By: Lunga Memela (Communications Engagement Lead)
More and more men in KwaZulu-Natal's KwaNongoma Sub-district are being encouraged to play a responsible role in their own journey of health by attending Phila Ndoda, a men-friendly clinic designed to address men's health issues, with the main focus being on HIV, TB, sexually transmitted infections (STIs) and non-communicable diseases (NCDs).
Phila Ndoda is an isiZulu term which, in itself, prompts men to take heed of their health, thereby fostering healthier communities through men protecting themselves and their loved ones from infectious diseases and other health conditions. The Phila Ndoda programme is a Department of Health (DoH) initiative that is strongly supported by the Health Systems Trust's SA SURE Plus Project for roll-out.
HST's Communications Team spoke to Siyabonga Gwala, the project's Area Co-ordinator supporting Nongoma sub-district, who explained: "HST and the Queen Nolonolo Clinic Operational Manager have run this initiative jointly since July 2019, leveraging both HST and DoH resources."
"Phila Ndoda makes healthcare services more easily accessible and appealing for men and boys, always with the assurance of strict confidentiality," says Gwala. "The aims are to increase uptake of HIV testing services (HTS) among men; improve index contact testing; fast-track antiretroviral therapy (ART) initiation for HIV-positive men; decrease treatment interruption and loss to follow-up among men on ART through implementing a case management modality until enrolment in differentiated models of care; and to improve companionship with women who are HIV-positive and pregnant, in order to reduce mother-to-child transmission of HIV."
Phila Ndoda is offered not only at the clinic but also at the KwaNongoma taxi-rank, fully run by male staff members including a Professional Nurse, a Community Mobiliser, and a Data Capturer at the facility. Services are extended to the nearby Mthashana TVET College to engage with youth for health screening, and the programme is also linked to MINA Campaign activities in its entirety.
HST's mobile units can be seen roaming the community, posters and flyers containing positive health messaging in isiZulu are widely distributed, and welcoming calls are heard through loud-hailers – all in the spirit of providing TB and HIV care and treatment (prevention, testing, treatment initiation, adherence support and return to care) in line with the SA SURE Project's core mandate.
Social media, WhatsApp and SMS messages are used to discreetly provide appointment and medicine collection reminders, health information, linkage to services, and treatment adherence tips.
"Men feel more comfortable when their health-seeking needs are properly understood and accommodated," says Gwala, "so having a Men's Corner in every health facility would be very valuable. When men feel free to verbalise their concerns to other men without fear of being judged, it is easier for them to sustain treatment adherence, achieve viral suppression, and adopt prevention measures as part of a healthier lifestyle. Phila Ndoda provides services for minor ailments, TB and NCD screening, and promotion of ART initiation and collection, while shortening service waiting times for men."
According to Gwala, Phila Ndoda uptake has many benefits. The initiative has seen more uptake of voluntary medical male circumcision and an increase in condom distribution, and also facilitates screening for men's health issues such as prostate cancer. "We are finding that more men are presenting themselves for health services sooner rather than later, and fewer male patients are missing their clinic appointments," he says.
The Phila Ndoda programme helps to strengthen treatment adherence by decentralising services to meet male clients where they are – whether within the workplace or at sports, educational and recreation sites – offering same-day ART initiation, drug dispensing, minimising the travel and waiting times for clinic visits, emphasising the benefits of treatment for partners and families, and enrolling clinical stable patients in differentiated care options.
"Early in the morning, Phila Ndoda staff members fast-track all male clients within the main clinic so that they can be attended to in the facility's Men's Corner", notes Gwala, "but timing the provision of our mobile and other community-based services beyond standard working hours enables us to reach as many men as possible."