Systems Strengthening for better HIV/TB Patient Outcomes
Funding Cycle: October 2012 to September 2017
This programme aims at ensuring universal access to comprehensive, integrated, family-centred quality HIV/AIDS and TB clinical services by providing technical assistance, modified facility and community Direct Service Delivery (DSD) as well as capacity building of Health Care Workers (HCWs) in the supported health facilities. The South African Government (SAG) is supported to strengthen health systems, thereby improving patient outcomes through comprehensive clinical services in KwaZulu-Natal (KZN) and Western Cape Provinces.
Kheth’Impilo supported DOH with activities focused on building health systems related to the Prevention, Care and Treatment of HIV/AIDS and TB.
The strategies utilized continue to be, but not limited to, the strengthening of:
- Monitoring Evaluation and Reporting (MER) systems,
- Pharmaceutical Services,
- Care and Treatment Services,
- Leadership and Governance, and
- Human Resource Development.
Support and services were provided in the districts of Amajuba, ILembe and City of Cape Town Metro, as well as in the Umsunduzi sub-district in Umgungundlovu district. 165 health facilities were supported, 70 in the Cape Metro, 28 in Amajuba, 39 in ILembe and 28 in Umsunduzi.
Kheth’Impilo supported DOH to provide a comprehensive package of PMTCT services and adult and paediatric HIV/AIDS and TB care and support services. 687 477 people were counselled and tested for HIV and received their results, achieving 164% HCT of the annual target. A total of 83 080 pregnant women were offered PMTCT services, representing an achievement of 102% of our annual target. Of these, 77 878 (94 percent) were tested for HIV, and 69% (18 948 of the 27 434) of ANC clients in need of ART were initiated on ART.
A total of 18 395 babies born to HIV positive women were provided with Early Infant Diagnosis (EID) and of these 198 (1.08%) tested positive at 6 weeks.
52 557 eligible adults and children were newly enrolled on antiretroviral therapy (ART) in this period, representing an achievement of 608% of our annual target. 242 571 adults and children were retained on treatment in our supported facilities at the end of the period. As a reflection of the quality of our programme, we achieved 74% (24 182 out of 32 557) adults and children staying alive and on treatment 12 months after being initiated onto antiretroviral therapy. 77 865 individuals had viral load test done against a target of 142 415 (achieving 55% of the target) while 69 219 of these had undetectable viral load representing a viral load suppression rate of 89%. 436 adherence clubs were set up during the year with a total of 10 671 patients in the clubs.
To ensure equitable access to safe, efficacious and quality-assured essential medicines that are appropriately used by providers and consumers, technical assistance was provided to improve stock management at facility level, compliance to good procurement, storage and issuing practices, and appropriate management of medication and medicine rooms. Kheth’Impilo pharmacists supported health care workers in DOH facilities to comply with Good Pharmacy Practice (GPP), thereby improving the availability of essential medication and reducing stock losses, and initiating interventions to improve compliance; we recorded 84% compliance to GPP across KI-supported health facilities.
Training on HIV and TB as well as adherence support was provided to 1 019 health care providers consisting of 69 doctors, 548 nurses, 40 pharmacists and 362 other health care workers (HCWs) in the supported districts. 363 HCPs were mentored (72 doctors, 256 nurses, 25 pharmacists, 4 medical students, 5 clinical associates and 1 other and 421 health care professionals (HCPs) were reached through Continuous Medical Education (CME).
Technical assistance to improve the availability, quality and use of health information was provided and 103 of 118 eligible sites signed onto Tier.Net, translating to 87% Tier.Net penetration.
Dr Oyebola Oyebanji
Dr Oyebola Oyebanji