Municipal Health Services In South Africa

Municipal health services is a term that has evolved in South Africa to define the package of health services to be rendered by local government. It is a specified package that is described in the National Health Act.

It can thus be seen as a sub-set of the bigger basket of environmental health services. The importance of municipal health services and their impact on health will thus be discussed within the general framework of environmental health.

Municipal Health Services In South Africa

Water quality monitoring

Food control

Waste management

Health surveillance of premises

Surveillance of communicable diseases, excluding immunization

Vector control

Environmental pollution control

Disposal of the dead

Chemical safety.

Municipal Health Services In South Africa

South Africa still has a high burden of preventable diseases which can be mitigated through improvements in the environment. Investigation of outbreaks of disease, monitoring of the environment and health promotion have in the main been provided by environmental health practitioners, most of whom are employed by local government.

With the long period of uncertainty around the responsibility for the delivery of primary health care (PHC) services at a local level and the delay in role clarification around municipal health services, municipalities have tended to invest less in health services in general and this has led to diminished growth and prominence of environmental health services at a local level.

LEGISLATIVE FRAMEWORK FOR MUNICIPAL HEALTH SERVICES

The following pieces of legislation govern municipal health services in South Africa:

o The Constitution of the Republic of South Africa

o National Health Act 61 of 2003

o Health Act 63 of 1977

o Municipal Structures Act 117 of 1998

Municipal health services are first mentioned in the Constitution of the Republic of South Africa as part of the powers and functions of municipalities in Section 156 (1) where municipalities are given executive authority in respect of and the right to administer the local government matters listed in Part B of Schedule 4 and Part B of Schedule 5.

Municipal health services appear under Part B of Schedule 4, whereas “health services” that appear in Part A of Schedule 4 and are thus concurrent national and provincial legislative competencies, but can be assigned or delegated to a municipality according to section 156 (1) (4) of the Constitution.

The definition of municipal health services is provided in the National Health Act 61 of 2003 that was promulgated in May 2005. Before then, local government legislation touched on municipal health services but there was no definition of municipal health services.

Municipal health services are defined in the National Health Act in Chapter 5 which deals with the District Health System. Section 32 (1) of the Act requires every metropolitan and district municipality to ensure that appropriate municipal health services are provided.

These municipal health services are defined in the Act as:

 Water quality monitoring;

 Food control;

 Waste management;

 Health surveillance of premises;

 Surveillance of communicable diseases, excluding immunisation;

 Vector control;

 Environmental pollution control;

 Disposal of the dead; and

 Chemical safety.

CURRENT CHALLENGES AND OPPORTUNITIES FOR MUNICIPAL HEALTH SERVICES

OPPORTUNITIES

Integration into IDPs and local development initiatives

The delivery of municipal health services by municipalities is an advantage as they can be integrated into service delivery at a local level. Municipal health
services are preventive services that need an intersect oral approach for best outcomes to be achieved, for example interaction with other municipal divisions responsible for infrastructure and management of water and sanitation is essential for municipal health services to fulfil its role of monitoring the quality of water provided by a municipality.

The municipal health services section will be part of the development of Integrated Development Plans (IDPs) and the development of infrastructure will take the needs of municipal health services into account. Municipal health services will thus be fully integrated into municipal strategic and operational plans.

Local level action

PHC works on the principle of providing services at the level closest to the recipients as this facilitates community participation and accountability on the part of health service providers. Environmental health practitioners work in the community, as opposed to facility based health services.

They thus know and monitor developments in health conditions on the ground and can provide solutions that are more realistic due to their proximity to the community. Interventions can also be made timeously due to this proximity.

Funding opportunities

Treasury has allocated a basic R12 per person for the provision of municipal health services. This will be a crucial basis on which to build municipal health services, especially in district municipalities that did not provide this function.

It has been stated before that two-thirds of the budget for municipal health services was already being provided by local government.

The new funding from Treasury is thus additional to what municipalities were already providing and if local municipalities maintain their previous levels of financial support to municipal health services these services could be improved. is especially important in light of the report that South Africa still does not meet the standards that have been set by the WHO for EHP coverage.

What is the role of municipality in health services in South Africa ?

These municipal health services are defined in the Act as:

• Water quality monitoring; Food control

; • Waste management;

• Health surveillance of premises;

• Surveillance of communicable diseases, excluding immunisation;

• Vector control;

• Environmental pollution control;

• Disposal of the dead; and

• Chemical safety.

Who is responsible for municipal health services in South Africa ?

CONCLUSION: The National Health Act, 2003, has made it mandatory for Local Government to render Municipal Health Services (MHS) at district level.

What are examples of municipal services in South Africa ?

What is a municipal service?

Water supply.

Sewage collection and disposal.

Refuse removal.

Electricity and gas supply.

Municipal health services.

Municipal roads and storm water drainage.

Street lighting.

Municipal parks and recreation.

What are the 7 names of the metropolitan municipalities in South Africa?

South Africa has eight metropolitan municipalities, namely:

Buffalo City (East London)

City of Cape Town.

Ekurhuleni Metropolitan Municipality (East Rand)

City of eThekwini (Durban)

City of Johannesburg.

Mangaung Municipality (Bloemfontein)

Nelson Mandela Metropolitan Municipality (Port Elizabeth)