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An evaluation of the "antiretroviral programme" in two informal townships in the Western Cape, South Africa : exploring AIDS patients access to and experiences of the programme
Author(s)
Kallon, Idriss
Date Issued
2010
Type
Thesis
Publisher
Cape Peninsula University of Technology
Abstract
This study aimed to evaluate the "Antiretroviral Programme" in two informal townships, Du
Noon and Doombacht, in the Westem Cape, South Africa. It evaluated how AIDS patients
access Antiretroviral Therapy (ART'), their knowledge of ART's efficacy, their adherence to
ART as well as their experiences of the quality of service at the Du Noon Clinic. Employing a
questionnaire survey among 124 (12%) respondents on ART of the registered 1, 050 clients
at the Du Noon Clinic, a systematic sampling of every 9th client (of the 1,050) was done. To
generate findings of a qualitative nature, the study also used focus group discussions with a
total of 36 AIDS patients on ART (18 of this number were also part of the survey), 11
community health/home-based workers and in-depth interviews with 2 nurses in charge of
the rollout programme at the Clinic.
Based on the survey results, the study determined that 93% (n=115) of AIDS patients access
ART at the Du Noon Clinic, 75% (n=93) of respondents reported to ART adherence and 75%
(n=93) displayed an understanding of ART's efficacy. It also revealed that 77% (n=95) of
AIDS patients made good comments regarding the quality of service at the Du Noon Clinic.
However, 25% (n=31) of AIDS patients were not adhering to ART. A Mann Whitney U test
confirmed a significant relationship between the respondents' length of time on ART and the
increase in CD4 count (p=0.01). However, AIDS patients who adhered to ART with the same
length of time on ART have a higher CD4 count difference (p=0.04). The focus group
discussions revealed AIDS patients' experiences of lack of confidentiality at the Du Noon
Clinic. In addition, in five of the six focus group discussions, respondents expressed concern
over disability grants not being awarded to patients with CD4 counts 200 cells lML and
below². Notably, more than half of the respondents have been on treatment for more than
one year.
The study concluded that ART access is humanizing in the Western Cape and controversial
AIDS treatment discourse has not significantly influenced the perceptions of AIDS patients
regarding ART's efficacy. A high percentage (75%) of AIDS patients were adhering to ART in
Du Noon and Doombacht. Addressing concerns over lack of confidentiality when accessing
ART at the Du Noon Clinic, as well as the quest for disability grants within the context of
AIDS treatment, could have further improved ART adherence in these communities.
The study recommends that monitoring and evaluation (M&E) should involve measuring
factors that influence adherence alongside accessibility to ART. Secondly, there should be
mechanisms in place to maintain confidentiality in accessing ART as it is with Voluntary
Noon and Doombacht, in the Westem Cape, South Africa. It evaluated how AIDS patients
access Antiretroviral Therapy (ART'), their knowledge of ART's efficacy, their adherence to
ART as well as their experiences of the quality of service at the Du Noon Clinic. Employing a
questionnaire survey among 124 (12%) respondents on ART of the registered 1, 050 clients
at the Du Noon Clinic, a systematic sampling of every 9th client (of the 1,050) was done. To
generate findings of a qualitative nature, the study also used focus group discussions with a
total of 36 AIDS patients on ART (18 of this number were also part of the survey), 11
community health/home-based workers and in-depth interviews with 2 nurses in charge of
the rollout programme at the Clinic.
Based on the survey results, the study determined that 93% (n=115) of AIDS patients access
ART at the Du Noon Clinic, 75% (n=93) of respondents reported to ART adherence and 75%
(n=93) displayed an understanding of ART's efficacy. It also revealed that 77% (n=95) of
AIDS patients made good comments regarding the quality of service at the Du Noon Clinic.
However, 25% (n=31) of AIDS patients were not adhering to ART. A Mann Whitney U test
confirmed a significant relationship between the respondents' length of time on ART and the
increase in CD4 count (p=0.01). However, AIDS patients who adhered to ART with the same
length of time on ART have a higher CD4 count difference (p=0.04). The focus group
discussions revealed AIDS patients' experiences of lack of confidentiality at the Du Noon
Clinic. In addition, in five of the six focus group discussions, respondents expressed concern
over disability grants not being awarded to patients with CD4 counts 200 cells lML and
below². Notably, more than half of the respondents have been on treatment for more than
one year.
The study concluded that ART access is humanizing in the Western Cape and controversial
AIDS treatment discourse has not significantly influenced the perceptions of AIDS patients
regarding ART's efficacy. A high percentage (75%) of AIDS patients were adhering to ART in
Du Noon and Doombacht. Addressing concerns over lack of confidentiality when accessing
ART at the Du Noon Clinic, as well as the quest for disability grants within the context of
AIDS treatment, could have further improved ART adherence in these communities.
The study recommends that monitoring and evaluation (M&E) should involve measuring
factors that influence adherence alongside accessibility to ART. Secondly, there should be
mechanisms in place to maintain confidentiality in accessing ART as it is with Voluntary
Additional information
Thesis (MTech (Environmental Health))--Cape Peninsula University of Technology, 2010
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