NATIONAL ASSEMBLY
FOR WRITTEN REPLY
QUESTION NO. 852
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 MARCH 2010
(INTERNAL QUESTION PAPER NO. 8)
Mr M Waters (DA) to ask the Minister of Health:
(1) How many patients died of septicaemia at each specified health
facility (a) in the (i) 2007-08 and (ii) 2008-09 financial years and
(b) during the period 1 April 2009 up to the latest specified date for
which information is available;
(2) whether any investigation was conducted into any of the deaths; if
not, why not; if so, what (a) were the contributing causes in each
case and (b) were the recommendations to improve the situation in each
case;
(3) whether all the recommendations for the said reports have been
implemented; if not, (a) why not, in each case and (b) which
recommendations have not been implemented in each case?
NW988E
REPLY:
1) The number of patients per facility that have died of septicaemia
during the period mentioned is not known. The current patient
information system(s) employed by public health facilities does not
routinely capture this information. The information system employed by
Statistic South Africa that is based on the Department of Home
Affairsâs Death Notification form and on the ICD-10 coding also does
not provide for the required information.
2) Investigations into all deaths including death due to septicaemia
caused by a wide range of possible microbes, are conducted by
clinicians during morbidity and mortality meetings at facility level
and/or by provincially-based Clinical Risk Committees when the cause
of death is reported as an adverse event. However, due to the absence
of an electronic patient record system, determining the contributing
causes of death in each individual case will require a comprehensive
retrospective medical record review/audit of all cases.
The formal process followed during the Confidential Equiries into
Maternal Deaths requires a thorough investigation of each maternal
death and a subsequent provincial assessorâs report that is sent to
the National Committee on Confidential Enquiries into Maternal Deaths
(NCCEMD). This Committee compiles a final report that is distributed
to Provinces who in turn distribute information to Regions and
Districts. The recommendations contained in the NCCEMD report to
improve maternal health services are generic and aimed at improving
the delivery system. It is not case specific.
3) Provincial health departments manage all facility-acquired infection
outbreaks in their respective provinces. Their investigations
culminate in reports that include recommendations on interventions
needed. On average these outbreaks are usually caused by a break in
applying universal infection prevention precautions such as sound hand
washing practices that could easily be addressed. However, in some
instances more long-term interventions are required, for example where
structural changes to the building are required due to the initial
poor layout and design of the health facility.
END.