The Thusong programme started in 2004 in order to identify and fast track access to care for HIV-positive indigent individuals in need of antiretroviral therapy (ART).
Thusong works within the treatment parameters set by the National Department of Health but works to assist HIV-positive people who are unemployed or have a low income but no medical aid and is delivered by general practitioners in private practice. The programme targets rural areas or areas where there are either no ARV initiation sites or where such sites have long waiting lists.
By the end of 2008, Thusong was treating over 2200 patients.
In March 2008, Thusong moved to a larger working space in offices in Milpark, near Auckland Park, Johannesburg. A call centre has been set up which allows case managers to interact with patients and doctors. Stable patients are telephoned on a monthly basis to offer support, counselling, and practical advice, more frequent calls are made to patients that require attention.
As Thusong expands, more staff members are added in a pre-determined algorithm to prevent staff being overloaded. Right to Care supports general practitioners with counsellors when there are more than 20 patients at a site.
Case managers receive ongoing training from the in-house HIV specialist doctor clinician, which gives them greater independence and confidence in their interactions with patients and primary care providers. This ongoing training also improves staff satisfaction with their growth, and thus results in retention of employees who have scarce skills and are in demand.
As part of continued professional development, case managers attend academic ward rounds on Fridays at Helen Joseph Hospital. On the same day Right to Care’s clinicians have an academic day where they attend ward rounds, journal clubs, and topic and case presentations with specialists from the Clinical HIV Research Unit.
The increasing numbers of CCMT sites supported by us enables us to transfer some patients to CCMT facilities. This in turn frees up resources for Thusong to further its mandate of reaching people who, for financial or geographic reasons, have little or no access to ART.