Page 168 - Provincial Treasury Estimates.pdf

Department: +HDOWK
1.5 Demands for and expected changes in the services

The demand for Public Health Care in the province has continued to increase due to the increasing

quadruple burden of disease (BOD) of HIV and TB, high maternal and child morbidity and mortality, rising
non-communicable diseases and high levels of violence and trauma.

Tuberculosis (TB) remained the leading cause of natural death followed by Diabetes Mellitus. In the overall
TB and HIV followed by non-communicable diseases remain the top leading causes of death in the Eastern
Cape. The order of the top ten causes of death is changing and reflects the massive effort and expenditure

on the HIV epidemic in the last two decades, which have reduced the contribution of deaths due to HIV in
the province. The success of antiretroviral treatment programme, with focus on early initiation of treatment
in the course of the disease has resulted in an improvement in life expectancy in the Province.

The implementation phase of the National Health Insurance (NHI) has been extended by three years to

2026. There is a steady improvement towards NHI readiness. All eight districts in the province are
implementing NHI programmes and will continue to prioritise the re-engineering of Primary Health Care
programme, in particular the number of Ward-Based Outreach Teams (WBOT) with Community Health

Workers providing outreach preventive healthcare. This programme will be further strengthened by the
integration with other departments through Operation Masiphathisane whose goal is to improve integrated
service delivery and pooling of resources at the community level.

1.6 The Acts, rules and regulations

The legislative mandate of the department is derived from the Constitution of the Republic of South Africa

section 27 and several pieces of legislation passed by Parliament. In carrying out its functions, the
department is governed mainly by the following Acts and regulations: Allied Health Professions Act (of
1982), Births and Death Registration Act (of 1992), Chiropractors, Homeopaths and Allied Health Service

Professions Act (of 1982), Choice of Termination of Pregnancy Act (of 1996, as amended), Dental
Technicians Act (of 1979), Foodstuffs, Cosmetics and Disinfectants Act (of 1972), Health Act (of 1977),

Health Professions Act (of 1974), Human Tissue Act (of 1983), International Health Regulations Act (of
1974), Medical Schemes Act (of 1997) Medicines and Related Substances Act (of 1965, as amended),
Mental Health Care Act (of 2002), National Health Act (of 2003), National Health Laboratories Services

Act (of 2000), Nursing Act (of 2005), Pharmacy Act (of 1974, as amended), Prevention and Treatment of
Drug Dependency Act (of 1992), and South African Medical Research Council Act (of 1991) and the
National Roads Traffic Act, (of 1996).

1.7 Budget decisions

The department continues to operate within a fragile space bedded within intractable service pressures

with resource limitations. This fragility is fuelled by the escalating burden of disease, including the multi -
morbidity from chronic diseases, mental illness and others. While the pace and scale of progress has been

151