MatCH provides support for adult treatment programs in eThekwini and Umkhanyakude districts in KZN which have a combined population of approximately 4,2 million; an antenatal prevalence rate of 37.4% in 2011; and a disproportionately high incidence of HIV & TB, especially amongst young women of reproductive age (15-24 years). In FY12 MatCH had initiated nearly 96,500 adults on ART. District targets for FY13-14 are150,000 adults on ART. Retention in care is currently > 85%.Technical support for adult treatment will be provided to district level services including training, coaching, quality assurance, assisting with complicated referrals and management of adult cases. Uptake of these specialized services will be monitored on a monthly basis. This will facilitate the transition from service delivery to technical support at facilities.
MatCH will support KZN DOH with technical skills development through in-service, on-site training and mentoring for health workers (doctors, nurses, pharmacy assistants, counselors, data entry staff, managers, community care-givers (CCGs)). Training will include ‘core’ topics such as PICT, ART, PMTCT, HIV-related diseases, adolescent and pediatric care & counseling, SRH, nutrition, GBV, TB, HIV prevention. MatCH will also work with KZN DOH to pilot and roll out task shifting and task sharing interventions. MatCH roving and on-site multidisciplinary teams will support program implementation. MatCH will work with DOH district, sub-district and facility teams to implement models for task-shifting including mentoring in nurse initiated management of ART (NIMART) at PHC sites and supporting PHC nurses to complete dispensing courses; increasing skills and capacity of pharmacist assistants through pre-and in-service training, and utilization of CCGs for HIV defaulter tracing. The implementation of SOPs and guidelines for decentralizing and integrating HIV care and related training of health providers and health management is key to successful, comprehensive task-shifting programs and MatCH will provide training and dissemination of good practice and lessons learned. MatCH roving doctor advisors, pharmacy advisors and pharmacy assistants will mentor DOH staff in Supply Chain management at PHC facilities in accordance with DOH regulations.
MatCH will support data collection at sites using standardized tools and reporting via the DHIS. DOH Health and data entry staff will be trained on M&E tools and indicators. Strengthening district capacity to conduct monitoring and capacity –building activities will be a key focus. Monthly and quarterly DHMT meetings will be held to review DHIS data and monitor progress towards achievement of targets. In addition, an annual review of the KZN PSP 2012-2016 will be conducted.
MatCH will assist DHMTs with target setting and verifying Adult ART data reported to the DHIS. MatCH will also support tracking of ‘Reach against Targets’, entry into care and retention in care and implement interventions to improve retention e.g. telephonic follow-up of clients, home visits, SMS reminders. Findings will be used to inform program improvement, and provide baseline information to initiate defaulter tracing programs; to improve data systems and quality of care at facilities; and to address loss to initiation and delays in accessing treatment.
Support for human resource development, financial management and governance will improve adult treatment service delivery and outcomes.
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Treatment
PDTX
1,093,719
0
Narrative:
MatCH provides support for adult treatment programs in eThekwini and Umkhanyakude districts in KZN which have a combined population of approximately 4,2 million; an antenatal prevalence rate of 37.4% in 2011; and a disproportionately high incidence of HIV & TB, especially amongst young women of reproductive age (15-24 years). In FY12 MatCH had initiated nearly 96,500 adults on ART. District targets for FY13-14 are150,000 adults on ART. Retention in care is currently > 85%.Technical support for adult treatment will be provided to district level services including training, coaching, quality assurance, assisting with complicated referrals and management of adult cases. Uptake of these specialized services will be monitored on a monthly basis. This will facilitate the transition from service delivery to technical support at facilities.
MatCH will support KZN DOH with technical skills development through in-service, on-site training and mentoring for health workers (doctors, nurses, pharmacy assistants, counselors, data entry staff, managers, community care-givers (CCGs)). Training will include ‘core’ topics such as PICT, ART, PMTCT, HIV-related diseases, adolescent and pediatric care & counseling, SRH, nutrition, GBV, TB, HIV prevention. MatCH will also work with KZN DOH to pilot and roll out task shifting and task sharing interventions. MatCH roving and on-site multidisciplinary teams will support program implementation. MatCH will work with DOH district, sub-district and facility teams to implement models for task-shifting including mentoring in nurse initiated management of ART (NIMART) at PHC sites and supporting PHC nurses to complete dispensing courses; increasing skills and capacity of pharmacist assistants through pre-and in-service training, and utilization of CCGs for HIV defaulter tracing. The implementation of SOPs and guidelines for decentralizing and integrating HIV care and related training of health providers and health management is key to successful, comprehensive task-shifting programs and MatCH will provide training and dissemination of good practice and lessons learned. MatCH roving doctor advisors, pharmacy advisors and pharmacy assistants will mentor DOH staff in Supply Chain management at PHC facilities in accordance with DOH regulations.
MatCH will support data collection at sites using standardized tools and reporting via the DHIS. DOH Health and data entry staff will be trained on M&E tools and indicators. Strengthening district capacity to conduct monitoring and capacity –building activities will be a key focus. Monthly and quarterly DHMT meetings will be held to review DHIS data and monitor progress towards achievement of targets. In addition, an annual review of the KZN PSP 2012-2016 will be conducted.
MatCH will assist DHMTs with target setting and verifying Adult ART data reported to the DHIS. MatCH will also support tracking of ‘Reach against Targets’, entry into care and retention in care and implement interventions to improve retention e.g. telephonic follow-up of clients, home visits, SMS reminders. Findings will be used to inform program improvement, and provide baseline information to initiate defaulter tracing programs; to improve data systems and quality of care at facilities; and to address loss to initiation and delays in accessing treatment.
Support for human resource development, financial management and governance will improve adult treatment service delivery and outcomes.
Implementing Mechanism Details
Mechanism ID: 17039
Mechanism Name: Comprehensive Clinic-Based District Services (Hybrid)
Funding Agency: U.S. Agency for International Development
The BroadReach Healthcare (BRHC) program supports the following objectives in support of SAG: 1) improve HIV-related population outcomes by strengthening health and patient management systems at district level; 2) build capacity of District Health Management Teams (DHMT)in coordination with provinces to support HIV/TB services and HSS; 3) support development and implementation of SAG policies for HIV-related interventions; and 4) support transition to a sustainable national comprehensive HIV/TB program. The objectives and TA delivered will be aligned to the USG-SAG PFIP, NSP, NSDA, PHC Reengineering program, NCS and NHI objectives. The BRHC Team supports the following districts: Ekurhuleni (GP), Sisonke (KZN), West Coast (WC), Bojanala (NW), and Ngaka Modiri Molema (NW) covering a total population of over 6,000,000. BRHC support will focus on the DHMT, while a CDC partner will focus on HSS at sub-district and facility levels.
BRHC’s capacity building and TA approach empowers SAG to assume leadership in the delivery of HIV/TB services, thus reducing costs over the life of the project. The mentorship and supervision provided by the BRHC Team will transition to SAG staff, and be monitored through the use of implementation and M&E plans. The approach leverages the BRHC Team’s technical expertise to deliver scalable and sustainable solutions while ensuring cost efficiencies.
BRHC’s M&E strategy will track results achieved, providing the basis for monitoring patient and client outcomes; monitoring performance and program quality; data quality management, reporting, dissemination and use; strengthening M&E capacity; and measuring program effects in the achievement of program, USAID and SAG objectives. Project outcomes will be monitored through mid-term and final evaluations
