Decanting stable patients to community adherence clubs
The Care and Support for Improved Patients Outcomes Project (CaSIPO) aims to achieve improved patient outcomes by leveraging community support to strengthen linkage to and retention in care. By the end of June 2017, CaSIPO had established 3038 community adherence clubs (ACs) attended by 75299 HIV positive stable patients.
The Universal intervention during adherence clubs sessions
Nutrition and sexual reproductive health (SRH) form an integral part of the care and support services. During the quarter, eleven districts were able to record the screening of patients for nutrition during adherence club sessions while ten districts recorded screening for sexually transmitted infections (STI). A total of 15259 patients attending community ACs were screened for nutrition and 14346 patients underwent screening for STI.
Tracking and Tracing Loss to Follow Up (LTFU) by CBOs gaining momentum
Community Based Organisations (CBOs), in collaboration with ward based outreach teams (WBOTs), play a key role in tracing lost to follow up (LTFU) patients and facilitating their reintegration in care. Nationally, 1579 patients out of 2007 (79%) LTFU were successfully traced by CaSIPO supported CBOs in eleven districts. CBOs are also responsible for referring and linking unstable patients from community ACs back to the clinics.
During the quarter, the CBOs referred 1104 patients to facilities for further management. CaSIPO continued to provide technical assistance to the CBOs and WBOTs to strengthen the interface with health facilities and support the implementation of LTFU action plan issued by the National Department of Health (NDOH).
The focus of CaSIPO’s technical assistance included strengthening data collection and use; harmonizing data management systems as well as intensified tracking of missed appointments and optimization of patients’ education and support.
Treatment New Support Groups
As the number of patients on antiretroviral treatment (ART) keeps increasing, adherence to treatment is critical to the sustainability of the ART program in South Africa.
CaSIPO provided intensified technical assistance (ITA) to CBOs for the establishment of TX_New support group with the objective to retain patients in care from the onset of their treatment. During the reporting period, 2034 patients attended the 123 TX_New Support Groups established and maintained across five districts (Alfred Nzo, eThekwini, Capricorn, Mopani and Dr. Kenneth Kaunda).
CaSIPO continues to enhance capacity development
To achieve its programmatic goal, CaSIPO’s strategic approach focuses on developing capacity of organisations and individuals at community level to facilitate sustainable access to quality comprehensive care and support services closer to the patients.
CaSIPO contributes toward the development of human resources for health through organizational and individual capacity development. During the quarter, CaSIPO provided training to 290 staff members from the Department of Health (DOH) (facility and District Health staff), including 118 WBOTs.
Hundred and three CBOs and their staff members (479) were trained on Comprehensive Approach to Care and Support (CACS), South African Adherence Guidelines (AGL) for HIV, tuberculosis (TB) and non-communicable diseases (NCDs) and Adherence Club Facilitation. Direct intensified technical (ITA) assistance was provided to 57 CBO’s engaging 556 implementers from the respective CBO’s.
CBO Development takes center piece towards program sustainability
The CaSIPO 2017 Sites Improvement Monitoring System (SIMS) Planner has 196 CBO’s listed. SIMS baselines were completed for the 34 new CBOs, meaning that all 196 CBOs on the planner have been assessed. During the quarter, CaSIPO conducted 332 mentorship visits to address SIMS Gaps.
Community based Distribution – Medicine Access
Access to medicines, an essential component of ACs, remained a key challenge across most of the districts. Where possible, CaSIPO assisted CBOs to register as Pick up Points (PuPs), relieving the pre-packing load from the facility staff. To date, 15 CaSIPO supported CBOs are registered as PuPs.
Data Quality Management
During the quarter, CaSIPO continued to validate data and put processes in place to justify the accuracy, validity, precision and integrity of data. The district technical support teams worked on enhancing the quality of data being reported resulting in a marked improvement in data quality with the margin of error decreasing from 18% in Quarter 1 to 4% in Quarter 3.