Immunodeficiency

Changing Obstetric Practices in the Context of HIV: An Evaluation of service provision in the national PMTCT learning sites

Published by: 
Health Systems Trust
This report is based on a rapid assessment of the effects of the introduction of PMTCT on the overall provision of obstetric services, and to evaluate changes in clinical obstetric practice made in response to concerns about transmission of HIV. The study concentrated on labour and delivery practices, and did not evaluate antenatal care. Twenty-one PMTCT facilities in eight provinces were visited. Staff were given a questionnaire and medical records were reviewed. Each facility was evaluated in terms of service patterns. Results highlight issues related to clinical obstetric care, human resources, quality of care and operational aspets of the programme.

The Integration of HIV/AIDS Care and Support into Primary Health Care in Gauteng Province

Published by: 
Health Systems Trust
This study aimed to assess the integration of HIV/AIDS care and support in Gautengs primary health care (PHC) services. With this aim in mind, the research sought to provide answers to three main sets of questions. Firstly, are care and support services for people with HIV/AIDS being provided at PHC clinics, what is the quality of these services, and to what extent are these services being utilised? Secondly, are the inputs (e.g. staff knowledge and attitudes) and support systems (e.g. drug supplies), necessary for good quality, accessible HIV/AIDS care, present in the PHC infrastructure? Thirdly, what if any, systems changes are required to improve the access and quality of PHC services for people living with HIV/AIDS? This research was conducted in collaboration with, and partly funded by, the Gauteng Provincial Department of Health which is in the process of disseminating primary health care clinical guidelines in the Province.

Interim Findings of the National PMTCT Pilot Sites: Summary of Lessons and Recommendations

Published by: 
Health Systems Trust

HIV/AIDS is affecting everyone in South Africa. There are many organisations and individuals working hard to fight the spread of the virus. In 2000 the South African government introduced a programme offering prevention of mother-to-child transmission (PMTCT) services at 18 pilot sites.

The programme is an important part of the country s response to the epidemic. This booklet provides some basic facts about the effects of the medicine, Nevirapine, and formula feeding in a PMTCT programme. It then goes on to summarise the interim findings of an evaluation of the pilot sites.

Rapid appraisal of primary level health care services for HIV-positive children at public sector clinics in South Africa

Published by: 
Health Systems Trust
Several effective health and social interventions are available which have been shown to improve life expectancy and quality of life in HIV-infected children. The Children's Institute (UCT) recently completed a rapid appraisal of primary level health care services to determine the extent to which some of these interventions are available to children. The study highlights the need for improved monitoring and evaluation of the implementation of existing policies and guidelines and for training of primary level health care staff on the appropriate management of HIV in children.

South African Health Review 2001

Series Name: 
South African Health Review
Published by: 
Health Systems Trust

Among significant events that affected the health system during 2001 are the process of decentralisation of health services, greater attention to proper corporate governance especially with regard to financial reporting, and the increasingly profound impact of HIV/AIDS. Decentralisation of health care, the treasured policy goal of health services being managed by the sphere of government closest to the people, is, albeit slowly, becoming a reality to South Africans. The 2001 South African Health Review reflects on this process of transformation, including the necessary enabling legislation and funding of local government for health care delivery at this level. A series of chapters commissioned for this Review, based on qualitative research with managers working in the health system, provide insights to some of the day-to-day pleasures and frustrations in managing the South African health service. Many health sector developments during 2001 were overshadowed, at least in the media, by the contested nature of our response to HIV/AIDS. Understanding that HIV/AIDS is but one of the important priority programmes in a comprehensive health care system, the Review singles out financing of HIV/AIDS and implementation of the national HIV/AIDS and STD strategic plan for comment. Providing an informative and reliable review of progress in the health sector year-by-year is a demanding task. It would indeed be impossible without the assistance provided by numerous health workers who although overburdened by the day-to-day responsibilities of providing quality health care, still managed to pause and reflect on the important questions that the Review sought to answer.

Table of Contents

  1. Health Legislation
  2. The District Health System
  3. Financing Local Government Health Services
  4. Private Sector Financing
  5. Public-Private Partnerships
  6. Using Information for Health
  7. Annual Reports and the Public Finance Management Act
  8. HIV/AIDS Financing
  9. Mainstreaming HIV/AIDS: Progress and challenges
  10. Voices of Service Users

    Voices of Health Policy Makers and Public Health Managers: An Introduction

  11. Voices of Facility Managers
  12. Voices of Hospital Superintendents/Managers
  13. Voices of District Managers
  14. Voices of National and Provincial Managers
  15. Voices of Parliamentarians
  16. Voices of Health Policy Makers and Public Health Managers: Key Themes
  17. Health and Related Indicators

Interim Findings on the national PMTCT Pilot Sites

Published by: 
Health Systems Trust
This report primarily describes the process, progress and extent of service implementation in the 18 pilot PMTCT sites, so as to help improve the effectiveness and efficiency of PMTCT services and inform any planned expansion of the programme. Data and information is based on discussions and interviews with managers, coordinators and clinicians site visits routine statistics document reviews and attendance of national PMTCT steering committee meetings. The report does not provide data on the impact of the programme on HIV transmission or health outcomes, mainly because the programme is still too young for this. However, Section 6 presents and discusses what is currently known about mother-to-child transmission, including the proven efficacy of NVP. It also discusses the effects of different forms of infant feeding on HIV transmission and child health, and raises a number of important policy issues.

Forum for the establishment of appropriate services for management and prevention of STDs in South Africa, Workshop proceedings, 25 - 26 September 1997, Johannesburg

Published by: 
Health Systems Trust
Sub-Saharan Africa is experiencing an HIV/AIDS pandemic, made worse by the fact that the region also has some of the highest levels of sexually transmitted diseases (STDs) in the world. In July 1997, the South African HIV/AIDS & STD Directorate of the National Department of Health conducted a National Review of the AIDS/STD situation in the country. Among the priority areas recommended for action was improved STD control. South Africa has the opportunity to learn from the experiences of other countries in Africa. Therefore the Department of Health in partnership with the Health Systems Trust, the Reproductive Health Research Unit and the Henry J Kaiser Family Foundation, convened a meeting with the purpose of determining strategies to prevent and manage STDs The forum had the active participation of people from provincial and National Departments of Health complemented by the experience of both national and international experts.

Focus on HIV/AIDS and STDs

Series Name: 
HST Update
Published by: 
Health Systems Trust
So often, with the doom and gloom attitude by which HIV and AIDS is portrayed in our newspapers, it is easy for us to feel despondent. Yet there is some good news. There are things we as health workers can do that can make a real difference. Good sex and life skills health promotion is an essential component to promoting healthy behaviour. A multi-centre study undertaken by the World Health Organisation has conclusively shown that such education does not encourage promiscuity. In fact it is seen to delay the onset of first sexual activity. Recent research from KwaZulu-Natal has also shown that most parents are in support of such sex education for their children. This dispels some of the myths that have jeopardised some health promotion initiatives in the past.