Abstract
BackgroundThe demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC) is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease.SettingThe study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal.AimThe objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics.MethodsA quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization's guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities.ResultsNone of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure.ConclusionHIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.
Highlights
Social valueThere has been a significant expansion in the need for HIV care and treatment in Africa as well as in the world.[1]
This study describes the evaluation of primary healthcare (PHC) clinics within a health district in South Africa with a high HIV burden, to establish whether these clinics are equipped for integrated HIV care and treatment services
Analysis revealed that clinics that had Non-governmental organisations (NGOs) support for the HIV programme were more likely to provide antiretroviral therapy (ART) as part of their HIV care and treatment services (Fisher exact p < 0.01)
Summary
Social valueThere has been a significant expansion in the need for HIV care and treatment in Africa as well as in the world.[1]. One of the critical challenges is the delivery of long-term care for the increasing population of clients on antiretroviral therapy within the context of overburdened health systems.[2]. In order to promote accessible, equitable and sustainable HIV services within resource-constrained systems, HIV programmes need to be decentralised (brought closer to the people) and integrated with other health services.[2] A primary healthcare (PHC) approach is generally considered as being central to providing equitable healthcare.[5,6,7]. The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC) is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal
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