Improving the efficiency of monitoring adherence to antiretroviral therapy at primary health care level: a case study of the introduction of electronic technologies in Guguletu, South Africa

Figures & data

Figure 1: HIV prevalence in South Africa (ASSA 2003 Model)

Figure 2: Actual versus planned rollout of antiretroviral (ARV) therapy in South Africa

Table 1: Key input indicators, November 2002–November 2004

	November 2002	November 2004
Number of patients	44	437
Number of doctors	1	4
Number of nurses	2	3
Number of counsellors	8	28
Administrative staff	2	4
Total staff	13	39
Total staff per ARV patient	0.3	0.1
Number of patients per therapeutic counsellor	5.5	15.6
If each patient is visited once a week for one and a half hours (including travel), % of time spent by therapeutic counsellors visiting patients^1	20%	60%
% of time used by therapeutic counsellors for administration, data entry etc. (calculated as 100% minus the line above)	80%	40%
Monthly cost of the pharmacy plan (R32 per ARV patient) – data from Cell-Life		R13 984
Monthly cost of the cell phone adherence system (R37.48 per ARV patient) – data from Cell-Life		R16 379
Indicative monthly salary bill (in 2005 prices)^2
Therapeutic counsellors	R29 280	R102 480
Total salary bill (i.e. including doctors, nurses, administrative staff and therapeutic counsellors) at HCTC	R120 054	R322 095
Salary bill for therapeutic counsellors plus cost of the cell phone adherence system	R29 280	R118 859
Salary bill for therapeutic counsellors plus the cost of the cell phone adherence system per ARV patient^3	R666	R272
Total salary bill plus costs of electronic system	R120 054	R352 458
Total salary bill plus costs of electronic system per ARV patient	R2 729	R807
^1This is calculated as the number of patients multiplied by 1.5 times 4 (to get the number of hours per month spent on visiting patients) expressed as a percentage of the total number of counsellor hours available for all work (administrative and counselling).
^2These are not actual salaries from HCTC. They are indicative salaries based on the average cost estimates for 2001 provided in Geffen et al. (2003), inflated by 10% per annum to provide a 2005 figure.
^3This is calculated as total costs (the total salary bill for therapeutic counsellors plus the costs of the cell phone system) divided by the number of patients. Although the costs rose over the period, the number of patients rose faster, and hence cost per patient fell.

Geffen , N , Nattras , N C. and Raubenheimer . 2003 . The Cost of HIV Prevention and Treatement Interventions in South Africa . Centre for Social Science Research , Working Paper no. 28

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