Umdoni & Vulamehlo HIV/AIDS Association: Nakimpilo-Care for Life

The Nakimpilo-Care for Life is an initiative of the Umdoni and Vulamehlo HIV/AIDS Association in partnership with the provincial Department of Health, Virtualpurple Professional Services and various funding and networking NGOs. It is based at GJ Crookes Hospital in Scottsburgh, KwaZulu-Natal. The project has four main components: home-based care; a computer-based information and monitoring system for hospital staff called “BookWise HIV and AIDS Clinic Management System”; and Road to Recovery, a program that provides transport money to 100 HIV+ mothers so that they can reach the hospital’s ARV centre. Nakimpilo is in the process of training 5 rural men for Man to Man, an education program focused on HIV/AIDS-related gender issues targeted at men’s groups. Nakimpilo-Care for Life provides its services to a population of about 170, 000.

Innovation

This project is innovative in its approach to increasing the efficiency of rolling out ARVs to the community. Virtualpurple and the Hospital staff worked closely in developing a computer system that facilitates GJ Crookes Hospital’s ARV centre to streamline the delivery of HIV/AIDS treatment. Separate screens are available for Doctors/Clinicians, Counselors, Dieticians, Laboratories, Pharmacies, CD4 Clinics and Reporting staff showing only the information necessary to carry out the functions of each position. They are now working to allow for data to be captured at source by the home-based care workers.

Effectiveness

The computer-based tracking system has proven to be effective in the following ways: electronic medical records are now kept for all patients attending the ARV Clinic; data management is more accurate; statistical reporting is now possible; and defaulters are tracked more effectively.  The system has also been helpful in reducing waiting times at the hospital's ARV centre. Whereas patients who come in the morning used to wait until sometimes 4 o’clock in the afternoon, they must now wait only until about midday. The GJ Crookes Hospital now has more than 2000 people on ARVs with an average of 80 new patients per month. More than 500 people are assisted through home-based care. Patients are also assisted in applying for social welfare grants. 100 HIV+ mothers are provided money for transport to collect their ARV medication. In addition, the project employs 2 full-time staff and 9 part-time staff from rural areas. Residents are continually applying for access to services provided by the project, demonstrating the popularity of the project. One of the weaknesses of Nakimpilo-Care for Life is that volunteers manage many components of the project and that the nursing staff work in a part-time capacity.

Poverty Impact

Nakimpilo-Care for life has improved the quality of life for all of its patients who now receive home-based care by providing treatment, as well as clothing, blankets, and crèche fees. Patients are able to pay for their transport to the hospital ARV centre for treatment, and 11 people have received gainful employment.

Sustainability

Nakimpilo-Care for Life costs between R600, 000 and R700, 000 to run per year. Currently, the project’s income outweighs its expenditures. Funding for home-based care and Road to Recovery initiatives is secure for the next 10 months with assurances of further funding from current donors. This project’s planning provides that support groups be registered as NGOs and assume the implementation role by 2010. Two treasurers who report to a chairperson, a steering committee, and an executive committee oversee the financial management of the project. Operations are managed by a project coordinator and project managers. Namkipilo-Care for Life’s main concern is to maintain funding for the home-based care program, which it says is the anchor for all other components. This challenge has been partially overcome by assertive fundraising.

Replication

This project is replicable in either a hospital or a clinic setting. The computer program created for this project was designed to be adaptable for health facilities of different scales and with different specific needs. Potential constraints in replicating the Nakimpilo project include a lack of funding, space and/or trained staff. The Nakimpilo project does not face any of these challenges at present. If funds were available to have more salaried staff, Nakimpilo estimates that a similar project could serve 500, 000 people.

Partnerships

• Provincial Department of Health, GJ Crooks Hospital (in-kind donations, training, infrastructure)
• Ugu District Municipality (funding)
• CRUSAID UK (funding)
• DG Murray Trust (funding)
• AFSA (funding)
• Positive Moms Foundation (funding)
• Santa Scottburgh Branch (funding)
• Rotary International Scottburgh (funding)
• SAPPI Saiccor (PTY) Ltd (funding)
• Virtualpurple Professional Services (computer program development and training)
• Futuristic Training Solutions (training)