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Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of non-governmental organisations in a South African district

Author

Listed:
  • Simukai Shamu
  • Jean Slabbert
  • Geoffrey Guloba
  • Dalene Blom
  • Sikhulile Khupakonke
  • Nomea Masihleho
  • Julius Kamera
  • Suzanne Johnson
  • Thato Farirai
  • Nkhensani Nkhwashu

Abstract

Introduction: Although current data projects South Africa potentially meeting the UN target to test 90% of all people living with HIV by 2020, linking them to HIV care remains a big challenge. In an effort to increase linkage to care (LTC) of HIV positive clients an innovative collaborative intervention between two non-governmental organisations was developed and implemented between 2016 and 2017. This paper investigated the outcome of this collaborative intervention. Methods: We used a mixed methods approach to assess the outcome of the innovative relationship. This was done by analysing routine programmatic quantitative data on LTC between 2015 and 2017 and qualitatively interviewing five programme managers, four programme implementers and five HIV positive clients on their perceived success/failure factors. Qualitative data were analysed using thematic content analysis while LTC rates were descriptively analysed. Two consultative meetings presented draft findings to programme managers (n = 7) and implementers (n = 10) for feedback, results verification and confirmation. Results: In 2015 cumulative LTC rate was 27% and it rose to 85% two years post-intervention in 2017. Six themes emerged as success factors at the health system and structural levels and these include: provision of client escort services, health facility human resource capacity strengthening, inter and intra-organisational teamwork, onsite LTC, facilitated and expedited jumping of queues and shifting administrative tasks to non-clinical staff to protect nurses’ time on ART initiation. These measures in turn ensured increased, affordable and swift ART initiation of clients while strengthening client support. Conclusions: We concluded that multi-faceted interventions that target both health system challenges including staff shortages, efficiencies, and extended facility opening times, and structural inadequacies, including client time and resource limitations due to poverty or nature of jobs, can help to increase LTC.

Suggested Citation

  • Simukai Shamu & Jean Slabbert & Geoffrey Guloba & Dalene Blom & Sikhulile Khupakonke & Nomea Masihleho & Julius Kamera & Suzanne Johnson & Thato Farirai & Nkhensani Nkhwashu, 2019. "Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of non-governmental organisations in a South African district," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-14, January.
  • Handle: RePEc:plo:pone00:0210826
    DOI: 10.1371/journal.pone.0210826
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    References listed on IDEAS

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    1. Pfeiffer, J. & Johnson, W. & Fort, M. & Shakow, A. & Hagopian, A. & Gloyd, S. & Gimbel-Sherr, K., 2008. "Strengthening health systems in poor countries: A code of conduct for nongovernmental organizations," American Journal of Public Health, American Public Health Association, vol. 98(12), pages 2134-2140.
    2. Susie Hoffman & Theresa M Exner & Naomi Lince-Deroche & Cheng-Shiun Leu & Jessica L Phillip & Elizabeth A Kelvin & Anisha D Gandhi & Bruce Levin & Dinesh Singh & Joanne E Mantell & Kelly Blanchard & G, 2016. "Immediate Blood Draw for CD4+ Cell Count Is Associated with Linkage to Care in Durban, South Africa: Findings from Pathways to Engagement in HIV Care," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.
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    1. Chutima Suraratdecha & Duncan MacKellar & Thabo Hlophe & Makhosazana Dlamini & Dawud Ujamaa & Sherri Pals & Lenhle Dube & Daniel Williams & Johnita Byrd & Phumzile Mndzebele & Stephanie Behel & Ishani, 2022. "Evaluation of Community-Based, Mobile HIV-Care, Peer-Delivered Linkage Case Management in Manzini Region, Eswatini," IJERPH, MDPI, vol. 20(1), pages 1-9, December.

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