Eastern Cape Province, South Africa (2013-2014)

Nelson Mandela district team, Eastern Cape, South Africa

Armed with lessons learnt from Lesotho, the Eastern Cape  program was implemented in partnership with the Department of Health, Johnson & Johnson and the MAC AIDS Fund. The focus was on key PMTCT indicators as agreed by the Department of Health, as well as one non- PMTCT indicator (stock availability) as pathways to the attainment of its goal of accelerating the elimination of vertical transmission.  We worked with champions from the provincial level who provided strategic leadership to district teams during review meetings.

Key highlights at the provincial level included better quality data and its use in decision making. District teams also became more effective in the use of the dashboard system to measure and report on performance. Interdisciplinary teams evolved over the implementation period to constitute more functional and effective teams, compared to the siloed mentality prior to program implementation.

Our program was also instrumental in the reversal of perennial stock-outs which hampered service delivery in the whole province. A multidisciplinary team set up at provincial level developed a detailed depot assessment tool for purposes of analyzing operations at the province’s 2 depots. The team streamlined the supply chain by eliminating mini depots that further delayed delivery of supplies. The team also addressed tactical challenges which allowed districts direct access to order from the depots. Accountability improved as frequency of reporting of stock levels by depots increased.

PMTCT program indicators of early antenatal care attendance and initiation on antiretroviral therapy improved with the positivity rates at 6 weeks reducing.