Africa

Citation

(2005), "Africa", International Journal of Health Care Quality Assurance, Vol. 18 No. 5. https://doi.org/10.1108/ijhcqa.2005.06218eab.003

Africa

Africa

Aids treatment now available in all South African districts

Keywords: Quality standards, Health education, Acquired immune deficiency syndrome, HIV, Africa

The Department of Health has met its target in the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV and Aids for the financial year ending 31 March, 2005.

The Department had a target of establishing at least one service point for Aids related care and treatment in all of the 53 districts in the country before the end of March 2005. In pursuing this goal, the Department initiated an accreditation process aimed at strengthening the health system by evaluating the capacity of health facilities to provide quality health services including effective screening, diagnosis, treatment and monitoring of safety of people living with HIV and Aids. The health facilities that are eligible to provide antiretroviral drugs are certified through this process. This approach was necessary because of the complexity of the programme to administer in particular antiretroviral drugs safely and effectively. The national accreditation team visited various hospitals across the country to establish if they met the requirements for the provision of quality health services.

The facilities that did not meet the requirements were assisted by the Department of Health to develop urgent action plans to address their deficiencies. The facilities were only accredited after the accreditation team conducted follow-up visits to verify if the identified service delivery challenges had been adequately addressed. On 30 March the national accreditation team visited and accredited Kuruman Hospital in Kgalagadi district (Northern Cape), which was the last district without an HIV and Aids service point. Kgalagadi district is one of the 13 most impoverished districts in the country identified as nodal points for the Integrated Sustainable Rural Development Programme. The Minister of Health, Dr Manto Tshabalala-Msimang, said she was delighted that her Department has been able to achieve the goal it set for itself. “Although it has not been easy, the accreditation process has been a valuable process in ensuring that there is an equitable distribution of services across the country right from the beginning of implementation of this programme,’ said Minister Tshabalala-Msimang. The accreditation process also assisted the Department in identifying the challenges in the health system and problems facing health facilities in various settings. Some of the common challenges highlighted by this process are:

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  shortage of critical personnel including doctors, pharmacists and dietitians;

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  lack of appropriate accommodation particularly for confidential consultation;

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  longer turn-around times for laboratory results;

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  lack of adequate and safe storage for medicines and consumables like nutritional supplements; and

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  lack of training in AIDS-related treatment across various health professions.

Significant efforts have been made to address the challenges of implementation and strengthen the overall health system. 250 laboratories have been certified to provide laboratory support to the programme and three pharmacovigilance centres have been established to monitor and investigate adverse reaction to treatment. More than 1,060 health professionals have been recruited to support the programme and more than 7,600 health personnel have been trained on the management, care and treatment of HIV and Aids.

The tender for the supply of antiretroviral drugs was awarded to seven successful pharmaceutical companies earlier this month and all accredited facilities have adequate supply of antiretroviral drugs. The tender for inventory management and tracker system is being evaluated. Patients tested positive for TB and/or HIV are assessed for their nutritional needs and those who qualify are given nutritional supplements and multivitamins. A nationally-agreed form for collecting data is being implemented in all sites. Customization of existing information system to allow for tracking of patients between facilities and provinces is being piloted in KwaZulu-Natal and Mpumalanga. This patient information system should allow for easy access to programme indicators like number of patients, laboratory specimen details and other clinical details of patients. About 370 officials are expected to be trained on monitoring and evaluation to improve collection and flow of quality data.

Minister Tshabalala-Msimang and officials in the Department of Health will be visiting the accredited facilities to establish the quality of service being provided and address the challenges that may be undermining quality service delivery on the ground.

For more information: www.hst.org.za