve the industry and the service provision, and the Department is keen on catching up with priorities that were pushed out during 2020, rebuilding capacity in the system, and remaining prepared for any future shocks. 

“As always there are many programmatic goals. The key goals are stated in the Annual Performance Plan which will be tabled in Parliament once it has been signed off. All of the goals have at least three-year targets,” says Mohale.

“This year, it is expected that the NHI Bill will be passed in Parliament so there is an increased effort to build the technical capacity to manage the Fund.

“There is renewed effort to improve hospital management in the public sector and capital works is focussing on sustainable electricity in the health facilities.

“Projects that lost impetus through Covid are being revived, such as the Mine Worker Compensation, and pandemic preparedness is still centre-stage so revival of the National Public Health Institutes of South Africa (NAPHISA) is receiving attention,” he adds, describing just a few high-level strategies that are being driven right now.

VACCINATION PARTNERSHIP

Importantly, the vaccine rollout, in partnership with some of the world’s most important healthcare companies such as Abbott, was key in halting the pandemic and allowing for some return to normalcy. A public-private partnership was key here as the government embraced involvement from companies with global expertise.

“The Covid-19 vaccination programme was unique in that it was a mass campaign executed very quickly across public and private sectors. There was a single digital record system – the Electronic Vaccination Data System (EVDS). This has been extremely positive and created capacity for additional improvements in data management going forward,” explains Mohale.

Everyone over the age of 12 can enrol, and the system allowed for digital verification of vaccination status. This progress remains vital as the fight against Covid is far from over – the virus is still a threat to many different groups of people, especially in developing countries. And catch up to relieve backlogs on health systems remains a serious concern. All of this while South Africa faces a fresh outbreak of measles and cholera. For businesses and employees, ongoing care and knowledge around vaccination is vital, not just from a Covid-19 perspective, but a wider health concern.

“The routine vaccinations took a bit of a knock, so we are now experiencing a measles outbreak. We are increasing the responses to all vaccinations but with immediate focus on Covid and Measles,” says Mohale. “The Department has reviewed the organisational support for vaccines and vaccination programmes and is moving them all to one centre of management. It is critical to keep vaccination coverage high so that there is sufficient immunity in the risk pool. Catch-ups are difficult and distract from other programmes so should be avoided.”

TIRELESS PATIENT CARE

Following the pandemic, hard work has been required to normalise the industry while remaining cautious and well-prepared for any further shocks. This is where success has been easier to find in the health space.

“The public health programmes did experience setbacks but there is evidence of recovery now that resources are redirected to the programmes,” says Mohale. “All programmes and the service delivery components in the health departments have ‘catch-up’ plans which are being implemented.

“Digital health capacity received a major step up during Covid and will enjoy more attention in 2023. There are low-hanging fruit from the Covid and pre-Covid systems work, but the limiting factor will remain connectivity (linked to load-shedding).”

He adds that not all technology adds significant value, and each project much be reviewed and examined in detail to ensure its contribution. “We have started to implement Health Technology Assessments so that there can be evidence-based decision-making,” Mohale confirms.

With this is mind, and considering the asset base boasted by the system, the South Africa Department of Health is looking forward with confidence. The country is home to by far the most advanced standard of healthcare in Africa and has globally renowned care facilities in the private sector. bringing high-quality care to more and more people each year is only possible thanks to a dedicated and caring set of people.

“We are extremely proud of the majority of healthcare workers who work tirelessly to look after patients and who rise to every occasion which presents. This against an increasingly difficult environment where civil society has lost trust in leadership and the establishment,” concludes Mohale.