1887

n Acta Academica - Anticipating future challenges to ART provision in South Africa : reflections on the Khayelitsha ART programme

Supplement 1
  • ISSN : 0587-2405

Abstract

The Khayelitsha ART programme has been in existence for five years. The emerging challenges are indicative of challenges other districts will face in the future. The number of adult patients started on ART annually in Khayelitsha has increased from 80 to 1 500. The gap between need and provision has narrowed, with a concomitant increase in the baseline CD4 count at ART initiation. Over time, adherence preparation has become less intensive, but the patient-centred approach has been retained. Consultations and staffing (especially doctors and counsellors) have increased substantially over four years, without deterioration in clinical outcomes. To keep up with projected demand, the service needs to quadruple enrolment over the next five years. This will only be possible by utilising the full breadth of the primary care system and by integrating TB / HIV / ART care at each service point.

<b>Antisipering van uitdagings vir antiretrovirale voorsiening in Suid-Afrika : oorwegings van die Khayelitsha ART-program</b> <br>Die Khayelitsha ART-program bestaan reeds vir vyf jaar. Die uitdagings wat ervaar word, dui op probleme wat ander distrikte in die toekoms sal ondervind. Die aantal volwasse pasiënte wat jaarliks met ART by Khayelitsha begin, het van 80 tot 1 500 toegeneem. Die gaping tussen behoefte en voorsiening het vernou, met 'n gepaardgaande toename in die basis-CD4-telling by ART-inisiasie. Na verloop van tyd is voorbereiding vir terapietrou afgeskaal, maar die pasiëntgesentreerde benadering is behou. Konsultasies en personeel (veral dokters en voorligters) het oor vier jaar beduidend toegeneem, sonder agteruitgang in kliniese resultate. Om met die geprojekteerde vraag tred te hou, moet die diens in die volgende vyf jaar vervierdubbel. Dit is slegs moontlik deur gebruik te maak van die volle spektrum van die primêre sorgsisteem en geïntegreerde TB / MIV / ART-sorg by elke dienspunt.

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/content/academ/2006/sup-1/EJC15078
2006-01-01
2019-10-19

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