1. Informing the Capacitation of Clinic Committees
in High Prevalence Areas
R Rapiti, N Nkhwashu, R Maithufi, F Cleghorn and M Madibane
in collaboration with the
South African National Department of Health
PHASA 2012
Bloemfontein, South Africa

2. Slide 2
Background
• USAID Sexual HIV Prevention Programme (SHIPP);
• HIV Combination Prevention;
• Multi- sector approach : health, education and social;
• Capacity building and deliver technical assistance;
• Provision of short-and medium-term technical
assistance;
• Strengthen coordination of efforts at the local level.

3. Slide 3
Geographic Focus

4. Slide 4
SHIPP’s Objectives
1. Strengthen leadership capacity of SAG
departments
2. Strengthen HIV prevention service delivery
systems
3. Improve the quality, effectiveness and
coverage of HIV prevention programmes

5. Slide 5
AIM
• Series of health capacitation activities at the district
level;
• Using a Baseline Evaluation to Inform the
Capacitation of Clinic Committees in High Prevalence
Areas of Gauteng, KwaZulu-Natal and Mpumalanga
Provinces

6. Slide 8
Transfer of skills
Best
Sustainable
Practices
Share/
Evaluate
Apply

7. Slide 9
A Balancing Act

8. Slide 6
Method
• 13 Sub districts;
• Randomly selected 10 facilities in each district;
• Technical officer and district health officer;
• Clinic committee representative;
• Questionnaire: Quantitative
Qualitative;
• Timeline: February and July 2012;
• Health promoter, operational manager or
chairperson completed the questionnaire.

9. Slide 7
Determinants
a. Functionality;
b. Role of clinic committee members;
c. Challenges;
d. Best Practices.

10. Slide 10
Results 1 - Members

11. Slide 11
Results 2 – Technical Documents
• 22% of the committees did not keep minutes
or any records;
• 39% indicated that they used the DHP as a
knowledge management or guidance tool;
• 60% indicated that they were not aware of the
IDP;
• In KZN, 100% of the clinic committees
interviewed were aware of the IDP and its role
and referred to the document during meetings
i.e OSS / “war rooms”.

12. Slide 12
Results 3 – PHC Re-engineering
• 43% of the
respondents indicated
that the clinic
committees will play a
vital role in the PHC re- 17%
engineering process play a role
currently involved
• Only 17% had members 43%
who were currently
involved in the PHC re-
engineering

13. Slide 13
Results 4 – Governance & Representation
• Governance framework to assist clinic committees
• 56% indicated that there was a framework in place;
• However only 23% had the framework at the facility;
• Representation of the clinic committee at district or
municipal level was only indicated by 3 facilities;
• In KZN, respondents referred issues to the war room or
to their ward councilors;
• 65% of respondents indicated that there should be
strong links with local government but most could not
articulate assistance except to action or resolve issues.

14. Slide 14
Results 5 – Challenges
• 95% respondents indicated that there were 2
or more challenges experienced
• Challenges:
- Commitment from members;
– Role clarification;
– Providing the community with feedback;
– Which documents to refer to;
– Capacitation on health issues;
– Demotivated members due to unresolved issues;
– Members should be provided with a stipend.

15. Slide 15
Recommendations
• Develop a framework of coordination for HIV
prevention related activities between local political
stakeholders, health care workers and the
community members.
Community
Clinic
Committee
Health care
Municipal
workers

16. Slide 16
Recommendations 1
• Coordinate resources geared towards HIV
combination prevention services.
“services are provided on different days which would
mean patients have to come in more than once”
• Capacitation of members on clinic committee’s
and its role in advocating HIV combination
prevention activities within communities.

17. Slide 17
Recommendations 2
• Aligning activities to the District Strategic Plan
(DSP) and the needs of the community, using
their available resources.
• Capacitating members to monitor
implementation of agreed activities as aligned
to the DSP.
• Capacitate committee members to develop a
framework encapsulating best practices

18. Slide 18
Acknowledgments
• SHIPP would like to acknowledge the contributions
of:
*District health officers;
*Clinic committee members and
*USAID

19. Slide 19
Acknowledgements
This presentation is made possible by the
support of the American people through the
United States Agency for International
Development (USAID) and do not
necessarily reflect the views of USAID or the
United States Government.

20. • For further information on this presentation
please contact:
Ravikanthi Rapiti
USAID SHIPP
rrapiti@futuresgroup.com