All Policy Briefs

Delivery of antiretroviral therapy by nurses in South Africa: An evaluation of NIMART by facility type

South Africa now offers two major public sector approaches to NIMART: centralized, hospital-based HIV outpatient clinic and decentralized, full service, primary health clinics (PHCs). While both approaches typically use NIMART, hospitalbased clinics may use both nurses and doctors to manage ART patients whereas PHCs rely primarily on nurses. We evaluated the outcomes and costs of these two approaches to NIMART for HIV treatment 

THE HIV BURDEN ON INPATIENT FACILITIES: AN URBAN HOSPITAL IN JOHANNESBURG, SOUTH AFRICA

Prior to large-scale availability of antiretroviral treatment (ART) in South Africa public inpatient facilities were reporting an increase in the number of HIV infected patients presenting with serious HIV-related complications and AIDS . ART was first made available in South African at public health facilities in 2004 and since then the treatment program has grown to be the largest in the world with over 2.6 million on ART . It is commonly assumed that broad access to ART will reduce the 

Towards 90-90-90 How close is South Africa to reaching the UNAIDS HIV treatment targets?

UNAIDS has set a worldwide goal for the year 2020: for 90% of people with HIV to know their status, 90% of those diagnosed with HIV to be on ART, and 90% of those on ART to have viral suppression. Researchers at National Health Laboratory Service (NHLS), HE2RO and Boston University (BU) have been working to set up systems to monitor and evaluate the evolving HIV response in South 

DELIVERY OF ANTIRETROVIRAL THERAPY BY NURSES IN SOUTH AFRICA: AN EVALUATION OF NIMART BY FACILITY TYPE

When the South African national antiretroviral therapy (ART) program began in 2004, it relied primarily on hospital-based HIV clinics with services delivered by doctors . In 2010, in the face of increasing demand for care and limited personnel, South Africa revised its treatment guidelines to allow the initiation and management of patients on ART by nurses at both hospitals and primary health clinics under a program known as Nurse Initiated and Managed Antiretroviral Therapy (NIMART) . NIMART 

INITIATING ANTIRETROVIRAL THERAPY AT A PATIENT’S FIRST CLINIC VISIT: THE RAPIT STUDY

One of the most persistent operational challenges facing South Africa’s antiretroviral therapy (ART) programme is late presentation of patients for care and high rates of attrition from care between HIV testing and ART initiation. Even among those who have been diagnosed and found to be treatment-eligible, loss to care before starting ART has consistently been estimated at a third to a quarter of patients1,2.  There are multiple causes of loss to care before treatment initiation, but one 

Initiating Antiretroviral Therapy at a Patient’s First Clinic Visit: The RapIT Study

The RapIT study was conducted from 2013 to 2015  at two clinics in Johannesburg, South Africa. It was a randomized controlled trial of rapid ART initiation that allowed patients to have treatment eligibility determined, all treatment preparation steps performed, and ARV medications dispensed on the day of their first HIV-related clinic visit. Although it took place at only two clinics, both in urban areas in a single province, the RapIT trial showed that it is possible to start nearly all 

Pharmacy Automation for HIV Treatment: An Evaluation of Costs

In October 2012, an automated dispensing system (ADS) for dispensing antiretroviral medications (ARVs) was installed in the pharmacy in an outpatient HIV care and treatment site located in a public hospital in Johannesburg, South Africa. This site dispenses ARVs to almost 300 patients per day. The Health Economics and Epidemiology Research Office (HE2RO) evaluated the introduction of the ADS in this facility. In this policy brief, we report the estimated cost per script dispensed under manual 

SA HIV TB Investment Case Summary Report

On Mar 22, 2016 the reports for Phase 1 of the South African HIV and TB Investment Case were launched by the Deputy President during the World TB Day celebrations. HE2RO staff were heavily involved in all aspects of the development of the Investment Case, from devising the analytical framework to reviewing evidence for interventions and enablers to developing the novel optimisation method driving the model analysis to writing the 

SA HIV TB Investment Case Full Report

On Mar 22, 2016 the reports for Phase 1 of the South African HIV and TB Investment Case were launched by the Deputy President during the World TB Day celebrations. HE2RO staff were heavily involved in all aspects of the development of the Investment Case, from devising the analytical framework to reviewing evidence for interventions and enablers to developing the novel optimisation method driving the model analysis to writing the