In 2014 Tirisanong continued its core activities within the arena of prevention of mother-to-child transmission (PMTCT) of HIV. Most recently, the programme assisted government in implementing government’s MomConnect National Pregnancy Registry through training staff in 51 Gauteng-based facilities.
Clinic staff have been equipped to help expectant mothers register for the MomConnect SMS service, which not only functions as an information tool but also enables mothers to rate clinic service and allows the DoH to collect vital information on mother and child health.
Tirisanong has also continued to fulfil its role as a key facilitator of access to quality HIV treatment services through providing nurse-initiated management of antiretroviral treatment (NIMART), training 237 nurses over 2013 and 2014.
NIMART involves training nurses to initiate and monitor HIV treatment, shifting this task away from doctors, whose low numbers cannot meet the country’s huge HIV treatment and care demand. With nurses taking on this responsibility doctors are then also able to attend to clients with complications.
Tirisanong’s training support also extends to pharmacy and pharmacovigilance training and mentoring, helping to institute best practice when it comes to drug supply in Gauteng.
As a trusted partner in the province, Anova, through Tirisanong, is also assisting the District in facilitating the creation of ideal clinics through assessing services according to the national core standards and identifying and advising on gaps. This also involves rolling out Integrated Chronic Services Management (ICSM) and alternative distribution models like chronic clubs.
Tirisanong has collaborated with the DoH to pilot the innovative ICSM initiative, training 15 facilities between August and September 2014. Training involves making healthcare workers aware of how they can restructure and reorganise space in their facilities; putting patient booking systems in place; and implementing alternative distribution models.
ICSM will allow for the consolidated treatment and care of multiple chronic conditions, including HIV, diabetes and high blood pressure. This is an incredible improvement on the current model where different chronic diseases are treated by different staff, often on different days, ultimately increasing the amount of time clients spend in clinics. The implementation of ICSM means that clients being treated for more than one chronic disease can receive ‘one-stop’ streamlined care.
As part of ICSM, chronic clubs are another creative strategy designed to improve service and alleviate congestion in healthcare facilities by making them more efficient.
Chronic clubs involve ensuring that stable HIV-positive clients who are receiving treatment are channelled away from mainstream services, reducing the number of trips HIV-positive clients must make to their healthcare facility, and allowing these services to more effectively attend to acute clients.
This is done through doing basic health checks on members of a chronic club on an allocated day, followed by dispensing a pre-packaged two-month supply of the client’s HIV medication.
At Johannesburg’s flagship chronic club facility, Jabavu Clinic in Soweto, 1355 of 2000 clients on treatment have been allocated to the chronic clubs programme, reducing unnecessary visits and waiting time, and improving service significantly.
Since the chronic clubs model was piloted at Jabavu, Tirisanong has rolled out the initiative in six more facilities across Gauteng.
Dr Moyahabo Mabitsi