Immunodeficiency

Annual Report 2002/3

Series Name: 
HST Annual Report
Published by: 
Health Systems Trust

This Annual Report presents a few highlights of HSTs work in 2002/2003, including the National HIV/AIDS Scientific Forum organised jointly by HST and the National Department of Health in August 2002 the national Public Health 2003 Conference hosted by HST and PHASA in March 2003, and the launch of the 2002 South African Health Review in March 2003.

Providing Antiretroviral Treatment in Southern Africa - A Literature Review

Published by: 
Health Systems Trust

This report outlines experience with ART in a number of sub-Saharan countries. ART is provided through a number of different avenues, which include the public sector, the non-profit sector, the corporate sector and the private sector. ART programmes may involve collaboration between two or more sectors with such partnerships being encouraged in recognition that the magnitude of the task may exceed the capacity of any one sector. Particular attention is paid to Botswana, the first sub-Saharan country to provide ART on a wide-scale through the public sector.

An Evaluation of the Quality of Counselling Provided to Mothers in Three PMTCT Pilot Sites in South Africa

Published by: 
Health Systems Trust

The aim of this study was to assess the quality of counselling provided to mothers through the programme to prevent mother-to-child transmission (PMTCT) of HIV in South Africa. This was a cross-sectional descriptive study and data collection methods included structured observations of consultations and exit interviews with sixty mothers attending clinics in three purposively selected PMTCT sites across South Africa. One feedback workshop was held in each site with key role players to discuss the findings and to enhance interpretation and understanding.

Governmental Relationships and HIV/AIDs Service Delivery

Published by: 
Health Systems Trust
This research project examined inter-governmental relations in the health sector in South Africa. It focused on HIV/AIDS services but the intention was to use HIV/AIDS as a tracer or probe of broader health system functioning. The main objectives of the research were to describe what HIV/AIDS services are provided, how the different functions are allocated between government actors, and how they are then coordinated. The study was conducted in two parts. Phase 1 was completed in the second half of 2002 and provided a broad National Overview of HIV/AIDS activities in the national, provincial and local spheres of government. Phase 2 was done in early 2003 and consisted of detailed Case Studies from three different tracer municipalities. The research methodology was mainly qualitative and exploratory and included literature review, document analysis and key informant interviews. An output of the Local Government and Health Consortium, funded by Health Systems Trust and comprising Health Systems Trust, Centre for Health Policy and Health Economics Unit

Case Study Reports on Implementation and Expansion of the PMTCT Programme in the Nine Provinces of South Africa

Published by: 
Health Systems Trust

Implementation of a pilot programme for the prevention of mother to child transmission (PMTCT) of HIV commenced in early 2001 in South Africa following a National government decision in late 2000. A total of 18 pilot sites, two in each of the 9 Provinces, were selected using broad criteria including high HIV prevalence, representation of urban and rural health services, and primary and secondary level facilities. These served as research and learning sites to assess the feasibility of implementing this programme more widely.

An Evaluation of PMTCT and Infant Feeding Training in Seven Provinces of South Africa

Published by: 
Health Systems Trust
Capacity building for PMTCT and Infant Feeding in South Africa began in April 2001, soon after the start of the Pilot PMTCT Programme. A consultant was seconded from UNICEF to facilitate training of front-line health providers in the provinces, thereby developing a critical mass of Trainers using the selected training manual to address the key competencies of health providers with regard to PMTCT and IF. As the demand for training increased, and with limited capacity in most provinces to manage the process, a tender was issued by the National DOH and the CDC to support training efforts. A Consortium was awarded the tender in July 2002. The Consortium consists of the Health Systems Trust, Womens Health Project and the School of Public Health at the University of Western Cape. These organisations were appointed to co-ordinate and sustain the demand for training in seven provinces, which included conducting a rapid assessment of the training and a training needs assessment in each of the provinces, assisting provinces in developing a provincial training plan and evaluating the short term impact of the training.

Infant Feeding Practices in KwaZulu-Natal - An exploratory study of current infant feeding practices of mothers with 0-6 month old infants attending PMTCT and non-PMTCT clinics in Central Durban

Published by: 
Health Systems Trust
Introduction: Exclusive breastfeeding for the first six months of an infants life is recommended worldwide. In 1998 the South African Demographic and Health Survey (SADHS) showed that only 10% of mothers exclusively breastfeed at 3 months. As the HIV virus is transmissible via breast milk, UNAIDS (2000) recommends that women in developing countries should be given a choice of feeding method, after counselling on the risks and benefits of breast feeding versus formula feeding. As a result, the Prevention of Mother-to-Child Transmission (PMTCT) programme was launched in KwaZulu-Natal with the aim of providing interventions to prevent mother to - child transmission of the HIV virus. However, research has shown that infant feeding practices are influenced by numerous factors. Ultimately mothers will feed their infants in a manner they feel comfortable with, even if it is not always the most appropriate choice. Aim: The aim of this study was to determine and compare the current infant feeding practices and some of the factors that influence these practices of Zulu mothers with 0 - 6 month old infants attending PMTCT and non - PMTCT clinics in Central Durban, KwaZulu-Natal.

Sexually Transmitted Infections - An Overview of Issues on STI Management and Control in South Africa

Published by: 
Health Systems Trust
Control of Sexually Transmitted Infections (STI) is a key intervention in the fight against HIV/AIDS and is one of the key areas of focus for the national strategic plan. This booklet provides an overview of broad issues related to the management of STI in South Africa. It reviews both the public and private sector issues describing the key health system problems and strategies being taken to address them by different stakeholders.

HITTING HOME - How households cope with the impact of the HIV/AIDS epidemic: A survey of households affected by HIV/AIDS in South Africa

Published by: 
Health Systems Trust
This report summarizes the results of a survey of 771 AIDS-affected households in different parts of South Africa. The households were randomly selected from the client lists of non-governmental organizations providing support to AIDS-affected households in the regions where the survey was conducted. The survey and this report are an attempt to document the impact of HIV/AIDS on South African households. Although it is not representative of all AIDS-households in South Africa, the report provides a snapshot of the devastating impact of HIV/AIDS on already poor families. As bleak as the findings of this survey are, the households in this survey are likely better off than most since all households in the survey had contact with non-government organizations providing support to HIV-affected households.