News from the 3rd quarter around HPCA activities & the CaSIPO project

Operations Department

• SAT – from a report gathered by Amory Goodman (MER Officer) 7 hospices were removed from the system due to lack of activity or progress with their assessments. Reasoning being, there are monthly running costs for each “active” hospice on the system.

• HDMS migration has been initiated, this means that the system is being moved from the platform of our service providers to the HPCA cloud.

• The next phase is to amend the reporting structure and make it more flexible for users and also to establish super users in each province to support hospices.

If you have any question around Operations please feel free email augie@hpca.co.za

HR Department

A ghost link has been created for our Member Hospices to access regarding policies that they might need guidance on or want to implement within their setting – https://apcc.org.za/new//frontpage/hospice-resources.html

• We welcome Xolelwa Jako – Saqu, the newly appointed PAA for Eastern Cape for the CaSIPO Project

Communications Department

#HospiceVisits

The Communications Department will be visiting 2 hospices (Boikhuntsong Hospice & Choice Trust) in the month of August. These hospice visits will include 2 Adherence Clubs visits which will be in line with the CaSIPO objectives.

ehospice | Website | Social Media

We are in the process of completing changing our website and giving it a brand new look and feel which will feature a prominent section on our member hospices. Once this gets finalised we will communication with hospices and the HPCA website will be of great benefit to our members.

Unfortunately, at this stage, HPCA has no budget and will be looking at other alternatives to either get funds through a sponsor or look at getting a student who requires “practical” experience. This is currently being investigated.

In terms of stats we have 18 849 page views for August, averaging 2:05 mins on the page and the top 5 clicked pages were category/Gauteng, hospice directory, contact us, what is PC, who qualifies for PC?

CaSIPO Resources

CaSIPO resources which includes all posters form the AIDS 2017 conference is now available on the HPCA website. This information has been communicated to staff which will allow them to download and print.

ehospice website

Although the ehospice site is up and running, we are looking at moving it to another service provider. A quote has been presented and this will be discussed at the ehospice executive team to make a decision.

In terms of stats 2474 page views (August). Users have spent an average time of 2:31 mins on the page. In terms of the top three articles with the most link clicks it was namely; Garden of remembrance, most people don’t have Palliative care in Africa, and an article around abstracts for the ICPCN conference.

Social Media

Facebook | For August, we had 62 279 impressions, 1822 Engagements and 402 link clicks. We currently stand at 21708 likes acquiring an extra 89 likes during the above mentioned time period.

Twitter | For August, we had 16907 impressions, 578 engagements and 32 link clicks. We currently at 1359 followers and gained an extra 37 followers during that period.

Instagram | 150 engagements, 540 followers (lost 2 followers during this period).

Mandela Day

Mandela Day was celebrated at the Woodside Special Care Centre and it was a huge success!

We are very grateful for the kind donations from Wimpy Kenilworth, Starke Ayres Plants & Paintworld for contributing to this initiative.

To read more about this day, click here.

CaSIPO Project

As CaSIPO completes its third quarter, the momentum is gaining traction on implementation of community adherence clubs across the country

Decanting stable patients to community adherence clubs

The Care and Support for Improved Patients Outcomes Project (CaSIPO) aims to achieve improved patient outcomes by leveraging community support to strengthen linkage to and retention in care. By the end of June 2017, CaSIPO had established 3038 community adherence clubs (ACs) attended by 75299 HIV positive stable patients, achieving 63% and 52% of the annual targets respectively. These results are below the required 75%. In terms of number of patients decanted to ACs, four districts achieved more than 75%. A total of 157 patients exited community ACs. The CaSIPO team plans to achieve a minimum of 80% of the annual targets by the end of the upcoming quarter.

The Universal intervention during adherence clubs sessions

Nutrition and sexual reproductive health (SRH) form an integral part of the care and support services.  During the quarter, eleven districts were able to record the screening of patients for nutrition during adherence club sessions while ten districts recorded screening for sexually transmitted infections (STI). A total of 15259 patients attending community ACs were screened for nutrition and 14346 patients underwent screening for STI.

Tracking and Tracing Loss to Follow Up (LTFU) gradually decreasing

Community Based Organisations (CBOs), in collaboration with ward based outreach teams (WBOTs), play a key role in tracing lost to follow up (LTFU) patients and facilitating their reintegration in care. Nationally, 1579 patients out of 2007 (79%) LTFU were successfully traced by CaSIPO supported CBOs in eleven districts. CBOs are also responsible for referring and linking unstable patients from community ACs back to the clinics. During the quarter, the CBOs referred 1104 patients to facilities for further management. CaSIPO continued to provide technical assistance to the CBOs and WBOTs to strengthen the interface with health facilities and support the implementation of LTFU action plan issued by the National Department of Health (NDOH). The focus of CaSIPO’s technical assistance included strengthening data collection and use; harmonizing data management systems as well as intensified tracking of missed appointments and optimization of patients’ education and support.

Treatment New Support Groups

As the number of patients on antiretroviral treatment (ART) keeps increasing, adherence to treatment is critical to the sustainability of the ART program in South Africa. CaSIPO provided intensified technical assistance (ITA) to CBOs for the establishment of TX_New support group with the objective to retain patients in care from the onset of their treatment. During the reporting period, 2034 patients attended the 123 TX_New Support Groups established and maintained across five districts (Alfred Nzo, eThekwini, Capricorn, Mopani and Dr. Kenneth Kaunda).

CaSIPO continues to enhance capacity development

To achieve its programmatic goal, CaSIPO’s strategic approach focuses on developing capacity of organisations and individuals at community level to facilitate sustainable access to quality comprehensive care and support services closer to the patients. CaSIPO contributes toward the development of human resources for health through organizational and individual capacity development. During the quarter, CaSIPO provided training to 290 staff members from the Department of Health (DOH) (facility and District Health staff), including 118 WBOTs. Hundred and three CBOs and their staff members (479) were trained on Comprehensive Approach to Care and Support (CACS), South African Adherence Guidelines (AGL) for HIV, tuberculosis (TB) and non-communicable diseases (NCDs) and Adherence Club Facilitation. Direct intensified technical (ITA) assistance was provided to 57 CBO’s engaging 556 implementers from the respective CBO’s.

CBO Development takes center piece towards program sustainability

The CaSIPO 2017 Sites Improvement Monitoring System (SIMS) Planner has 196 CBO’s listed. SIMS baselines were completed for the 34 new CBOs, meaning that all 196 CBOs on the planner have been assessed. During the quarter, CaSIPO conducted 332 mentorship visits to address SIMS Gaps.

Community based Distribution – Medicine Access

Access to medicines, an essential component of ACs, remained a key challenge across most of the districts. Where possible, CaSIPO assisted CBOs to register as Pick up Points (PuPs), relieving the pre-packing load from the facility staff. To date, 15 CaSIPO supported CBOs are registered as PuPs.

Data Quality Management 

During the quarter, CaSIPO continued to validate data and put processes in place to justify the accuracy, validity, precision and integrity of data. The district technical support teams worked on enhancing the quality of data being reported resulting in a marked improvement in data quality with the margin of error decreasing from 18% in Quarter 1 to 4% in Quarter 3.

Advocacy

Support given to hospices at Provincial DOH – Director of Hospice Support has been visiting DOH staff in different provinces, and has found provinces are excited, and have accepted the need for palliative care with enthusiasm.  They are looking forward to revive palliative care in their provinces. HPCA and the hospice Regional Chairs have been working on MOUs for all provinces, some draft MOUs have been sent to provincial DOH and are with their legal depts for approval. The way forward now is to sign the draft MOUs with each province and to develop palliative care provincial action plans.

ILO

International Labour Organisation (ILO) is an NGO which is supporting  small community organisations to build capacity to advocate for themselves.  ILO has chosen HPCA member hospices to benefit from the Advocacy training and provinces chosen were Free State and KwaZulu-Natal.  ILO wants to roll this out to other provinces depending on funding. Some hospices mentioned that the training was very relevant to their work and they will use it in their advocacy. Lesedi Hospice reported that they received funding from the Australian Embassy as result of this advocacy training.

Provincial Advocacy Representatives

The provinces nominate their Provincial Advocacy representatives. These are the individuals, employed by hospices, who will spend an estimated ten hours per month advocating for Palliative Care in their provinces. With an intent to strengthen provincial capacity for advocacy, HPCA will conduct Provincial Advocacy workshops.

Workshops will include provincial advocacy representatives who need to be trained in advocacy skills.  This will help the provincial advocacy officers to represent their hospices with Provincial DOH.

For sustainability, the provincial advocacy representatives, after receiving training, will continue training with their hospices to advocate with district DoH.  Workshops will include:

•      Training on the content of the policy, (and on how to leverage the opportunity the policy presents for a hospice to further its footprint in its community for sustainability);

•      Training on how to advocate at local level, to identify district PC champions and empower patients and families to speak about their experiences

•      Train hospices to advocate for palliative care in the DOH district implementation plan.

HPCA has applied for funding for the above activities, once funding received training will commence. Thus the above activities are dependent on receiving funding.