District Health Services - HIV and AIDS/STI/TB
OFFICE OF THE DIRECTOR FOR HIV AND AIDS/STI/TB
The aim of HIV and AIDS/STI/TB Services is to develop, implement and monitor District Health Services in the Eastern Cape that comprise of primary health care and level one hospital services. Primary health services are rendered through 47 district hospitals and 18 provincially-aided hospitals. One hospital is managed by a private company and there are 751 clinics excluding the 256 municipal clinics and 32 community health centers. The strengthening of the provincial health system is important for the integration and delivery of a comprehensive HIV and AIDS programme that is responsive to the needs of the population. It is essential that the HIV and AIDS strategy addresses the structure of the health system, to ensure that the provision of critical services is addressed. The current range of prevention strategies include voluntary counseling and HIV testing, prevention of mother-to-child-transmission, post-exposure prophylaxis, syndromic management of STI’s, TB management, provision of barrier methods, life skills programmes and an information, education and communication campaign that is in line with the prevention strategy. Some of these strategies are critical entry points for treatment and care interventions. Miss C. Nogoduka, Tel: +27 (0) 40 609 3937 Fax: +27 (0) 40 609 3660 Cell: +27 (0) 83 378 0461 E-mail: coceka.nogoduka@impilo.ecprov.gov.za
VOLUNTARY COUNSELLING AND TESTING (VCT) Voluntary HIV Counseling and Testing is a key component of the National HIV and AIDS strategy. It aims to promote awareness and understanding of the risk and spread of the HIV infection, provide access to the continuum of care, treatment and support, reduce stigma and discrimination through knowledge and mutual support and empowers people to adopt preventive behaviours. The goal of this programme is to provide access to voluntary counseling and testing through a public health-non-governmental sector partnership to an adult population between the ages of 15 – 49, focusing on rural communities and facilitating behaviour change and HIV prevention. Voluntary counseling and testing is available at 893 facilities in the province that includes 93 hospitals, 32 community health centers, 722 clinics (98%), 160 mobile clinics and 46 non-governmental organizations. During the first quarter, 59 539 people received pre-test counseling, 42 253 agreed to be tested and 11 830 tested positive.
Mrs Liziwe Lunyawo
Tel: +27 (0) 40 609 4253
Cell: +27 (0) 833780397
PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV AND AIDS
The goal of the programme is to provide management of HIV positive pregnant women and prevent the transmission of HIV from mothers to children during pregnancy, child birth and breast feeding. The effectiveness of the programme depends on the women’s HIV status being known. Pregnant women who are HIV positive require special and unique management challenges. These include expanded Voluntary Counseling and Testing services, HIV testing for pregnant women, provision of single dose nevirapine to the mother during labour and the infant within 72 hours of life, monitoring and where necessary, provision of highly active anti-retroviral therapy, counseling regarding infant feeding and strengthening of antenatal, during labour and post-delivery care programmes.
These services are offered at 722 clinics and 92 hospitals. During the first quarter, 35 776 first visits of anti-natal clients were recorded, 23 281 underwent tests and 4 936 tested positive. The number of babies tested at 12 months were 1 136, and 247 babies tested positive.
Mrs Nomfumaneko Siwundla,
Cell: 0833780441
POST EXPOTURE PROPHYLAXIS
Post Exposure Prophylaxis/sexual assault care is the comprehensive management of sexual assault clients by helping them to deal with the immediate and long-term effects of the trauma encountered. It consists of early intervention, care, treatment and support of the sexual assault victim and his/her family. The victim is offered trauma counseling, pre and post HIV counseling and referred to appropriate additional management services.
Post Exposure Prophylaxis/sexual assault care is available at all public hospitals (100%) in the province and ten Rape Crisis Centers provide Post Exposure Prophylaxis services for sexual assault clients. During the first quarter 357 rape cases were reported and clients were offered Post Exposure Prophylaxis services.
ACCELERATED PREVENTION STRATEGY
Nationally the year 2006 was declared as the year for Accelerated Prevention Strategies and all nine provinces were required to produce action plans. In support of the youth programme, the department launched the Voluntary HIV Counseling and Testing Week from 10 to 16 June. This will become an annual event on the health calendar where all sectors will be expected to engage in the promotion of HIV testing activities. Five clinics throughout the province volunteered to pilot routine counseling and testing in support of the Accelerated Prevention Strategies.
The following districts developed district specific plans:
- Amatole District: The Mbhashe local service area organized information days with community members.
- Cacadu District: Engaged in a door to door campaign that promoted the HIV and AIDS prevention strategy.
- Nelson Mandela Metro: Trained health care providers on the early testing of babies as well as baby follow-up visits.
- OR Tambo: Trained community health care workers and community stakeholder’s i.e. traditional leader’s wives on follow-up visits for babies. Questionnaires on the prevention programme were distributed to community members.
- Chris Hani District: Engaged in a door-to-door campaign and Imbizos for information sharing. Involved Love Life and Youth participation.
- Ukhahlamba District: Held campaigns at clinic level to reach target communities.
- Alfred Nzo District: Engaged in a door to door campaign, held meetings with ward councilors and held interdepartmental meetings to strengthen the programme.
An increase in female service points were reported which resulted in all primary health care facilities offering female condoms. Traditional leader’s wives in ten tribal authorities have been trained in HIV and AIDS/STI prevention strategies.
Ms N. Nelani
Cell: +27 (0) 833780422
ANTI-RETROVITRAL TREATMENT INTERVENTIONS
The strategic goal is to provide comprehensive care, treatment and support to people affected by HIV and AIDS, by strengthening the health care system. The programme is planned and implemented within the framework of the primary health care approach, the district health system, its referral structures and support services.
The strategic goal is to provide comprehensive care, treatment and support to people affected by HIV and AIDS, by strengthening the health care system. The programme is planned and implemented within the framework of the primary health care approach, the district health system, its referral structures and support services.
Since the launch of the comprehensive HIV and AIDS plan on 14 May 2004, the Chief Directorate: HIV and AIDS/STI/TB Services of the Eastern Cape Department of Health accredited and implementing the Anti-Retro Viral Therapy Roll-out Programme to 32 hospitals, 4 community health centers and 253 clinics in the Eastern Cape.
In the 2005/2006 financial year, the Province planned to have 15 165 patients on ARV therapy but acceded the target by 642. During this time 10 000 adult female, 4 000 adult male, 641 paediatric female and 665 paediatric male clients received treatment, amounting to a total of 15 807 clients.
The Eastern Cape Regional Training Center together with their partners has been instrumental in training health care providers to increase the capacity within the health care system to provide treatment and monitor progress. Despite the shortage of doctors and pharmacists, the average weekly uptake of clients increased from 70 to 400 making it feasible to achieve the target of 15 000 clients as anticipated.
Since the start of the 2006/2007 financial year the St Barnabas Hospital, Andries Vosloo Hospital, Empilweni Hospital and four Community Health Centers have been accredited and referral systems have been streamlined to refer clients to facilities that include rural hospitals and clinics that are closer to where the clients stay. During the period March to June 2006, 18 726 adult males and females and 1 568 paediatric males and females started with ARV therapy, increasing the total number of clients to 20 294. Since the programme started, 20 294 clients started treatment and the Department’s target is 27 000 clients by the end of March 2007.
The Department has also increased the number of community care workers in the clinics from five to seven to improve TB treatment adherence. This increased the number of care givers from 4 835 to 6 335 throughout the province.
The plan is comprehensive. In addition to the provision of Anti Retroviral Therapy there are other important activities that form part of the plan. These include:
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Training health officials to provide them with the necessary skills and knowledge. The Regional Training Centre in the Walter Sisulu University was established for this purpose.
- Improving the infrastructure of health facilities. HIV and AIDS counseling requires additional privacy. Institutions or facilities where space is limited, receives funding to do minor renovations in order to provide the necessary space.
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Employment of health professionals. Additional health and administration officials have been appointed and include pharmacists, doctors, nurses, dieticians, social workers, administration clerks and data capturers.
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Provision of nutritional supplements. These are available at all health facilities where patients are being prepared to access Anti Retroviral Therapy and at institutions where medicines are provided.
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Medical and Laboratory Supplies. To ensure the regular availability of medicines and laboratory supplies.
Clinical Support Services
The programme has strengthened the Laboratory Services in the Province. Three laboratories, in Mthatha, Port Elizabeth and St Elizabeth provide CD4 cell count testing. The laboratory in Mthatha also provides viral load testing and Polymerase Chain Reaction testing for diagnosing children with HIV. The turn-around times for all other tests have greatly improved as clinics receive their results within two to seven day.
Mrs Shiela Hokwana,
Cell: 0833780390
INTERGRATED NUTRITION PROGRAMME
Sixty four percent of the population in the Eastern Cape reside in rural areas where poverty and high unemployment result in malnutrition, stunting and wasting of children. The Integrated Nutrition Programme is equipped to address these challenges through the direct intervention of the health department and collectively, through the social needs cluster and the departments of Agriculture and Education.
These interventions contribute to food production and the undisputed role good nutrition plays in ensuring a healthier population. An adequate substantial diet increases the effectiveness of medication that treats conditions such as HIV and AIDS, and TB.
At the beginning of 2005 the department engaged an NGO who assisted in facilitating the creation of clinic gardens for vegetable production, resulting in 62 clinic gardens being created in the O.R. Tambo area. In addition, the department funded the establishment of 25 demonstration clinic vegetable gardens, one in every local service area throughout the Eastern Cape. These demonstration gardens rekindled the interest in food production and at the same time made the produce available to vulnerable members of the community. With the support of the Department of Agriculture an additional two clinic gardens were funded in this financial year, at a cost of R37 000.00 per garden. Currently the department is busy reviewing a proposal to commence with six hospital gardens at Nessie Knight, Sipetu, Holy Cross, St Barnabas and All Saints.
Mrs Nomawonga Kama
Tel: +27 (0) 40 609 4243
Cell: +27 (0) 833781119
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