Health

The health of all citizens is very important for the development of a country. Everyone has the right of access to basic health care services and medical treatment.

What is in this guide?

This guide provides government policy on health to provide access to affordable and good quality health care. It contains the following sections:

1. Providing affordable and good quality health care
2. Key strategies used by the Department of Health
3. Priorities for accelerating quality health care delivery
4. Patients' Charter
5. Key health care programmes provided at clinics
6. How development workers can assist in health care delivery
7. Key challenges facing the Department of Health

1. Providing affordable and good quality health care

The Department of Health (DOH) aims to create a caring and humane society in which all South Africans have access to affordable and good quality health care. The overall approach to achieving this is contained in its Health Sector Strategic Framework 1999 - 2004 document.

The DOH is striving to:

• Build on the achievements, since 1994, in improving access to care and advancing equity;
• Deal decisively with the HIV and AIDS epidemic and its impact on the family, education, economy, workplace and the broader society.
• Improve the functioning of our hospitals and clinics

Since 1994 free health care has been introduced for pregnant women and children under 7. It will soon be extended to disabled people. Hundreds of new clinics have been built to extend primary health care to communities. Doctors now have to do compulsory community service so that people in rural areas can have access to better medical care.

2. Key Strategies used by the Department of Health

The key strategies used by the Department of health to provide affordable and good quality health care are:

• Strengthening partnerships with communities, key stakeholders, the private sector, NGOs and CBOs and;
• Building an accountable public health sector that is committed to improving the standard of health care delivery to ensure a healthier nation working in the spirit of Batho Pele.

3. Priorities for accelerating quality health care delivery

While the period 1994 - 1999 focused largely on increasing access to health care especially for those who did not have access in rural and other under-served areas of the country, the current period focuses on accelerating quality health service delivery.

The key priorities in this period include:

• Reorganisation of certain support services like blood transfusion
• Legislative reform;
• Improving quality of care;
• Revitalisation of hospital services;
• Speeding up delivery of an essential package of services through the district health system;
• Decreasing morbidity and mortality rates through strategic interventions;
• Improving resource mobilisation and the management of resources without neglecting the attainment of equity in resource allocation;
• Improving human resource development and management;
• Improving communication and consultation within the health system and between the health system and the communities we serve; and
• Strengthening co-operation with our partners internationally.

For each of these priority areas the DOH has a strategy and programme of action.

4. Patients Charter

The DOH is committed to Batho Pele. It has developed a Patients' Charter which has to be on display at all public health facilities. The Patients' Charter spells out the rights and obligations of patients.

EVERY PATIENT HAS THE RIGHT TO:	RESPONSIBILITIES OF PATIENTS:
A healthy and safe environment	Living a healthy lifestyle
Access to health care	Care and protect the environment
Confidentiality and privacy	Respect the rights of other patients and health staff
Informed consent	Utilise the health system optimally without abuse
Be referred for a second opinion	Know the health services available locally and what they offer
Exercise choice in health care	Provide health staff with accurate information for diagnosis, treatment, counseling and rehabilitation purposes
Continuity of care	Advise health staff on his or her wishes with regard to death
Participation in decision making that affect his/her health	Comply with the prescribed treatment and rehabilitation procedures
Be treated by a named health care provider	Ask about management costs and arrange for payment
Refuse treatment	Take care of the patient carried health cards and records.
Knowledge of their health insurance/medical aid scheme policies
Complain about the health service they receive

5. Key health care programmes provided at local clinics

Health care in South Africa is provided through local clinics and hospitals. Local clinics, referred to as Primary Health Care Clinics, are the first point of service for communities. Treatment and care is provided to patients and cases that require specialist interventions are referred to hospitals. The government has set up norms and standards which guides nurses in their delivery of services. Our clinics provide a range of services that include:

• Women's reproductive health: The focus is on antenatal, delivery, postnatal, termination of pregnancy, and family planning care.
• Management of genetic disorders and birth defects: Genetic services are part of the integrated maternal, child and women's health care. It aims to assist individuals with a genetic disadvantage to live and reproduce as normally and responsibly as possible. The services provided include clinical diagnostic services, counseling, laboratory support, prevention strategies and public awareness campaigns in collaboration with NGOs, CBOs and other government sectors.
• Integrated management of childhood diseases: The focus of this area of work is to educate communities and provide preventative treatment and care to reduce incidence of diseases afflicting children. These include diphtheria, pertussis, Hib, tetanus, measles, poliomyelitis, hepatitis and tuberculosis (TB).
• Adolescent and youth health: The aim of this area of work is to provide information, treatment and care to young people. The focus is on growth and development, gender specific needs of adolescents, oral care, nutrition, and risks to health of alcohol, smoking and drugs, safe sex, condom use, STD, HIV, AIDS, and TB.
• Cholera and diarrhoeal disease control is an essential daily element of clinic services as well as an element in outbreak prevention and control.
• The prevention and management of STDs is a service available daily at a clinic and is a component of services for reproductive health and for control of HIV and AIDS.
• HIV and AIDS: This area of work includes education, prevention, care, voluntary testing and counseling, treatment of opportunistic infections and anti-retroviral treatment. It further includes the medical rights of people living with HIV and AIDS, such as confidentiality, HIV testing and informed consent, and the right to health care and medical treatment.
• Home based care: Home based care givers are icommunity volunteers who visit bed-ridden people at home and provide basic care. They work with people of all age groups with terminal illnesses, chronic illnesses, physical challenges, and mental challenges. Clinics manage and support the work of home based care givers.
• Prevention and treatment of malaria: South Africa has an effective control programme for malaria although seasonal outbreaks occur in some high risk areas.
• Tuberculosis: This programme focuses on providing treatment and care for people inflicted with TB. The clinics offer comprehensive treatment which includes support through the DOTS programme (direct observation of treatment).
• Trauma and Emergency Services: Clinics provide emergency and resuscitation service, treatment and referral of patients that have experienced trauma and/or injury and have arrangements to deal with disaster situations.
• Survivors of sexual abuse, domestic and gender violence: The service involves co-operation between the health sector, the police and the Department of Justice. Survivors are provided with counseling, STD prophylaxis and HIV testing, emergency contraception, care of injuries, medico-legal advice.
• Treatment and management of chronic diseases: Treatment and education is provided for by the health department and home based care givers to people suffering from diseases like diabetes and hypertension.

6. How development workers can assist in health care delivery?

Development workers have a key role to play to ensure that people access the services they are entitled to. Clinics and programmes should also be monitored to ensure that a decent service is delivered and that problems such as a shortage of medicines are dealt with. Development workers should also help build partnerships between the community and health services, by:

• Working with health care providers in educating the community on their rights and obligations based on the Patients' Charter;
• Working with Community Health Forums where they exist;
• Mobilising volunteers for home based care, education and other programmes that require the support of local communities

7. Key challenges facing the Department of Health

The Department of Health is working on addressing numerous challenges to improve the quality of health care. This includes the deployment and retention of trained health personnel to rural areas and other under serviced areas and ensuring that all people have access to affordable health care.

Many of the present initiatives on setting up a national medical insurance system, re-deployment of doctors and restricting profits on medicines, are aimed at addressing these challenges.

Resources:

The Department of Health Strategic Framework 1999 - 2004 - www.doh.gov.za
Patient's Charter can be obtained from local clinics

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