Summary:

The Institute for Youth Development South Africa (IYDSA) is a new PEPFAR partner selected for funding in

August 2008 (but not yet funded - the CDC is currently processing the paperwork to award a cooperative

agreement). However, IYDSA is a current sub-partner under the Track 1 Catholic Relief Services (CRS)

program. In FY 2009 the Track 1 CRS program will transition, and IYDSA will become one of three local

implementing partners that will have CRS funds and responsibilities transferred to it.

Background:

IYDSA is an indigenous South African organization providing care, treatment and support to people living

with HIV in the Eastern Cape Province (EC). Within IYDSA, the care and treatment program is called Zisa

Uncedo, which means ‘bring help'. Reducing HIV infection and AIDS morbidity and mortality is the purpose

of this program.

The IYDSA hub-and-spoke model includes main ART sites, extensions and satellite sites to ensure

equitable access for the poor with minimum cost to themselves. This is achieved through a strategy that

mobilizes clinical staff from major treatment sites to remote sites through an extensive outreach program.

There are three main treatment sites where all HIV care and ART are provided with a full staff complement

(Doctor, Social Worker, Nurses, Pharmacist, and Dietician). IYDSA has established three extensions that

are linked to an ART site. Remote satellites are located where there is a large concentration of enrolled

patients. Here VCT is provided, with referral back to treatment and extension sites for ART initiation. The

remote satellites are key to enabling ‘access for all'

Initiation and preparation for effective treatment is a crucial first step, the better the preparation, the better

the outcome. IYDSA strives to ensure that the treatment centers where people are initiated on ARV

treatment has all the necessary skills to ensure patients are properly prepared before being initiated on

HAART.

Once the patient is consistently taking their treatment and they have been stabilized, the best long-term

solution is for them to collect their treatment close to where they live, at the same time receiving localized

monitoring and support. It is with this as a philosophy that IYDSA works towards creating ‘access for all' in

the Eastern Cape.

Activities:

1) Provide access for all: Through the use of a this model IYDSA seeks to provide services at as many sites

as possible to ensure access to treatment with minimum cost. The maximized use of resources, spreading

scarce skills through a mobile staff strategy is cost and time efficient, supplemented by a high level of

training for the primary health care (PHC) staff, who remain in the community.

2) Provide comprehensive HIV medical care to 18,384 HIV positive adults and children, and initiate and

maintain 6,128 people on antiretroviral treatment: Zisa Uncedo will build on current treatment activities of

IYDSA in South Africa, using the extensive capacity and current network of sites to rapidly scale up

treatment numbers. Zisa Uncedo will include assessing site needs and readiness, capacity building of

medical professionals and developing continuum of care mechanisms. This will establish community-based

linkages and systems to support the continuity of care from the health facilities to the households.

3) Build Local capacity, enhancing sustainability: The resultant training of professionals located in rural

areas increases the professional skills within these areas which may be accessed by people from these

communities.

4) Enable people living with HIV and AIDS to lead healthy and productive lives: Ultimately care without an

enabling environment increases dependence. Healthy productive lives are the result of empowering the

individual. This is practiced throughout the program.

There are a number of organizations that IYDSA partners with, these include Government departments at

various levels, local NGOs and faith-based organizations, as well as contracted service providers. The

primary partners are ‘The Pill Box', providing a complete Pharmaceutical Solution, and ‘PEZ' who is

responsible for all administration, development and maintenance of the Adherence Monitors component of

the program.