South Africans are hit hard when government plans do not translate into action. But now Health-e News Service is using an innovative programme to give communities a voice – and to help people track the progress of the NSP from the ground up.

OurHealth is a citizen journalist programme that started with the placement of community journalists in five of some of the country’s worst performing districts, each of which were also National Health Insurance pilot sites. There are now 20 citizen journalists stationed across the country.

Already, OurHealth journalists have broken several major stories in the Eastern Cape. These include the closure of the Village Clinic at Lusikisiki and the drug depot strike at Mthatha which prompted an emergency intervention in December 2012 by the Treatment Action Campaign and Doctors Without Borders. OurHealth’s citizen journalists are also helping to monitor NSP goals.

NSP Target: Initiate at least 80% of eligible patients on antiretroviral (ARV) treatment. At least 70% must be alive and on treatment after five years.

Achieving this NSP target will depend on people living with HIV having access to treatment and to drug supply chains which function properly. In October 2012, Goso Forest Clinic in the OR Tambo District in the Eastern Cape ran short of medicines, including ARVs. OurHealth investigated this case, as well as four other NHI pilot sites, where further ARV stock-outs were discovered and reported it to the Department of Health.

OurHealth has also partnered with the Southern African Regional Programme on Access to Medicines to prevent stock-outs from occurring.  We are conducting monthly monitoring of essential medicine stocks in almost all of the 11 NHI pilot districts. The findings are also being shared with the Stop Stock-outs Project.

NSP Target: 1 600 000 men circumcised by 2016/17

OurHealth citizen journalists have been monitoring the progress of South Africa’s medical male circumcision programme (MMC) in four provinces, including the Free State, North West and Mpumalanga and Eastern Cape. With increasing numbers of men requesting MMC, there is concern that the public sector will be unable to cope with the demand. In July, Senamile Phungula reported that the health facilities in Mpumalanga’s Gert Sibande District were battling to cope with an increase in requests. She later reported that the South African Nursing Council gave the Mpumalanga Department of Health permission to allow professional nurses to perform MMC under the supervision of a doctor.

NSP Target: distribute one billion male condoms annually by 2016

Although the NSP has set high targets for the number of male condoms to be distributed, OurHealth has reported that many facilities face ongoing shortages or stockouts. In the Gert Sibande District, local non-governmental organisations also face problems in accessing and distributing condoms, and this is jeopardising the district’s ability to meet its distribution targets.

NSP Target: Reduce the number of TB deaths by 50%

While some districts have improved the TB services they provide, OurHealth journalists has found that others are struggling. TB test results provide an entry point for life-saving treatment. But in Johannesburg, tests results for many Soweto patients were delayed recently due to the introduction of a new information management system. These delays also affected results for HIV, CD4 counts and pap tests. In contrast, the Sesifuba TB Hospital in Mpumalanga, has reduced both its TB death and its defaulter rates in the last year. According to one nurse, this is because the hospital has managed to better integrate its TB and HIV services.

NSP Target: 90% of clinics will provide services after hours or on weekends by 2016

OurHealth journalists have noted that the length of opening hours at clinics are still a problem in many parts of the country. In March 2013, for example, two clinics in the town of Soshanguve in Gauteng were found to have closed early during the Easter holidays due to staff shortages. Similarly, in Ermelo in Mpumalanga, attempts to extending clinic hours also failed due to staff problems.

NSP Target: The creation of Ward AIDS Councils

Ward AIDS Councils help to gather ward-level data and strengthen governance. In the Msukaligwa Municipality of Mpumalanga, an OurHealth journalist attended the re-launch of the local AIDS council and the introduction of 19 new ward AIDS councils in October 2013.