HORIZONS PROJECT
Different Models of Delivering Antiretroviral Therapy and Integration with Tuberculosis Services in South Africa: A Situation Analysis

In 2005, the South Africa Department of Health (DOH) reviewed its Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment. The DOH decided to adopt the lessons and strategies developed by the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD), which recommend collaboration of HIV and tuberculosis (TB) programs. The strategies of WHO and IUATLD emphasize the delivery of antiretroviral therapy (ART) and TB services in the same place at the same time to increase patient adherence and to improve treatment outcomes.

The Government of South Africa has set standards and protocols for providing services for TB and HIV patients, but there are gaps in the implementation process, which is not well documented. Therefore, the Horizons program is seeking to:

1. Articulate or identify key output and outcome indicators of ART and TB service provision.
2. Document financial and human resources inputs, processes, outputs, and outcomes in the ART treatment facilities selected for the study.
3. Document which of the service-delivery models (e.g., government with private, government alone, and so forth) have the inputs and processes that lead to successful delivery.
4. Describe and document how TB and HIV services have been integrated, if at all, in different sites.

The situation analysis is being conducted in four provinces: Gauteng, Mpumalanga, Limpopo, and North West Provinces. Ten sites are involved: three government/public health facilities, one private public health facility, four NGO health facilities, and two private health facilities.

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Location

Eastern Cape, Gauteng, KwaZulu-Natal, Free State, Limpopo, Western Cape Provinces, South Africa

Duration

July 2006–June 2007

Horizons and Population Council researchers

Tonicah Maphanga, Naomi Rutenberg, Lewis Ndhlovu

Non-Council collaborator

Lindiwe Madikizela (consultant)

Donor

US Agency for International Development

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See Also

• South Africa

• Horizons Program

• HIV and AIDS

• HIV and AIDS/Policy Development

• HIV and AIDS/Prevention

• HIV and AIDS/Treatment, Care, and Support

• Quality of Care

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