Data was collected through self-administered questionnaires, staff interviews and record
reviews. Detailed information on specific aspects of HIV and AIDS programmes was obtained
by interviewing key informants including HIV and AIDS coordinators and district managers.
Management of HIV and AIDS Services at the sub-district level
The study revealed that at sub-district level there is a range of public and private sector role
players as well as civil society organisations providing HIV and AIDS services.1 However, HIV
and AIDS activities were characterised by lack of coordination between the Departments of
Health (DoH), Social Development (DoSD) and Education (DoE), between and within provincial
and local government health services, and between the public, private and civil society sectors.
Referral systems between the different levels of service provision such as between communitybased
services, clinics and hospitals were often lacking or weak.
Information management systems (IMS) were also weak. HIV and AIDS information was not
integrated into the routine health IMS and most sub-districts collected different pieces of
information, which were managed through IMS. Hospital and primary health care (PHC) data
were also fragmented with district information officers (DIOs) often not having access to
hospital HIV and AIDS data including prevention of mother-to-child transmission (PMTCT) data,
data on provision of post-exposure prophylaxis (PEP) and Step Down Care. Data on provision
of services by non governmental organisations (NGOs), even where these were funded by the
DoH or DoSD, were often difficult to obtain and where data was available it was hard to
interpret.
The lowest level at which funds were managed was at district level. However, this varied
between provinces and between departments. It was difficult for provincial departments to
provide data on the amounts of the conditional grant given to a particular district or the criteria
used to allocate the grant between districts. The only funding information that was easily
provided by most departments was the amount of money given to NGOs for provision of home
based care (HBC), child care and support to people living with HIV and AIDS (PLHAs). |
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