HIV epidemic in South Africa

22 December 2011

On 1 December 2009 President Zuma announced renewed efforts to address the HIV/AIDS epidemic in South Africa. This call was followed through by Dr Motsoaledi, the South African National Minister of Health, and targets were issued to institute the HIV/AIDS expansion program which included a massive upscale of HIV Counselling and Testing (HCT) and improved access for the many people with HIV who qualified for antiretroviral treatment.

However, South Africa faces the challenge of responding to a major HIV disease burden within the constraint of limited human resource capacity to provide and sustain care to the more than 5 million South Africans estimated to be living with HIV. In response to the need for rapid upscale of training for nurses in HIV care, the Human Resource Strategic Programme of the National Department of Health adopted the Integrated Common Programme (ICP) approach, a shift from the traditional classroom type training which draws nurses out of service, to on-site training through educational outreach.

The KTU assisted the National Department of Health in this drive for training to capacitate facilities to provide access to ART in primary care. Allowance has been made by the National Department of Health for nurses who receive appropriate training and are assessed to be competent to provide ART. This has become known as Nurse Initiation and Management of Antiretroviral Therapy (NIMART).

The KTU provides training in the PALSA PLUS guidelines which are fully aligned with current national HIV and TB guidelines and were last updated in November 2011. We have partnered the National Department in its drive to strengthen training through the regional training centres in the provinces and we have now established PALSA PLUS trainers in all nine provinces. This has required continued Training of Trainers, and encouragement of these trainers to take the PALSA PLUS guidelines and training into their designated facilities. The on-site training has allowed for rapid scale up and effective distribution of the guideline.

We are working hard to mobilize all resources and secure provincial and district support to continue this project. Funding was initially provided by the National Department of Health, and the magnitude of this roll out needs considerable funding. Thanks to Discovery Health who responded to this need in 2010, the KTU has been able to continue with training and distribution of the guidelines in the provinces of Free State, Northern Cape, Limpopo, Free State, Northern Cape, Kwazulu Natal, Gauteng and Mpumalanga. The South Africa National Clothing and Textile Workers Union also supported the KTU to conduct training in Kwazulu Natal and the Free State, providing coverage for their health providers and allowing this to benefit the districts where they are working. The Centre for Disease Control stepped in to support training in the Eastern Cape, and training in the Western Cape continues to be supported by that province. This wide scale roll out of PALSA PLUS in the country is helping to secure familiarity with National policy and build confidence and competence of nurses to treat and manage HIV & TB.

Our aim for 2012 is to continue to support the provincial PALSA PLUS master trainers and facility trainers to reinforce the appropriate management of HIV, TB & STIs.

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