The Themba Lethu Clinic Programme
The City of Johannesburg’s Helen Joseph Hospital is a public hospital providing tertiary health care services to the people of Gauteng. About 22,000 patients come to the clinic from Johannesburg’s B, C and D regions. The University of Witwatersrand’s healthcare teaching programme is integrated into the hospital.
As part of the Accelerating Program Achievements to Control the Epidemic (APACE) grant under the Anova Health Institute (Anova), Right to Care (RTC) provides specialised services at the Themba Lethu Clinic, situated at the Helen Joseph Hospital. These services include:
Advanced HIV disease is a major factor driving both admissions and deaths at the hospital. Of the patients initiated on antiretroviral treatment (ART) at the clinic:
Low resistance rates showed that HIV Drug Resistance (HIV-DR) testing is a cost-effective strategy to identify and tailor third-line treatment.
At the Themba Lethu Clinic, we:
support the National Department of Health (NDoH) with rolling out treatment and care for HIV and TB patients
provide advanced clinical care for patients: with complications from TB and HIV and experiencing comorbidities, treatment side effects or treatment failure.
This programme began in 2004 and is now in its 16th year.
Activities at the clinic
Advanced HIV and TB care is offered with strong clinical support from different departments within the hospital. This support has:
Our main activities focus on complicated cases and cover:
The programme’s direct service delivery support encompasses:
UNAIDS 90-90-90 targets
Our work here is also focused on:
- reaching UNAIDS 90-90-90 targets and
- addressing barriers to achieving these targets.
Goals towards reaching the first 90 have been achieved by:
- holding weekly data review meetings,
- providing additional support for lay counsellors,
- using extended operating hours over weekends,
- attaining high positivity yield in the wards,
- providing TB screening with every patient’s clinic visit,
- holding weekly Treatment Acceleration Programme (TRAP) meetings and
- performing effective data analysis to address gaps.
Goals towards achieving the second 90 have been achieved by:
- improving ward initiations,
- collaborating on TB/HIV cases,
- holding weekly data review meetings,
- keeping patient flow charts which improve ART initiations and
- ensuring rigorous follow up of patients who are co-infected with HIV and TB to allow treatment initiation.
Goals towards achieving the third 90 were achieved by:
- introducing adolescent and youth-friendly services,
- ensuring close monitoring of patients due for viral load (VL) testing,
- tracing of discharged patients by the call centre,
- ensuring that adolescents and students remained in care and
- establishing a call centre to trace patients who were transferred to local clinics to ensure they were retained in care.
