Integrated chronic care initiative kicks off in KZN

The number of people living with HIV who develop chronic conditions, such as cardiovascular and respiratory disease, cancer or diabetes, is increasing.

Right to Care, together with the Bhekhuzulu Self-Sustaining Project and the Mpilonhle Sanctuary Organisation, has launched a new, integrated chronic care initiative in KwaZulu-Natal’s (KZN) UThukela District. The aim is to reduce the incidence of chronic diseases in HIV-positive patients.

KZN has the highest HIV prevalence rate in South Africa. The national HIV prevalence in South Africa is 29,7 percent; while in KZN it has reached 40,1 percent. HIV, non-communicable diseases (NCDs) and other communicables are on the increase, exacerbated by poverty – more than a third of KZN’s population live below the poverty line and 40 percent of the population is unemployed.

The programme is being rolled out in three sub-districts of the UThukela District: the Alfred Duma Local Municipality, the UKhahlamba Municipality and the iNkosilanga Libalele Municipality, and is being implemented at 16 facilities: nine clinics and seven mobile clinics.

Sibongile Ramotshela, cervical cancer coordinator at Right to Care, says: “People living with HIV are at higher risk of developing common cancers, TB and other NCDs. This is due to the HIV infection itself and antiretroviral therapy (ART) side effects as well as lifestyle factors. The Joint United Nations Programme on HIV/Aids (UNAIDS) reports that one-third of persons screened at HIV testing sites are obese and have hypertension. Despite the clear links between HIV and chronic diseases or NCDs, the healthcare system’s prevention and treatment response remains fragmented. An integrated response (ART) that deals with overlapping problems and common risks has become a healthcare priority, as ART is enabling people to live long enough to develop other diseases.”

Right to Care and its partners, the Bhekhuzulu Self-Sustaining Project and the Mpilonhle Sanctuary Organisation, are working with the regional and district Departments of Health to increase awareness, screening and treatment services. Communities, women’s groups and faith-based organisations are also being called upon to help raise awareness.

“The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and the most common cause of 70 percent of cervical cancers,” notes Ramotshela. “The HPV vaccination of young girls is not well implemented in school health programmes in this area, even though it’s a primary prevention strategy for cervical and other HPV-related cancers.

“The UThukela programme is being implemented in association with the Department of Health, as healthcare workers are required to take a far more coordinated approach. Furthermore, we are hoping to create more youth-friendly health services – something that has been identified as a vital element of prevention strategies.”