Naomi Lince-Deroche

Naomi Lince-Deroche is no longer working for HE2RO


  • 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 
  • A Cost Description of HIV Counselling and Testing (HCT) Models in South Africa

    South Africa’s National Strategic Plan for 2011-2016 (NSP) aims to see a halving of HIV incidence over this period, and a realisation of 80% HIV treatment coverage, or 3 million patients on antiretroviral therapy (ART). The realisation of these goals relies on increased and equitable access to and uptake of HIV Counselling and Testing (HCT). Achieving sustained high levels of HCT in turn requires accurate cost data from which budgeting decisions can be extrapolated. Although a number of 
  • Establishing a Package of SRH Services for HIV-Positive and Negative Women

    South Africa has extensive guidelines and policies regarding the provision of sexual and reproductive (SRH) services; however, there are limited, if any, resources available which provide guidance on the current costs of service provision and the potential costs given new policy goals for increasing access. HE2RO staff are engaging policymakers at the national and provision level to establish a clearer understanding of SRH funding in the country and goals for shifting and/or scaling up access. 
  • Contraceptive Service Delivery

    South Africa recently launched new guidelines for contraceptive provision and approved the contraceptive implant for use in the country. The new guidelines provide targets for shifting the contraceptive method mix and increasing contraceptive prevalence over time. Integrated primary health care requires that patients are able to access all primary health services, including contraceptive services, at one facility. Dedicated HIV facilities have not historically offered these services, but there 
  • Managing Breast Conditions, Including Breast Cancer

    Breast cancer is the most common cancer among women worldwide. It also affects men. However, breast cancer is just one of many breast conditions which may require diagnosis and treatment. Access to comprehensive breast care services is extremely limited in South Africa. Further, little information exists as to the prevalence and epidemiology of breast masses in HIV-infected women and men across the country. HE2RO is partnering with the Breast Care Clinic at Helen Joseph Hospital, Right To Care 
  • Approaches for Diagnosis and Treatment of Sexually Transmitted Infections (STIs)

    South African guidelines call for syndromic management of most STIs, including HPV. With this approach, symptomatic individuals are given treatment for a diagnosed “syndrome” rather than a specific pathogen. Although this approach is recommended for low-resourced settings, the frequent lack of any or specific symptoms in women infected with (an) STI(s) may lead to over or under treatment and continued transmission of STIs and HIV. New technologies, including point-of-care diagnostics, may 
  • Costs and Cost Effectiveness of Alternatives for Cervical Cancer Screening and Treatment

    Cervical cancer is one of the most common cancers among women worldwide. Most is caused by persistent infection with high-risk human papillomavirus (HPV). Recent research shows that HIV is a major risk factor for both HPV infection and progression to cervical cancer. In South Africa, where HIV prevalence is high, HPV infection and cervical cancer are significant public health challenges. Scarcity of service delivery capacity in rural communities and specialist services in urban communities 
  • An Evaluation of an Automated Dispensing System for Pharmaceutical Services

    In both developed and developing countries, pharmaceutical management is a critical issue due to escalating health care costs and increased pressure to improve access to services. The past few decades have seen the role of pharmacy staff expanding. For example, in many resource limited settings burdened by HIV, the complexity of HIV-related medication, the increased life span of HIV-positive patients that comes with antiretrovirals, and the comorbidity of HIV/AIDS with other diseases has 
  • An Evaluation of the Acceptability and Feasibility of Booked Appointments in a Large HIV Clinic in Johannesburg, South Africa

    In many resource-limited settings, health care delivery systems face constraints due to increasing need for health expenditure and the large proportion of the population reliant on the public sector. In South Africa, the existing service delivery structure faces additional challenges related to the growing number of HIV-infected South Africans initiating antiretroviral therapy. Long queues, long wait times, and overcrowding are often characteristic of South Africa’s public health care