What we do

Community Based Care
Community based care is the care that patients or clients can access nearest to home for their specific heath needs. During the 2008 alone an average of 4862 TB patients were supported daily by 498 Treatment Supporters and their team leaders based in the 8 sub-districts of the City of Cape Town.

• Workplace support
  Patients who choose to take their TB treatment at work are supported through this programme. In addition to the on-site training of the workplace supporter, health information sessions are conducted for workers and any persons with symptoms are referred to the health services for further investigation.
• Enhanced TB adherence pilot
  This pilot project was done in collaboration with City of Cape Town Health Department and the Medical Research council. The project aims to determine whether TB patients would benefit from the model of adherence support which is applied to patients living with HIV on Antiretroviral treatment.
• HIV support
  ARK (Absolute Return for Kids) funded a project and provided the training for 4 teams of Patient Advocates based at Hout Bay, Albow Gardens, Langa and DuNoon. They support patients on antiretroviral treatment through conducting home assessments, providing adherence support and facilitating referral for need services.

Rehabilitation
At every health facility we have an Area Treatment Supporter (team leader) who provides disease specific information to newly notified TB patients, to identify possible barriers to treatment adherence, to refer to appropriate resources and to link patients with Treatment Supporters.

Health Promotion
This programme also responds to requests from workplaces for health information sessions, peer education training and allaying fears of workers where a colleague has been diagnosed with TB.

Outreach and Additional Support

• Administrative support at high burden facilities
  The TB Assistant and TB Clerk programme provides administrative support for the TB nurses in facilities. This initiative is a partnership between the health services and TB/HIV Care Association whereby the day to day operational management of the TB Clerks and TB Assistants is the responsibility of the facility managers, TB/HIV Care is responsible for the human resource component and the provincial Administration provides the funding. In recruiting staff we target young school leavers who live in and know the area around the facility.
• Support at Brooklyn Chest Hospital
  • Paediatric project
    “Taking the kids out of their cots” is one of the aims of the project. Two edu-care teachers provide a structured programme of play for approximately 40 children admitted at any given time. Parents are also assisted with travel fare to ensure that the children are visited and our community based supporters assist with home assessments and follow-up of discharged children. A toy drive arranged with KFM radio and Standard Bank resulted in a generous donation of toys for the children.
  • Support for XDR and MDR patients
    In collaboration with the staff of Brooklyn Chest hospital conducted a survey among the patients to identify how their environment could be improved for XDR and MDR case holding. We now provide board games, music centres, music cd’s, bibles, guitars and subside travel for visitors.

Pollsmoor Correctional Services

With the health staff at Pollsmoor TB and HIV health information sessions have been given to the offenders. 10 offenders and 5 officials were trained to administer DOT (Directly Observed Treatment). Also mass TB and HIV screening has been carried out to screen all offenders at Pollsmoor.

Project Integrate

• VCT with TB and STI screening
  We have established 5 non-clinical voluntary counseling and HIV testing (VCT) teams. Each team consists of a professional nurse counselor, two lay counselors and one community mobiliser. There are fixed community sites in Atlantis, Malmesbury and Vredenburg. Two mobile VCT teams have provided services in prisons, farms, factories and other workplaces. The project also supported VCT in 6 primary health care clinics and 3 hospital-based ART clinics. All of our counselors have provincially approved training and provide personalised risk reduction counseling according to national standards.
• Community mobilisers encourage community members to test for HIV by educating them about the benefits of knowing your HIV status and explaining that counseling and testing is free and confidential. Clients are routinely screened for TB and STIs during pre-test counseling. Counsellors and community mobilisers provide HIV prevention education, demonstrate the use of male and female condoms and distribute free condoms.
• Clinical mentorship
  Clinical training workshops were conducted for sub-district coordinators responsible for HIV/AIDS, STI and TB (HAST) and community based services (CBD) sub-district coordinators as well as facility managers and nursing staff from Saldanha, Matzikama and Cedarberg. Participants were trained on TB/HIV clinical care including WHO clinical staging, prophylaxis and treatment of opportunistic infections, diagnosis and treatment of TB in HIV-infected patients, tuberculin skin testing and isoniazid preventive therapy (IPT). Training reinforced the importance of routinely offering HIV testing to TB patients, and screening HIV-positive clients for TB at clinical visits. Training also addressed infection control and issues related to MDRTB in the context of HIV.
• Integrated community-based adherence support
  Project integrate trains community health workers on priority health issues to provide integrated community care. Their primary role is community-based adherence support for patients taking prophylaxis, ART and/or TB treatment. A patient who is on both TB and ART treatment is supported by the same community health worker. Community health workers are also responsible for the following activities:
  • HIV prevention and condom distribution
  • Education on STI symptoms and the importance of seeking treatment for STIs
  • Promotion of voluntary HIV counseling and testing
  • Education on TB symptoms and the importance of seeking treatment for TB
  • Education on the importance of adhering to prophylaxis, antiretroviral treatment and TB treatment
  • Identification of child contacts of TB patients who require TB prophylaxis
  • Assistance in obtaining social support grants
  • Referral to support services to address substance abuse and domestic violence
• Monitoring and evaluation
  Staff have been placed in health facilities to assist with TB/HIV monitoring and evaluation. TB/HIV Care has collaborated with the provincial HIV M&E unit to develop specifications for electronic HIV care register that is used in South Africa. We also provide technical support to the KwaZulu-Natal Department of Health M&E system that is being implemented through the province.