EU Match Project | European Union

This project which is being carried out in the OR Tambo District was implemented as a partnership between SPF and Oxfam Italia. The project commenced in 2012, following the 2011 PMTCT pilot project initiated at the Holy Cross Gateway Clinic in Flagstaff. Support was provided to 13 clinics in Lusikisiki and Flagstaff and was mirrored by projects in the Democratic Republic of Congo and Tanzania, also supported by the European Union (EU).

The focus for this project was developed through meetings with the DoH in Qaukeni sub-district, yielding the following expectations from the department. The results of the programme are reflected after each point.

  • Reduction of mother to child transmission of HIV/AIDS to below 3%. Results: 1.2%.
  • Improvement in the breastfeeding behaviour of HIV positive mothers with support from their families. Results: Improved counselling and support has led to improved exclusive breastfeeding.
  • Training of nurses and volunteers to provide integrated antenatal care (ANC)/PMTCT/maternal and child HIV/AIDS treatment, care and support. Results: All 13 clinics have implemented and use this.
  • Improvement of male partners’ involvement in PMTCT. Results: Improved male partners testing through outreach to villages and homes 30%.
  • Improvement of the quality of care being provided in clinics. Results: Major improvement in PMTCT, vaccination and defaulter tracing.
  • Increasing knowledge of ANC/PMTCT/Maternal and Child Health (MCH) among community members, to improve support to HIV positive women and their families. Results: Improved early booking for ANC and decreased MTCT.
  • Empowerment of girls and boys with sexual and reproductive health education. Results: 30 schools and more than 3,000 girls and boys were educated.
  • Training of treatment teams to support Nurse Initiated Management of ART (NIMART) in primary health care clinics. Results: All clinics confident and competent to initiate patients on ART and increased ART treatment of mothers and babies.

Achievements

  • Steering committee meetings with stakeholders every 2 months and regular reporting to the Local AIDS Council.
  • Mobilisation of local communities through Participatory Learning and Action (PLA) workshops.
  • Recruitment, training and deployment of 26 CHW’s in 13 clinics.
  • Training for clinic nurses and DoE CHW’s, to enable the clinics to provide an integrated ANC/PMTCT/ART service. The nurses’ training focused on initiation of children onto ART which allows decentralisation of paediatric ART for HIV positive children to receive their treatment quicker.
  • 10 clinic supervisors attended training on international and national guidelines on HIV prevention, ART and PMTCT; HIV epidemiology; tools for promoting HIV awareness; planning of health services specifically maternal and child health (MCH); evaluation tools for HIV-related services; quality improvement of provided services
  • Implementation of integrated PMTCT, MCH and ART and an effective referral mechanism for CHW’s to trace defaulting patients.
  • Training of sub-district staff, clinic nurses and clinic committee members on the balanced score card. Development of balanced score cards for each clinic.
  • Training of clinic committee members on health-related rights, balanced scorecard, PMTCT and MCH guidelines, in order for them to monitor clinic services, increase accountability of clinics to the communities, improve patient-centered care and ensure compliance with national guidelines.
  • SPF and Oxfam conducted an outreach campaign in August/September 2013, targeting areas which were not receiving outreach from the DoH. This was ascertained through a meeting with the department to plan the outreach. A total of 59 villages were visited by SPF nurses.
  • An additional 2,580 pregnant women and 775 male partners were tested and counselled, bringing the total for the project period to date to 5,190. This is a success not enjoyed by SPF’s other projects i.e. 30% of male partners of pregnant women have been mobilised and have been eager for information on PMTCT.
  • Of the 663 women testing positive, 587 (88.53%) were placed on the PMTCT regime. The reason for this is that some women did not report back to the clinic after being diagnosed as HIV positive. Attempts were made to trace them and refer them back to the clinic, but some were found to have left the area, and others were deceased.
  • In total, 1,588 babies (98.8% of live births) received Nevirapine prophylaxis within 72 hours of birth.
  • Audit of clinic records, to check whether all HIV patients return to the clinic for their visits. Defaulters and patients lost to follow up were referred to CHW’s, and control lists were put in place in all clinics to ensure defaulting patients are identified, traced and continue with treatment.
  • Exchange seminar with the national DoH, Tanzanian, Congolese, Oxfam and EU partners.
  • Study tour to Eastern Cape by the partners to visit project clinics and talk to sub-district staff.
  • Training of 12 CBOs on organisational management, following a capacity analysis workshop which identified the CBOs’ training needs.