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TB IC PROGRAM AT UMGUNGUNDLOVU HEALTH DISTRICT :. PRESENTED BY : KUMBUZILE KHUMALO. DISTRICT CONTEXT. 2 nd Largest District in KZN Population in excess of 1 Million souls 84,3% of Population considered indigent and totally dependent on state service delivery
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TB IC PROGRAM AT UMGUNGUNDLOVU HEALTH DISTRICT: PRESENTED BY: KUMBUZILE KHUMALO
DISTRICT CONTEXT 2nd Largest District in KZN Population in excess of 1 Million souls 84,3% of Population considered indigent and totally dependent on state service delivery Comprises of 7 Municipalities Provides services to clients that drain from surrounding Districts
SERVICE DELIVERY PLATFORM PRIMARY HEALTH CARE: - 51 Fixed PHC Clinics - 17 Mobile PHC Clinics - 23 School Health Teams - 14 PHC Family Health Teams COMMUNITY HEALTH CENTRES: 3 HOSPITAL SERVICES: 9 HOSPITALS - 1Tertiary, 1Regional, 2District & 2Specialized TB and 3 Specialized Psych Hospitals.
DISTRICT STRATEGIES FOR TB IC Engaging TB Patients and the Community in Advocacy campaigns to prevent infections To Develop TB IPC Plan for the District and in all healthcare facilities. Ensure safe sputum collection Promote cough etiquette and cough hygiene Triage TB suspects for fast track care or separation Assure rapid diagnosis and initiation of TB treatment Improve room air ventilation Protect healthcare workers Build capacity to prevent infections To monitor infection control practices
BEST PRACTICES Patient and Staff Educational Material displayed in all strategic areas TB Risk Assessments are conducted All facilities have IPC Files with Policies and Protocols and Guidelines
Guidelines and Tools have been distributed across the District
Air Flow Direction Doctor/ Nurse Patient
N95 Respirators for Staff and Surgical Masks for Patients available at all entrances in Critical Areas
CHALLENGES & LESSONS EMANATED FROM PROCESS Resistance to change/staff attitude Lack of managerial support to IPC Programme Lack of collaboration and integration in Programmes Staff turn over for PHC IPC Champions due to resignations High patient-staff ratios Infrastructural challenges Programme conflicts with TB IC/NCS Vs (Ideal Clinic)
IDEAL CLINIC VS NCS NCS Ideal Clinic
ESSENTIAL ELEMENTS OF EFFECTIVE TB IC AT FACILITY & DISTRICT LEVEL Comprehensive District IC Plan which outlines the Controls for TB IC Effective Maintenance Department Capacity Building Enhance collaboration between TB/IPC/HIV/CDC/MCWH Programmes
TB IC FUNCTION/ COLLABORATION WITH OTHER PROGRAMS DISTRICT SUPPORTING PARTNERS
OUR PLAN TO CONTINUE QUALITY CONTROL IN TB IPC Ensuring Managerial support for improving TB IPC Practices Arranging continuous training sessions in TB Infection Control Monitoring the functioning of IPC Committees and their roles in TB. Ensuring the establishment of baseline patterns of client movement and air flow in facilities To ensure special waiting areas for patients Ensuring TB Infection Control at reception areas in facilities Effective management of all suspects and TB clients Ensuring an adequate respiration protection Programme is available in all facilities Monitoring provision for personal protective equipment Development of risk assessments Ensuring adherence to quality(NCS) Ensuring effective screening process
CONCLUSION TB IPC should not be viewed as an isolated intervention rather, it is a part of general infection prevention and control and an important part of a TB prevention and treatment package along with IPT, ICF, TB treatment and access to early ART.
THANK YOU FOR LISTENING! • KUMBUZILE KHUMALO • Kumbuzile.khumalo@kznhealth.gov.za • 033 897 1000