Staff capacity and resources at nine Free State clinics: shortcomings in the TB programme

Abstract

South Africa faces a continuously escalating tuberculosis (TB) epidemic. This article explores the extent and nature of shortcomings in intra-clinic TB programme resources and staffing. Data was gathered by means of in-depth interviews and observations in nine clinics in the Free State. The main findings of the study include the following: not all TB programme co-ordinators or implementers in the nine clinics had been formally trained in the principles of the National TB Control Programme; knowledge of TB diagnosis was limited; the treatment volunteer system was not optimally managed or utilised; policy guidelines were not available at all facilities; the   recording and reporting infrastructure at some clinics was flawed; the drug, supply and equipment infrastructure at some clinics was lacking; the information, education and communication infrastructure was not utilised to its full extent, and management support was in need of improvement. The findings of this study should alert TB programme managers at the provincial, district, local and clinic levels to the existence and extent of problems at some primary health care (PHC) clinics and the urgent need to address them.