18 February 2013

South Africa: NHI Pilot Project Launched in Eden District BU Western Cape Health MEC Theuns Botha

press release

Western Cape Minister of Health, Theuns Botha, today launched the National Health Insurance (NHI) pilot project in the Western Cape in the district selected for this purpose - Eden. The event took place at the George Town Hall. On display were the three mobile clinics that will be used to reach out to selected schools in the Eden health district.

There are a total of 163 primary schools and 36 high schools in the Eden health district.

One of the main functions of the NHI is to re-engineer primary health care, and the strengthening of the South African health system will be rooted in the primary health care philosophy. The NHI pilot project will be rolled out through a focus on schools and promoting health among learners, and preventative health care, whilst rendering quality curative and rehabilitative services. This project is called the Integrated School Health Programme.

Integrated School Health Programme

The Integrated School Health Programme includes health assessments for learners in Grade R and Grade One, which include hearing, eye, gross motor, weight and height and oral health. It also includes health promotion and health education and further activities that address the health needs of the learner.

In practice it means that six professional nurses of Western Cape Government Health, one nurse per sub-district, will visit the selected schools. They were appointed as from July 2012.

To support these school health nurses, six community care workers, were appointed by contracted community home based care NPOs. They also started in July 2012.

Whilst the Integrated School Health Programme focuses on school-going children, the school community - educators, school management, school administrators and auxiliary staff, as well as parents and other caregivers - should also benefit from the programme.

The wider school community has much to gain from access to health information and opportunities to develop skills for healthy lifestyles.

In Eden district a phased -in approach will be used to provide the package of services:

Phase one (2013) focusing on the Grade R and 1 learners in quintile 1 & 2 schools

Phase two (2014) focusing on Grade R, 1 and 4 learners in all schools

Phase three (2015) focusing on grade R/1, 4 and 8 learners in quintile 1 & 2 schools

Phase four (2016) focusing on grade R/1, 4 and 8 learners in all schools and

Phase five (2017) focusing on grade R/1, 4, 8 and 10 learners in all schools.

Monitoring and evaluation

The Eden District management team has a weekly meeting to review the progress of all the projects.

A project manager has been appointed to co-ordinate and support.

Progress reports have to be submitted every two weeks by all the contracted service providers of the different projects.

Monthly financial and narrative progress reports are submitted to Western Cape Government Health.

Quarterly financial and narrative reports are submitted to the National Department of Health.

Regular meetings are held with the National NHI team to discuss and monitor progress and for trouble-shooting.

Health, Education and Social Development working together

Implementation of the Integrated School Health Programme requires collaboration and linkages of different sectors, most importantly, the respective departments of Health, Basic Education and Social Development. The latter will support in cases where parents or caregivers are unable to follow through on referrals.

Details about the mobile vehicles

There are three vehicles received:

Eye services

For optometric services

Fully equipped with eye care equipment (11 items)

Spectacle repair kit

Oral Health

1. Complete dental unit with 2 hand pieces, compressor and clean water system

2. Dental chair

3. Equipment, including x-ray unit, curing light, amalgamator

PHC mobile vehicle

1. Operating table (for circumcisions/Pap smears etc.)

2. Theatre light

3. Autoclave

Position of the Western Cape Government on the NHI pilot project

Whilst the Western Cape Government is participating in the Eden NHI pilot, this does not indicate unqualified support for the as yet not formally tabled policy document for NHI.

There are ten pilots in the country that are "piloting" various options and we are implementing the pilot in the Eden district. There is no final model. The reason for the Western Cape participation is the belief that the province can contribute to the development of the best ultimate model.

The Western Cape Government policy is one of Universal Health Care for All which is supported by the World Health Organisation, but through a model of a functioning health system at provincial level without the centralising of all funding and management through the National Department.

Western Cape Government opposes the centralisation of health facilities.

All that is currently being undertaken by Western Cape Government through the support of the NHI pilot project is to strengthen health services in the Eden District and to provide the country with viable models of health care that have worked and will continue to provide quality patient centred health care services.

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