Assessing the Impact of Integration of HIV and TB Services into Primary Health Services in the Public Sector in South Africa: An Evaluation of Resource Utilisation at Facility Level

Early in the HIV epidemic, in South Africa and other low income countries, HIV and TB services were provided in vertical programs as a result of disease-specific funding or approaches to service provision. Provision of separate services for specific health problems or specialisation usually means that patients need to visit separate and specialised clinics for their different health problems or needs, and can result in “missed opportunities” for service provision, fragmented and inefficient services and possibly also duplication of services. South Africa is exploring the potential for integrated services, yet an exact model for integration does not exist and the implications of such a model are not known. At the national level, there are conversations underway about the best models for integration and where and how integration should take place, and guidance is urgently needed. This study aims to examine the impact of integration of HIV and TB services into PHC services in terms of resource utilisation from the health care provider’s perspective.