Enhancing Rural Health Outcomes Through Budget Prioritization and Coordination

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Improving rural health outcomes requires aligning health budgets with current needs and future goals. Minister Godongwana's budget initiatives are a positive start, but more detailed planning is essential to fulfill constitutional health rights. Focus must be on enhancing data systems, infrastructure, human resources, and primary healthcare services for rural communities to achieve universal health coverage by 2030.

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Uploaded on Apr 03, 2024 | 1 Views

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Improving Rural Health outcomes through prioritisation and good coordination of budget allocations March 2024

Health budgets needs to speak to the realities of the past and the future for improved health system It is encouraging to see the minister Godongwana make direct references to health, introducing budgeting initiatives that will tackle some of the most pressing challenges. But this is only the first step and in general more detail is needed to ensure that people s constitutional health rights will actually be realised. Health needs of rural communities have changed since the establishment of the National Health Act, as this NHA is a framework and regulation for the provision of equitable quality access to healthcare. We need to re assess if realities of the past and the future. Budgets are designed to still speak to the health needs communities had about 12 years ago. We need to make sure that current budget divisions do speak to the improvement of the health system in general: We are happy that the minister has made provision for the improvement of data health information system including digital patient filing. We also need to make sure that infrastructure and human resource provision is prioritized for the rural communities. And most importantly primary health care services need to be improved and prioritized for rural communities and for the achievement of the universal health coverage in 2030. 2 | 3 April 2024

Priorities essential healthcare for rural communities RHAP research team have conducted a desktop literature review to assess and highlight the progress of South Africa s journey to achieving the universal health coverage in rural districts that RHAP works at. Data was obtained from the district health barometer, South African Health Review and from the Provincial Annual Financial Reports. These research briefs can be found on our website https://rhap.org.za/resources1/ Summary of the research briefs: To achieve Universal Health Coverage by 2023 we need a strengthened PHC and district health system. As PHC is said to be an effective UHC vehicle, for improved access to essential healthcare services for rural communities, there is a need to priorities these health areas: -Reproductive, child and maternal health: Access to family planning is very crucial component in primary healthcare and reducing maternal and child mortality. According to the newly published DHB 2022/23 we still have high rates of maternal mortality due to pregnant women presenting late for antenatal care. -Infectious diseases such as HIV and TB: Great progress have been done in making sure that HIV positive people are on treatment, but there is still a greater need -Non communicable diseases such as diabetes of which it is the second leading cause of death in South Africa: Diabetes is the second leading cause of death in South Africa. Investment in addressing this health problem for rural communities is needed, we need more screening and routine testing is key for rural communities in early detection and/ prevention of the onset of this disease -Service capacity and access which mainly looks and staffing and access to medicine: We welcome the recent filling of the post for medical officers after the unemployed doctors took their problem to the streets, we need to use this opportunity to address the issues of maladministration of rural healthcare worker posts and prioritisation of the healthcare worker force in need for effective PHC service provision. 3 | 3 April 2024

Access to quality rural healthcare We acknowledge the provincial additional budget allocations including for department of health as well We welcome the recent filling of the medical officer posts; we need to use this opportunity to address the maladministration of rural healthcare posts and priorities filling of these rural posts as suggested on the human resources for health strategy. An effective coordination of this budget is important, as the goal of these allocations is to make sure that the constitutional obligations are met as stated on section 27 of the constitution Effective coordination of budgets will improve access to healthcare for rural communities because there will be prioritisation of funds being administered according to health needs of the rural communities Rural health needs are mainly access to Primary Health Care services at local clinics and district hospitals. More investment in health is still needed, if we want to successfully achieve universal health coverage in 2023. 4 | 3 April 2024

Recommendations Call a joint sitting of the portfolio committee of health , finance and appropriations to consider how to priorities budgets for states ability to meet its constitutional mandates Call all provinces to present plans detailing what measures are being implemented to ensure that rural health services are protected from budget cuts Call the national department to outline what plans are put in place for the implementation of the National Human Resources for Health Strategy 5 | 3 April 2024