Free State takes healthcare to residents

Thursday, June 14, 2018

At a time that healthcare across the country has come under the microscope, the Free State Department of Health has decided to take the stethoscope to the door step of its residents.

In a campaign called “back to care”, the province has set up war rooms at municipal and district level to actively turn around the quintuple burden of disease through its “prevention, care and support programmes”.

In an interview with SAnews shortly after briefing Parliament’s Portfolio Committee on Health on the state of health in the province, Health MEC Montseng Tsiu said the “back to care” campaign was founded on the ethos that a massive number of departmental health workers visit the household in designated wards to profile and assess the health conditions of family members.

“Back to care means going to the people. You do not have to wait for the people to come seek help. You go into their households and you are able to assist everyone in that household,” she said.

With its mainly rural population of 2.7 million, 82% of the residents, or 2.2 million, who are accessing health care services in the province are uninsured.

The prevalence of Tuberculosis (TB) in the province, a disease that rates among the top killers, stands at 10% of the total population. Despite this, the department’s head of department, Dr David Motau, said while briefing MPs that over the past five years, the incidence of TB per 100 000 population has been on the decline – from 758 per 100 000 in 2013/14 to 466 per 100 000 in 2017/18.

The number of patients completing treatment has improved from 79% in 2013/14 to 85% in 2017/18.

As part of the “back to care campaign”, provincial executives, senior managers and health professionals will raise awareness through door-to-door campaigns; mobilise for screening of communicable diseases and promote and prevent, reduce stigma and provide care for people infected by HIV, including Aids orphans and other vulnerable children.

In the main, trained health workers – who will be equipped with a map, household register and an individual assessment tool, will walk through the ward, talking, listening, answering questions and facilitating decisions about the burden of disease.

“Those that are ill, you give them services right there at home, and that would reduce people from coming to the facilities and having overcrowding or long waiting hours but you make sure that people get health services at the comfort of their own home,” the MEC said.  

Province under pressure, implementing HR turnaround strategy

With an overall staff establishment of 21 617, the province currently has 17 151 posts filled with 4 466 vacancies.

Its vacancy rate remains high at 20.66% and the staff turnover stood at 1 744 during 2017/18 – which is attributed to retirements, attrition and resignations.

A common trend across its hospitals – from the tertiary, regional down to district hospitals – is that the provinces is struggling to attract medical specialists.

“The main points that I think the province wanted to highlight were issues of human resources management, issues of the insourcing of services like security, the kitchen.

“On human resources, the appointment of specialists [remains a challenge] because those are the things that really bothers us with regards to providing health services. So issues of the funding of the department itself, the fact that we were instructed to reduce the compensation of employees but it seems to be going up…”

She said the healthcare system relies heavily on warm bodies being employed in order to improve the quality of healthcare in the province.

“Apart from the fact that on a yearly basis we get an increment of the salaries, there are warm bodies that you need to employ.

“If you need to provide health services, you need warm bodies. The machines cannot operate themselves, the nursing of the patients are not done via the machines, you need warm bodies. You need human resources to provide those services. So those are the things that I think we need to work on if we need to improve the way we give health to our city.”

She said the department was implementing a turnaround strategy to deal with the province’s challenges.

“There is a strategy indeed because we do have human resource plans and those plans, we just need to work around what we have at the moment as to what is that we would do to ensure that we cover all the services with the little money that we have,” she said.

In a presentation to MPs earlier, Dr Motau said the department was in a process of revising its human resources plan for the 2018/19 financial year and that several policies were under review – including the recruitment and selection policy; as well as the retention of staff policy to address the high turnover and the inability to recruit and retain staff.

He said despite delays in the filling of posts due to further centralisation of approvals from National Treasury, the province was proceeding with the filling of all vacant and funded posts in terms of urgency and priority on its critical list. –