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Taking healthcare services to the people


New Free State Health MEC Montsheng Tsiu is determined to address the challenges facing the health sector in the province.


She aims to do this through the proper implementation of government’s re-engineering of the primary healthcare (PHC) policy, which aims to increase access to and improve the quality of health services.


The re-engineering of PHC has four outputs: increasing life expectancy, decreasing maternal and child mortality, combating HIV and AIDS and decreasing the burden of disease from tuberculosis (TB), and strengthening the effectiveness of the health system. Conceived by the National Department of Health in 2010, the model for re-engineering South Africa’s PHC landscape was subsequently adopted by provincial government.


MEC Tsiu said if the province gets the implementation model right, its healthcare system will be the best in the country.

“If we implement it correctly, the department will ultimately not need a lot of money to deliver services. If we help our people to prevent diseases, we will be able to save money for the department because when a person gets sick it increases the burden on the department to take care of that person,” she explained.


“If our residents are empowered to prevent diseases, we will have healthier residents who do not need to visit healthcare facilities often. They will be able to go for check-ups while they are still healthy and infections will be picked up early, treated and con- trolled,” she added.

MEC Tsiu was appointed to the position in May this year and be- lieves she is the right woman for the job because she has worked for the health department for over 30 years, first as a professional nurse in primary healthcare and later as the provincial head of nursing.


Since day one, MEC Tsiu has em- phasised the importance of taking primary healthcare to the people. She said the department will be running campaigns across the province to promote preventative healthcare.


The MEC said high volumes of people visit the province’s health facilities.

“We find that some of our facilities are too small to carry the number of patients that come through.

However, they are not turned away. We help everyone who comes to our facilities,” she added.

Core challenges

Budget is one of the biggest factors contributing to many of the department’s challenges. For this financial year, the department has a budget of R10.4 billion, which MEC Tsiu explained is inadequate. She added that most of the money goes to salaries.


However, she said innovative ways are being found to make the money go further without compro- mising service delivery.


The province’s population is about 2 763 024, and many of these peo- ple live in rural areas. Around 82 percent of the population does not have medical aid and makes use of public healthcare services. The department constantly finds itself having to pay for things that it did not budget for, such as litigation and servicing people from other provinces and abroad, especially in hospitals.


The MEC said the department is trying its best to ensure that it em- ploys skilled people but explained that sometimes healthcare workers end up making mistakes because of the heavy workload, which is exacerbated by staff shortages.


She said that the shortage of staff at health facilities is, however, not unique to the Free State.


MEC Tsiu acknowledged that the country has a burden of diseases, especially in the Free State where many people are infected with HIV and AIDS, and TB. Maternal deaths and neo-natal and infant mortali- ties are also high.


Recent reports have indicated that the three provinces with the highest HIV prevalence are

KwaZulu-Natal, followed by the Free State and the Eastern Cape.


MEC Tsiu said the Free State’s Lejweleputswa, in particular, which is a mining district, has a high level of TB.


“We also have many patients living with non-communicable diseases like hypertension, high levels of trauma and mental health issues,” she said.


“We are trying hard to ensure that we do not overburden our healthcare workers,” she said. With the province being at the centre of the country, a number of national roads pass through it. This means that Free State health facilities are often called upon to

treat travellers from other areas who have been involved in accidents in the province. The N8, N5, N6, N1 and N3 all pass through the Free State and carry high traffic volumes, especially over holiday periods.

Top priorities

Among the priorities that the MEC has earmarked for this financial year are:

■ Centralised Chronic Medicines Dispensing and Distribution – this will enable people to collect their medication from different points at their own conveni- ence.

■ Improving health infrastruc- ture across the province – the department recently opened two state-of-the-art hospitals in the rural areas of the Free State, namely Albert Nzula District Hospital in Trompsburg and Senorita Ntlabathi in Ladybrand. The Batho Clinic in Mangaung operates as a 24-hour clinic, as do the Dr Che Guevara Clinic in Sasolburg and the refurbished Sasolburg Clinic. Other clinics will start operating day and night during this financial year.

■ Implementing the Health Patient Registration System across facilities in the province – the electronic registration of patients will result in better case manage- ment. Pelonomi and Universitas hospitals have already started using the electronic registration model.

■ TB screenings – the department will intensify TB screenings and ensure that infected people are put on treatment.

■ The distribution of condoms – this will be increased and health education will be provided.

■ Efforts to prevent mother-to-child transmission of HIV will also be stepped up.


One of the successes that the department has had over the years is enrolling 130 clinics for assessment.

The MEC added that the department has various partnerships with the private sector and also works with other government depart- ments to improve service delivery at healthcare centres.

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