Assessing and improving care for patients with TB/HIV/STIs in a rural district in KwaZulu-Natal South Africa

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dc.contributor.authorLoveday, Marion
dc.contributor.authorScott, Vera
dc.contributor.authorMcLaughlin, Jennifer
dc.contributor.authorAmien, Feroza
dc.contributor.authorVirgina, Zweigenthal
dc.date.accessioned2014-02-25T20:28:49Z
dc.date.available2014-02-25T20:28:49Z
dc.date.issued2011
dc.description.abstractSetting: Despite the prioritisation of TB, HIV and STI programmes in South Africa, service targets are not achieved, have had little effect, and the magnitude of the epidemics continues to escalate. Objective. To report on a participatory quality improvement intervention designed to evaluate these priority programmes in primary health care (PHC) clinics in a rural district in KwaZulu-Natal. Methods: A participatory quality improvement intervention with district health managers, PHC supervisors and researchers was used to modify a TB/HIV/STI audit tool for use in a rural area, conduct a district-wide clinic audit, assess performance, set targets and develop plans to address the problems identified. Results: We highlight weaknesses in training and support of staff at PHC clinics, pharmaceutical and laboratory failures, and inadequate monitoring of patients as contributing to poor TB, HIV and STI service implementation. In the 25 facilities audited, 71% of the clinical staff had received no training in TB diagnosis and management, and 46% of the facilities were visited monthly by a PHC supervisor. Eighty per cent of the facilities experienced non-availability of essential drugs and supplies; polymerase chain reaction (PCR) results were not documented for 54% of specimens assessed, and the mean length of time between eligibility for ART and starting treatment was 47 days. Conclusion: Through a participatory approach, a TB/HIV/STI audit tool was successfully adapted and implemented in a rural district. It yielded information enabling managers to identify obstacles to TB, HIV and STI service implementation and develop plans to address these. The audit can be used by the district to monitor priority services at a primary level.en_US
dc.description.accreditationDepartment of HE and Training approved listen_US
dc.identifier.citationLoveday, M. et al. (2011). Assessing and improving care for patients with TB/HIV/STIs in a rural district in KwaZulu-Natal South Africa. South African Medical Journal, 101(12): 887-890en_US
dc.identifier.issn0256-9574
dc.identifier.urihttp://hdl.handle.net/10566/1040
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherHealth and Medical Publishing Group (HMPG)en_US
dc.rightsCopyright © 2011 Loveday et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.status.ispeerreviewedtrue
dc.subjectRuralen_US
dc.subjectHIV/TB/STI integrationen_US
dc.subjectAccessen_US
dc.titleAssessing and improving care for patients with TB/HIV/STIs in a rural district in KwaZulu-Natal South Africaen_US
dc.typeArticleen_US

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Research Articles (School of Public Health)
Dr. Vera Scott (School of Public Health)