CoJ Health Department

CoJ Health Department

March 2007

IDP Regional Consultations

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Growth and Development Strategy principles

Growth and Development Strategy principles

• Proactive absorption of the poor

• Balance and shared growth

• Facilitated social mobility

• Settlement restructuring

• Sustainability and environmental justice

• Innovative governance solutions

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Vision of the Health Department

A City with a high quality, efficient, accessible, and equitable health system for all, that has adequate and flexible capacity to meet the changing health challenges facing Johannesburg.

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Long Term Goals 5 Year Strategic Objective

IDP Programme 2007/08 Draft Deliverables

Systematic improvement in environmental health conditions

Environmental health plan to prevent and minimise environmental pollution

Pollution prevention and reduction programme

Air Compliance monitoring of

all identified sources on an ongoing basis

Emissions measurement Imbawula project

• Database of sources of air pollution in place by June 2008

• 50 identified households in informal settlements provided with smokeless imbawula’s

• 6420 diesel vehicle tested per annum for emissions

Noise• Noise contouring

requirements for new developments• Noise compliance

monitoring

• Completed database of sources of new developments that require compliance to noise contouring requirements.

IDP programmes & 2007/08 deliverables

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IDP programmes & 2007/08 deliverables…

Long Term Goals

5 Year Strategic Objective



Environmental health plan to prevent and minimise environmental pollution

Pollution prevention and reduction programme

Noise• Noise contouring

requirements for new developments• Noise compliance monitoring

Completed database of premises where night time noise nuisances are experienced.

WaterWater pollution monitoring

95% Compliance to sampling protocol/programmes for the city – Water quality management

LandIllegal dumping prevention programmes

100% Inspection of vacant council owned properties (as per regional database)

100% inspection of vacant non-council owned properties (as per regional database)

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Long Term Goals




An integrated and well resourced system in place for environmental health certification; monitoring and enforcement

Environmental risk management programme

Develop a seamless approach to health & safety surveillance so that there is a single point of certification for buildings, food establishments, early childhood development facilities, other places of care, etc

• Completion of implementation plan of a single point of certification

Within this seamless approach, further develop and maintain well-resourced and efficient systems of monitoring compliance and enforcement for: •Food hygiene at food establishments•Waste management at key points of waste generation•Water quality monitoring•Disposal of the dead at funeral undertakers and cemeteries•Chemical safety•Surveillance & prevention of communicable diseases•General public health at high risk buildings and premises.•Vector control

• 100% of the monitoring system implemented by March 2008


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Long Term Goals




An integrated and well resourced system in place for environmental health certification; monitoring and enforcement

Environmental risk management programme

Increase the number of EHO’s in the field based on actual workloads.

• 16 EHO’s (subject to additional funding)

Reduce the risk of vector borne diseases through targeted vector control programmes in selected hotspots (key targeted areas to include: Alexandra)

• 8 Pest control staff employed

Develop a clear set of health safety guidelines for all categories of capital projects of the City of Johannesburg, and ensure 100% compliance with these (as assessed through CIMS)

• 10% Of identified categories of capital projects for which health & safety guidelines completed


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Long Term Goals




At a consistent rate of monitoring and enforcement, reduced incidence of non compliance with environmental health regulations and set standards

Environmental Health promotion programme

Within a seamless approach promote health and safety to create environmental health awareness and compliance to legislation

• 1 campaign per region focusing on nuisance buildings (7 campaigns)

Annual citywide campaigns to promote public awareness around the safe handling and storage of chemicals in private households (Lead, paraffin safety, storage of chemicals, etc)

• 1 campaign per Region on chemical safety and lead awareness (7 campaigns)

Develop and run an ongoing Health Promotion and education campaign targeting informal food handlers

• 1015 identified informal food traders trained citywide

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Long Term Goals



Within a broader disaster management response capacity, maintenance of ability to respond to any and all public health threats

To reduce the risks of potential outbreaks and effectively contain outbreaks when occurring

Communicable disease outbreak response improvement programme:

• Refine a health surveillance system, integrated with the City’s own disaster management response that is aligned with the provincial and national systems, with a focus on ensuring early warning on key risks and rapid responsiveness.• Identify areas of greatest risk in each region and

institute preventative measures to mitigate communicable diseases.• Review systems and procedures to ensure

immediate investigation of selected notifiable conditions.• Coordinate and monitor outbreak response

where necessary

• 100% of cases investigated and 80% reported within 3 working days

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Long Term Goals



Massive reduction in HIV and AIDS prevalence/incidence rates and reduced impact of HIV and AIDS on communities

Improved awareness of HIV and AIDS risks, prevention methods and available services

Reduced rate of new HIV infections

HIV prevention programme

Develop and implement Peer education programmes for communities in Hostels (including males), informal settlements, sex workers and for the youth

• 2 Peer education programmes implemented in Hostels• 100 Peer educators trained (including

traditional healers)• 2 Peer education programmes

implemented in informal settlements• 1Youth programme implemented• 90% Of identified hotels with CSW

supported as part of the outreach campaign• 90% Of identified hotels with CSW

with at least 1 peer educator

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Long Term Goals




Improved awareness of HIV and AIDS risks, prevention methods and available services

Reduced rate of new HIV infections

HIV prevention programme

Develop & conduct VCT, PMTCT and ART community awareness campaigns to increase acceptability and use of the programmes in the community

• One campaign per region conducted on VCT, PMTCT and ART • 76 (100%) fixed health facilities

providing rapid on site HIV testing services

Strengthen and improve the provision of syndromic management of STI’s services

• 100% Of health services points providing STI treatment

Expand availability and distribution of male condoms throughout the COJ

• 100% Of health service delivery points distributing male condoms.• 60% Of other council buildings

distributing male condoms • 220 community based condom

distribution points

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Long Term Goals




City-wide access to comprehensive HIV & AIDS support services to ensure effective medical care for people infected and affected by HIV & AIDS

Medical care and ART roll-out support programme

Develop & conduct community awareness programmes on Post Exposure Prophylaxis (PEP)

• PEP awareness campaigns conducted in all regions

Implement TB/HIV collaboration programmes: INH prevention therapy

• 60% of fixed clinics implementing INH preventive therapy• 100% fixed clinics offering Diflucan

Support the establishment and provision of comprehensive HIV and AIDS Management Treatment Plan (CCMT) in the COJ

• 100% regions with access to CCMT• 2 Antiretroviral (ART) sites

established

Ensure provision of PMTCT at fixed clinics that provide comprehensive ANC services

• 100%of fixed clinics that offer comprehensive ANC providing PMTCT services• 60% of fixed clinics conducting

PCR testing in children.

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Long Term Goals




City-wide access to comprehensive HIV & AIDS support services to ensure effective community based care for people infected and affected by HIV & AIDS

HIV & AIDS community care and capacity development programme

Develop community capacity on care and support for people and families infected and affected by HIV and AIDS

• 12 Informal settlements implementing Jozi Ihlomile programme

Establish food gardens in clinics and FBOs in order to ensure availability of vegetables to support families and individuals in need of nutritional support

• 40% of fixed clinics establishing food gardens

• 25 Food gardens established in community based facilities

Develop and implement PWA support and HBC services programmes in all regions of the COJ

• 40% Wards with access to PWA support groups and HBC programmes

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Long Term Goals




Reduced rates of City of Johannesburg staff absenteeism and departure attributable to HIV & AIDS

Workplace Wellness HIV and AIDS programme.

Develop and implement employees wellness programme

• 100% access for infected and affected employees

Ensure workplace HIV and AIDS strategy and planning

• 8 workplace wellness and HIV and AIDS forums established. (also in all MOE’s)• 80% Compliance with minimum standards

on HIV and AIDS in the workplace.• 1 Baseline HIV survey to determine

prevalence conducted.

Strengthen workplace HIV and AIDS programme

• 100% of departments / entities conducting awareness programme targeting COJ employees• 100%of council buildings having access to

male condoms• 100% of COJ employees with access to VCT

services

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Long Term Goals






Ensure employee access to EAP, VCT and ART programmes and protect jobs and benefits

• 100% access to the extended treatment, care and support for infected and affected employees• 100% access to comprehensive ART

programme to COJ employees requesting service• 100% availability of femidoms on request• 100% access to post exposure prophylaxis

(PEP) for the City’s employees• 100% access to counseling services to COJ

employees• 100% access to debriefing sessions for COJ

role players involved in the HIV and AIDS programme

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Long Term Goals






To strengthen the implementation of Comprehensive HIV and AIDS Management Treatment Plan

• 100% access to Comprehensive HIV and AIDS Management Treatment Plan to COJ employees

Improve openness and transparency in the management of HIV and AIDS in the workplace

• 40% of managers trained on HIV and AIDS programme

Increase HIV and AIDS awareness and understanding among COJ employees

• 400 workplace wellness and HIV and AIDS peer educators trained

• 2 citywide road shows conducted per annum

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Long Term Goals



All citizens to have access to a comprehensive basket of health services, especially primary health care

Equitable distribution of primary health care clinics and more convenient operating hours in clinics Improvement in perception of PHC services as measured by CoJ Customer Satisfaction Surveys

Primary Health Care strengthening and expansion programme

Extended clinic hours (more convenient operating hours in clinics)

• 2 clinics with extended service hours

Extend satellite clinics into full five day operating facilities

• 2 satellites clinics operationalised to fixed clinics

CAPEX audit and 5 year CAPEX plan

• 5 year costed Capex Plan developed

On the basis of a PHC audit, ensure functional integration in services with provincial health facilities, and synchronize referral systems.

• 2 regions with functionally integrated health facilities.

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Long Term Goals






Multi-skilling of PHC staff

• PHC training plan (HRD plan) completed• 10% annual increment on PHC trained nurses

from baseline• One EMS training session per quarter. • PHC training unit costed

Adequate staffing in PHC facilities

• 100% completion of revised organograms

Early identification and referral of people with mental illnesses.

• 20% of clinicians trained in early identification of people with mental illnesses

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Long Term Goals






Cost centre development

• 50% of managers trained on cost centre management• 80% managers trained on Drug Supply

Management

Fraud & risk management strategy – pharmaceuticals

• Less than 5% drug shrinkage per region• 2 internal audit reports on pharmaceutical

services• 100% Service delivery points with monthly

stock control systems• 100% Service delivery points with monthly

Laboratory control systems

Develop integrated HR & HRD annual plans, M & E systems

• 100% Staff recruitment and retention strategy developed

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High level key programmes & quantifiable deliverables…

Long Term Goals






Ensuring more equitable staffing levels across all clinics and that staff gaps are filled.

• 100% completion of revised PHC facility organograms.

Ensure adherence to the core set of service standards

• Approved service improvement plan. (100%)• 2 biannual reports on adherence to norms

and standards, and DHS systems.• 100% facilities implementing applicable

norms and standards.

Assessment of waiting times improvement in health facilities

• One annual waiting times survey conducted at all clinics

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Long Term Goals






Promote patients’ rights charter, implement customer care with complaints management systems

• 100% of facilities implementing applicable Clinic Supervisor Manual Checklist. • 1 Annual Client Satisfaction Surveys

(CSS) conducted for services at clinics.• 100% of staff trained in customer care.• 100% of correctional measures

implemented as per CSS results.

Monitoring of PPP partnerships.

• 10 partnerships that contribute to PHC services in the City

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Long Term Goals






Increase responsiveness to community needs by facilitating the training and empowerment of community structures that can liaise with clinics including traditional healers

• 50% of ward health sector representatives trained.• 2 training sessions for community

structures including traditional healers per annum

Monitoring of complaints management protocol.

• Time taken to respond to regional service requests and complaints• % of requests for services and complaints

resolved from the total request and complaints received from regions

(As per criterion)

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Long Term Goals




Improved TB cure rates across the city

Tuberculosis control programme

Strengthen TB treatment programmes to improve detection, reduce treatment interruption rates and improve cure ratesImprove case holding through effective utilisation of Community Health Workers (CHW)

• 67%Cure rate of New Smear Positive TB patients• 8% or less Interruption rates• 80% Of newly diagnosed (New smear

positive) placed on treatment• 90% TB patients on Directly Observed

Therapy (DOT• 70%Of sputum results received within

48 hours• 1 TB awareness programmes

conducted in each region

Implement TB/HIV collaboration programmes: INH preventative therapy (IPT)

• 60% Of fixed clinics implementing INH preventive therapy

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Long Term Goals




As measured by a five-yearly survey, improved community awareness of health risks, healthy lifestyle and the availability of services for chronic conditions

Comprehensive and integrated health promotion programme

•Develop & run a proactive health promotion outreach programme from all fixed clinics especially in informal settlements & other vulnerable communities with specific interventions for males.

• 100% Existence of “integrated Health Promotion strategy”

• 2 Health Professionals per region trained in Health Promotion

Intensify health promotion interventions to encourage healthy lifestyles, and to raise awareness around chronic (non-communicable) illnesses so as to enable early recognition and timely health-seeking behaviour.

• Substance abuse awareness and education programmes conducted at 3 high schools per region• 100 males screened for prostate

gland & testicular cancer• Cervical & breast cancer awareness

programmes conducted in each region• Awareness programmes on chronic

conditions of lifestyles conducted in each region

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Long Term Goals




As measured by a five-yearly survey, improved community awareness of health risks, healthy lifestyle and the availability of services for chronic conditions

Comprehensive and integrated health promotion programme

Partnerships on health promotion & intersectoral collaboration in health promotion activities

• 1 support group established & maintained per facility

Expand the provision of chronic care services at all fixed facilities

• 80% Of fixed facilities providing chronic care

Promote mental well-being through integrated and proactive health promotion campaigns

• 1 awareness programme on mental health conducted per region

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Long Term Goals




Five-yearly improvement across a selected set of national indicators of child-health

Children and youth health programme

Develop and conduct community awareness programmes on the need for immunization in each region, and ensure the availability of an Expanded Programme on Immunisation (EPI) in all areas of the city.

• 1 EPI awareness programme conducted per region• 88% (full) immunization

coverage of children under 1 year• 88% Measles coverage of

children under 1 year

Implement “Growth monitoring and Promotion” of children under 5 year olds for early identification of growth faltering

• 100% of severely malnourished children monitored/followed up• 88% Vitamin A coverage in

children under 1 year old• 85% Weighing rate of children

under 5 year old

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Long Term Goals






Review and ensure effective implementation of the Integrated Management of Childhood Illnesses (IMCI) strategy

• 16 additional Professional Nurses trained in IMCI

Ensure provision of Prevention of Mother to Child Transmission (PMTCT) programme at all fixed clinics that provide comprehensive antenatal (ANC) care

• 100% provision of PMTCT at fixed clinics that provide comprehensive ANC

Develop and conduct community awareness programmes to prevent childhood accidents and injuries

• 1 awareness programmes on prevention of childhood accidents and injuries (including Lead Poisoning) conducted in each region

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Long Term Goals






Ensure provision of an expanded community health outreach programme from all clinics, targeted at ECD facilities identified in the annual census to promote awareness and education around all child health issues

• 50% of ECD centres visited to conduct integrated awareness programmes

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Long Term Goals




Five-yearly improvement across a selected set of national indicators of women’s health service provision

Women’s Health programme

Ensure provision of comprehensive antenatal and postnatal care at all fixed clinics in the city

• 50% fixed facilities per Region providing comprehensive ANC • 75% of ANC patients pre test

counselled for HIV• 25% Of Vitamin A coverage in

post partum mothers

Provide family planning services at all clinics and facilitate referral in order to ensure access to Choice of Termination of Pregnancy (CTOP) services

• 35% contraception coverage in women 15 – 45 years (uninsured)

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Long Term Goals




Five-yearly improvement across a selected set of national indicators of women’s health service provision

Women’s Health programme

Strengthen breast and cervical cancer screening in all clinics, and conduct awareness & education programmes on reproductive, maternal and women’s health in all regions.

• 5% increase in cervical cancer screening coverage from the baseline• 1 awareness programme on cervical and

breast self examination in each region• 1 awareness and education programme on

reproductive and maternal health in each region including postnatal depression• Awareness programmes on teenage

pregnancy conducted in 2 high schools per region

Establish Youth Friendly Services (YFS) in regions in order to encourage and facilitate youth access to health care.

• 1 additional YFS site established per region

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Long Term Goals



Environmental & Primary Health Care strategy for the 2010 Soccer World Cup

Reduce environmental health risks, improve accessibility to and quality of service at primary health care clinics and undertake comprehensive and integrated health promotion.

2010 Soccer World Cup programmes

To ensure that the environmental health requirements in terms of the environment, food control including food establishments and accommodation establishments are addressed and complied with

• Informal food traders training and certification

• Cleaning of vacant stands. (Private, Council owned and government owned)

• 100% Accreditation of all venues and

accommodation establishments prior to 2009 to ensure compliance – Increase in EHP’s will increase the monitoring and compliance

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Long Term Goals






Improve compliance to environmental health by-laws and legislation

• Education campaign on COJ by-laws• Law enforcement activities around illegal

dumping in identified hotspot areas• Law enforcement activities related to illegal

handling of meat and disposal of animal carcasses• Serving of notices and fines to owners and/or

occupiers of bad buildings• Inspections at butcheries• Certification of known identified food premises• Environmental health awareness programmes• Inspections at public conveniences• Vector control

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Long Term Goals






Upgrade health facilities near stadiums / practice venues.

• Upgrade of clinic facilities near stadia• 2 clinics with extended service hours• 2 satellites clinics operationalised to fixed

clinics

Implement integrated health promotion activities with focus on environmental health, and HIV & AIDS and STI's

• Environmental health awareness programmes• 2 Peer education programmes implemented in

Hostels• 100 Peer educators trained (including traditional

healers)• 2 Peer education programmes implemented in

informal settlements• 1Youth programme implemented• 90% Of identified hotels with CSW supported as

part of the outreach campaign• 90% Of identified hotels with CSW with at least 1

peer educator

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Long Term Goals






Ensure compliance by health facilities to cope with emergencies & disasters, in collaboration with EMS and Disaster Management.

• One EMS training session per quarter.

• Functioning Outbreak Response teams in each region

• 100% of cases investigated and 80% reported within 3 working days

Documents

CoJ Health Department