13 October 2010

Increasing wellness in Western Cape

A plan to increase the wellness of the people of the Western Cape was launched earlier today by the Minister of Health, Theuns Botha.


A plan to increase the wellness of the people of the Western Cape was launched earlier today by the Minister of Health, Theuns Botha.

The focus of the launch was “wellness” and not just the management of disease and the prevention of disease.

According to the statement, the progress of measuring is a set of high-level impact indicators have been chosen specifically to local circumstances and in line with the Millennium Development Goals. These are life expectancy, maternal and infant mortality, the incidence of HIV and TB infection and the patient experience of the public health service.

There are two parts to the plan

The first, foundational part is to reduce the burden of disease by tackling the primary drivers of mortality and morbidity.

Subjects focused on are: HIV/Aids; TB; injuries, largely caused by inter-personal violence and road traffic accidents; non-communicable diseases such as cardio vascular disease, high blood pressure, asthma and cancers; mental illness, especially mental illness caused by substance abuse; and childhood illnesses, many of which are a function of poverty and a lack of basic sanitation services.

The second part of the strategy is to improve the quality of care we offer in managing the burden of disease at our health care facilities.

Reducing the burden of disease

The plan to tackle the downstream drivers of the burden of disease includes:

  • A Summit on the Burden of Disease, the purpose of which will be (1) to review the latest available data on the burden of disease, (2) to review the response to the burden of disease by all levels of government and by role-players outside of government in the private sector and civil society and (3) to identify an action agenda for implementation designed to advance the collective effort of all role-players.
  • The roll-out of our mass HIV Counseling and Testing Plan (HCT), which seeks to test 1.2 million people, provide ART to 31 000 new clients, keep 96 000 HIV patients in care, screen 1.1 million people for TB, distribute 122 million male condoms and 1 million female condoms. The campaign is supplemented by on-going effort to encourage safe sex and provide information about TB.
  • The development of a road safety strategy to reduce injuries and fatalities, in partnership with the Department of Transport, the Department of Community Safety, the City of Cape Town and other municipalities.
  • The further development and implementation of a substance abuse strategy, which covers both alcohol and drug abuse, and involves extending drug intervention services to key hospitals, increasing the number and reach of drug treatment programmes, increasing the provision of psycho-social support services at schools, the implementation of the Liquor Act, the increase of aftercare and reintegration services for victims of substance abuse and the introduction of case management and monitoring and evaluation tools for all provincial substance abuse services.
  • The introduction of a Healthy Lifestyles campaign designed to tackle (1) the excessive consumption of salt, unhealthy fats and sugar, (2) a lack of adequate exercise and (3) the long-term use of tobacco products. Before implementing such a campaign we will do extensive research on international best practice and carefully consider the costs and potential benefits of such a campaign.
  • The implementation of a strategy to reduce childhood illness that targets both the environment in which many children live and the healthcare response to the problem. Interventions include the implementation of our human settlements strategy, which seeks to increase the number of serviced sites in informal settlements, the accelerated rollout of the Department of Health’s immunization programme, the accelerated rollout of the Department of Health’s programme to prevent the transmission of HIV from mothers to their children and the on-going implementation of the Department of Health’s strategy to prevent deaths caused by diarrheal dehydration.

The statement said that it is crucial to understand that while illness is often an unavoidable affliction, wellness is also to a significant extent a matter of choice.

These were also included in the statement: road accidents can be avoided by sticking to speed limits and not driving under the influence of alcohol and drugs; many diseases can be avoided by eating in moderation, exercising and choosing not to smoke or drink excessively; HIV infection can be avoided by engaging in safe sex.

Improving the quality of care in the public health system

The challenge for the public health service is to deliver high quality, value for money health care. While the Western Cape Department of Health prides itself on being the best performing Health Department in the country, health services in the Western Cape continue to operate under immense pressure.

Symptoms of this include the high bed occupancies in hospitals, the frequent need to divert ambulances between hospitals, an inability to timeously secure intensive care beds for critically ill patients, long waiting times at clinics and long waiting lists for surgical procedures.

The Western Cape Department of Health is currently evaluating the outcomes of Healthcare 2010, and developing a strategic and business plan for Healthcare 2020, which is scheduled for delivery on 1 August 2011.

The Healthcare 2010 strategy was overwhelmingly successful. The Department of Health is the best run in the country. It is well managed and its finances are sound. Healthcare 2010 drove the introduction of a Comprehensive Service Plan which set out the Department’s delivery agenda in respect of people, equipment and infrastructure. Healthcare 2010 also focused on health services at the most appropriate level though a primary health care approach, rooting services in communities at clinics, community health centres and through home-based care.

The success of Healthcare 2010 has created an opportunity for us to take healthcare in the Western Cape to the next level. The Healthcare 2020 strategy will involve the following key elements:

  • A focus on patient experience
  • Improving health outcomes through monitoring and evaluation
  • Enhancing Primary Health Care
  • Strengthening District Services
  • Building strategic partnerships.
  Baseline estimates Target 2014 Source
Materal mortality rate (MMR)      
Western Cape 98/ 100 000 live births : 2004 90/ 100000 live births: 2004 Third report on confidential enquiries into maternal deaths in South Africa. Strategic plan: 2010-2014
South Africa 140-160/ 100 000 live births 100 or less/ 100 000 live births Negotiated service delivery agreement
Child Mortality Rate (Under five years of age)      
Western Cape 38.8/ 1000 live births (2007) 30 per 1000 live births Strategic plan 2010-2014
South Africa 69 deaths per 1000 live births 45 or less per 1000 live births Negotiated service delivery agreement
TB cure rate      
Western Cape 79.4% in 2009/10 80% is the target for 2012/13 Annual report: 2009/10 Annual performance plan 2010/11
South Africa 65% 85% Negotiated service delivery agreement
HIV/Aids prevelance      
Western Cape 15% in 2004 8% Strategic plan: 2010-2014


Average life expectancy for 2001 – 2006 and 2006 – 2011 in the Western Cape and South Africa


  Male   Female   Source
  2001-2006 2006-2011 2001-2006 2006-2011 Development indicators 2009:
The Presidency, Republic of South Africa
Western Cape 59.3 61.6 66.5 67.9  
South Africa 51.1 52.7 55.7 56.4  


The statement said that patient experience will need to be better defined, indicators and targets identified and measured. As part of the Healthcare 2020 plan, we will develop a method of measuring patient experience, benchmark it, and then set targets for improvement.


Issued by:                                Theuns Botha MPP Minister of Health: Western Cape


Media enquiries:                     Hélène Rossouw

                                                   082 771 8834



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