Linked to these outputs are clearly articulated indicators and targets. Major targets include the following:
Specific interventions of the health sector to achieve these outputs are elaborated in detail in the Negotiated Service Delivery Agreement (NSDA) 2010-2014.
Background
Government’s four outputs are premised on the fact that South Africa faces a quadruple burden of diseases consisting of;
The four outputs outlined in the NSDA 2010-2014 have been considered an integrated response to the quadruple burden of diseases. Interventions to tackle this burden of disease dovetail with efforts to accelerate progress towards the health related Millennium Development Goals (MDGs). A need exists to also address social determinants of ill-health, which lie outside the health sector, such as poverty; lack of potable water; lack of proper sanitation and child neglect.
Increasing Life Expectancy
This is the first of the identified outputs to achieve the desired outcome. The Department will increase its focus on strategies aimed at the primary prevention of non-communicable and chronic diseases through educating individuals, households and communities on the benefits of healthy lifestyles. This will be proactively supported by a programme of community mobilization involving the utilization of community health workers through a re-engineered and integrated Primary Health Care system that encourages health promotion and prevention at the household and community levels.
Decreasing Maternal and Child Mortality
The second output focuses attention on decreasing maternal and child mortality. A Primary Health Care approach that is designed as the foundation of the health system for promoting healthy lifestyles, prevention of diseases (including early detection), provision of early and quality ante- and post-natal services as well as essential infant and child health services and nutritional advice will be used in aggressively reducing the unacceptably high maternal and child mortality rates in the country.
Combating HIV and AIDS and Decreasing the Burden of Disease from Tuberculosis
This is the third output towards achieving Outcome 2. HIV, AIDS and Tuberculosis (TB) contribute a significant proportion to the burden of disease that is faced by the South African population, particularly among the poor and vulnerable groups. This is the primary reason why the government has decided to direct its efforts towards addressing the challenges of HIV and AIDS and TB in an integrated manner. The core of the strategies to effectively combat these diseases is encompassed in the HIV and AIDS Counselling and Testing (HCT) Campaign whose primary focus is to scale up the integrated prevention strategy based on behavioural change, use of barrier methods, provision of medical male circumcision, the scale-up of syndromic management of STI and the early prophylaxes to prevent Mother-To-Child Transmission.
Strengthening Health System Effectiveness
The fourth identified output that contributes to the achievement of Outcome 2 is; “Strengthening Health System Effectiveness”. To effectively strengthen the public health system, a number of parallel but equally important initiatives will also be undertaken by the Department of Health, complementary to those proposed for Output 1 to 3 above. The scope of these activities include the need to overhaul the health services delivery platform from one that is based on a largely curative, high cost care model to one that also promotes cost-effective Primary Health Care delivered as close to the community and household as is possible, supported by strong enhancements in management and supervision.
Free State Health Sector
The Free State’s public health sector comprises of: