primary

Brazil and Thailand got it right – can SA really make NHI work?

In 1988, less than half of Brazil's population had health coverage, according to the World Health Organisation (WHO). But by 2008, it estimated that 75% were covered. 

By the early 2000s, nearly a decade ahead of schedule, Thailand had beaten or was on track to meet all of its millennium development goals, according to the United Nations Development Programme. The millennium development goals are eight international targets supported by United Nations member states to be achieved by 2015.

Rwanda government figures show that in less than two decades the country's life expectancy improved from 30 to 55 years. 

Public health facilities in a dire state

A poisonous snake slithering through a district hospital, badly cracked walls and rooms filled to the roof with broken equipment were some of the challenges facing researchers as they conducted the first national audit of public health facilities.

 

For most of last year, 20 data collection teams visited 3 880 public health facilities, throughout the country, ranging from tiny clinics to national central hospitals. The vast majority – 3 074 – were clinics.

The aim was to assess all public health facilities according to six criteria so that problems could be identified and addressed.

Cuban med schools for KZN

The KwaZulu-Natal Department of Health is to set up Cuban medical schools in the province to boost its delivery of primary health services, a key feature of the country’s new National Health Insurance (NHI) plan.

Making the announcement at this week’s Provincial Consultative Health Forum in Pietermaritzburg, KZN Health MEC, Dr Sibongiseni Dhlomo, said a departmental delegation would visit Cuba later this month to explore the options.

“We know that as a country we are not producing enough doctors. The demand far exceeds our current output of doctors each year,” Dhlomo told conference delegates, which included senior government officials.

Doctors will get NHI pay — minister

Department of Health would guarantee the payment of private general practitioners (GPs) who worked in public clinics in the National Health Insurance (NHI) pilot districts, Health Minister Aaron Motsoaledi said yesterday.

The NHI envisions private practitioners being involved in public health institutions, and this is the first time that Dr Motsoaledi has fleshed out the proposal and guaranteed the payment of such medical officers.

The thinking is that private sector health resources will improve referral systems, as well as increase patients’ confidence in primary healthcare facilities.

Dr Motsoaledi was addressing journalists on the sidelines of the South African Medical Association’s (Sama ’s) conference.

First nurses trained to initiate MDR-TB treatment

South Africa will increasingly move towards nurse-initiated treatment for multidrug-resistant tuberculosis (MDR-TB) in the next five years, and a programme in KwaZulu-Natal Province, which has a high HIV/TB burden, is already training nurses to manage MDR-TB patients.

Faced with a chronic shortage of doctors, South Africa moved to nurse-initiated antiretroviral treatment (NiMart) in April 2010. Now, government plans to roll out nurse-initiated MDR-TB treatment, and to make it and NiMart available at all primary healthcare, antenatal, TB and mobile outreach clinics by 2016, according to the National Strategic Plan on HIV, STIs [sexually transmitted infections] and TB.

Low potential for NHI success in rural health

Simon Puttergill* is a clinical manager at a state hospital in an isolated part of the Eastern Cape. His colleagues describe him as exceptionally competent.

Over the past seven years he has been instrumental in reducing by half the number of babies dying in the first week of their lives. He has helped to increase the number of infants delivered in hospital instead of the mothers giving birth at home by more than 50%.

Premier finds queues at health facilities

LONG queues at Gauteng healthcare facilities were an indication that health services in the province faced huge demand, Premier Nomvula Mokonyane said yesterday as she toured health facilities.

Ms Mokonyane visited the Kliptown Clinic and the Chris Hani Baragwanath Hospital in Soweto, where she found long queues of patients in the waiting rooms, some claiming to have been waiting to be served for more than four hours.

"The perception that primary healthcare in Gauteng was not functional is incorrect," said Ms Mokonyane. The overcrowding indicated that residents still had confidence in primary healthcare services in the province, she said.

NHI: Quality non-negotiable

For National Health Insurance (NHI) to be successful the quality of public healthcare must improve “tremendously” and a stop must be put to the pricing of private health “which is running away with us”, health minister Dr Aaron Motsoaledi told the Healthcare in Africa meeting last night (TUES).

 

“In fact it is non-negotiable,” the minister told The Economist sponsored meeting, which will today discuss the challenges of health systems in Africa.

Health spending gap narrowing

The gap between South African public and private health expenditure is narrowing as the public sector plays catch up. Public spending is expected to exceed private sector spending in the future, the 2011 South Africa health review released yesterday showed.

According to the report compiled by the Health Systems Trust, public hospital spending on average has increased by 5.4 percent a year over the past three years.