The Republic of South Africa is working to meet the health challenges facing its people, which include a high HIV prevalence compounded by high incidences of sexually transmitted infections (STIs) and tuberculosis (TB). In anticipation of National Health Insurance, and new policy guidelines including HIV Test and Start, the key health initiatives in South Africa currently focus on strengthening the primary healthcare system (PHC) to provide greater access to quality care to the most vulnerable populations. These initiatives include the Ideal Clinic Realization and Maintenance (ICRM), Differentiated l Models of Care, and PHC re-engineering.
To support this effort, I-TECH South Africa works with government and community leaders, individuals, and communities to improve the effectiveness and sustainability of the South African national HIV, STI, and TB response.
In 2003, at the request of the National and Provincial Departments of Health (NDOH) and the US Center for Disease Control and Prevention’s Global AIDS Program (CDC GAP), I-TECH began work in South Africa to help implement the government’s Operational Plan for Comprehensive HIV and AIDS Care, Management, and Treatment. More recently to align with the latest phase of PEPFAR, I-TECH programs have shifted to focus on Sustainable Control of the Epidemic to reach the UNAIDS 90-90-90 global goals (pivoted around five action agendas: Impact Action agenda, Efficiency Action agenda, Sustainability Action agenda, Partnership Action agenda and Human Rights Action agenda). I-TECH South Africa has aligned its programmatic objectives to focus on reducing HIV and TB incidence; strengthening community systems to prevent HIV and TB transmission; strengthening managerial capacity across the public sector particularly in monitoring and evaluation, information systems, implementation and HIV mainstreaming; increasing institutional capacity to deliver health system functions; and investing in operational research and new innovative methods to evaluate true impact of programs.
In all of its efforts, I-TECH South Africa places an emphasis on program assessment, monitoring and evaluation, and continuous quality improvement with sustainable local involvement for transition.
- Increase capacity of Regional Training Centres (RTCs) to coordinate in-service trainings with an emphasis on targeting improved performance around 90-90-90 indicators.
- Provide TA to develop the in-service training strategy for the RTCs to target improvement with regards to 90-90-90 indicators.
- Provide TA to NDOH Human Resource Division, to develop the National 2030 HRH Recruitment and Retention Strategy.
- Develop and implement the Ideal Clinic capacity development initiative to achieve 90-90-90.
- Develop trainings for Community Health Assistants and to increase bi-directional referral between communities and facilities.
- Provide TA to the South African Nursing Council to finalize the first CPD framework for Nurses and pilot implementation of CPD.
- Provide TA to the National Pharmacovigilence Center (NPVC) to conduct quality, innovative, PV trainings for front line HCWs and improve documentation of Adverse Drug Reaction reports.
- Provide TA to the Academy for Leadership and Management in Health (ALMH) for coaching and mentoring to pilot the development of leadership and management skills working with District Management Teams and Central Hospital Management Teams in 4 sites.
- Implement an evidence-based intervention using HIV Peer Navigators and SMS technology to enhance linkage and retention to care.
- Develop a functional web-based Knowledge Hub system that supports professional growth for health practitioners including linking competencies and job profiles to performance management.
- Provide TA to NDOH Health Policy Division to develop, implement, track, and evaluate health policies in South Africa.
- Scale up the evidence based PRIME intervention integrating screening and referral for basic mental health disorders and substance abuse through training lay counselors at PHCs.
- Develop an e-learning foundational Epidemiology course for front line HCWs.
- Implement TB/HIV trainings that target HIV and TB 90/90/90 indicators.
- Strengthen the Ward Based Outreach Teams (WBOTS) response to the 90/90/90 targets in all 27 priority districts in South Africa.
- Developing and facilitating an Inter-Ministerial Working Group (IMWG) to develop a policy and referral system between government departments or state agencies to support a patient-centered approach.
- Develop and roll-out an MSM sensitization training for HCWs.
- Provide training and TA to under-resourced provinces to establish Antibiotic Stewardship programs in order to address rise of antibiotic resistance.
- Develop an e-learning module for in-service training of HCWs to manage sexual and/or physical abuse among children and adolescents.
- In the future, a new Care and Treatment Programme will undertake to review of existing training and learning materials to integrated Care and Treatment components working with Care and Treatment and HIV/AIDS Programmes at NDoH level.