ARV Site Support

In partnership with the Institute for Healthcare Improvement (IHI), CRH offers support to HIV and AIDS service centres in rural KwaZulu-Natal Province which have a special focus on Antiretroviral Therapy (ART) . With a central office at Ngwelezane Hospital (Empangeni), the team assists over nine service centres to find practical solutions to the problems they have at hand. This support has been offered for two years in the Umkhanyakude district, and for a year in Uthungulu.

Active sites in Umkhanyakude include Manguzi, Mosvold, Bethesda, and Mseleni Hospitals, as well as KwaMsane Clinic (connected to Hlabisa Hospital). In Uthungulu sites are at Eshowe, Ngwelezane, St Mary's and Nkandla Hospitals. In the future it is planned to also offer support to hospitals in the Zululand district.

The support team helps health professionals to identify gaps in the roll-out approach, and then find ways to improve these. HIV service points are assisted to maximise the resources they have on hand, firstly to increase the number of people on treatment, and secondly to increase the quality of care for those already taking ARVs.

The approach used involves regular visits to the service points. During these visits an IHI approach known as the Breakthrough Series Collaborative Model is used, whereby the team offers individual support to the service centres, facilitates group learning sessions, and also strongly encourages communication for learning purposes between the sites in the times between the learning sessions. In this way the sites learn from each others' successes and mistakes, not just their own, and furthermore the sense of rural isolation is less pervasive.

A recent success of the project includes the 'down-referring' of ARV support from a hospital level to a clinic level (read more on Referrals and Support). At clinics nursing staff have been trained to effectively offer quality care to ARV users — this is both less costly of time and money.

The perception of the site support team is that where ARV distribution is increasing, stigma concerning HIV and AIDS is decreasing . This certainly seems to be the case at Manguzi Hospital, where at the end of 2006, 1 600 clients were taking ARVs, and the aim was to double this by the end of the following year.

This project forms part of the KZN Health Learning Complex.
Read about other HIV and AIDS projects at CRH:

HIV Diploma
HIV Adaptions to IMCI
Orphan & Vulnerable Children (OVC)