HARARE - Harare City Council has moved to decentralise the treatment of tuberculosis (TB), with all 12 polyclinics equipped not only to initiate patients on HIV treatment, but also to prescribe for and monitor TB patients, a city health official has said.
Prosper Chonzi, the city health services director, told the Daily News last week that the decentralisation programme — which started two years ago — had been completed and was targeted at eliminating accessibility barriers that have been hindering some patients from accessing services.
“We started slow but now all our clinics are offering TB treatment, by this I mean all the clinics have TB drugs and patients can access them from these clinics,” Chonzi told the Daily News.
Harare has 12 polyclinics, 13 satellite clinics, six primary care clinics, six family health care clinics, four dental clinics and two infectious diseases hospitals.
On average, the 32 clinics attend to approximately 50 000 initial patients per month, the December 2010 statistical records of council says.
“We are excited with this development because we have brought TB services to the people. Centralisation of services can be a huge barrier to access,” Chonzi said.
The clinics are carrying out all the treatment processes and administering drugs. But X-rays are still confined to Beatrice Road Infectious Diseases Hospital (BRIDH).
“Sputum positive patients are being started on treatment at the local clinics and only go to the hospital for notification,” he said.
“All the polyclinics in Harare (12) are now offering microscopy services and one can go to these for sputum examination any time.
“Seven of these polyclinics can also offer gene X-pert screening which is a more advanced test to detect TB in patients that may not be that symptomatic.
“In terms of investigations, it is only the X-rays that are still being done at BRIDH but all the others are at the clinic level,” said Chonzi.
Prior to this intervention, patients could only access drugs from BRIDH and Wilkins Hospital.
Chonzi said doctors will visit the clinics twice a week to provide specialist back-up to the nurses.
Noting the relationship between tuberculosis and HIV, he said the city has in tandem decentralised the latter’s treatment.
“Patients can now access ARVs from these same clinics and some patients can even be initiated on treatment at the clinics by the visiting doctors,” said Chonzi, while citing challenges often faced by many similar institutions in the country as they adjust to modern set ups.
“Challenges faced are mainly to do with the availability of trained staff to run these programmes and sometimes erratic supplies of drugs and sundries,” he said.
He urged other councils to do the same.
Harare City Health employs over 800 health professionals including 21 doctors, 560 nurses, 12 laboratory scientists and other supporting staff.