AA 2005 Supplementum 1

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http://hdl.handle.net/11660/9663

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Browsing AA 2005 Supplementum 1 by Author "Heunis, Christo"

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    Hospitalisation for TB in the Free State: opinions of health workers and managers
    (University of the Free State, 2005) Heunis, Christo
    English: Non-governmental health care providers in the Free State have traditionally provided long-term hospitalisation services for TB patients. This history now appears to have come to a halt. This paper documents the opinions of a purposive selection of public health workers and managers with regard to TB-related hospitalisation. The views and experiences of health workers and managers at the district, provincial and national levels were recorded by means of self-administered questionnaires and personal interviews over the period 2001-2003. In the Free State this period was characterised by a range of intricate problems. Indications are, however, that public district hospitals are capable of dealing with the burden caused by the sequential closure of the former Allanridge Chest and Santoord hospitals.
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    One patient, two diseases: collaboration in controlling TB and HIV in the Free State
    (University of the Free State, 2005) Peters, Annatjie; Heunis, Christo
    English: A perilous synergism exists between TB and HIV/AIDS, which form a dual epidemic requiring joint action. This paper first reviews key global and South African policy developments in relation to TB-HIV/AIDS control. Secondly, the early response of the Free State to global and national directives to implement integrated TB-HIV/ AIDS programmes is described. As is clear from the experience of the first TB-HIV training site in the Free State, the Mafube local municipality, integrated TB and HIV/AIDS control is made possible by means of actual practical interventions as well as the collaboration of a range of role-players. In Mafube, and later also in the Free State at large, attempts at integration have resulted in substantially more TB patients undergoing voluntary counselling and testing for HIV.
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    Social capital and community TB care in the Free State, South Africa
    (University of the Free State, 2005) Meulemans, Herman; Van Ouytsel, Jeff; Rigouts, Leen; Mortelmans, Dimitri; Heunis, Christo; Matebesi, Zacheus; Van Rensburg, Dingie
    English: Where do TB patients turn for help in the South African health care system? Do they go to a clinic or a community health centre for ambulant treatment, thus retaining contact with their families and local communities? Or are they hospitalised, which means that they can no longer perform their normal duties? In order to answer these questions, a data set was compiled on the basis of oral interviews with a stratified random sample of 310 pulmonary TB patients in the Free State province. A logistic regression analysis of the data revealed that TB patients who can rely on an extended network of relationships, with relatively large amounts of social capital at their disposal, generally make use of clinic treatment and community TB care. Clinics play a central role in TB control programmes, not only as a locus of treatment, but also as a point from which patients can be referred to higher echelons in the healthcare system.
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    Tuberculosis control in South Africa: reasons for persistent failure
    (University of the Free State, 2005) Van Rensburg, Dingie; Janse van Rensburg-Bonthuyzen, Ega; Heunis, Christo; Meulemans, Herman
    English: This study reviews the origins and spread of tuberculosis in South Africa in the international context. It shows that TB is far from being under control, despite the availability of effective technology. Five arguments offer explanations for this failure. First, control strategies fail to eradicate the macro-conditions that create a breeding ground for TB. Secondly, new disease conditions — especially HIV/AIDS and MDRTB — confound efforts at control. Thirdly, the health system and its priorities are insufficiently focused and resourced to cope with TB. Fourthly, healthcare staff responsible for TB care are often weak links in the chain of control. Fifthly, TB patients fail due to ignorance, delay in seeking care, and non-adherence to treatment regimens. TB consequently remains a major public health challenge, today more than ever in its protracted history.