Gauteng delivers poor quality of HIV services, according to new report

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  • Data collected over two three-month periods 
  • More than 4 000 healthcare users surveyed
  • Staff shortage a key issue


Gauteng healthcare services for people living with HIV are found to be of poor quality, according to a new report by Ritshidze called the Gauteng State of Health.

Ritshidze is a community-led monitoring collaboration by organisations representing people living with HIV including the Treatment Action Campaign, the National Association of People Living with HIV, Positive Action Campaign, Positive Women’s Network and the South African Network of Religious Leaders Living with and affected by HIV/AIDS.

The group monitors 120 clinics and community healthcare centres across the province. The report was developed using data collected over two time periods -  July, August and September 2020 and October, November and December 2020.

About 4 137 healthcare users were surveyed in both periods. About 83% of the participants were people living with HIV, 67% identified as female and 80% were over 25 years of age.

Recently, the Thembisa model found that Gauteng was the second worse performing province in reaching HIV 90-90-90 targets.

Findings

The 32-page document found that one of the contributing factors in poor healthcare delivery is the shortage of staff. This has led to patients waiting for a long time when collecting their antiretroviral therapy (ARV).

Ritshidze’s monitoring shows that in the first round of the survey, 75.8% of facility managers reported that there was not enough clinical and non-clinical staff at their facilities. The situation worsened when in the second round where 77,5% from 111 responses showed a decline in clinical and non-clinical staff at facilities.

Other findings include the lack of ARV adherence clubs, staff attitude being a major barrier reports of staff reactions to people who missed a facility visit for ARV collection were often “unwelcoming, unempathetic, or at worst objective human rights violations”.

At clinics, only 56.3% of patients thought that the staff were friendly and professional. The group also received a wide range of complaints of drug stockout, which has impacted people’s adherence to their medication.

The interventions needed

Ritshidze recommends that the State ensure that all vacancies are filled in 2021 and that additional staffing costs should be prioritised for healthcare workers.

The group wants the provincial government to eradicate barriers that cause stockouts, to ensure that by the end of March 2021 a full audit of all public health facilities to assess whether sufficient TB infection control measures are in place and to increase the availability of services to key populations such as sex workers, men who have sex with men, transgender people, and people who use drugs.

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