sector skills plan for the health sector in south africa

3.10.5 STRATEGY TO FIGHT TUBERCULOSIS
According to the DBSA, approximately 74% of TB cases are not managed appropriately – 44% of cases
treated are not cured and 30% of cases are not reported. Poor case management in the district health
system is contributing to increases in incidence of TB and multi-drug resistant TB (MDR-TB) and
extensively drug resistant TB (XDR-TB). 139 In response, the government declared TB a national
emergency and adopted the Tuberculosis Strategic Plan for South Africa 2007-2011 to expand control
efforts, enhance access to treatment services, and improve the cure rate. The strategy requires earlier
detection, increased surveillance for MDR-TB, active case management, as well as monitoring of
treatment completion. 140 Improved infection control in hospitals and clinics will also be required to
prevent further outbreaks. 141 Clearly, skills will be required at primary and secondary level, including
doctors, nurses, pharmacists, mid-level healthcare workers, infection control officers, etc.
3.10.6 MATERNAL AND CHILD HEALTH
Mortality rates for mothers and babies have increased since the baselines for the Millennium
Development Goals (MDGs) were set. Many preventable maternal and neo-natal deaths have been
attributed to failures in the health system, such as lack of staff, inadequate skills and weak health
management systems. 142 There is a need to expand care coverage, improve obstetric and neo-natal care
and prevent mother-to-child transmission of HIV and AIDS. The DoH set a target to increase the
percentage of mothers and babies who receive post-natal care within six days of delivery from 20% in
2010 to 80% by 2013. 143 To achieve this, the quality and productivity of existing skills must be improved
and the skills base should be expanded, especially in the public sector. 144 Vaccination programmes will
also be stepped up to improve immunisation coverage and more emphasis will be placed on nutrition. 145
139 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System.
140 Karim, S. S. A., Churchyard, G. J., Karim, Q. A. et al. 2009. “HIV infection and tuberculosis in South Africa: an urgent need to
escalate the public health response”. Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August
2010).
141 Harrison, D. 2009. An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for
New Gains. Published at www.doh.gov.za (Accessed February 2010).
142 Chopra, M., Daviaud, E., Pattinson, R. et al. 2009. “Saving the lives of South Africa’s mothers, babies, and children: can the
health system deliver?” Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August 2010);
Harrison, D. 2009. An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for New
Gains. Published at www.doh.gov.za (Accessed February 2010).
143 Portfolio Committee on Health. 2010. “Health plans major increase in vaccination and HIV work”. Published at
http://sabinetlaw.co.za/health/articles (Accessed August 2010)
144 Chopra, M., Daviaud, E., Pattinson, R. et al. 2009. “Saving the lives of South Africa’s mothers, babies, and children: can the
health system deliver?” Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August 2010).
145 National Treasury. 2010. “Vote 15: Health”. Estimates of National Expenditure 2010.
39