Promoting Person-centered TB Care in South Africa


Newcastle subdistrict of the Amajuba District Municipality, KwaZulu-Natal. Predominately African (Zulu) population. Four public health facilities in the Newcastle area; the MDR-TB unit in Madadeni Hospital, Newcastle Clinic, Stafford Clinic and Osizweni 3 Clinic.

Disease Prevelance

Performance indicators in Amajuba District are a cause for concern with a high TB burden, low TB treatment initiation rate 52% (vs 73% nationally), and high TB death rate 12.2% (vs 6.6%). TB care is a vertical programme in PHC, with separate staff, waiting areas and consultation rooms. Care is neither holistic nor person-centred, with little attention to psychosocial difficulties or the high prevalence of comorbid depression. Infection risk is a problem for families and health workers, and infection control measures complicate counselling, and the delivery of comprehensive, holistic and person-centred care.