Anova’s partnership (through the Rivoningo-Lesedi project) with the South African Department of Health in the Bushbuckridge and Thaba Chweu sub-districts has shown how, with the right strategies, health facilities and the services they offer can be strengthened and optimised to their full potential to offer the surrounding communities a comprehensive health service.

Infrastructure upgrades

A significant number of Anova’s support in Mpumalanga has been manifest in the form of upgrades to existing infrastructure. Most recently this has included significant changes to four clinics in Bushbuckridge – namely Mkhuhlu, Marite, Cottondale and Tulamahashe – in order to expand ART programmes in these clinics.

The four newly-renovated clinics now provide ART to 2,186 people and 13,843 people have made use of the clinics’ HIV counselling and testing services.

By renovating existing structures and devising methods to use staff and their expertise optimally, Anova has extended its support in the Bushbuckridge and Thaba Chweu sub-districts to 47 facilities.

Through Anova’s support of the facilities, 17,455 people are receiving antiretroviral treatment (ART) and a staggering 73,393 people were counselled and tested for HIV between October 2010 and September 2011.

As these improvements are highly disruptive to the healthcare service and everyone is anxious for the services to run optimally and smoothly as quickly as possible, Anova’s team in Bushbuckridge have developed a highly efficient approach to renovations. “We have decreased our turnaround time to less than three months,” says Dr. Cephas Chikanda, senior manager for the province.

Voluntary Medical Male Circumcision (VMMC)

Anova renovated and upgraded Mpilo clinic at Mapulaneng hospital in November 2010. The clinic now functions as a VMMC site and is the only facility offering VMMC in BBR. The facility averages approximately 80 clients per week.

Optimising staff

Anova’s upgrade of HIV-related services in parts of Mpumalanga also included increasing staff capacity and expertise.

Working with local government, the Anova team has introduced innovative new management strategies to overcome difficulties in recruiting new staff. This approach has included consulting with staff on the more efficient allocation of tasks and training numerous healthcare professionals in HIV-related care.  

For instance, combining the operations manager and government liaison into one post has freed up another doctor’s time to allow optimal use of clinical skills. Dr. Chikanda explains: “You don’t need a doctor to liaise with government. Administrators in government can meet with clinicians on a needs-basis. This arrangement provides better value for money.”

The Mpumalanga team has also helped to train nurses, lay counsellors and doctors to provide MMC services.
Whilst the capacity of the Anova team is often overstretched, it continues to employ creative problem solving, built on a culture of open communication of needs and concerns.

Roving teams

Another innovation includes the introduction of “roving teams” to Bushbuckridge sub-district clinics. A team is made up of a doctor, nurses, a data capturer and a pharmacist and collectively they are able to provide a comprehensive service to a number of sites. The operations manager assigns the mobile unit according to the needs of the different clinics.

Through roving teams Rivoningo-Lesedi has managed to expand ART services to  36 of the 38 facilities in Bushbuckridge. This translates into acheiving close to 100 percent coverage in the area.

Rivoningo-Lesedi Treatment Sites