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Sep 07
Integrated Action Review brings hope for reaching UNAIDS 95-95-95 targets in Zululand

By: Lunga Memela (HST Communications Engagement Lead)

Makhosazana Khoza, HST's District Co-ordinator for the SA SURE PRO Project in Zululand

Meet the Health Systems Trust's (HST) Zululand District Co-ordinator, Makhosazana (Makhosi) Khoza – a fervent and compassionate game-changer for health service delivery in partnership with her local Department of Health (DoH) within the province of KwaZulu-Natal (KZN). She is employed under HST's South Africa Sustainable Response to HIV/AIDS (SA SURE PRO) Project, which is funded by the Centers for Disease Control and Prevention (CDC) through the United States President's Emergency Plan for AIDS Relief (PEPFAR).

Makhosi co-ordinated a successful three-day Integrated Action Review (IAR) in August, attended by a full house of HST and DoH colleagues from Zululand: District Management Team members, District and Sub-district Programme Co-ordinators, Data Management Team members, and Area Co-ordinators.

Facilitated by a joint HST and DoH team, with specialist facilitation on Wellness for Effective Leadership (WEL) by Sarah Davids, the group convened away from their place of work and home district in order to give full focus to the purpose of the event ‒ finding effective solutions for improving programme performance. 

The programme for this workshop was designed as a follow-up to the Provincial IAR held in June 2022, where a broad strategy for KZN and a related workplan for implementation had been set out. The aim of the August workshop was to customise and operationalise the strategy and workplan for the Zululand context, based on programme data and evidence of impact. The gathering was an opportunity for the district team to formulate ways of achieving the UNAIDS 95-95-95 targets for HIV epidemic control – requiring all present to collectively review the gaps to target across key indicators, identify root causes and quality improvement plans, and devise innovative ways of recording and reporting data. 

UNAIDS has stated that despite impressive advances in the HIV response, the gap between achievements to date and the goal of ending the AIDS epidemic as a public health threat by the year 2030 remains much too wide. Countries must actively fast-track their efforts towards ensuring that 95% of the HIV-positive population are on treatment; reducing new HIV infections to 200 000 or fewer; and upholding zero discrimination towards people living with HIV.   

South Africa remains the epicentre for HIV infections globally, with KwaZulu-Natal still recording the highest number of new infections across all nine provinces. Holding the Zululand-focused IAR was intentional, as it is the HST-supported district that has come closest to achieving the 95-95-95 targets, and an action plan with buy-in from all stakeholders will accelerate this achievement.

Group sessions mapping a way forward for Zululand at the IAR.

The workshop sessions focused on the capacitation of leadership in Zululand's Health District, including CEOs and District Managers, who are the custodians of HIV and TB programme roll-out and are responsible for its success. Their grasping of project focus and purpose makes it easier for implementation to take place within facilities and in local communities.

The participants were introduced to the re-engineered functioning of the Nerve Centres – a system that integrates data collection, processing, reporting, and use of the information necessary for improving health service planning through evidence-based programme management.

Working towards this common purpose (pictured above) are Makhosi; Nandi Khambule (Pharmaceutical Services Manager); and Hlengiwe Myeza (Zululand DoH District Clinical Specialist, Advanced Midwife, and Acting Deputy Director of Clinical and Programmes).

They were excited by the IAR, because it enabled alignment and synthesis of information for all the interventions required in the district. They stressed the importance of clean and accurate reporting to show evidence of the work that they do, because "Zululand currently sits at a fairly impressive 92-86-89 against the UNAIDS 90-90-90 targets," they said.

Reviewing performance in order to integrate action entails streamlining of services, promoting service synergies with other District Implementing Partners, demonstrating good practice to enhance benchmarking and capacity-building, and deploying the most effective tools for optimal use of data in programme design and monitoring.

The sessions were facilitated by renowned Wellness Coach, Sarah Davids, and HST's Provincial Technical Assistance Lead, Sibongile Shezi, pictured above next to Makhosi.


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