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Apr 13
NIMART training continues to increase access to antiretrovirals in KZN

By: Lunga Memela (Communications Engagement Lead)

Department of Health, Metro and South African National Defence Force during NIMART training at Clairwood Hospital's Conference Centre in eThekwini.

The Health Systems Training Institute (HSTi) is making significant strides with improving anti-retroviral treatment (ART) access to persons living with HIV through one of the training courses that is offered to health professionals, called Nurse Initiated Management of Anti-retroviral Treatment (NIMART).

In its Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, the World Health Organization (WHO) recommends that all people living with HIV must be provided with ART in order to bring the globe one step closer to achieving universal access to HIV treatment and care, striving to end AIDS as a public health threat.

Twenty years of evidence presented by the Joint United Nations Programme on HIV/AIDS (UNAIDS) demonstrates that HIV treatment is highly effective in reducing the transmission of HIV. UNAIDS confirms that, "People living with HIV on antiretroviral therapy who have an undetectable level of HIV in their blood have a negligible risk of transmitting HIV sexually."

While South Africa still records the highest number of HIV infections globally, access to ART is heavily reliant on as many health professionals as possible to be able to initiate HIV-positive individuals on ART. A district support partner to the Department of Health and the training arm of the Health Systems Trust (HST), HSTi responded to the national challenge of providing ART to clients due to a shortage of medical practitioners in the public health sector by introducing NIMART to professional nurses managing patients with HIV in primary healthcare settings and other public health facilities.

"This course is about the entire spectrum of HIV," explains the Head of HSTi, Dr Susanna Naude. "It includes the epidemiology, prevention, diagnosis and staging of HIV. It deals with the principles of initiation of antiretroviral therapy for children, adolescents, pregnant women, adults and the management of HIV and opportunistic infections. Antiretroviral medicine, indications, contraindications, side-effects and adverse effects as well as reporting, monitoring and evaluation of programmes are addressed."

HST's Advanced Clinical Care Clinician, Dr Ganizani Mlawanda, facilitates teaching and learning at the NIMART training recently held in eThekwini.

The latest NIMART training was received by a cohort of over 40 KZN DoH, Metro and South African National Defence Force professionals at Clairwood Hospital's Conference Centre south of eThekwini and, per national regulations, underpinned by the Consolidated Guidelines for the Management of HIV in Adults, Adolescents, Children and Infants and Prevention of Mother-to-Child Transmission.

The five-day theoretical training is accompanied by a portfolio of evidence emanating from course-based, work-based learning in order for attendees to be certified. After completing the course, participants are able to:

  • Describe the epidemiology of HIV and TB.
  • Explain how to diagnose and stage HIV-infected clients.
  • Outline HIV prevention methods.
  • Discuss medicine management, including the prescription of ART, for HIV infected children, adolescents and adults, and pregnant women adhering to national treatment guidelines.
  • Explain how to detect and manage TB, including drug-resistant TB cases, adhering to national treatment guidelines.
  • Identify and manage opportunistic infection and refer patients appropriately for more specialised care
  • Explain how to identify and manage HIV patients' eligibility for prophylaxis for opportunistic infections, including TB Preventative Therapy (IPT).
  • Explain how to detect and manage adverse reactions associated with Anti-retroviral and TB treatment.
  • Describe the recording and reporting systems utilised in HIV and TB management.

Individuals interested in the course and other courses upskilling health professionals can get in touch with HST's eThekwini District Training Co-ordinator, Kubashini Nair or HSTi's Course Co-ordinator Cassius Semaushu on 


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