PROVINCE OF KWAZULU-NATAL
ISIFUNDAZWE SAKWAZULU-NATALI
PROGRESS REPORT ON
HCT CAMPAIGN
02 MARCH 2011
Presentation Outline
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HIV Prevalence
Provincial Response
HCT Achievements
School Health Programme
Public Service Sector – HCT
HIV PREVALENCE ANC SURVEY
2007 - 2009
KZN-HIV Prevalance by district
50
Prevalance
40
30
20
10
0
Prov.
ma
Sis
Ugu
Umk
Umz
UTh
Utk
Zul
eTh
ILe
uMg
2007
38.7
39.3
34.1
37.3
39.8
31.6
36.2
35.9
34.6
41.6
41.4
40.8
2008
38.7
34.7
35.8
40.6
39.9
29.2
38.6
36.1
36.1
40.3
35.8
45.7
2009
39.5
37.3
35.2
40.2
39.7
28.2
46.4
37.7
36.7
41.5
40.6
40.9
Trend in Age related prev. from 2007 - 2009
Prevalence
40
35
30
25
20
15
10
5
0
15-19
20-24
25-29
30-34
35-39
40-44
45-49
other
2007
10.2
33.7
29.1
17.6
7.8
1.2
0.1
0
2008
11.8
30.8
30.1
17
8.7
1.5
0.1
0
2009
12.9
31.9
28.1
17.6
7.5
1.7
0.1
0.2
Age Category
2007
2008
2009
Provincial Response
NSP 2007-2011
 Two primary aims
 reduce the number of new HIV infections by 50%
by 2011
 reduce the impact of HIV and AIDS on individuals,
families, communities and society
 By expanding access to appropriate package of
treatment, care and support to 80% of all people
diagnosed with HIV
 Priority Areas
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Prevention
Treatment care and Support
Monitoring, Research and surveillance and
Human and Rights and access to Justice
Provincial Response
 Presidential declaration of 01 December
2009:
 to treat HIV and TB under one roof
 ART for pregnant women and TB/HIV co infected
individuals
 Treatment for all the HIV infected infants <1yr
 All SA citizen should know their HIV status
 HIV Counseling and Testing Campaign – Aim to
test 15 million people in South Africa
 KZN HCT target is just above 3 million
people to be tested by end June 2011
HEALTH OUTCOMES – National
Service Delivery Agreement
 Increasing life expectancy
 Reduce child and maternal morbidity
and mortality
 Combat HIV and AIDS and decrease
the burden of disease from
Tuberculosis
 Improve health systems effectiveness
HIV COUNSELLING and TESTING
 The total population eligible for HCT is 6,244 million
people aged 15 – 49yrs
 KZN HCT target is 3,059,234 million people to be tested
by June 2011
 Provincial launch on 30 April 2010 in Umgungundlovu
District
 Total achieved so far 1, 731, 552
 Total positive 360, 105 (21%)
 Achieved 57% of the target
 District plans have been developed to accelerate efforts
towards achieving HCT target
HCT CAMPAIGN – 21 Feb 2011
District
Target
Achieved (%)
TB screened
Sisonke
138 743
103, 696
(75)
82,830
Umgungundlov 322 101
151,796
(47)
93,253
Uthukela
184 289
107, 297
(58)
60,196
Umzinyathi
128 263
88,588
(69)
77,861
Amajuba
178 223
133,641
(75)
35,790
Zululand
235 060
160,725
(68)
62,455
Umkhanyakud
165 315
88,192
(53)
80,644
Uthungulu
260 112
191,102
(73)
290,206
Ilembe
185 510
92,141
(49)
57,084
Ugu
208 504
152,443
(73)
53,998
Ethekwini
1 053 113
461,931
(44)
476,923
TOTAL
3,059,233
1,731,552 (57%)
Total HIV Pos
360,105
(21)
1,371,240
SCHOOL
HIV COUNSELLING AND
TESTING
School Health Programme
 School HCT Campaign announced by
the Minister of Health in October 2010
 Extension of HCT Campaign to youth in
schools
 Target: secondary/high school learners
aged 12 years and above, educators
and school community
Provincial Task Team
 A provincial interdepartmental task team
formed
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Premier’s Office (coordinating body)
Department of Education
Department of Health
Department of Social Development
Provincial Council on AIDS
 Has conducted series of interdepartmental
planning meetings
 Has held a series of stakeholder engagement
meetings
KZN School HCT Strategy
 Developed a standard operating procedures
(SOP) for the implementation of school HCT
in KZN – adapted from DBE/ SANAC strategy
 Development of Terms of Reference to define
roles and responsibilities
 Mapping of resources by all departments
 Engaged NGO partners, traditional leadership
 Further engagement planned for the coming
week
School HCT Strategy
The School HCT Campaign aims to achieve the following:
 To provide a comprehensive package of health screening
services inclusive of HIV.
 To mobilize the school community to know their HIV
status
 To promote prevention messages about healthy
lifestyles irrespective of HIV status
 To increase the availability of HCT services for youth
outside the health facilities through partnerships
between public, private and non-governmental
institutions
 To increase health seeking behaviour; and
 To increase access to treatment, care and support
services
SOCIAL MOBILISATION
 Provincial Mobilisation is being undertaken by
OTP, DOE, DOH, DSD
 School HCT in Ukhozi FM radio during health slot
 District Mobilisation is being undertaken in
all districts
 Key stakeholders have been engaged (eg.
Traditional Leadership, Unions, Civil Society,
SGBs, parents) so as to facilitate mobilisation
process
KZN Preparedness
 Provincial meeting conducted on
31/01 – 01/02 – all districts
interdepartmental and other sectors
 Share School HCT strategy
 Share lessons learnt by Partners with
experience
 Conclude process of mapping all
resources
 District implementation plans developed
KZN Preparedness
 There are approximately 642 secondary
public schools throughout the province
 Umgungundlovu
 Umzinyathi
 Umkhanyakude
= 158
= 129
= 34
 A comprehensive list of schools to be
targeted has been drawn up
Package of services
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Health education
HCT
TB screening
Vision screening
Oral health
BMI
Nutritional assessment
HB
Depression/ Mental Assessment
Substance Abuse
Referral for further management
Pre &Post Test Counselling
 A right-based approach is adopted for the
implementation of the programme
 Testing will be voluntary and will be conducted on an
informed consent basis.
 Testing will be conducted under conditions that ensure
privacy and confidentiality of those who test
 Pre and post test counselling will focus on HIV
prevention education.
 Group and individual counselling sessions will be
provided
IMPLEMENTATION
 Alignment of the School HCT Campaign
with Operation Sukuma Sakhe (Flagship
Programme)
 Engaged with Health Committee of the
House of Traditional Leaders.
 Education programme (HCT) in schools.
 Umkhanyakude & Umzinyathi started
testing on 14 February as per their
implementation plans.
IMPLEMENTATION (CONT)
 Umkhanyakude
 Tested 1,262 learners
 12 learners HIV positive
 Psychosocial support has been given to
the 12 learners and their families
RECENT DEVELOPMENTS IN
SCHOOL HCT
 Meeting 28 February 2011 of called by NDOH
 Health Minister Dr A. Motsoaledi addressed all
provincial DOE, DOH, DSD, partners
 Maintained all SA citizens should know their status
inc. youth
 Change from School HCT to School Health
Programmes
 Comprehensive PHC approach emphasis on
prevention and promotion
 De-Link from HCT campaign
 Strengthen Youth Friendly services
 Mixed model of service provision which includes
community involvement and participation
RECENT DEVELOPMENTS
 Integrated approach to address
 Stigma and discrimination
 Psychosocial support
 Teenage pregnancy
 PMTCT
 Access to MMC
 Substance abuse
 Other factors e.g. violence, gender issues, poverty
 Provincial Teams to develop models of implementation
 Therefore should slow down, not rush numbers but
provide services in a comprehensive and integrated
approach
Monitoring and Evaluation
 The data flow will follow the current HCT
campaign data flow – nerve centres, DHIS
 The existing indicators will be utilized with
some modifications and additions where
necessary
 An evaluation form for learners and
educators will be used to assess the
effectiveness of the project
CHALLENGES
 Communication – National, Office of
the Premier, Sector Depts, Partners
 Human Resource Limitation
 Time (Teaching vs. Testing)
WAY FORWARD
 Site visits by Provincial Task Team to
assess district State of Readiness
 Provincial Launch
 Roll-Out
 Monitoring and Evaluation
PUBLIC SERVICE SECTOR
HCT CAMPAIGN and HEALTH
SCREENING
COORDINATION OF HCT CAMPAIGN AND
HEALTH SCREENING/ASSESSMENT FOR
PROVINCIAL GOVERNMENT EMPLOYEES
 The Office of the Premier coordinates HCT Campaign &
health screening/ assessment of employees.
 All provincial departments participate in the Campaign.
 Wellness screenings are conducted to raise awareness of
health conditions within government departments.
 Wellness screenings include the testing for HIV ie.HCT.
 Government employees benefit from the convenient
opportunity to be professionally screened for existing
and potential health risks.
COORDINATION OF HCT CAMPAIGN AND
HEALTH SCREENING/ASSESSMENT FOR
PROVINCIAL GOVERNMENT EMPLOYEES
 The aim is to enable employees to
detect health risks as early as possible,
so that the progression of diseases is
prevented or minimised.
 On a wellness day, healthcare
professionals set up a wellness testing
venue at a department.
 All employees at the work place are
invited to voluntarily attend the
wellness screening.
WELLNESS SCREENINGS/TESTS
PACKAGE
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HIV Counseling and Testing
Glucose
Blood Pressure
Cholesterol
Body Mass Index
Exercise
Heart Disease
Stress
Waist Circumference
Weight Control
Alcohol abuse
Head and neck massages (in some cases)
HCT RESULTS as at Jan 2011
DEPARTMENT/FACILITY/
SITE NAME
Estimated
VCT target
Pop (80%
proposed)
HCT
TARGET
(49%) TO BE
TESTED
Pre-Test
Counselled
Tested
Uptake in
Testing
(%)
Teste
d
Positi
ve
Posit
ivity
rate
Scree
ned
for
TB
%
screene
d for TB
Refer
red
for
clinic
al
diagn
osis
of TB
2,657
1,329
506
158
11.89%
11
6.96
%
0
0.00%
0
430
430
118
54
12.56%
7
12.96
%
0
0.00%
0
3,745
0
0
0
#DIV/0!
0
#DIV/
0!
0
#DIV/0!
0
345
345
38
38
11.01%
3
7.89
%
38
11.01%
0
Education
98,811
49,405
834
342
0.69%
39
11.40
%
66
0.13%
0
Health
52,800
32,340
247
164
0.51%
7
4.27
%
3
0.01%
0
Human Settlements
683
484
155
71
14.67%
10
14.08
%
30
6.20%
0
Office of the Premier
364
300
453
184
61.33%
9
4.89
%
0
0.00%
0
Provincial Legislation
217
0
0
0
#DIV/0!
0
#DIV/
0!
0
#DIV/0!
0
Provincial Treasury
367
287
99
50
17.42%
0
0.00
%
0
0.00%
0
1,735
0
0
0
#DIV/0!
0
#DIV/
0!
0
#DIV/0!
0
Agriculture Environment
Affairs & Rural Dev
Arts and Culture
Co-Operative Governance
Traditional Affairs
Economic Development and
Tourism
Public Works
#DIV/
SUMMARY OF DATA
 The HCT uptake is low.
 3253 Pre-test counselled & 1449 employees
tested in 75 events/sessions
Average: 43 Pre-counselled & 19 tested employees per event
 Screening for TB a challenge.
 Challenge with capturing as different service
providers use different reporting tools.
 Capturing in the Provincial Nerve Centre per
district remains the only solution – When data
is captured in districts, there is no separation
between community and employees.
RECOMMENDATIONS
 Aggressive strategy to be developed to encourage
employees to do regular health screenings.
 An assessment to be conducted to ascertain reasons for
low uptake.
 Re-design and intensify the HCT & TB Campaign in line
with the Minister of DPSA’s directive.
 Capacitate departments to manage health screenings.
 Strengthen the current referral system.
 Office of the Premier to continue assist departments,
prioritising those who are currently not reporting.
THANK YOU