Effectiveness of tuberculosis management at KwaMsane clinic.

Abstract

South Africa has the highest Tuberculosis (TB) incidence in the world. In 2006 it was estimated that in South Africa, with only 0.7% of the world population; some 28% of HIV positive adults had TB. To treat one patient with ordinary TB costs the Health Department approximately R310 and a patient with multi-drug TB (MDR-TB) more than R2000. TB has added to the burden of a country which is struggling to cope with the HIV/AIDS pandemic. TB is one of the national health priorities of the Department of Health (DoH). KwaMsane Clinic is located at Mtubatuba, in the UMkhanyakude district. The uMkhanyakude district has the highest prevalence of HIV and the highest number of cases of TB in South Africa. The UMkhanyakude district stretches from the Umfolozi River, which is south of Mtubatuba, to the Mozambique and Swaziland borders. The clinic is a Primary Health Care centre and is open 24 hours a day. UMkhanyakude has a population estimated at 614,046. According to the DoH National Tuberculosis Management Guidelines (2009), the greatest challenge that the TB programme faces are inadequate financial and human resources for TB control, resulting in poor case detection, increasing numbers of multi-drug resistance TB, extensively dry-resistance TB and poor quality data collection and data analysis. The study set out to identify the challenges that KwaMsane clinic faces in terms of TB management. It was found that the problem facing KwaMsane clinic’s effectiveness was largely due to two factors. The first is the delay in patient diagnosis and the second is the negative nurse/patient ratio which affects the workload and compromises levels of service delivery. The population was sufficiently small, but statistically adequate and all 31 employees were surveyed. Of these, 61% or 19 of the employees agreed that there is a delay in patient diagnosis. The recommendations for KwaMsane clinic include more effective recruiting of staff; attracting and retaining qualified and experienced health personnel; equipment and resources need to be more available; and the clinic management should ensure that they have enough personnel to cope with high number of patients More research is needed on issues such as recruiting attracting and retaining qualified and experienced health personnel; provision of skills training for clinic management and other health personnel to improve service delivery; management of information systems at primary health care clinics for record keeping and data analysis; and integrating TB and HIV/AIDS management.