adminFocus on Mash West
Catherine Murombedzi H I V Issues
THERE is a team of dedicated men and women that visits health centres, clinics and even homes of people living with HIV across the country to assess the impact of the anti retroviral therapy programme and to see if there are challenges that need to be addressed too.
Community Monitoring of ART and Opportunistic Clinics taken by People Living with HIV (PLHIV) is becoming a regular feature in the national response. The team has visited all the provinces and the reports were handed over to the parent ministry.
The first visit was in Matabeleland South at the end of 2012 and the team visited Mashonaland West on 18 -22 February 2013.
The process of community monitoring was initiated by the Zimbabwe HIV and AIDS Activist Union (ZHAAU) which secured permission from the Ministry of Health and Child Care to visit Health facilities and communities to assess the ART services from a consumer perspective.
A 12-member delegation visited Mashonaland West. The team comprised of representatives from ZHAUU, ZNNP+ at national and provincial levels, the representative of PLHIV in the NAC Board, the PLHIV representative in the CCM, the MIPA Technical Working Group representative, Positive Living Association of Zimbabwe (PLAZ) and representative of the Harare Advocacy Committee. The MIPA and Orphaned and Vulnerable Co-ordinator from NAC provided technical and logistical support.
The objectives of the visit were as follows: (i) To assess the availability of ARVs in the Opportunistic Infections (OI) clinics (ii) To tackle challenges facing OI clinics ( iii)
To discuss with OI clients the quality of services they get from OI clinics and challenges (iv) To assess the state of OI key equipment such as CD4 Counting machines, hematology machines and to speak to patients and clients on first hand value.
“Two teams were formed out of the delegation. Health facilities visited by the teams include Chinhoyi Hospital, Chinhoyi Clinic, Father O’ Hea Hospital, Chidamoyo Hospital, Karoi District Hospital, Chegutu District Hospital, Kadoma District hospital and Sanyati Baptist Hospital. In each site the team visited the OI Clinics (OICs), the laboratories and pharmacies as well as talking to the clients in support groups.
“ART services were being provided in all the sites in spite of the challenges of staff shortage, occasional shortages of medicines especially cotrimoxazole, poor diagnostic services in the laboratories and inadequate space in OICs. Mission hospitals seem to be offering better services as compared to public institutions,” said Mr Stanely Takaona, the monitoring team spokesperson.
The challenges at most centres were uniform with critical shortage of nursing staff to cater for OI Clinics and outreach work, which leads to patients waiting for a long time without being served.
Transport e.g. ambulance from Murombedzi was used for outreach in areas outlying leaving the hospital with no ambulance service when the truck is out.
There is a noted shortage of laboratory scientists and pharmacy technicians working at centres in the province.
“No access to viral load services and chemistry analyzers. Delays in supply of medication from NATPHARM since December the hospital was giving one month supply,” said Mr Takaona.
At Chinhoyi Provincial Hospital it noted that there is an integrated OIC and TB unit and this was commendable.
With integration a TB-HIV patient gets treatment at once without having to visit two different rooms.
“The OIC operated on Tuesdays and Thursdays and is partnering well with Family AIDS Counselling Trust (FACT) Mutare, formerly New Life on counseling.
The centre experienced stock out of second line ART medicines. The HIV and T.B treatment collaborations initiated in 2010 is going on very well. The TB Unit offers consumers provider initiated counseling and testing but clients are not coming back for results. Few children are getting anti-TB treatment and the Unit ran out of test kits for sputum tests. The CPH – FCH is located within some spacious area but there is need for physical, recreational and psychological support for pediatrics,” said Mr Takaona.
“Of the 15 laboratory staff, only three members are trained to do rapid tests. The hospital has one BD-FAX CD4 Count machine and the PARTEK machine was not working. About 30-40 CD 4 count tests are conducted every day (daily Mon to Friday),there is no viral load machine at the hospital. Reagents are sourced from NATPHARM.
The National Aids Council bought BD-FAX Count machines for district hospitals but there is no technician at St Rupert in Makonde to operate the machine and Norton faces the same challenge,” he said.
The challenges faced by other hospitals were similar in the province but with these monitoring and evaluation there is room for this to be addressed.
With a voice and feedback and reporting, surely there is a chance for greater health delivery despite the financial challenges the health sector is facing.
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