Stock-outs of antiretroviral and tuberculosis medicines in South Africa: A national cross-sectional survey.

BACKGROUND: HIV and TB programs have rapidly scaled-up over the past decade in Sub-Saharan Africa and uninterrupted supplies of those medicines are critical to their success. However, estimates of stock-outs are largely unknown. This survey aimed to estimate the extent of stock-outs of antiretroviral and TB medicines in public health facilities across South Africa, which has the world's largest antiretroviral treatment (ART) program and a rising multidrug-resistant TB epidemic. METHODS: We conducted a cross-sectional telephonic survey (October-December 2015) of public health facilities. Facilities were asked about the prevalence of stock-outs on the day of the survey and in the preceding three months, their duration and impact. RESULTS: Nationwide, of 3547 eligible health facilities, 79% (2804) could be reached telephonically. 88% (2463) participated and 4% (93) were excluded as they did not provide ART or TB treatment. Of the 2370 included facilities, 20% (485) reported a stock-out of at least 1 ARV and/or TB-related medicine on the day of contact and 36% (864) during the three months prior to contact, ranging from 74% (163/220) of health facilities in Mpumalanga to 12% (32/261) in the Western Cape province. These 864 facilities reported 1475 individual stock-outs, with one to fourteen different medicines out of stock per facility. Information on impact was provided in 98% (1449/1475) of stock-outs: 25% (366) resulted in a high impact outcome, where patients left the facility without medicine or were provided with an incomplete regimen. Of the 757 stock-outs that were resolved 70% (527) lasted longer than one month. INTERPRETATION: There was a high prevalence of stock-outs nationwide. Large interprovincial differences in stock-out occurrence, duration, and impact suggest differences in provincial ability to prevent, mitigate and cope within the same framework. End-user monitoring of the supply chain by patients and civil society has the potential to increase transparency and complement public sector monitoring systems

Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018

No abstract available

MANAGING SOUTH AFRICAN

MBA - WBSThe study aimed to assess whether Nonprofit Organisations (NPOs) are utilising any systems or techniques to manage and to evaluate their programmes. The study further aimed to establish if there is a link between organisations that are well managed and perceived as accountable and the ability to generate long-term funding. Long-term funding prospects would indicate that an NPO is sustainable into the future. The study attempts to assess these issues from two angles; firstly, the perceptions of the NPOs themselves, secondly, the perceptions of those making and managing the funding grants. Personal interviews were conducted and analysed qualitatively. The proposition was that business models could be applied to NPOs to develop a combination model that would allow NPOs to maintain their foci, but still operate more effectively and efficiently. The findings identified that many organisations perceived as accountable had established management practices and were utilising relevant evaluation tools. However, even those NPOs perceived as credible and effective, did not see themselves as able to offer best practice advice to other NPOs. Furthermore, both the NPO managers and the fund managers have very little knowledge and understanding of business techniques and how these could be applied within the NPO context to facilitate their work. Further research to explore which business models, and how they could be applied, needs to be undertake

An entrepreneurship-as-practice perspective on the development and growth of social enterprise in South Africa

Within the third sector, scarce resources make it difficult for social enterprises to survive financially, become more innovative and entrepreneurial, and generally grow and develop to scale. Although there is no agreement on the definition, the extant literature tends to frame social enterprise as critical for addressing challenging social problems. Social enterprise involves some degree of profit-making, while maintaining a strong focus on social mission. The latest literature points to social enterprise as an example of a hybrid organisational form that has the potential to act as a solution to complex social problems. However, the literature also highlights the considerable tensions inherent in hybridity, as well as the substantive mission-drift that inevitably occurs. The current body of knowledge does not describe how social enterprise growth and development occurs, nor does it adequately illustrate how social enterprise hybrids can continue to meet their important social missions while generating sufficient operating income to sustain themselves. Additionally, there is a dominant view that non-profit social enterprises may face difficulties in surviving as hybrids due to the risk of mission-drift. An in-depth study of non-profit social enterprises that had already reached scale was undertaken to address this. By doing so, a contribution was made to the development of the social entrepreneurship and social enterprise fields. The theory on social enterprise ideal-types was deepened. In addition, this study provides a framework for social enterprise growth and development within this organising context. Strategy-as-practice (SaP) core concepts as influencers within an entrepreneurship-as-practice (EaP) theoretical framework, contained by a social practice theory theoretical lens. The result was a focus on daily business management and strategic development practices. Additionally, contextualisation – as the link between the micro-context in each organisation and macro environment – was studied as the context for this growth and development.Thesis (DPhil)--University of Pretoria, 2020.Gordon Institute of Business Science (GIBS)DPhilUnrestricte

Palliative care guidelines for the management of HIV-infected people in South Africa

Care that places the relief of suffering at its core, affirms life and does not hasten nor postpone death, but regards dying as a normal process, according to World Health Organization (WHO).http://www.sajhivmed.org.zaam2020Immunolog

South African HIV self-testing policy and guidance considerations

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education

South African HIV self-testing policy and guidance considerations

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education