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Department: Health2.2 Key challenges Anti-Retroviral Treatment (ART) The ART client start rate, reached 9 002, falling short of the target of 12 708, primarily due to lower HIV test positivity rates and underreporting by hospitals. Similarly, the ART adult remains on rate of 67 per cent and the ART child viral load suppression rate of 54.2 per cent failed to meet their targets, mainly due to high loss to follow-up and data capturing issues. To address these challenges, the programme has proposed a series of interventions, including bolstering district support through technical visits, training, and workshops, as well as conducting monthly reviews. Furthermore, efforts will be made to enhance the tracing of missed appointments and improve patient adherence to treatment. Non-communicable diseases Under non-communicable diseases, mental health treatment rates have underscored the PHC mental disorders treatment rate achieving 0.04 per cent against the target of 0.2 per cent. The department will capacitate health professionals to improve recording and management of mental health services. Immunisation coverage Immunisation coverage for children under 1 year fell short of the target at 67.2 per cent, 21.8 per cent below the goal. Similarly, measles second-dose coverage and vitamin A supplementation for children aged 12-59 months also underperformed, with respective rates of 65.5 per cent and 69.9 per cent, both falling below their targets. These outcomes were largely attributed to severe prematurity, pregnancy-related infections, and congenital abnormalities. The department will encourage WBCOTs to carry vaccine cooler boxes to catch up on missed children and strengthen the administration of Vitamin A administration at a community level by Ward Based Outreach Teams. Medico legal claims In the light of financial sustainability, medico-legal settlements have created historic debt with accruals and payables impacting day-to-day operations, 30-day payment of SMMEs and threatening liquidity of the province. Emergency Medical Services (EMS) Whist for the EMS P1 rural response under 60 minutes was not achieved with 61.3 per cent as against the planned target of 65 per cent due to the terrain of the roads, network challenges and chronic shortages of ambulances due to mechanical problems and trained personnel. 3 OUTLOOK FOR THE COMING FINANCIAL YEAR (2025/26) Digitalisation and E-Health Digitalisation of the systems and e-health interventions remains an area of focus as these put people at the centre to address the needs of those who need healthcare. The aim is also to enhance integration of patient registration, enhance billing and revenue management. Infrastructure Health Facilities Management, 15 projects will be ready to be advertised in 2025/26 for the provision of new healthcare facilities, upgrading and revitalisation and maintenance of existing facilities. In pursuit of ensuring that health facilities are in a habitable state, a total of 42 capital infrastructure projects are planned to be completed in 2025/26 financial year. The planned capital infrastructure projects include completion of SS Gida Hospital - renovations & refurbishments in Amathole, Taylor Bequest hospital: new 30 bed isolation facility and Steynsburg hospital: completion contract refurbishment and maintenance in Joe Gqabi. 172