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Safer pregnancy for HIV discordant couples

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The USAID funding for Witkoppen Health and Welfare Centre (WHWC) (AID-674-A-12-00033 from 01/10/2012 to 30/09/2017) is for providing HIV and TB diagnosis, care, support, treatment and referral services at primary care level to residents of informal settlements; interventions that build capacity in the local Department of Health (DoH) clinics; transition of the USAID-funded direct service delivery to the DoH and the implementation and evaluation of effective innovative approaches to integrated primary care for HIV and TB.

Underpinning these innovations are five operational research projects, including specific focus on paediatric care, comprehensive PMTCT services over the spectrum from pre-pregnancy to maternal and infant care, intensified TB and HIV case finding at clinic and community level, and improving adherence and retention-in-care among children, adolescents and adults, as follows:

1. Primary care model for paediatric HIV care, diagnosis of paediatric TB and management of paediatric TB/HIV co-infection at primary care level;
2. Optimizing the Primary Care model for early initiation of antenatal care, PMTCT, tracking mother-baby pairs, early infant diagnosis, and male involvement in PMTCT;
3. Case finding for TB and HIV using a community-based program with Community Health Workers using mobile devices;
4. “Adherence clubs” – a model of treatment monitoring, adherence support and ARV distribution based on Community Health Care Workers;
5. Adolescent support groups to improve adherence and retention-in-care at primary care level.
A sixth operational research project is also underway, although under different funding: Discordant couples – “SAAFER” primary care model to address the needs of HIV positive women and men in discordant couples wishing to conceive safely.
Findings from the research will be utilized to develop new models for primary care and community care and transition effective innovations into policy, implementation and institutionalization to inform the development of the Department of Health policies on integration of HIV/TB in Primary Health Care.

In addition, WHWC plans to develop an evidence base that will inform South African Policy ahead of National Health Insurance, part of which is to assess the unmet health needs of informal settlements by mapping the Diepsloot community using GIS software to identify “hotspots” of unmet health needs.
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