With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the TB/HIV Care Association runs a clinical nurse mentorship program to improve good clinical practice in South African health facilities in the Sisonke District of southern KwaZulu-Natal. The program strengthens the standardized monitoring and evaluation system, and teaches staff to use data to make their programs more efficient and effective. Responding to high levels of HIV and TB infection, public health facilities provide a comprehensive integrated TB/HIV service.
The nurse mentorship program has placed a nurse mentor in each of the 5 sub-districts of Sisonke to mentor the staff and provide supportive supervision. Mentoring is done through regular, onsite visits, and training is provided on integrated TB/HIV management, intensified TB case finding, infection control and isoniazid preventive therapy, which prevents TB in communities affected by HIV. Quarterly meetings on HIV/AIDS, sexually transmitted infections and TB are held to review key program results and to discuss issues of concern. As a result of the mentorship program, 98% of HIV-positive clients are screened for TB. The program has also has increased implementation of isoniazid preventive therapy by identifying and removing the barriers to implementation. Over a nine month period, there was excellent adherence to preventative therapy and no cases of TB were diagnosed in 3708 patients initiated on isoniazid preventive therapy. This represented 30% of the 12,433 people in pre-ART and ART care.
The mentorship program has also strengthened efforts to prevent the spread of TB. There is a designated infection control person in each of the supported facilities and a written infection control plan. The infection control tool is used to audit the site quarterly and action plans are made to address gaps that are identified.
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