COVID-19 “adjusted” Phase 2 vaccine rollout 5 July 2021

COVID-19 “adjusted” Phase 2 vaccine rollout 5 July 2021

The NDoH official policy communication on vaccination 5 July outlines how the adjusted vaccination rollout. It differs from the original PHASE 2 rollout hence the use of “adapted.” It is not explicitly linked to phase 2 but it is hard to see where else it fits.  Missing are those with comorbidities like NCDs, including diabetes and cancer.

1.4 Every vaccination site (public or private) must have a pro-active plan for managing walkins for vaccination.

 

  • Age group (+40) and congregate responsibilities government supported by private ;
  • Essential workers according to government sector “vertical” rollout
  • Workers by priority “economic” sector (mining, automotive industry, taxi operators) rollout via companies. Not clear if limited to the above sectors.
  • A general caveat about using EVDS to register all who are vaccinated.
  1. NDoH & provincial DOH (PDoH) collaboration with private sector responsibilities

    1.1 Vaccination registration & administration by age groups (5 subpoints around EVDS and reimbursement).
    1.2 Working group 1: capacity analysis including underserved areas for the attention of PDoH, presumably with the prospect of solving problems (members NDoH/Business for SA).
    1.3 Working group 2: NDoH equity monitor of demand in districts/municipalities to resolve coverage issues & look at rollout to 40+.
    1.4 Walkins are OK & every vaccination site (public or private) must have a pro-active plan for walkins.  (6 subpoints)
    1.5 Congregate settings: homes for people with disabilities, old age homes and later on prisons (correctional facilities) remains PDoH / privates sector responsibility.

Roll-out of essential worker programme public sector

2.1  “Vertical” rollout with key government “sector” “projects” departments (9 subgroups)
2.2  PDoH not responsible for the above except “DBE project and around 220,000 people from 6 categories.
2.3  Vaccination of remaining health care workers (HCWs) according to V4HCW registration site and these also include “private employers.”  (5 items)
2.4  Police (SAPS) is managing its own vaccination project.
2.5 Department of Defence and Military Veterans for the SANDF programme due to start on 8 July.
2.6 A number of government services still to be finalisied e.g. correctional services vaccination.

3 Prioritised sectors of the economy

3.1  President listed these previously mining, automotive manufacturing and taxi operators.
3.2  Many private sector companies have started vaccination of employees and contract workers.
3.3  Companies using in-house or outsourced health services.[/vc_column_text][vc_column_text]

4  EVDS-related issues

Four caveats about the importance of registering via EVDS in all circumstances.

UHC people’s consultation for South Africa in 20 July 11:00-13:00

UHC people’s consultation for South Africa in 20 July 11:00-13:00

On 20 July 2021, the SA NCDs Alliance is co-hosting and coordinating a people’s consultation on universal health coverage (UHC). This is especially for you if you use government health services.

The South African version of UHC is called “national health insurance” or NHI. But are we talking about the same thing? There are some big differences. What do you think?

The event is a virtual focus group lasting 2 hours with 30 participants.  You can only participate if you apply. We want to hear your voice especially if you are part of a vulnerable or hard-to-reach group that uses public or government health services. So you need to complete that application form and showing us why your participation is important.

Apply to join the conversation here

  •  People who are left behind or have trouble having their health needs met before or during COVID-19?
  • Civil society participants, breakout group facilitators or note-takers.

We want to make sure that we hear from you, the people, and especially if you are in that “seldom heard” and vulnerable group. We can help a few selected participants with data package to participate on the day.

The event forms part of the United Nations Civil Society Engagement Mechanism (CSEM) for UHC2030 efforts to gather South African insights on the state of UHC.  Your views will be inputted into the UN State of the UHC Commitment Report for publication at the end of 2021 (around UHC Day 12 Dec). Here is the 2020 State of the UHC Commitment Report.

An excellent and relevant reference just published by WHO is Voice, agency, empowerment: Handbook on social participation for UHC 2021

Health system boosted to respond to COVID-19

Health system boosted to respond to COVID-19

Government will in the next financial year avail an additional R8 billion to the health system for the country’s COVID-19 pandemic response.

This will be in addition to the R20 billion the state allocated in the 2020/21 financial year, Finance Minister Tito Mboweni said on Wednesday, while delivering the 2021 Budget Speech, in Parliament.

In a Budget Review document, the National Treasury said the funds were to enable the sector to expand prevention, screening, testing and hospital capacity.

The R8 billion, which will be allocated to provincial health departments through the provincial equitable share, is expected to enable the sector to sustain these activities and respond to possible future waves of COVID-19 infection.

“Provincial governments receive an additional R8 billion in 2021/22 to continue the public health response to the pandemic, and the potential for additional waves of infection. Provinces can mitigate the negative impact of COVID-19 and the associated lockdowns on their revenues by improving efficiency, particularly in the procurement of health equipment,” said the Minister.

In total, the health expenditure function will over the medium term make up 14.2 percent of total government spending, declining from R247 billion in 2020/21 to R245 billion in 2023/24.

“Provincial health departments receive about 92 percent (R678.7 billion) of these medium-term allocations.

Reductions to the sector, mostly focused on compensation spending, are estimated at about R50.3 billion over the 2021 MTEF period,” the document reads.

To achieve this, other reductions would be required from health departments to increase efficiency. This included generating savings through centralised procurement of certain goods, reducing variations in unit costs in HIV programmes and improving management of overtime costs.

The COVID-19 pandemic has had a massive impact on the South African health system. As at 16 February 2021, the country had 1.5 million confirmed cases and over 137 000 excess deaths as reported by the South African Medical Research Council.

Over the MTEF period, R29.4 million is allocated to Tygerberg Regional Hospital and R100 million to Klipfontein Regional Hospital in the Western Cape through the health facility revitalisation grant.

1 joint plan = paradigm shift = District Development Model

1 joint plan = paradigm shift = District Development Model

President Cyril Ramaphosa, accompanied by Deputy President David Mabuza and Cabinet Ministers and the President’s Coordinating Council (PCC) met on Friday, 28 February 2020.

The extended PCC meeting included premiers of the 9 provinces, mayors of 44 district and 8 metropolitan municipalities. It convened to assess progress on the District Development Model (DDM) implementation. It resolved that all spheres of government must work together for efficient service delivery at a local level.

The report is SA Government News media statements.

Definition – joining the dots in districts for integration

DDM model explained SABC

The DDM approach aims to improve integrated planning across government with the creation and implementation of ‘One Plan’ per district or metro. It brings together all partners to stop dysfunctional silos and to make a joint plan across departments with relevant stakeholders. Local partners include business, civil society, faith based communities and traditional leaders in a compact for development.

Piloted in 3 district municipalities (OR Tambo, Waterberg and Ethekwini) the DDM represents a paradigm shift in government’s efforts to build a coherent and coordinated state.

More than R70 billion of public sector investments have been made in the in the three pilot sites since August 2019. A further 20 districts are to be included by the end of 2020 with all districts covered by 2021.

An analysis of the lessons learnt so far confirms the enormity of the socio-economic challenges faced by districts. It also assisted government to direct spending to the areas of greatest need in a more informed and integrated way.  Transparency and accountability at a local government level is a much anticipated outcome.

The pilot of the DDM at the three sites assisted to uncover potential sectors for growth which can be tapped into to improve the living conditions of the most vulnerable. When the DDM is fully operational it will ensure greater inclusivity through gender budgeting.

The PCC has thoroughgoing discussions on the implementation of economic reforms to drive inclusive growth and job creation, infrastructure investment and development, efforts being made to bolster youth employment through the Presidential Youth Employment Intervention and as a progress report on the provision of water services and human settlements.

The President called the PCC an historical meeting of leaders from all spheres of government to support a “joined up approach” that when it comes to development no district gets left behind in development.

The President called on all social partners take the lessons learnt into account and use further impetus to the DDM vision. This vision of capable unitary developmental state with a strong neutral bureaucracy and solid societal relations.

Reproductive health services “improvement is ongoing”

Reproductive health services “improvement is ongoing”

Minister in the Presidency Jackson Mthembu says South Africa will continue working to improve access to reproductive health care services.

Speaking at the International Conference on Population and Development (ICPD), which is currently underway in Nairobi, Kenya, Mthembu said the newly completed five-year plan for the country’s 6th democratic administration affirmed that South Africa will in the next five years continue to improve access to reproductive health services, including targeting adolescent sexual and reproductive health and rights in order to address pregnancies and risky behaviour.

The plan also includes upscaling existing campaigns and programmes on new HIV infections among youth, women and persons with disabilities and develop targeted programme on adolescent sexual and reproductive health and rights, including gender mainstreaming, youth and disability issues in programmes, and addressing teenage pregnancies.

Mthembu said South Africa will strive to further reduce child and maternal mortality and to improve access to reproductive health services and anti-retroviral treatment.

Highlighting some of the country’s interventions in ensuring access to quality health services, Mthembu said the country is currently piloting the National Health Insurance (NHI) in order to enhance universal access to quality health care as well as to bridge the quality gaps that exist in the private and public sectors.

“South Africa has also embraced the importance of extending free dignity packs to poor women and girls with a view to improve women’s reproductive health and contribute to the retention of girl children in schools who often miss school during their cycle.

“We are confident that these interventions will ensure that we continue to place people at the centre of our developmental agenda,” Mthembu said.

He said South Africa continues to commit itself to tackling the challenges identified for the 2019 Nairobi Summit on #ICPD25.

The ICPD Programme of Action commitments are centred around achieving zero unmet needs for family planning information and services; zero preventable maternal deaths; zero sexual and gender-based violence and harmful practices against women and girls referred to as Ukuthwalwa; and providing detail for implementing second phase of the democratic transition.

Reproductive health care programmes

South Africa has also expanded reproductive health care through various programmes such as the Integrated School Health Programme which focuses on addressing both the immediate health problems of learners, including barriers to teaching and learning as well as implementing interventions that can promote their health and well-being during childhood and beyond.

The National Department of Health has introduced programmes such as B-Wise – a young person’s interactive cell phone health platform to empower adolescents and youth to make the right choices based on accurate information; and She Conquers Campaign – A youth-led campaign which will run for 3-years collaborating with government, NGOs, business, and civil society to address the major issues that adolescent girls and young women face in South Africa today.

South Africa has over the last 25 years embarked on a number of legislative and policy interventions which focus on the sexual health and wellbeing of young people, as well as providing for women to choose a contraceptive method that they prefer. The Choice on Termination of Pregnancy Act which was passed in 1996 has ensured deaths from unsafe abortion has declined by more than 90%. Access to Primary Health Care Services measured in terms of visits per annum, increased from some 67 million in 1998 to over 128 million in March 2018. Furthermore, the total numbers of new HIV infections declined from 270 000 in 2016 to 231 000 in 2018.

South Africa is currently also in the process of decriminalising sex work to ensure that the sex work industry is regulated and that women are protected.