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Tonicah Maphanga,
Lewis Ndhlovu,
Lindiwe Madikizela, and
Naomi
Rutenberg. "Exploring the accessibility of ART and TB
services in health facilities in South Africa." (Poster no.
B198)
ABSTRACT
Background and objectives
In 2003, the South African government released a detailed
operational plan for treatment of HIV-infected individuals. While
tuberculosis (TB)
guidelines were also put in place to ensure access to TB screening
and treatment, there is little information about general
accessibility to antiretroviral therapy (ART) and TB services.
Methods
The study was conducted between October and December 2006, at 14
purposively selected health facilities in three provinces of South
Africa. Interviews were conducted with 262 patients accessing ART
and TB health facilities, and with 14 facility managers and 43
health care providers.
Results
Of the 262 patients, 61 percent had visited for ART services and the
rest came for TB treatment. The mean age of all patients was 39
years, and the majority were female (72 percent) and unemployed (85
percent). Type of
service accessed was significantly associated with sex: 54 percent
of males came for TB treatment compared to 33 percent of females,
whereas more females than males came for ART services (67 percent versus
46 percent). Ninety percent of patients indicated that they did not pay for
consultation services or medication. Of those who paid, the majority
(71 percent) said the cost was acceptable; only 11 percent thought it was very
expensive. The majority of patients (53 percent) reported that the
facilities where they obtained TB or ART services were far away, and
over half (52 percent) reported that they used some form of transport
(taxi, bus, train) to get to health facilities. Operating hours were
convenient for almost all patients (93 percent).
Conclusion
Consultation and medical costs are not key obstacles for
accessing services, but distance to facilities may restrict access.
That the majority of patients accessing ART and TB services were
women raises pertinent access issues for males, particularly for
ART, and suggests a need for strategies to bring them to services.
3rd South African AIDS Conference Web site
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