The scale up of access to HIV care and treatment is critical to the success of achieving the UNAIDS 95-95- 95 goals in South Africa (SA)(1). There were an estimated 5.4 million people on Antiretroviral therapy (ART) in the SA public sector in 2021, including 137,655 children (<15 years) and 5,328,800 adults(2). Despite the large HIV burden, it is estimated that only 62% of the 7.5 million people who are living with HIV (PLHIV) in the country are on ART. Recent reports suggest that the
The scale up of access to HIV care and treatment is critical to the success of achieving the UNAIDS 95-95-95 goals in South Africa (SA)(1). There were an estimated 5.4 million people on Antiretroviral therapy (ART) in the SA public sector in 2021, including 137,655 children (<15 years) and 5,328,800 adults(2). Despite the large HIV burden, it is estimated that only 62% of the 7.5 million people who are living with HIV (PLHIV) in the country are on
The district health management structure contains several key areas important for the management of the HIV, AIDS, STIs and TB (HAST) and community outreach services (COS) interventions managed under the HAST programme. These work areas include clinical, data, human resource, supply chain management and
Procurement planning is part of the District Health Plan (DHP) development process which involves a needs analysis of health facility and sub-districts. The needs analysis includes assessment of skills to inform the Human Resources Plan which is an important element in the DHP process. During the procurement process, the districts formulate a document referred to as the demand plan, or a wish list of purchases for the next financial year. The demand plan is completed between February and March
The achievement of the objectives of the HIV, AIDS, STIs and TB (HAST) and community outreach services (COS) business plans relies on effective working relationships between different stakeholders. Therefore, optimising communication between key stakeholders such as financial and HAST programme managers is necessary for optimal planning and achieving district-level objectives. This brief presents the communication-specific outcomes of engagements conducted to understand bottlenecks to HAST
Understanding the sources, validity and accuracy of data is extremely important in the development of the HIV, TB and STI (HAST) business plans. It is important that both the finance and programme managers monitor the implementation of all indicators including budget and output measures. Effective data management can help in tracking progress against indicators in each level of a performance-based management cycle. This includes data collection to ensure accurate data records exist, data
A 10% increase in HIV prevalence was noted in the West Rand district municipality of Gauteng province between 2011 and 2015. This was anticipated as mortality rates declined due to a growing ART programme and patient adherence to treatment. Our research investigated how the burden of HIV is managed in the national and local policy frameworks, particularly looking at how South Africa’s National Strategic Plan (NSP) for HIV, TB and STIs is adapted for implementation at the municipal level
Measuring the impact of an intervention or technology on clinical tasks often involves performing a time and motion study. While some studies rely on passive observation and specific activities are timed, others ask staff to keep a log file to estimate the time spent on a specific activity (Kranzer et al, 2012), but both are subject to observer errors. HE²ROand IBM investigators worked together to develop non-invasive electronic devices or “wearable tags” to conduct a time and motion (TIM)
AIDS-related mortality among working-age adults reduces GDP growth but has an ambiguous effect on GDP per capita. In the short run, population size decreases due to reduced fertility and increased child mortality owing to HIV, and GDP per capita increases, but this results in lower growth of the working-age population and of GDP in the long run. A smaller elderly cohort due to HIV-related early mortality mitigates the fiscal burden of an ageing population, but as HIV treatment is scaled
AIDS-related mortality among young adults results in an increase in the number of orphans, and orphanhood is associated with impaired access to education. Early mortality among working-age adults causes a loss of skills and experience and a drop in returns to investment in education. Educational outcomes have weakened in regions with higher HIV prevalence but investments in the HIV response are effectively mitigating HIV’s negative impact on human
The direct effects of health-related productivity shocks on economic output are magnified by their negative impact on investment. Poorer health decreases productivity, which results in lower economic output and consequently lower investment, which again reduces productivity and output over time. Higher mortality reduces incentives for saving and investment. Empirical studies (not HIV-specific) suggest that this could be an important link between HIV and growth, but there is no clear
Early on, there were concerns that AIDS-related mortality would erode state governance and institutions and thus compromise economic development, but there is little evidence to suggest that such effects have been significant. HIV – especially at late stages of disease progression –results in reduced productivity and lower employment of people living with HIV, though the economy-wide effects are unclear. Treatment has been effective in restoring the productivity and – with some
