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The science and practice of people-centred health systems

Low-angle view of hospital sign.

Cape Town was abuzz with healthcare specialists from all over the world for the 3rd Global Health Systems Symposium. The conference theme kept up with current industry trends, looking at “People Centred Health Systems Research”. Interestingly, the word “People” alone sparked a debate. Who are the “People” we are referring to? Are they patients? Are they the community we serve? Are they the healthcare professionals? Who are they? And so the conference opened bringing together divergent thinking from Public health specialist, Academics, Development Partners, Policy Makers, Healthcare Professionals, Global Funds and Activist.

The conference set the precedence for a robust discussion on application based research, forcing contributors and participants to bring forth actionable research that could be interrogated, strengthened and then translated. What this highlighted for many is that, the community of practice is vast, there are so many examples of what to do and what not to do. This also highlights to us once again the structural complexity of delivering healthcare in dynamic environments. Experts are recognizing that there is a reason now more than ever to look for solutions outside the healthcare industry.

There was a great analogy made in the opening plenary: “Animals adapt to their environment but people change their environment.” Thus for meaningful transformation in the healthcare system we need the structures to change. Thus much of the focus of the conference was focused on transformation of the building blocks.

One of the most topical issues was Human Resource investment. This investment calls for the development of a much needed skilled workforce. Policy makers debated norms and standards for workforce to help create a conducive environment. Once again the leadership was top of mind, “We need courageous doers! – that will purposefully realize designed health reforms”.

It was rather alarming that the World Health Organisation (WHO) had to put out a press release condemning the rising violence against healthcare workers. It is unfair that front line healthcare workers lives are put at risk while they work to save others. “More than 2300 incidents involving serious acts or threats of violence in health-care settings between January 2012 and July 2014, but many more attacks go unreported”, according to the International Committee of Red Cross (World Health Organisation). Therefore there is a need for states to make a greater effort to protect healthcare workers.

Universal Health Coverage (UHC) is still top of agenda and there have been many recent implementations that were shared: Thailand, Ghana, Philippine, Mexico. It is worth looking into the World Bank report that provides a detailed analysis of UHC in 25 low and middle income countries. Daniel Cotlear, the Health Economist from the World Bank left a key message based on the analysis, “It is important for countries to stay the course if they decide to undertake UHC”. The analysis shows that this is not a quick fix and each implementation needs to be considered individually and amended based on evolving dynamics of the healthcare system in which it is implemented

It was personally motivating to have the Ministry of Health Director General of South Africa and her team all at the conference for sharing the journey that South Africa has embarked on since 2009 and the series of reforms being implemented in preparation for South Africa’s National Health Insurance implementation. The Deputy Director Generals also provided insight into some of the more recent work such as Operation Phakisa Ideal Clinic initiative that aims to take primary healthcare delivery to the next stage led by Jeannette Hunter. The CFO, Ian van Merwe has aligned Financial Performance to the Non-Negotiables and Dr. Terence Carter Deputy Director General for hospitals, Tertiary Services and Workforce gave confidence in the institutional reforms his team is driving.

There is energy and commitment now more than ever to drive reforms in the healthcare system by bringing patient needs to the forefront of delivery. There is a need to create an inclusive healthcare system so we forget about the boundaries of public and private healthcare. We need to open ourselves to the innovations of the 21st century in to create room for individuals, communities and nations to grow and develop. We need to be prepared to make healthcare a personal agenda, so much so that we can obtain multi-lateral commitments t that results in actions. The recent Ebola Pandemic has reminded us that healthcare service delivery is universal; we need to have a system that works.

Preventing procurement fraud and corruption

preventing fraud and corruption

If your business carries out any kind of procurement processes, it automatically becomes exposed to different forms of fraud and corruption. While everyone says they have processes in place, very few organisations know how to implement the right measures and controls.

Clamping down on fraud and corruption in the procurement cycles of any organisation has to be viewed as “proactive” and not a reactive reflex.

Almost every survey conducted and statistical trend reported indicates that not only is the frequency of procurement fraud and corruption on the increase, but the quantum of losses is becoming significant enough to affect the sustainability of organisations.

  • As a business owner, ask yourself the following questions.
  • Is my organisation or business immune to fraud and corruption?
  • Are we in a position to detect any fraud and corruption within the organisation?
  • What measures can we put in place in order to prevent fraud and corruption?
  • Is there enough transparency in the procurement processes to ensure no corruption can take place?
  • What are the common procurement fraud “red flags”?

Detecting fraud and corruption should not be viewed as the responsibility of auditors, security and compliance personal. It is the responsibility of all the stakeholders of the organisation. How do we nurture this new mind set?

Expertise and professional advice is essential. Deloitte has specialists across many business models that can help with all aspects of this hot topic – “Preventing procurement fraud and corruption”.

Read the full article here

World Food Day: Agriculture in Africa – Trends for success

Omri Van Zyl (2)

World Food Day on 16th October seeks to raise awareness on world hunger and food security. Food production demand is on the rise due to increasing populations and emerging markets, and Africa is well positioned to benefit from this demand because of the availability of quality arable land.

Omri van Zyl, Head of Deloitte Africa Agricultural Unit (DAAU) & Deloitte Africa Agriculture leader, states that the agricultural sector will experience exponential growth only if investment is made to overcome structural, financial and infrastructural challenges. Omri has extensive experience in Agriculture Consulting across Africa. Below are key trends van Zyl identified to address world hunger and security concerns:

Considerations for growth:

  • Agriculture output has to be diversified in order to tap into diverse global markets and grow the sector.
  • Infrastructure expenditure on road, power and market networks is essential to tap into the potential of agriculture
  • New technology developed should be used to increase agricultural production and ensure food security
  • Agri-hubs should be included in mining development plans to create an opportunity for commercial agriculture and agri-business growth.
  • Different climatic conditions across Africa should be exploited to produce a variety of agricultural products.
  • Overall, collaboration between the private and public sector is required to ensure the industry is well supported.

Click here to read the full press release on agriculture in Africa.

Contact: Antoinette Shand should you have any enquiries

Climbing and conquering mountains

Deloitte CFO Survey Report

What is currently top of mind for over 300 CFOs in Southern and East Africa? Deloitte is revealing it all – today!

This year’s Deloitte CFO Survey received an overwhelming response from CFOs operating in South, Southern, East and West Africa.

The reports are the most comprehensive gauge of African CFOs’ views yet – with 73% of CFO survey participants from companies with an international footprint. They reveal valuable insights into the surveyed CFOs’ underlying mood, as well as the underlying drivers that are shaping these CFOs’ business approach and their strategic choices.

To download the South Africa CFO Survey Report, please click here

To download the Botswana CFO Survey Report, please click here 

The West Africa and East Africa CFO Survey Reports will be available towards the end of November. If you haven’t yet registered to receive those, please click here

Deloitte 2014 | CFO Survey Reports | South Africa, Southern Africa, East Africa and West Africa

Deloitte CFO Survey Report

The Deloitte 2014 CFO Reports will soon be available and will reveal the fascinating views of over 300 CFOs in South Africa, the rest of Southern Africa, East Africa and West Africa.

Our assessment is that this year’s reports are the most comprehensive gauge of CFO opinion on the African continent yet.

Remarkably, 73% of the CFO survey participants are from companies with an international footprint.

These reports will provide you with valuable insights into issues that are commonly on CFOs’ minds, including:

  • Cash flow and investment priorities
  • Growth opportunities and challenges in Africa and other markets
  • The availability and use of key talent
  • The economy and the current business climate
  • Strategic
  • Short-term and medium-term currency outlook
  • Cash flow and investment priorities for 2014 and beyond
  • Topical subjects like smart technology and social media

This year, Deloitte will publish separate reports for South Africa, Botswana and Zimbabwe in October and separate reports for East Africa and West Africa towards the end of November.

register

Please register to receive one or more of the Deloitte 2014 CFO Survey Reports, and be the first to open a “bag” of mixed and interesting views.

Deloitte recognises the daily challenges that CFOs face as they juggle between the roles of themselves and their companies.

Four steps to create an effective centre of excellence

Centre of Excellence

Many companies already rely on an internal group of experts to support their enterprise resource planning (ERP) projects. Whether they call it a COE or not, every company needs to set up an organisation to maintain, care for and improve its ERP project after it goes live.

Companies look at the tremendous size of the investment they’ve just made in an ERP implementation and recognise that there is a need to keep going to get the required value and return from it. A COE should focus on improving business efficiency, continuously enhancing new tools and capabilities to meet evolving business requirements and maintaining the solution on an ongoing basis.

However, a COE should not be confused with a basic IT maintenance organisation. In addition to routine care, the COE should focus on change management and advancing the organisation. ERP projects are very different from traditional IT projects. They bring together a very diverse, multi-disciplined team and usually have very high stakes in improving the business and gaining good, solid ROI.

Click here to download the article

Contact Glen Krynauw at gkrynauw@deloitte.co.za if you have any questions or require a more detailed discussion.

Building the next 20 years of healthcare delivery

20 years of healthcare

This article, titled Building the next 20 years of healthcare delivery on a solid foundation of health system strengthening, is the first in a series of articles which examine the building blocks of a healthcare system that needs to be enabled to implement sustainable healthcare programmes and interventions.

Building the next 20 years of healthcare delivery on a solid foundation of health system strengthening

The demand placed on the South African Healthcare System between 1994 and 2014 has resulted in a series of reforms aimed at addressing South Africa’s healthcare needs. These reforms took place at a time when our HIV and AIDS problem was growing fast and when there was limited access to healthcare, which resulted in the creation or reform of deep capabilities where they were desperately needed, such as Central Medical Stores, National Health Laboratory Services, HIV clinics and district structures.

The unfortunate consequence of this process is the creation of a system of vertical structures that have limited integrated service delivery, which today is a priority for the Ministry of Health. Health system strengthening has been the foundation on which many countries have been tasked to build their healthcare system. It’s not that the framework is misleading or too complicated; the challenge lies in how to make it actionable to drive the service delivery transformation that government/providers seek to realise.

Click here to download the report

It is essential for all leaders to rally around a call to action to adopt the very essence of the National Development Plan, to make it their own and to reform, in camaraderie, the healthcare system for the next 20 years.

Contact Harsha Desai at hardesai@deloitte.co.za should you have any questions.

Five essential truths about cyber security CFOs should understand

Changing the game on cyber risk

CFO Insights – Cyber security: Five essential truths

Cyber risks, it seems, are everywhere. Retailers breached. Intellectual property stolen. Data hacked almost on a daily basis. It’s enough to rattle even the most steadfast of CFOs – and often it does.

Given the costs and the increasingly malicious nature of cyber attacks, CFOs are understandably focused on identifying potential cyber risks and planning their corporate responses.

Given that hackers have likely already infiltrated. Organisations should focus more on the detection side to increase their vigilance against attacks and on recovery after the fact.

A typical cyber-risk budget should break down into about 30 percent on firewalls, 50 percent on detection, and 20 percent on resilience preparation.

To have any chance of winning the cyber wars, however, there are several realities that CFOs should understand.

Click here to download the CFO Insights article, “Cybersecurity: Five essential truths,” to learn more

 

The new International Integrated Reporting Framework

Integrated Reporting Framework

The International Integrated Reporting Framework, published in December 2013, sets the new reporting standard across the globe, and assigns very clear and public responsibility to the Board. The attached guide assists Audit Committee and Board members in their review of the Integrated Report.

Click here to access the full report

The new International Integrated Reporting Framework – A review guide for Audit Committee members

In December 2013 the International Integrated Reporting Council published the International Integrated Reporting Framework (“the framework”). This framework has since been adopted in South Africa and sets the new reporting standard across the world.

It is important for Audit Committees to note that the framework assigns very clear and public responsibility to the Board as explained under the first section below. The overriding question remains whether the Integrated Report explains how the organisation has in the past and plans to create and sustain value into the short, medium and longer term.

The framework includes guiding principles and content elements, all of which needs to be appropriately addressed in order for the organisation to call its report an Integrated Report. This guide has been prepared to assist Board and Audit Committee members in their review of the Integrated Report and is drafted in a question and answer manner to allow for ease of reference.

If you have any questions or require a more detailed discussion on the content of the report, please contact Nina le Riche at nleriche@deloitte.co.za

Executives recognise that “social business” offers promise of progress

social - business

Global companies are maturing in their use of social engagement tools. They are going beyond seeing social as “media” they can use to broadcast marketing messages and, in a very important business trend, weaving social tools and interactions more into their everyday, global operations.

In line with this shift, business executives’ assessment of the value of social is changing rapidly. In a 2011 survey by Deloitte and MIT Sloan Management Review (of 2,500-plus managers across 99 countries and 25 industries), only 18 percent of responding executives said they considered social “important today.”

When the study was repeated in 2012, that figure doubled to 36 percent. And most of the rest saw social capabilities quickly becoming more vital: More than half of the 2012 respondents said that social would be “important within the next year.”

The finding was supported by Deloitte’s 2013 Globalisation Survey, a separate polling of 423 global executives. It found that 61 percent of these executives expect social media to become much more or somewhat more important to their company over the next three years.

To succeed in the years ahead, businesses will likely need the right balance of global reach and a local footprint. They will require a sharp awareness of problems when they arise and the flexibility to quickly reconfigure operations in response.

Leading companies will innovate by collaborating with others. An increasing number of executives now recognise that “social business” offers a promise of progress across all of these dimensions. As corporate ambitions grow, so will the use of social tools. They can allow organisations to “be global” while removing many of the hurdles associated with “going global.”

Read more . . . . Social business, global business 

If you have any questions or require a more detailed discussion on content presented in this article, feel free to contact Rob Latham at Deloitte Digital at rlatham@deloitte.co.za

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