An Assessment of Current Support Strategies for Patients with TB in KwaZulu-Natal

Poverty has long been recognized as one of the factors predisposing people to TB (Lancet 2005) and, in South Africa, many patients with TB live in poor conditions. In order to ameliorate these conditions, a few initiatives to support patients with TB have been made in KwaZulu-Natal. To date, support for TB patients has been provided in the form of free treatment at government hospitals and clinics (Department of Health 2001), and nutritional supplementation and social grants (Department of Social Development 2006)1. In the past, nutritional supplementation was given to patients at primary care clinics, in the form of powdered food supplements or food parcels. This programme has recently been reinstated in the province2 and is complemented in certain clinics by involving patients in gardening projects. The social (disability) grant is given, in conjunction with the Department of Social Development, to patients who are certified by a doctor to be incapacitated by TB.

Although these programmes have been functioning for a number of years, they have never been formally assessed in terms of the costs involved, the effects on the target populations, and the responses of patients. A recent study in Brazil investigated a range of support strategies for patients with TB that included material and financial assistance, improved health services support and better administrative organization - from the patient's perspective (Belo et al 2006). Such a study has not been undertaken in South Africa however, given the large amount of money spent on support to TB patients, this is necessary to better inform such programmes.