24 Mar Partnering is the key to treating TB and reaching people where they are
March is TB awareness month around the world, and thus a perfect time to reflect on the work that is being done to eradicate TB in South Africa. A key part of the work is partnership – between Government and the people who work with communities to ensure that strategies are implemented, and therefore effective.
South Africa’s TB problem is indeed complex. Treatment can cure the disease within six months, but it requires a particular regiment of treatment and it requires the medicines to be accessible. As well as having high numbers of cases of ordinary TB, there are also increasing numbers of cases of multidrug-resistant TB (MDR-TB). This type of TB is severe, the bacteria are resistant to multiple antibiotics and is therefore more difficult to treat, requiring up to 24 months of treatment. In South Africa, around five percent of TB cases are MDR-TB.
The likelihood that someone will contract TB is not only related to their health, but also to their living conditions, location, work environment, and socio-economic context. Accordingly, this context has to be taken into account if plans to treat TB are to be successful. Partnerships amongst organisations on the ground and the National TB Programme are key to initiating TB treatment and ensuring that patients are able to remain on treatment programmes.
In many instances, communities do not have access to doctors because of a skills shortage. Nurses fill the gaps and often are a patient’s first port of call when initiating treatment, including for MDR-TB.
To ensure that this service provision meets the needs of patients, as well as health standards, the NDoH contracted JPS Africa to provide training for health care providers. This is supported by the use of the Jhpiego-developed Training Information and Monitoring Systems (TIMS©). Through this partnership, JPS Africa and the NDoH hope to create sites of excellence for TB treatment initiation and for TB management.
In addition to training nurses on MDR-TB initiation and treatment, JPS Africa also provides accredited training on MDR-TB management for Health Care Workers, Otoxicity (measuring patients’ hearing changes), training for Community Caregivers or Home Based Caregivers, and EDR.Web (a web-based electronic DR-TB register). This cohesive package of training aims to address multiple elements of the existence and prevalence of MDR TB, and to monitor treatment success. JPS Africa is also the key partner implementing miLINC (mobile electronic linkage to care application) that aims to initiate Rifampicin Resistant patients into care in less than 5 working days of being diagnosed.
This miLINC solution will include a training application for nurses and doctors, and a multimedia educational library. This keeps information accessible to Health Care Workers, wherever they are. In addition, the same miLINC application should also trace patient’s data from entry into the system, through their admission, and to their discharge. This is to be programmed soon. In this way, nurses are able to see the results of their training, and the NDoH is able to have current information on the success of available treatments.
These programmes are extensive and require the support of the NDoH, but also from ordinary South Africans.
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