DEPARTMENT OF HEALTH

1
DEPARTMENT OF HEALTH

• Presentation to JMC
• Programmes for Persons with Disabilities
• 14 September 2007

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INTRODUCTION

• Focus of the Sub-Directorate Disabilities is to
• increase accessibility of health services to
  persons with disabilities
• improve, promote and maintain accessibility to
  quality rehabilitation services
• through implementation and integration of
  rehabilitation models and policies into the PHC
  system
• following a Community Based Rehabilitation
  approach.

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UNDERLYING PRINCIPLES

• Health Act
• National Rehabilitation Policy
• UN Convention on the Rights of Persons with
  Disabilities
• Same range, quality standard of care
• Early identification, intervention
• No discrimination
• Local service delivery

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NDOH CONTEXT

• Strategic Plan
• Improve access to health care for persons with
  disabilities
• Monitoring implementation of Free Health Care,
  using national guidelines
• Improve access to assistive devices
• Improve accessibility to health care facilities.

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FREE HEALTH CARE

• Full health service package at hospital level.
• Application of national protocol and assessment
  criteria.
• Includes persons on disability grants.
• Varying degrees of success in provinces
• Crucially dependent on awareness by management
  and admin staff.

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ACCESS TO ASSISTIVE DEVICES

• NDOH eradication of backlog
• Up to 30 000 wheelchairs buggies
• 16 000 hearing aids
• Intention for Districts to develop sustainable
  budgeting process not always successful
• Observed backlog on some provinces
• Significant backlog in N Cape
• Wheelchair repair Project
• Access to service delivery
• Socio-economic development in disability sector.

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ACCESSIBILITY OF HEALTH FACILITIES

• Initiated nationally, implemented at a district
  level involving teams including the disability
  sector.
• Addresses ALL levels of access including
  communication.
• Levels of accessibility acknowledged in terms of
  Bronze, Silver Gold awards

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ORIENTATION MOBILITY SERVICES FOR THE BLIND

• Previously, significantly ignored area of
  rehabilitation.
• Primary service provider presently the NGO
  sector.
• Consultation with all key stakeholders
• Document now complied on the options for service
  delivery
• NB SERVICES INTEGRATED INTO THE HEALTH
  SYSTEM

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TRAINING OF HEALTH WORKERS ON SIGN LANGUAGE

• Need to facilitate access to health services by
  Deaf persons
• DOH initiated training for health workers in
  provinces on sign language with focus on health
  related vocabulary.
• Provinces now exploring initiatives to roll-out
  training to health workers.
• Definite projects in KZN Free State involving
  NGO partnerships.

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CHALLENGES

• HUMAN RESOURCES
• Community Services significant access to
  services especially in rural areas
• HOWEVER very poor recruitment retention of
  rehabilitation personnel
• Remuneration
• Conditions of service
• Career development

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CHALLENGES (contd)

• BUDGET
• No dedicated budget for service, development,
  assistive devices
• Funding allocation fails to reflect services at
  different levels of care
• Linked to lack of priority of the programme,
  generally
• Poor budgeting results in services which are not
  sustainable

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CONCLUSION

• Significant progress in one or more aspect in all
  provinces.
• Access has been created to services for the first
  time.
• Sustainable service delivery can only be
  facilitated through
• Enhanced priority and budgeting at provincial and
  district levels
• Link to key programmes incl HIV and AIDS and MCWH
• Specified recruitment and retention policies
• Alignment to national rehabilitation related
  policy, UN Convention on the Rights of Persons
  with Disabilities