HST Blog

​By: Nandipha Jacobs (Project Manager UB eThekwini) and Rakshika Bhana (Programme Manager: Health Systems Strengthening)

Addington Hospital – HAST Unit, discussion on patient case management

The Unfinished Business for Adolescent and Paediatric HIV programme in KwaZulu-Natal (UB project), funded by the ELMA Philanthropies, is implemented in three districts, namely eThekwini, uMgungundlovu and Zululand, and seeks to improve outcomes for the age group 0–19 years across the HIV 90-90-90 cascade. This multi-year programme is implemented in collaboration with the KwaZulu-Natal Department of Health (DoH) and is part of a UB Consortium comprising CHAI (National Co-ordination), ANOVA Health Institute, WITS RHI and the Health Systems Trust (HST).

A delegation from ANOVA Health Institute led by Dr Carol Tait (Project Advisor: Paediatric and Adolescent Scale-up Project) and Dr Nomcebo Nene (Project Manager: Paediatric and Adolescent Scale-up Project) visited the Unfinished Business project in eThekwini district for a benchmarking visit on 26 and 27 May 2022. The purpose of the visit was to look at, and assess HST strategies and interventions targeting the 15 to 19-year-old age groups. This visit took place over two days comprising of health facility visits at selected facilities, a presentation by HST's community case management partner Cindi Network and a debriefing session.

Three facilities in eThekwini district were selected for the facility visits. These were Addington Hospital, Chesterville Clinic and Sivananda Clinic. These facilities were selected based on their HIV performance cascade targets, the resources mix, UB strategies implemented at the different facilities and different institutional arrangements that exist in each, for example, Chesterville Clinic is a municipal clinic. 

Some of the key lessons learnt from the visit as captured from the debriefing session included: 

• The provision of Adolescent and Youth Friendly Services (AYFS) and flexibility of the AYFS package/services offered at facilities to the youth creates demand for these services. The services offered are also aligned to resources available in the facility.
• The importance of understanding the patient flow of the target group and consistent reviewing of the flow, with optimal use of the space available in health facilities.
• The hosting of youth care clubs over weekends to attract youth who cannot attend during the week.
• The consistent use of the HIV screening tool and viral load monitoring tool to improve client outcomes.
• The importance of ownership of the programme by DoH staff as well as community partnerships fostered in each health facility. Collaboration is a critical factor to ensure sustainable client outcomes.
• The value adds offered by the UB outreach team in tracking and tracing clients, including the community-based campaigns hosted to improve service demand.
  

Rakshika Bhana.

HST's Health Systems Strengthening Manager, Rakshika Bhana said: "HST is passionate about promoting AYFS that are tailored to the needs of youth, and at the same time ensuring that the quality of service standards are met."