Guideline Detail

Multi-Drug Resistant Tuberculosis: Policy Framework on Decentralised and Deinstitutionalised Management for South Africa

Source: South Africa National Department of Health
Publication Date: August 1, 2011

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2011 South Africa National Department of Health assessment of the need for and benefit of decentralized and deinstitutionalised care and treatment of multidrug-resistant (MDR) tuberculosis (TB), with recommendations for organisational structures and human resources required for decentralisation as well as expected functions of each level of operations and guidance on monitoring and evaluation. Topics addressed include description of decentralised and deinstitutionalised management of MDR TB, including the need for clarity of functions across all levels and for linkages to the entire health system; description of the elements of decentralised and deinstitutionalised MDR TB care; types, structure, levels, and functions of MDR TB units, including provincial level, districts or subdistricts, decentralised drug-resistant TB units, satellite MDR TB units, primary healthcare facilities, mobile teams, and direct observation of therapy supporters/caregivers at the community level; management teams/committees at different levels; treatment follow-up; infection control at home and during patient transport; monitoring and evaluation of the decentralised and deinstitutionalised MDR TB treatment programme; facility readiness assessment tool; example of provincial plan; and building treatment capacity to meet increasing MDR TB burden.

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Keywords: Tuberculosis - Resource-Limited Settings, Tuberculosis - Drug Resistance, Tuberculosis - Transmission and Prevention