During the Department of Health (DoH) budget vote on 5th May 2015, Minister of Health, Dr Aaron Motsoaledi, highlighted the importance of implementing effective eHealth systems to cut waiting times in clinics across the country and to improve the wellbeing of patients.

Minister Motsoaledi opened his speech by reemphasising the importance of the National Development Plant (NDP) in guiding the policies of the DoH to focus on increasing life expectancy, reducing the quadruple burden of disease, decreasing the infant mortality rate and improving the quality of healthcare, all by 2030.

“Every single vision in health, every single policy, plan, programme, decision or campaign will from now henceforth be based on and be directed by the dictates of the NDP without any reservations whatsoever,” said Minister Motsoaledi.

Minister Motsoaledi used the recent Ebola outbreak in West Africa as an example of how weak health systems make it extremely difficult to prevent and manage disease outbreaks. “Whether it is Ebola, meningitis, TB, HIV and AIDS, polio, malaria or whichever outbreak it is, if the overall health system is weak, such an outbreak will be unmanageable,” said Minister Motsoaledi.

Minister Motsoaledi explained that a weak health system means “systemic and perennial inadequacies in the areas of information systems; health facilities; infrastructure and equipment; the number of health professionals; supply chain processes; financial management; and the ability to coordinate development partners and assistance from international organisations.”

Minister Motsoaledi and his fellow African Ministers of Health therefore believe it’s important to evolve from vertical programmes focusing on certain diseases, such as HIV/AIDS, to focus rather on strengthening the health system as a whole. “We believe that what will help Africa are strong health systems which in turn will withstand whichever outbreak emerges,” said Minister Motsoaledi.

According to Minister Motsoaledi, over the past financial year the DoH initiated plans and programmes to strengthen the public health system. “This will include preventing disease, promoting health and making sure that our people get good quality health care,” said Minister Motsoaledi.

One such prominent programme the DoH rolled out in August 2014 was MomConnect, an mHealth initiative that aims to register all pregnant women to receive vital information via SMS for a healthy pregnancy.

“In only eight months we have been able to register 383,354 pregnant women on the system. It is regarded as the largest number in the world. Before we started, Bangladesh was regarded as a world leader after registering 100,000 women in 18 months, while other countries are having only small pilot projects – nothing yet on a massive scale like we have,” said Minister Motsoaledi. “Our intention is to ensure that every one of the 1.2 million women who get pregnant annually registers on MomConnect.”

MomConnect also allows pregnant woman to ask questions and send unsolicited compliments and complaints. According to Minister Motsoaledi, the DoH has received 1,553 compliments so far, most notably about how the users appreciate the service. Out of the 290 complaints received, the most prominent one was long queues and long waiting times in public health facilities. “Long before MomConnect, we have come across this phenomenon of long waiting times as far back as 2010 when we did our own audit of health facilities,” said Minister Motsoaledi.

According to Minister Motsoaledi, the reason for the “unbearable waiting times” is the drastic increase of patients on ARVs. “In 2004, we only had 400,000 people on ARVs. By 2009 the figure more than doubled to 923,000 and today we have 3 million people on ARVs. This figure is more than 30% of the World’s programme. There is no way clinics and hospitals will not be congested. Add to these the explosion of non-communicable diseases like diabetes and high blood pressure, then you have very long queues in the making,” said Minister Motsoaledi.

Minister Motsoaledi identified eHealth as a solution by stating “one of the solutions lie in introducing new efficient technology systems in our health facilities,” as well as making sure less people are forced to visit hospitals and clinics by instead going to collection points to pick up their medicine with a special card or with an SMS sent to them by the DoH. “Presently we have 383,989 patients on this system and we are targeting 0,5 million people,” said Minister Motsoaledi.

Minister Motsoaledi also addressed the issue of drug stock-outs and how the DoH has instituted an mHealth programme to deal with it, which is currently being used in 1,160 or 25% of health facilities in the country. A nurse uses a cell phone provided by the DoH to scan a barcode on every package of medicines every week, the information is then sent to a central database where it is fed into a geomap. “The facility that has a stock-out will blink a red light in the geomap and we will phone the District Pharmacist in that District to warn them,” said Minister Motsoaledi.

Minister Motsoaledi concluded by requesting the DoH ‘s budget for 2015/2106 be increased by 7.4% to R36,46 billion from last year’s R33,95 billion. “This is broken down into four components: R772 million for compensation of employees; R1,579 billion for goods and services; R33,448 billion for transfers – these are the conditional grants that we provide to provinces; and R668 million for capital expenditure,” said Minister Motsoaledi.

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