THE JOURNEY SO FAR-PROGRESS

ON PHC RE-ENGINERING (WBOT)

Dr Khethisa Taole PHC Re-engineering Workshop

16 March 2015

School of Public Health

University of Witwatersrand

• Purpose

• Vision

• Mission

• Background

• Progress

• Challenges

• Wayforward

• Conclusion

PRESENTATION OUTLINE

• To present an overview on progress on

PHC re-engineering (WBOTs).

• To highlight challenges of implementation;

• To present way forward

PURPOSE

A long and healthy life for all

South Africans

VISION OF THE HEALTH SECTOR

To improve health status through the prevention

of illness and the promotion of health lifestyles

and consistently to improve the health care

delivery systems by focusing on access, equity,

efficiency, quality and sustainability.

MISSION OF THE HEALTH SECTOR

• Internationally, Primary Health Care is being emphasized

increasingly (WHO, 2008)

• SA Health Sector Reform- Primary Health Care Re-

engineering, 2010

• Rwanda, Liberia, India, Brazil, Zambia-Strong Community

Health Orientation

• Need to invest in primary health care reforms

BACKGROUND

Update on Ward Based PHC

Outreach Teams Q3

Province

Number of team

needed (Based on

1500 households/

team norm)

Established

(Registered in DHIS)

up to Dec 2014

Number of Reporting

teams Oct-Dec (Q3)

2014

Reporting Rate (based

on teams needed)

Oct-Dec (Q3) 2014

Eastern Cape 1,125 781 525 47%

Free State 549 124 75 14%

Gauteng 2,606 303 199 8%

KwaZulu-Natal 1,693 160 70 4%

Limpopo 945 237 147 16%

Mpumalanga 717 95 43 6%

Northern Cape 201 348 242 34%

North West 708 87 42 21%

Western Cape 1,089 0 0 0%

Total / Av 9,633 2135 1343 14%

Update on Ward Based PHC

Outreach Teams

Update on Ward Based PHC

Outreach Teams

• Provincial Guidelines of the implementation of PHC re-engineering

streams including WBOTs;

• Training modules (Phase 1, Phase 11), supported by Foundation for

Professional Development.

• Developed and distributed monitoring and reporting tools:

• Supported the development of the CHW accredited qualification by

QCTO, due to commence in 2015.

• Continuous training and orientation interventions, supported by

BroachReach Health Care-OTL, CHW and ToTs.

PROGRESS….1

• There are 4,277 municipal wards in the country and according to

policy each municipal ward should at least have one Ward –base

Primary Health Care Outreach Team (WBPHCOTs).

• Presently, there are 2135 WPHCOTs and of these 1343 reporting on

the District Health Information System (DHIS).

• Piloted mobile technology in NHI pilots and trained 79 CHWs

• Draft CHW /WBOT Policy Framework, 2014?

• Initiated Rapid Appraisal of WBOT, ASLEPH, 2014

PROGRESS….2

• Shortage of Professional Nurses

• Attrition of health care personnel

• Inadequate poor reporting rates due to poor data

capturing capability

• Unsustainable budget allocation

• Number of Teams (4,277) vs Number of Teams

Needed (9,633)

• Norms: high income, urban residents versus rural,

sparsely populated areas

CHALLENGES

• Fastrack the implementation of the revised supervisory

model:• Enrolled Nurses

• Enrolled Nursing Assistant

• PHC facility supervisor/local health area manager

• Rationalise and synchronise information management

systems-reconfiguration of WBOT module on the DHIS

• Identify and orientate data capturers;

• Review population norm-CHW policy process underway

• High-level leadership to support budget allocation

• Ensure appropriate responses by district development

partners

WAYFORWARD

The delivery of health service through a Primary Health Care

approach remains the most cost effective way in promoting

health, preventing illnesses and saving lives thereby

improving health status and increasing life expectancies of

South Africans.

CONCLUSION

KE A LEBOHA!

.