Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

The declaration of TB as a national emergency and the launching of the National TB Control Programme demonstrate a commitment at the highest levels to controlling the TB epidemic in South Africa. However, in many areas of South Africa, this commitment has yet to be translated into measurable improvements in the standard of TB services. Areas such as the Lower Orange region in the Northern Cape still report a high incidence of TB together with low cure rates and high rates of treatment interruption.

This situation can in part be attributed to an ineffective TB control programme which has operated in the area in the past. Whilst well-resourced in terms of access to drugs and laboratory and other services, the programme has been poorly managed with no clear plans for implementation or monitoring of outcomes. The incidence of TB in the region is reported to be as high as 1 000 cases per 100 000 people. Unless an effective control programme is implemented the situation can be expected to deteriorate further - particularly in the face of the rising incidence of HIV infection and multi-drug resistant TB.

The implementation of the District Health System has provided the opportunity to address the problem in a coherent and co-ordinated way. The Northern Cape Province has made significant progress in implementing the DHS and each of its districts now functions as an organisational unit with a well-established management team and clear lines of accountability.

For the past eighteen months, the Initiative for Sub-district Support has been working with the district management team in the Lower Orange District in an effort to improve TB control. Once TB had been identified as a major health problem, a situation analysis was undertaken looking at the incidence and distribution of the disease in the district and the organisation and management of TB services. Emphasis was placed on identifying obstacles to the provision of a high quality service. A TB Task Team was established with the brief of developing, implementing and monitoring a plan for control of TB in the district.