Presentation Outline

1. PROVINCE OF KWAZULU-NATALISIFUNDAZWE SAKWAZULU-NATALIPROGRESS REPORT ON HCT CAMPAIGN02 MARCH 2011

2. Presentation Outline • HIV Prevalence • Provincial Response • HCT Achievements • School Health Programme • Public Service Sector – HCT

4. HIV PREVALENCE ANC SURVEY 2007 - 2009

5. Trend in Age related prev. from 2007 - 2009

6. Provincial Response NSP 2007-2011 • Two primary aims • reduce the number of new HIV infections by 50% by 2011 • reduce the impact of HIV and AIDS on individuals, families, communities and society • By expanding access to appropriate package of treatment, care and support to 80% of all people diagnosed with HIV • Priority Areas • Prevention • Treatment care and Support • Monitoring, Research and surveillance and • Human and Rights and access to Justice

7. Provincial Response • Presidential declaration of 01 December 2009: • to treat HIV and TB under one roof • ART for pregnant women and TB/HIV co infected individuals • Treatment for all the HIV infected infants <1yr • All SA citizen should know their HIV status • HIV Counseling and Testing Campaign – Aim to test 15 million people in South Africa • KZN HCT target is just above 3 million people to be tested by end June 2011

8. HEALTH OUTCOMES – National Service Delivery Agreement • Increasing life expectancy • Reduce child and maternal morbidity and mortality • Combat HIV and AIDS and decrease the burden of disease from Tuberculosis • Improve health systems effectiveness

9. HIV COUNSELLING and TESTING • The total population eligible for HCT is 6,244 million people aged 15 – 49yrs • KZN HCT target is 3,059,234 million people to be tested by June 2011 • Provincial launch on 30 April 2010 in Umgungundlovu District • Total achieved so far 1, 731, 552 • Total positive 360, 105 (21%) • Achieved 57% of the target • District plans have been developed to accelerate efforts towards achieving HCT target

10. HCT CAMPAIGN – 21 Feb 2011

11. SCHOOL HIV COUNSELLING AND TESTING

12. School Health Programme • School HCT Campaign announced by the Minister of Health in October 2010 • Extension of HCT Campaign to youth in schools • Target: secondary/high school learners aged 12 years and above, educators and school community

13. Provincial Task Team • A provincial interdepartmental task team formed • Premier’s Office (coordinating body) • Department of Education • Department of Health • Department of Social Development • Provincial Council on AIDS • Has conducted series of interdepartmental planning meetings • Has held a series of stakeholder engagement meetings

14. KZN School HCT Strategy • Developed a standard operating procedures (SOP) for the implementation of school HCT in KZN – adapted from DBE/ SANAC strategy • Development of Terms of Reference to define roles and responsibilities • Mapping of resources by all departments • Engaged NGO partners, traditional leadership • Further engagement planned for the coming week

15. School HCT Strategy The School HCT Campaign aims to achieve the following: • To provide a comprehensive package of health screening services inclusive of HIV. • To mobilize the school community to know their HIV status • To promote prevention messages about healthy lifestyles irrespective of HIV status • To increase the availability of HCT services for youth outside the health facilities through partnerships between public, private and non-governmental institutions • To increase health seeking behaviour; and • To increase access to treatment, care and support services

16. SOCIAL MOBILISATION • Provincial Mobilisation is being undertaken by OTP, DOE, DOH, DSD • School HCT in Ukhozi FM radio during health slot • District Mobilisation is being undertaken in all districts • Key stakeholders have been engaged (eg. Traditional Leadership, Unions, Civil Society, SGBs, parents) so as to facilitate mobilisation process

17. KZN Preparedness • Provincial meeting conducted on 31/01 – 01/02 – all districts interdepartmental and other sectors • Share School HCT strategy • Share lessons learnt by Partners with experience • Conclude process of mapping all resources • District implementation plans developed

18. KZN Preparedness • There are approximately 642secondary public schools throughout the province • Umgungundlovu = 158 • Umzinyathi = 129 • Umkhanyakude = 34 • A comprehensive list of schools to be targeted has been drawn up

19. Package of services • Health education • HCT • TB screening • Vision screening • Oral health • BMI • Nutritional assessment • HB • Depression/ Mental Assessment • Substance Abuse • Referral for further management

20. Pre &Post Test Counselling • A right-based approach is adopted for the implementation of the programme • Testing will be voluntary and will be conducted on an informed consent basis. • Testing will be conducted under conditions that ensure privacy and confidentiality of those who test • Pre and post test counselling will focus on HIV prevention education. • Group and individual counselling sessions will be provided

21. IMPLEMENTATION • Alignment of the School HCT Campaign with Operation Sukuma Sakhe (Flagship Programme) • Engaged with Health Committee of the House of Traditional Leaders. • Education programme (HCT) in schools. • Umkhanyakude & Umzinyathi started testing on 14 February as per their implementation plans.

22. IMPLEMENTATION (CONT) • Umkhanyakude • Tested 1,262 learners • 12 learners HIV positive • Psychosocial support has been given to the 12 learners and their families

23. RECENT DEVELOPMENTS IN SCHOOL HCT • Meeting 28 February 2011 of called by NDOH • Health Minister Dr A. Motsoaledi addressed all provincial DOE, DOH, DSD, partners • Maintained all SA citizens should know their status inc. youth • Change from School HCT to School Health Programmes • Comprehensive PHC approach emphasis on prevention and promotion • De-Link from HCT campaign • Strengthen Youth Friendly services • Mixed model of service provision which includes community involvement and participation

24. RECENT DEVELOPMENTS • Integrated approach to address • Stigma and discrimination • Psychosocial support • Teenage pregnancy • PMTCT • Access to MMC • Substance abuse • Other factors e.g. violence, gender issues, poverty • Provincial Teams to develop models of implementation • Therefore should slow down, not rush numbers but provide services in a comprehensive and integrated approach

25. Monitoring and Evaluation • The data flow will follow the current HCT campaign data flow – nerve centres, DHIS • The existing indicators will be utilized with some modifications and additions where necessary • An evaluation form for learners and educators will be used to assess the effectiveness of the project

26. CHALLENGES • Communication – National, Office of the Premier, Sector Depts, Partners • Human Resource Limitation • Time (Teaching vs. Testing)

27. WAY FORWARD • Site visits by Provincial Task Team to assess district State of Readiness • Provincial Launch • Roll-Out • Monitoring and Evaluation

28. PUBLIC SERVICE SECTOR HCT CAMPAIGN and HEALTH SCREENING

29. COORDINATION OF HCT CAMPAIGN AND HEALTH SCREENING/ASSESSMENT FOR PROVINCIAL GOVERNMENT EMPLOYEES • The Office of the Premier coordinates HCT Campaign & health screening/ assessment of employees. • All provincial departments participate in the Campaign. • Wellness screenings are conducted to raise awareness of health conditions within government departments. • Wellness screenings include the testing for HIV ie.HCT. • Government employees benefit from the convenient opportunity to be professionally screened for existing and potential health risks.

30. COORDINATION OF HCT CAMPAIGN AND HEALTH SCREENING/ASSESSMENT FOR PROVINCIAL GOVERNMENT EMPLOYEES • The aim is to enable employees to detect health risks as early as possible, so that the progression of diseases is prevented or minimised. • On a wellness day, healthcare professionals set up a wellness testing venue at a department. • All employees at the work place are invited to voluntarily attend the wellness screening.

31. WELLNESS SCREENINGS/TESTS PACKAGE • HIV Counseling and Testing • Glucose • Blood Pressure • Cholesterol  • Body Mass Index • Exercise  • Heart Disease  • Stress  • Waist Circumference  • Weight Control • Alcohol abuse • Head and neck massages (in some cases)

32. HCT RESULTS as at Jan 2011

33. SUMMARY OF DATA • The HCT uptake is low. • 3253 Pre-test counselled & 1449 employees tested in 75 events/sessions Average: 43 Pre-counselled & 19 tested employees per event • Screening for TB a challenge. • Challenge with capturing as different service providers use different reporting tools. • Capturing in the Provincial Nerve Centre per district remains the only solution – When data is captured in districts, there is no separation between community and employees.

34. RECOMMENDATIONS • Aggressive strategy to be developed to encourage employees to do regular health screenings. • An assessment to be conducted to ascertain reasons for low uptake. • Re-design and intensify the HCT & TB Campaign in line with the Minister of DPSA’s directive. • Capacitate departments to manage health screenings. • Strengthen the current referral system. • Office of the Premier to continue assist departments, prioritising those who are currently not reporting.

35. THANK YOU