Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa
Background: Tuberculosis (TB) is the most common presenting illness among people living with human immunodeficiency virus (HIV), with co-infection occurring in up to 60% of cases in South Africa. In line with international guidelines, South Africa has adopted an integrated model at primary healthcar...
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doaj-8d9e117941ad484dbbd2aad2a3e2d59f2020-11-25T02:45:48ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362019-05-01111e1e710.4102/phcfm.v11i1.1831619Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South AfricaDishiki Kalonji0Ozayr H. Mahomed1Discipline of Public Health Medicine, University of KwaZulu-Natal, DurbanDiscipline of Public Health Medicine, University of KwaZulu-Natal, DurbanBackground: Tuberculosis (TB) is the most common presenting illness among people living with human immunodeficiency virus (HIV), with co-infection occurring in up to 60% of cases in South Africa. In line with international guidelines, South Africa has adopted an integrated model at primary healthcare level to provide HIV and TB services by the same healthcare provider at the same visit. Aim: The aim of the study was to conduct a rapid appraisal of integration of HIV and TB services at primary healthcare level in eThekwini District in 2015. Setting: The study was conducted in 10 provincial primary healthcare clinics in the eThekwini Metropolitan Health District in KwaZulu-Natal Province. Methods: An observational, cross-sectional study was conducted. Key informant interviews with operational managers and community health workers were conducted, as well as a review of registers and electronic databases for the period of January to March 2015. Results: Two clinics complied with the mandated integrated model. Three clinics were partially integrated; while five clinics maintained the stand-alone model. Possible constraints included reorganisation of on-site location of services, drug provision, TB infection control and inadequate capacity building, while potential enablers comprised structural infrastructure, staffing ratios and stakeholder engagement. Conclusion: HIV and TB integration is suboptimal and will need to be improved by addressing the systemic challenges affecting health service delivery, including strengthening supervision, training and the implementation of a change management programme.https://phcfm.org/index.php/phcfm/article/view/1831HIVtuberculosisintegrationhealth systemprimary healthcare |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dishiki Kalonji Ozayr H. Mahomed |
spellingShingle |
Dishiki Kalonji Ozayr H. Mahomed Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa African Journal of Primary Health Care & Family Medicine HIV tuberculosis integration health system primary healthcare |
author_facet |
Dishiki Kalonji Ozayr H. Mahomed |
author_sort |
Dishiki Kalonji |
title |
Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa |
title_short |
Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa |
title_full |
Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa |
title_fullStr |
Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa |
title_full_unstemmed |
Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa |
title_sort |
health system challenges affecting hiv and tuberculosis integration at primary healthcare clinics in durban, south africa |
publisher |
AOSIS |
series |
African Journal of Primary Health Care & Family Medicine |
issn |
2071-2928 2071-2936 |
publishDate |
2019-05-01 |
description |
Background: Tuberculosis (TB) is the most common presenting illness among people living with human immunodeficiency virus (HIV), with co-infection occurring in up to 60% of cases in South Africa. In line with international guidelines, South Africa has adopted an integrated model at primary healthcare level to provide HIV and TB services by the same healthcare provider at the same visit.
Aim: The aim of the study was to conduct a rapid appraisal of integration of HIV and TB services at primary healthcare level in eThekwini District in 2015.
Setting: The study was conducted in 10 provincial primary healthcare clinics in the eThekwini Metropolitan Health District in KwaZulu-Natal Province.
Methods: An observational, cross-sectional study was conducted. Key informant interviews with operational managers and community health workers were conducted, as well as a review of registers and electronic databases for the period of January to March 2015.
Results: Two clinics complied with the mandated integrated model. Three clinics were partially integrated; while five clinics maintained the stand-alone model. Possible constraints included reorganisation of on-site location of services, drug provision, TB infection control and inadequate capacity building, while potential enablers comprised structural infrastructure, staffing ratios and stakeholder engagement.
Conclusion: HIV and TB integration is suboptimal and will need to be improved by addressing the systemic challenges affecting health service delivery, including strengthening supervision, training and the implementation of a change management programme. |
topic |
HIV tuberculosis integration health system primary healthcare |
url |
https://phcfm.org/index.php/phcfm/article/view/1831 |
work_keys_str_mv |
AT dishikikalonji healthsystemchallengesaffectinghivandtuberculosisintegrationatprimaryhealthcareclinicsindurbansouthafrica AT ozayrhmahomed healthsystemchallengesaffectinghivandtuberculosisintegrationatprimaryhealthcareclinicsindurbansouthafrica |
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1724759999377309696 |