Exploring current practices in pediatric ARV rollout and integration with early childhood programs in South Africa: A rapid situation analysis

In 2005 more than half a million children died of AIDS the vast majority of whom lived in the developing world. In sub-Saharan Africa AIDS has become one of the leading causes of mortality among children under the age of five years. Yet despite increased availability of antiretroviral therapy (ART) children remain a neglected population group. In many countries in Africa there is a lack of experience in the identification treatment and management of young children who are HIV positive and limited knowledge of how community and health service providers can work together to improve childrens access to treatment. As the burden of care for children affected by and infected with HIV is now evident in many countries in Africa governments must increase their level of response swiftly to deal with the crisis. The goal of providing ART to children is to increase survival and decrease HIV- and AIDS-related morbidity and mortality. In South Africa 40 percent of deaths of children less than 5 years of age are attributable to HIV. The South African Cabinet approved a plan for a national HIV treatment program in 2003 the goal of which was to have at least one service delivery point in each district providing treatment by the end of March 2004. Initial treatment sites were identified and inspected under the auspices of the Department of Health (DOH) in terms of meeting a set of minimum criteria for service delivery. Once these service delivery points are deemed to be functioning adequately the roll-out process will cascade to lower levels as the governments experience improves. This report presents the results of a rapid situational analysis of the pediatric roll-out in South Africa. The study provides much needed information on critical issues of pediatric HIV care especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children and key factors that facilitate sustainability of treatment by young children. (excerpt)