Monitoring Paediatric Trends in a High

Prevalence Setting within KwaZulu Natal

Ravikanthi Rapiti

OVC IN AFRICA01 Nov 2010

Introduction

MatCH provides support to the eThekwini District

District population statistics: Total Population = 3 183 936 Paediatric population = 854 523 (0-14 yrs) HIV infected = +/-93 000

Processes

Monitoring and Evaluation

Paper Based

Paediatric Indicators

DHIS

Methods

Paediatric patients: initiated on ARVs No longer on the programme after 90 days

January 2007 – June 2010

10 public health facilities

Clinical registers & routine monthly statistics

Results Initiations

108

11 025 7

119 104

21 0 0

637

4066

101

32

235

311

250

112

50

517

6534

406

114

253

143

229247 273

0

100

200

300

400

500

600

700

PMM

H

CATO M

ANOR

CLAIR

WOO

D

CHARLES JA

MES

WENTW

ORTH

RK KHANS

ADDING

TON

KWAM

ASHU

KWADABEKA

DON M

CKENZIE

Total <1 Total 1-5 Total 5-15

No Longer on the Programme

1 1 0 0 0 0 0 0 0 00 4 4 0

21

0

197 4

207

30 27

46

113

44

17 1206

10

25

50

75

100

125

150

175

200

225

PMMH CATOMANOR

CLAIRWOOD CHARLESJAMES

WENTWORTH RK KHANS ADDINGTON KWAMASHU KWADABEKA DONMCKENZIE

0-1 yr 1-5 yrs 5- 15 yrs

Current

10710 0 25 7 0

10421 0 0

637

36 62 10132

214311

231105

46

310

64 28

376

87201 217

1054

90

502415

555481

126

140

229 263

126110231

0

200

400

600

800

1000

1200

Current 0-1 Current 1-5 Current 5-15 Current Total

Trends

1262

100

532

153

544279

1054

502555

481

263601

255

668

11690110 126

231

415

0

500

1000

1500

2000

2500

PMM

H

CA

TOM

AN

OR

CLA

IRW

OO

D

CH

AR

LES

JAM

ES

WEN

TWO

RTH

RK

KH

AN

S

AD

DIN

GTO

N

KW

AM

ASH

U

KW

AD

AB

EKA

DO

NM

CK

ENZI

E

Ever on ART Current on ART

Challenges

Children accessing care when they are very sick

Clinical staff misunderstanding the national guidelines for initiation

Reduce waiting period to initiate

Finding an appropriate caregiver

Mother’s resistance to testing the child

Addressing the Gaps

Training of the guidelines

Fast tracking of the counselling sessions

Developing innovative ways to train illiterate caregivers

Providing basic services and engaging with the mother to test the child for HIV

Conclusion Intensify programmatic efforts

Inconsistent enrolment numbers

Improve record keeping

Address challenges with Task Teams

Lack of data of patients aged 0-12 months

Evaluate systems

‘Care for us and accept us - we are all human beings. We are normal. We have hands. We have feet. We can walk, we can talk, we have needs just like everyone else - don’t be afraid of us - we are all the same!’

Nkosi Johnson (February 4,1989 - June 1, 2001)

Acknowledgements

This presentation is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents are the sole responsibility of MatCH (Maternal, Adolescent and Child Health) and do not necessarily reflect the views of USAID or the United States Government.