HEALTH MARKET INQURY PRESENTATION BY THE LIMPOPO DEPARTMENT OF HEALTH 18 MAY 2016 DURBAN 1
Introduction • Approximately 80% of the population in Limpopo is based in rural areas. This situation greatly impacts on the population’s capacity to acquire and access education, particularly tertiary education, which in turn influences the potential for gainful employment in the formal economic sector. • The South African Multidimensional Poverty Index (SAMPI) using census data has shown that Limpopo Province is having the third largest poverty headcount of all provinces in 2001 and 2011 after Eastern Cape and KwaZulu-Natal. 2
Cont… • The department is faced with multi- challenges of poverty that affects indicators such as the incidence of severe acute malnutrition, diarrhea, prevalence of HIV and AIDS, etc. These multi- dimensional factors of poverty further constrain the resources of the department in delivering health care services. 3
Cont…. • The province is a typical developing area, exporting primary products and importing manufactured goods and services. • It has a high potential for development, with resources such as tourism, rain-fed agriculture, minerals and abundant labour offering excellent investment opportunities. 4
Cont…. • About 80% of South Africa’s hunting industry is found in Limpopo. • In addition to commercial agriculture, subsistence farming is the mainstay of a large section of the rural population. 5
Cont…. • Limpopo is the gateway to the rest of Africa, with its shared borders making it favourably situated for economic cooperation with other parts of Southern Africa. • The province borders the countries of Botswana to the West, Zimbabwe to the North and Mozambique to the East. In the eastern region lies the northern half of the magnificent Kruger National Park. 6
Cont…. • In keeping with the NHI White Paper the LPDoH is pursuing a number of strategies to encourage greater cooperation between the public and private health care services. 7
DEMOGRAPHIC PROFILE OF LIMPOPO • Limpopo is the fifth largest of South Africa’s nine provinces covering an area of 125 755 square kilometers, which is 10.3% of South Africa’s total land area. • It has a population of 5.6 million (2014 Mid-Year Population Estimates). • The population of Limpopo is youthful with 33% (1.86 million) being children under the age of 15 years. 8
Cont.… • Economically active population (15 - 64years) constitutes 61% or 3.4 million, while elderly people are in the minority making up 5% of the province’s population. • Females constitute the majority, making up 53.1% (2.98 million) of the province’s population. 9
Cont.… • Average total fertility rate is estimated at 3.01 for the period 2011 – 2016, • while the average life expectancy at birth for males is estimated at 58.3 years • and that for females at 62.5 years in the same reference period. 10
Cont.… • Migration is an important demographic process in shaping the age structure of the provincial population. • For the period 2011 – 2016, Limpopo experienced an out-migration of nearly 303 101 people (Stats SA, 2014). 11
Cont.… • Table 1provides the age and sex distribution of the population while figure 1 depicts the age and sex structure (Stats SA Mid-Year Population Estimates, 2014 ). 12
Demographic profile cont.… Table 1. Population of Limpopo Province by age and sex, 2014 AGE MALE FEMALE TOTAL 0-4 343943 336040 679983 5-9 302541 296251 598792 10-14 292885 290970 583855 15-19 315349 315383 630732 20-24 309034 307582 616616 25-29 264946 263728 528674 30-34 195662 207980 403642 35-39 144500 169732 314232 40-44 108106 150298 258404 45-49 88610 133734 222344 50-54 73872 117180 191052 55-59 61576 99094 160670 60-64 50762 83659 134421 65-69 36324 65198 101522 70-74 24839 50341 75180 75-79 18163 43320 61483 80+ 18003 50862 68865 13 Total 2649115 2981352 5630467
Cont.… 14
Cont.… • The population pyramid above show the distribution of males and females across age groups in Limpopo. • The population pyramid resembles a developing country where there is high birth rate and short life expectancy. 15
Cont.… • This is an indicative of future trends which show that if not much is done in improving the health outcomes of the people, the life expectancy will continue to drop. 16
DISTRIBUTION OF PUBLIC HEALTH CARE FACILITIES IN THE PROVINCE • Limpopo Province is divided, for local government purposes, into five district municipalities which are in turn divided into twenty-five local municipalities (see figure 2 below): 17
Figure 2 18
Table 2 Tertiary SA Regional No..of District Hospitals No of Private Facilities Specialised Hospitals (Stats No..of Fixed Clinics Population Density Name of District No. of CHC Population (per km²) Hospitals Hospitals No..of No..of 2011) VhembeDistrict 21349 1294722 60,6 02 01 11 08 06 01 0 Municipality (Psychiatric) 6 CapricornDistrict 16988 261463 74,3 05 01 96 04 06 0 02 Municipality (Psychiatric) MopaniDistrict 24489 1092507 44,6 02 01 95 08 06 01 0 Municipality (Psychiatric) Sekhukhune 13426 1076840 80,2 01 0 84 03 05 02 0 ж District Municipality 0 Waterberg 49504 679336 13,7 05 0 61 02 07 01 0 District Municipality 19
Table 3 DISTRIBUTION OF DESIGNATED HOSPITAL BEDS IN LIMPOPO – PUBLIC & PRIVATE District District Regi Specia Tertiar Private Municipalitie Beds onal lised yBeds Beds s Beds Beds (Active) Vhembe 1649 538 390 0 44 Capricorn 988 0 786 1210 493 Mopani 1216 400 400 0 197 Sekhukhune 853 938 0 0 *(14)* Waterberg 962 273 0 0 191 TOTAL 5668 2149 1576 1210 925 20
IN SUMMARY – PROVINCE • Fixed Clinics : 452 • Community Health Centres: 25 • District Hospitals : 30 (5668 beds) • Regional Hospitals : 05 (2149 beds) • Tertiary Hospitals : 02 (1210 beds) • Specialised Hospitals : 03 (1576 beds) • Private Health Facilities : 14 (925 approved beds) 21
FUTURE PLANS • Sefako Makgatho Academic Hospital: +- 800 Tertiary beds 22
ESTABLISHMENT OF PRIVATE HOSPITALS IN THE PROVINCE • The process start with the proprietor of the facility submitting the application to the HOD. • The application must contain the following information: - Description of premises. - Particulars regarding their location. - The nature of the treatment to be rendered there. - Population groups of the staff attached to the private hospital. - Population group that will make use of the private hospital. - Architectural plans of the buildings or proposed buildings must accompany the application. 23
Cont… • Upon receipt of the application by the HOD, it is forwarded to the Evaluation Committee for processing, then to the Adjudication Committee, which will then recommend to the HOD for approval or non approval. • The HOD after consultation with the committees, shall satisfy him or herself as to the necessity or otherwise for such a private hospital to be established before granting or refusing permission. 24
Cont… • If permission is granted to proceed with the establishment , the applicant shall complete form 1 (Annexure B) attached in the R158 and submit architectural plans for approval by the HOD before construction can commence and/ or resume. • In addition, the applicant shall furnish the HOD with proof in writing, that neither the Government Departments concerned nor the Local Authority concerned have any objection to the private hospital being constructed on the premises concerned. 25
Cont… • The applicant must also provide written proof that the plans have been approved by the Local Authority concerned. • The applicant shall inform the HOD about the completion of construction of the private hospital, and the HOD shall dispatch a licensing team to conduct an inspection before the facility can be issued with a license to operate. • the operating license shall be valid for a period of 12 months, subject to renewal after this period. 26
Cont… • The proprietor is supposed to submit an application for the renewal of the certificate of registration at least 90 days before the date of its expiry in accordance with Regulation 11. 27
CRITERIA FOR LISENCING AND RENEWAL OF CERTIFICATES OF REGISTRATION • Before a license/ certificate of registration is issued to a private facility, a licensing team performs an inspection of the facility for compliance before recommendation to the HOD. • The private hospital must comply with and maintain compliance with the following: - National building regulation (NBR) SABS 0400. - Occupational Health and Safety Act, Act 85 of 1993. 28
Cont… - Regulation R158 of February 1980 as regulation to the Health Act, Act no 63 of 1977. - Basic Conditions of Employment Act. - National Department of Health Guidelines. - IUSS guidelines. 29
Cont… • In addition, more emphasis is put on National Core Standards: - Patient’s Rights. - Patient safety , Clinical Governance and Clinical Care. - Clinical Support Services. - Operational Management. - Facilities and Infrastructure. - Leadership and Corporate Governance. - Medicine Supplies and Laboratory services. - Health Technology. 30
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