Tuberculosis and health sector reform: experience of integrating tuberculosis services into the district health system in rural South Africa [Planning and Practice]

Author: D. Wilkinson¹

Source: The International Journal of Tuberculosis and Lung Disease, Volume 3, Number 10, October 1999 , pp. 938-943(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: Hlabisa health district, South Africa.

OBJECTIVE: To describe the integration of a ‘vertical’ tuberculosis control programme into an emerging ‘horizontal’ district health system, within the context of health sector reform.

DESIGN: Descriptive account of the process of integration of the programme into the health system.

RESULTS: A highly ‘vertical’ system of delivering tuberculosis treatment (with poor programme outcomes) was converted into a ‘horizontal’ team, integrated within the district health system, that used available resources such as village clinics and community health workers, with improved programme outcomes.

CONCLUSIONS: In some settings at least, integration of tuberculosis ‘programmes’ into the district health system as tuberculosis ‘teams’ is feasible, and may produce highly cost-effective outcomes.

Keywords: tuberculosis; health sector reform; district health system; community

Document Type: Regular paper

Affiliations: 1: South Australian Centre for Rural and Remote Health, University of South Australia-Whyalla Campus, Whyalla Norrie, South Australia

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