An evaluation of the implementation of the antiretroviral treatment policy in Amathole district municipality of the Eastern Cape

Abstract

The aim of this study was to evaluate the implementation of the government policy regarding antiretroviral therapy to all qualifying HN positive people in public health facilities at the Amathole Health District of the Eastern Cape Province. There has never been a detailed research study conducted in the Amathole Health District regarding the subject in question. The Constitution of the Republic of South Africa in Chapter Two, Section twenty-seven, prescribes that the State must make access to health, food and security a reality. Hence the provision of antiretroviral therapy to HN positive people acts as a response to constitutional imperatives of guaranteeing fundamental human rights. The literature review explored extensively on the models used in implementing antiretroviral therapy programmes globally. From those tested models elsewhere, it was evident that South Africa has one of the best models in implementing HN/AIDS treatment programmes notwithstanding some challenges cited in the study. This evaluation of the antiretroviral therapy implementation assisted in the establishment of the real facts about successful access of treatment to deserving communities. It became clear from the study that providing universal, effective and sustainable access to antiretroviral treatment in South Africa requires a broader advocacy agenda encompassing the development of health care systems and the generation of much larger resources for the health sector. The results to the study were received through answers from questionnaires developed and distributed to health facilities where antiretroviral therapy programme was implemented. All respondents were employees of the Department of Health at the Amathole District. In the main, the findings of the study in Chapter four proved the hypothesis to be indeed true in that the implementation of antiretroviral therapy in the Amathole Health District does currently face some challenges that make ART inaccessible to the HIV positive patients. The process of initiating patients on ARVs is very intensive and places additional burden on already immune-compromised patient. Therefore, it is essential that the pre-ARV assessment phase is streamlined and devolved to primary health care. A united and integrated response that is informed by sound scientific knowledge and supported by strong leadership is essential for mobilizing resources to address the challenges in the health system to scale up and sustain the response to HIV and AIDS.