HORIZONS PROJECT
Exploring Current Practices in Pediatric ARV Rollout and Integration with Early Childhood Programs in South Africa

After conducting an initial consultative workshop on pediatric HIV treatment in South Africa with expert practitioners and stakeholders, Population Council researchers visited antiretroviral (ARV) programs at 16 health facilities in five provinces. Together, the 16 sites were treating approximately 1,300 children on antiretroviral therapy (ART). Council researchers used qualitative and quantitative data collection methods, including observations of facilities, semi-structured questionnaires administered to various categories of health workers, and open-ended interviews with facility managers. In addition, a policy review was conducted.

Key findings include:

• There is currently no standardized training program on the management of pediatric HIV and AIDS available to medical personnel in South Africa, and most doctors report self-training and mentorship training in lieu of formal training.
• Nurses report fear of drawing blood from young children and complicated dosing for pediatric ARVs as barriers to expanding access to the lifesaving drugs to children.
• Referrals for the majority of children come from primary-level facilities and inpatient wards at hospitals. Linkages with prevention of mother-to-child transmission programs are weak.

Results and recommendations from the study have been disseminated to the study sites to guide them in strengthening their services. They also were shared with advocacy groups and government policymakers to inform their ongoing ARV rollout planning processes. Horizons is planning follow-on studies that will examine family-centered models of service delivery and the identification of orphans and vulnerable children in the community who need care.

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Location

Eastern Cape, Gauteng, KwaZulu-Natal, Western Cape Provinces, South Africa

Duration

November 2004–February 2006

Horizons and Population Council researchers

Naomi Rutenberg, Lewis Ndhlovu

Non-Council collaborators

Tammy Myers (Baragwaneth Hospital)

Gerald Boon (Cecilia Makawane Hospital, East London)

Willem Vlok (McCord Hospital)

Eric Goemaere (Médecins Sans Frontières/Khayelitsha)

Herman Reuter (Médecins Sans Frontières/Lusikisiki)

Brian Eley, Desireé Michaels (University of Cape Town)

Lizzy Tabane (University of the Free State)

Donors

US Agency for International Development

University of Cape Town, Infectious Disease Epidemiology Unit

Publications/Resources on this project

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See Also

• South Africa

• Horizons Program

• Gender and Family Dynamics

• Gender and Family Dynamics/Family Dynamics

• HIV and AIDS

• HIV and AIDS/Consequences for Individuals, Families, and Society

• HIV and AIDS/Orphans and Vulnerable Children

• HIV and AIDS/Prevention

• HIV and AIDS/Treatment, Care, and Support

• HIV and AIDS/Youth

• Reproductive Health

• Transitions to Adulthood

• Transitions to Adulthood/Critique of Current Approaches

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