Zimbabwe PHC clinics cascade TB-HIV care successfully: The story of Phakama Clinic

International Union Against Tuberculosis and Lung Disease
Feb. 26, 2014, 4:06 p.m.

Phakama Clinic is one of the 23 urban clinics supported since 2012 through The Union’s TB CARE project in 17 urban areas of Zimbabwe. Located in a high-density suburb of the City of Gwanda, provincial capital of Matabeleland South Province, Phakama Clinic is the only one participating in the project that is run by the local authority.

Since August 2013, Phakama Clinic has been accredited as an antiretroviral treatment (ART) initiating and follow-up site for its catchment population of more than 20,000 people. It currently provides follow-up ART for 966 patients who were transferred from Gwanda General Hospital and 107 patients who started their treatment at the clinic.

Full range of TB-HIV services offered at the clinic

Phakama clinic offers a full range of collaborative TB-HIV activities recommended by The World Health Organization, including TB screening, diagnosis and treatment; intensified TB case finding for patients in HIV care or on ART; provider-initiated testing and counselling  (PITC) for HIV for family members; cotrimoxazole preventive treatment (CPT) and ART to all HIV-positive patients who are eligible.

Special services and resources

Well-trained staff, with focus on nurses, leads to good results

The clinic staff has been trained in TB and HIV case management, as well as opportunistic Infection and antiretroviral treatment (OI/ART) management.  Nurses were mentored at a well-established clinic in Bulawayo, giving them hands-on experience in a primary health care setting.  

With infection control (IC) a top priority, the clinic has an IC committee, focal person and IC plan designed to protect both patients and staff. TB-HIV review meetings are held monthly; and data compiled and analysed quarterly is used as a basis for local decision making under the supervision of district, province and national staff.

Key results for Phakama Clinic

-- 97% of TB patients accepted PITC
-- 99% of HIV-positive TB patients commenced CPT
-- 83% of HIV-positive patients commenced ART

Source: The Union