Microbiology

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.

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.

National Report on the Assessment of the Public Sector's Voluntary Counselling and Testing Programme

Published by: 
Health Systems Trust
Voluntary counselling and testing (VCT) has an important role to play in this country's response to the HIV epidemic. This role can be evidenced at both the level of primary prevention by preventing the spread of HIV and at the level of secondary prevention of HIV, by the alleviation of distress among people infected and affected by HIV.For effective VCT, there is a need to understand that counselling and testing must be confidential and voluntary. This process must be accompanied by ensuring preparedness for clients to come into terms with their HIV status. This preparedness includes dealing with fear, guilt, stigma, discrimination, care for a chronic and fatal condition, early death, what one can do when infected and what to do to remain uninfected. This assessment of the public sector VCT sites was aimed at informing the National Department about progress made thus far with the implementation of their VCT programme.

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

The Cholera Outbreak: A 2000-2002 case study of the source of the outbreak in the Madlebe Tribal Authority areas, uThungulu Region, KwaZulu-Natal

Published by: 
Health Systems Trust
In August 2000 South Africa was xperiencing one of the worst cholera epidemics in the countrys recent history. Initial reports of the cholera outbreak came from the largely rural and impoverished communities on the outskirts of the Ngwelezane Township, near the Empangeni town. The source of the epidemic was traced to the uMhlathuze River, also in the northern part of the KwaZulu-Natal Province. However by the end of the year 2000, the northern Kwa Zulu-Natal cholera outbreak had replicated itself in eight of South Africas nine provinces.

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.