Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 May 9;11(1):e1-e7.
doi: 10.4102/phcfm.v11i1.1831.

Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa

Dishiki Kalonji  1 , Ozayr H Mahomed
Affiliations
Observational Study

Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa

Dishiki Kalonji et al. Afr J Prim Health Care Fam Med. .

Abstract

Background: Tuberculosis (TB) is the most common presenting illness among people living with human immunodeficiency virus (HIV), with co-infection occurring in up to 60% of cases in South Africa. In line with international guidelines, South Africa has adopted an integrated model at primary healthcare level to provide HIV and TB services by the same healthcare provider at the same visit.

Aim: The aim of the study was to conduct a rapid appraisal of integration of HIV and TB services at primary healthcare level in eThekwini District in 2015.

Setting: The study was conducted in 10 provincial primary healthcare clinics in the eThekwini Metropolitan Health District in KwaZulu-Natal Province.

Methods: An observational, cross-sectional study was conducted. Key informant interviews with operational managers and community health workers were conducted, as well as a review of registers and electronic databases for the period of January to March 2015.

Results: Two clinics complied with the mandated integrated model. Three clinics were partially integrated; while five clinics maintained the stand-alone model. Possible constraints included reorganisation of on-site location of services, drug provision, TB infection control and inadequate capacity building, while potential enablers comprised structural infrastructure, staffing ratios and stakeholder engagement.

Conclusion: HIV and TB integration is suboptimal and will need to be improved by addressing the systemic challenges affecting health service delivery, including strengthening supervision, training and the implementation of a change management programme.

Keywords: HIV; health system; integration; primary healthcare; tuberculosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Three models of tuberculosis and human immunodeficiency virus/acquired immune deficiency syndrome service integration.
See this image and copyright information in PMC

References

    1. World Health Organization Global tuberculosis report 2015. Geneva: World Health Organization; 2016.
    1. World Health Organization HIV-associated tuberculosis. WHO (ed.). Geneva: WHO; 2015.
    1. National Department of Health Department of Health Strategic Plan 2015/16 – 2019/20. Pretoria: National Department of Health; 2015.
    1. Pillay-van Wyk V, Bradshaw D. Mortality and socioeconomic status: The vicious cycle between poverty and ill health. Lancet Glob Health. 2017;5(9):e851–e852. 10.1016/S2214-109X(17)30304-2 - DOI - PubMed
    1. KwaZulu-Natal Department of Health KwaZulu-Natal Department of Health-Strategic Plan 2014/15 – 2018/19. Pietermaritzburg: KwaZulu-Natal Department of Health; 2015.

Publication types

MeSH terms

LinkOut - more resources