In Gauteng, Anova is supporting the implemetation of the six ‘Is’ of TB-HIV management at primary healthcare facilities, which involve Isoniazid preventative therapy, infection control, intensified case finding, initiation of ART in TB/HIV co-infected clients, initiation of co-trimoxazole prophylaxis in TB/HIV co-infected clients, integration of TB/HIV services.
This is being accomplished through training, ongoing mentoring, and the development and provision of tools.
Training community healthcare workers in basic TB to screen for TB at household level and trace treatment defauters is also an effective strategy that Anova employs to improve TB treatment and care.
Another way Anova is improving TB treatment adherence is through the provision of TB booking diaries to all facilities. This enables facilities to track and trace defaulters.
In rural Mopani District, Limpopo province, Anova’s Khutso Kurhula project uses a mobile TB unit to reach isolated communities in order to implement key aspects of the goverment’s TB programme.
Over the last two years Anova has also dediacted much of its focus to integrating TB-HIV services with nurse-initiated amanagement of antiretroviral treatment (NIMART) at TB sites. This allows for TB-HIV clients to get ‘one-stop’ HIV and TB treatment, as opposed to having to visit different areas of the clinic, staffed by different nurses, on different days. This has allowed for quicker identification of TB cases, early initiation of ART among TB-HIV infected people, and better treatment adherence. Thus far 20 Anova-supported clinics are providing ART within TB service points.
Anova is also taking an active role in re-establishing the District Infection Control Committee, with Khutso Kurhula’s TB technical adivor is one of the six people elected to serve on the committee.
Recognising that monitoring and evaluating data on TB treatment and care is vital in strengthening health services, Anova is assisting the District in improving the quality and utilisation of TB-related data through participation in HAST data reviews and TB data validation at sub-district level.
Anova is also facilitating integration of HIV and TB services in Soweto to promote comprehensive healthcare. This is being done through training and clinical mentorship of professional nurses on TB/HIV management.
This is being implemented in all the areas Tirisanong (Anova’s Soweto project) support, which is 77 PHC facilities in Johannesburg.
Anova is training on Isoniazid prophylaxis therapy (IPT) guidelines to promote provisions of IPT to eligible patients. We also support facilities to improve on their infection control
Anova addresses twin epidemics
An article published in the March 2014 edition of the Nursing Matters journal, written by Anova Health Institute’s TB Technical Advisor Dr Moyahabo Mabitsi, showcases the strides Anova has made in integrating HIV care into TB services in Soweto.
Research has shown that the timely initiation of HIV treatment among people living with HIV who are also infected with TB is critical to health and well being.
Anova has worked to resolve issues leading to delays in the initiation of HIV treatment among TB-HIV co-infected patients by improving the current set-up of TB and HIV services within Primary Health Care (PHC) facilities in Soweto.
Where most PHC facilities offer HIV and TB services in separate areas staffed by different healthcare workers, Anova has integrated HIV care into TB services in 13 facilities in Soweto. This has resulted in less clinic visits for patients and better treatment adherence.