SPF Project



KISTEFOS HIV/AIDS

Funded by: Kistefos, Norway

Project Coordinator: Khuzwayo August

Sector: Health

The Programme aims to make a meaningful impact in combating HIV/AIDS and TB in the Eastern

Cape Province by implementing a programme that provides services to disadvantaged communities

which is integrated into existing under-resourced and fragmented health services. The aim is to

create an enabling environment for behaviour change, build competency of individuals, communities

and organisations to provide prevention, care, treatment and support in a sustainable manner and

save lives of adults, pregnant women and children, with a further focus on testing Orphans and

Vulnerable Children under 5 years and getting those infected onto treatment and care.

 

Successes:

The Programme has drawn wide interest from the SA National and Eastern Cape Provincial Department of Health, European Union and OR Tambo District Health and Local Municipalities. The programme has achieved the key target of reducing mother to child transmission to 2% 

This was done by replicating the work of the Kistefos/Isilimela HIV/AIDS Action Programme into 3 new health sub-district and continue to support 48 clinics, 3 hospitals, 450 villages and 480,000 people.(Latest population estimates has grown to 757,097 by Statistics South Africa in 2013)

The project exposure is gaining momentum in the OR Tambo District Health, through the inclusion of all Small Projects Foundation Projects in the Health District Health Plan until 2018. The Kistefos funded programme is now recognised as a valuable partner for the Department of Health, not only at district level but also at Local Sub – District Health for all three Local Service Areas.

 

Activities:

-          48 PLA’s and feedback sessions completed

-          File audit of patients record management  completed in 63 Clinics 

-          A third office in Lusikisiki established and furnished.

-          Additional project administrator contracted in Lusikisiki office

-          SMS Lifeline (Dimagi CommCare) pilot launched

-          Employment of an Office Administrator and Protecting Futures Programme Implementer.

-          Bright Futures Programme implementation continues at Schools

-          Bright Futures Training for Life Orientation Teachers completed

-          Promotion of existing Coordinator to become the Regional Coordinator for three sub-districts.

-          Annual operation plan has been developed and is in place.

-          Clinic Committee training for all participating clinics has been completed.

-          Skills gap identification has been completed.

-          PMTCT and HCT training of community health workers was completed.

-          Home Based Care training of community health workers was completed.

-          Perinatal Mental Health training for Community Health Workers and Nurses was completed and identified cases referred and managed.

-          Additional 7 seater people carrier bought.

-          Launch of the Ensuring Futures Programme for young women and girls in Nyandeni Sub District.

-          Implementation of Better Care Training Model (Skills to Care).

 

Expected results over 2½ years (30 months) would be:

·         All pregnant women tested for HIV/AIDS (100%) (Estimated 37,000 women).

·         All HIV exposed infants tested for HIV/AIDS (100% of babies born to HIV positive mothers (estimated 7,000 babies).

·         All HIV positive infants put onto treatment within 2 weeks of diagnosis (Estimated 580 children).

·         Decreased mother to child transmission of HIV to 2% or less.

·         Adherence to HIV treatment of Adult patients of 98% (estimated patients 23,000).

·         All orphans and vulnerable children under 5 years tested (estimated 4,500).

·         All suspect TB infected children tested if TB infected (estimated 3,000).

·         Sixty-six percent (66%) of 480,000 community members reached in HIV/AIDS and TB prevention.

·         9,000 girls reached with sexual and reproductive health education in 90 schools.

·         45 Clinics and 3 hospitals with improved HIV/AIDS, TB and primary health care services.

·         630 Community Health Workers (CHW’s) trained and providing good and sustainable service.

·         9000 home gardens established (5 gardens/CHW/year x 3years x 630 CHW’s).

 

Accomplishments:

Project ActivitiesReachedTargets
Pregnant women tested38 55137 000
Infants tested for HIV10 6377 000
Infants on treatment (HIV and TB)2 618580
Prevention of Mother to Child Transmission (PMTCT) of all women reached over entire period31 4152%
Adherence : Defaulter patients and Lost to follow-up (LTF) patients bought back onto treatment234 19023 000
Under 5 tested-OVC11 3944500
Infants tested for  TB8 3993000

HIV/TB reached:

Directly in the last 2 months

Estimated population reached in last 32 months

20024 
339 810

(66% of 480 000)

316 800

Bright Futures (B/F) Girls targets169219000
Schools Targets9090
Sanitary towels packs distributed1146570
Primary Health Care (PHC) facilities reached6345
Participatory Learning and Actions (PLA) workshops completed4845
Community Health Workers (CHW) training HIV Counseling and Testing (HCT)172-
CHW training PMTCT172-
Finger pricking & pregnancy test training for clinics / CHW’s34-
CHW training- HBC66-
CHW training – Perinatal Mental Health (PNMH)74-
Skills to Care51-
File audited facilities (clinics) for patient file management6345
Boma Shade Cloth Structure at clinics for education and shelter4345
Porta Cabin for Counselling and testing (Cwele Mission)  &Mhlakulo2-
Home gardens11 6279000

 

Results:

·        HIV Testing of children under 5 years: 11 394 children have been tested and 469 children found to be HIV positive and put onto treatment (4.1%)

·        Children under 15 years on treatment for HIV: 28 593 children are being treated for HIV and provided with support.

·        There are currently some HIV and sexual and reproductive health counselling services for adolescents in Mhlontlo and Qaukeni, and Nyandeni sub-district. All but 3 clinics in Nyandeni have been accredited as youth friendly clinics by the ECDOH.

·        The Bright futures Programmes for girls is now complete, with the use of Future You booklets which have been developed and printed to train young girls on sexual reproductive health, and rights (16921 girls trained to date).

·        Prevention of Mother to Child Transmission (PMTCT) Programme:

-          3 948 defaulting (more than 1 month) PMTCT programme pregnant woman and mothers were identified and 2 663 have been traced and brought back onto treatment (67.5%).

-          2 052 lost to follow-up (more than 3 months) PMTCT programme mothers were identified and 1 728 of these women have been traced and brought back onto treatment (84.2%).

-          A total of 31 415 pregnant women have now put through the PMTCT programme.

·        Antenatal Care (ANC) Services:

-          30 532 pregnant women have accessed antenatal care.

-          20 131 of these women attended within 20 weeks (65.9%).

-          10 401 of these women attended after 20 weeks (34.1%).

This is better than the district average of 45%.

-          38 551 of 30 532 pregnant women were tested for HIV (126.3%). This is due to HIV negative women having a retest, making the number of tested pregnant women greater than the actual number of pregnant women.

-          3 239 of these 38 551 pregnant women tested positive for HIV (8.4%) at first ANC visit and were put onto treatment.

-          16 530 pregnant women who tested negative at first visit were re-tested at 32 weeks gestation and 765 tested positive for HIV and were put onto treatment (4.6%).

-          9 270 male partners were counselled and tested for HIV.

·        Exclusive Breastfeeding

-          26 515 mothers were counselled on exclusive breastfeeding.

-          14 966 of these women are now exclusively breastfeeding (56.4%).

·        6 Day Post Natal Check Up

-          13 051 mothers and their babies came in for their 6th day post-natal check-up.

·        Birth HIV test on Babies

-          629 babies tested for HIV (16.3% of those born from HIV positive mothers during this period).

-          Of these babies 36 were HIV positive (5.7%)

·        6 Week HIV Test on Babies

-          5 947 babies were tested for HIV

-          Of these, 199 babies were HIV positive (3.3%).

The latest results of Mother to Child Transmission rate per sub-district are as follows: Mhlontlo 0 %,

Nyandeni 1.2 % and Qaukeni 0.8%.

 

·        Test on babies 6 weeks after weaning from breast feeding:

Intensive work is needed in preventing HIV infections in infants, which is presumably caused by mixed feeding, by educating and supporting mothers to exclusively breastfeed. Small Projects Foundation has developed training material for such work. The target is to get (80%) of mothers exclusively breastfeeding for the first six month after birth, the current rate is (56.4%)

 

·        Test of HIV exposed babies at 18 months:

-          4326 babies tested at 18 months of whom 165 were HIV positive (3.8% down from 4.2%). These are babies identified as ill or needing testing and who must have been exposed to mixed-feeding.

 

·        Estimated Mother to Child Transmission:

 

-          The total mother to child transmission of HIV after 18 months of life is therefore estimated to be 3.7%. This includes babies infected after 6 weeks of birth through mixed breastfeeding, non-adherence of mothers to taking their anti-retroviral treatment while breastfeeding and possible milk-nursing by relatives/friends.

-          New babies with HIV are initiated onto ART within 2 weeks of diagnosis as a standard practice. The community health workers follow up and ensure such HIV positive babies are put onto ART and remain adherent with their mothers.

 

·        TB Treatment:

-          8 399 children were tested for TB of whom 1 108 tested positive for TB (13.2%).

-          1 083 of these children with TB were placed on treatment (97.7%).

-          37 of these 1 083 children defaulted on TB treatment but 31 were traced (83.8%).

 

·        Gardens Initiated:

-          1 1627 gardens were initiated of which 2 309 are newly established.

 

·        SA Government Community Health Care Workers Recruited or Engaged:

-          Total number of community health workers in this area: 1642.

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