SANAC and National Department of Health

NATIONAL EXPANSION PLAN NATIONAL EXPANSION PLAN FORFOR

HIV/AIDS PREVENTION AND HIV/AIDS PREVENTION AND TREATMENTTREATMENT

Background

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World AIDS Day 2009President announces new approach in the fight against HIV and AIDS

All public health facilities (fixed and mobile) must provide HIV testing

All PHC facilities to provide ARTDirects that the announcement will be with effect from 1st April 2010

National Strategic Plan on HIV and AIDS, 2007-2011

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GoalsTo reduce the rate of HIV infection by 50% by 2011

80% of people that need treatment to be provided with antiretroviral treatment

Implementation of World AIDS Day Announcements

Prevention Strategy Package for HIV/AIDS

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1. Information, education, mass mobilisation

2. STI detection and management

3. Know your status – HIV testing and counselling

4. Widespread provision of condoms (male and female)

5. Prevention of mother to child HIV transmission (PMTCT)

6. Safe blood transfusion

7. Post-exposure prophylaxis

8. Life skills educationMedical male circumcision

HIV Counselling and Testing (HCT) Campaign

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HCT is moving from voluntary testing, to a service delivery

model to offer HCT to all patients at their entry point in the

health system. Objectives

1. Mobilize people to know their status.2. Support people with key prevention messaging in

order to take proactive steps to a healthy lifestyle irrespective of HIV status

3. Increase incidence of health seeking behaviour; and

4. Increase the access to treatment, care and support

Components of the HCT Campaign

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National LaunchProvincial launches (all 9 provinces)

Mass social mobilisationCommunication and advocacyHealth systems strengtheningOngoing monitoring & evaluation

Campaign Theme – Continuation from World AIDS Day

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I AM RESPONSIBLE...I must take responsibility for my own

health and HIV status i.e. if I am HIV negative, to stay negative, if I am HIV positive, to seek support and services

to ensure I am healthy and don’t spread the virus to others, be they

partners or children

Campaign Theme – Continuation from World AIDS

Day

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WE ARE RESPONSIBLEI must take responsibility for enabling

those in my sphere of influence to make healthy choices (be they my children, my sexual partners, my

employees etc.)

Campaign Theme – Continuation from World AIDS

Day

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SOUTH AFRICA IS TAKING RESPONSIBILITY

Government is taking responsibility to ensure quality services are available

when people present to test

Target Population, June 2011

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15 million people targeted for HCT by June 200113.8 million people in 9 initial launch districts 9.9 million in phase II (July 2010 – March 2011)1.2 million in phase III (April – June 2011)Paying specific attention to 18 health priority

districts (poorest districts)

LocationHealth facilitiesSchool campaignOutreach in the community (mobile units)

HCT Rollout Plan

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Province Districts Rolled out Apr

– Jun 2010Phase I

Districts Rolled out Jul 2010 –

Mar 2011Phase II

Districts Rolled out Apr – June

2011Phase III

EC 1 3 3

GP 1 3 2

LP 1 2 2

NC 1 2 2

WC 1 2 3

KZN 1 5 5

MP 1 1 1

FS 1 2 2

NW 1 2 1

TOTAL 9 22 21

HCT Targets – Initial launch districts

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   TOTAL

POPULATIONTARGETED

POPULATION

TARGETED PRETEST COUNS

TARGETED TESTS

EC OR Tambo 1,828,557 1,009,611 544,177 494,709

FS Motheo 794,184 519,765 280,154 254,685

GP Ekurhuleni 2,622,298 1,805,692 973,268 884,789

KZN Ugu 710,847 425,518 229,354 208,504

LP Capricorn 1,206,089 696,763 375,555 341,414

MP Gert Sibande 920,205 568,001 306,152 278,320

NWDr. Kenneth Kaunda 708,193 466,495 251,441 228,583

WC Cape Town 3,242,009 2,167,516 1,168,291 1,062,083

NCJT Gaetswe (Kgalagadi) 197,627 116,970 63,047 57,315

Total 12,230,009 7,776,331 4,191,439 3,810,402

HCT Targets- Provinces

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 TOTAL

POPULATIONTARGETED

POPULATION

TARGETED PRETEST COUNS

TARGETED TESTS

EC All districts 6,884,482 4,117,741 2,219,462 2,017,693

FS All districts 2,972,983 1,926,174 1,059,396 963,087

GP All districts 9,859,543 6,834,865 3,683,992 3,349,084

KZN All districts10,077,620 6,243,334

3,365,157 3,059,234

LP All districts 5,357,949 3,144,090 1,694,664 1,540,604

MP All districts3,646,123 2,236,374

1,205,405 1,095,823

NW All districts 3,229,078 2,038,488 1,098,745 998,859

WC All districts 4,945,732 3,280,801 1,768,351 1,607,592

NC All districts 1,108,599 689,675 371,735 337,941

National 48,082,109 30,511,542 16,466,907 14,969,917

HCT Campaign National Launch

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Proposal:Venue: Gauteng ProvinceDate: 15th April 2010Target person: President / Deputy President

National Campaign

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Mass media – national radio, television, video snippets, personal journeys and testimonials of range of South Africans(Includes Prevention messaging)

Cell phone outreach to encourage testing

Use of new technologies for outreach and monitoring

Provincial Launches

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• The event will be simultaneously launched in the other 8 provinces by the National Ministers and Deputy Ministers on 19 April 2010

• The provincial launches will take place at the largest and most accessible hospital/health facility in the selected district (next slide)

• Form: health and wellness fairs, offering visitors access to a range of health tests available through the health facility. Mobile testing will also be offered by partners

HCT Campaign Provincial Launches - 19th April 2010

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(As selected by Provinces)Province DistrictEastern Cape OR TamboFree State MotheoGauteng EkurhuleniKwaZulu-Natal UguLimpopo CapricornMpumalanga Gert SibandeNorthern Cape JT GaetseweNorth West Dr. Kenneth KaundaWestern Cape City of Cape Town

District social mobilisation interventions (all SANAC sectors)

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Door to door campaigns Taxi rank/malls/public gathering activations

Education Institution eventsCommunity eventsEngaging the religious sectorLinking HCT to existing community events, health and wellness days

Health Systems Strengthening

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Health facility readiness includes:Recruitment of health workers: oRetired nurses and other cadres of health workers

Orientation of health care workers in the new HCT guidelines

Health Systems Strengthening

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Health facility readiness includes:Forecasting and quantifying test kits and commodities up to June 2011

Procurement of test kits and commodities – national tender in place

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Flow Diagram – HIV Positive

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Flow Diagram – HIV Positive Pregnant Women

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Full range of services to be provided by HCT sites

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HIV counselling and testing (HIV)Blood pressure (Hypertension)Blood sugar (Diabetes mellitus)HB (Anaemia)STI screening (questions and referral)

TB screening (symptomatic screening, 5 questions)Full clinical TB screening if yes to any of the 5 questions (sputum, culture, x-rays)

HIV Testing Capacity

Condoms

Medical Male Circumcision

INH Prophylaxis for TB Prevention

ART for Pregnant Women

TB-HIV Co-infected Patients

Infants accessing ART

Total ART Patients

ART Provision

4,300 PHC

Facilities providing

Full package ART by March 2011

Human Resources

Additional Health Workers

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Lay counsellors – 9,000 to be trained, in facilities

Nursing Council – 9,385 letters sent to retired pharmacists, social workers, SA Retail Association

50 testing sites to be set up in 50 malls by April 2010, increasing to 500 sites in 3 years

ENDEND