Recorded presentation

Andrew A. Fisher, ScD¹, Robert A. Miller, DrPH², Ester Snyman³, Lewis Ndhlovu, PhD⁴, Catherine Searle⁴, and Julie Pulerwitz, ScD⁵. (1) Horizons Program, Population Council, 4301 Connecticut Ave, NW, Suite 280, Washington, DC 20008, (202) 237-9400, afisher@pcdc.org, (2) Senior Associate, International Programs Division, Population Council, 1 Dag Hamarskjold Plaza, New York, NY 10017, (3) Maternal, Child and Women's Health, KwaZulu Natal Department of Health, P Bag X54316, Durban 4000, South Africa, (4) International Programs/Horizons Program, Population Council, P.O. Box 411744, Craighall 2024, Johannesburg, South Africa, (5) Horizons project, PATH, 4301 Connecticut Avenue N.W., Suite 280, Washington DC, DC 20008

Background: In KwaZulu Natal, South Africa the DOH with the Population Council conducted an HIV/AIDS-oriented Situation Analysis assessment in 98 randomly selected health facilities. The data allows examination of readiness of the facilities to deliver HIV/AIDS services, including antiretroviral drugs, and areas requiring strengthening. Methods: Data consists of observations of 418 clients receiving services, 399 exit interviews, 98 inventories, and 229 provider interviews. We assessed the readiness of hospitals, community health centers, and clinics. Among the components examined were whether: facility providers attended a course on PMTCT, HIV/AIDS testing, treatment of OIs; staff currently provide VCT, PMTCT, treatment of OIs, post-exposure prophylaxis, and most importantly treatment of HIV/AIDS with ARVs; the facility provides nevirapine to mothers or infants. Additionally, the study examined the availability of relevant diagnostic tests, educational materials; community based support groups for PLHA, basic equipment, and adequate supervision. Results: Results indicate that higher level facilities are more prepared to deliver HIV services and ARVs. However, substantial capacity exists at all levels to deliver a range of HIV/AIDS services including: counseling and HIV testing, MTCT with Nevirapine, control of opportunistic infections, referral of HIV positive people to community support, and systems in place to assist ARV patients with adherence. We conclude that while it will not be possible for KZN to immediately reach all HIV infected persons with ARV treatment, with the existing infrastructure, a large number of people could be reached now, and even more in the future with relatively modest additional investments.

Learning Objectives: At the end of the presentation, the audience will be able to

• Assess the "readiness" of KwaZulu Natal public sector health clinics in South Africa to to deliver antiretroviral therapy to large numbers of people;
• Identify the most important critical components (equipment, supplies, staff skills) of the health system in KwaZulu Natal that need to be strengthened to provide ARVs widely;
• Understand the Situation Analysis methodology and its importance as a source of data for assessing the potential of health care systems to deliver ARVs in the public sector.

Keywords: Health Care Delivery, Antiretroviral Combination Therapy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: KwaZulu Natal Province Department of Health facilities in South Africa
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation