| 11.1 | holistic package of HIV management care should inter alia, include: |
| (b) | Adherence counselling . |
| (c) | Psychological support. |
| (d) | Nutritional assessment and education . |
| (e) | Integration with the TB prevention and management programme. |
| 11.2 | A treatment adherence programme should be implemented for all HIV cases. |
The programme should cover the following:
| (a) | Education about the disease. |
| (c) | Medication to be taken and possible side effects . |
| (d) | Importance of adherence to prescribed treatment regime. |
| (e) | Available psychosocial support . |
| (f) | Treatment support and monitoring . |
| (g) | Viral suppression monitoring . |
| (h) | Lifestyle modification . |
| (i) | Loss to follow-up in HIV patients whilst in employment. |
| (j) | Referrals (where there are no in-house services) . |
| 11.3 | Continuity of HIV care beyond employment |
| (a) | Where a patient's employment is terminated while on ART, the patient should be referred to an appropriate HIV care facility where the patient can continue treatment. |
| (b) | Explore options to implement the TIER.Net , cross border referral system through National TB Programme Managers, TEBA and other relevant service providers. |
| (c) | The patient should be provided with a letter or form (generated from the TIER.Net system) detailing the diagnosis, bacteriological investigations conducted (including dates) , treatment regimen dosages , CD4 count and viral load trends on the monitoring tool and other chronic medication or ancillary medication that the patient is taking . |
| (d) | If the existing employee has co-morbidity (HIV and TB) a letter should be provided indicating the expected date for follow up at the mine health centre/one stop services during and post treatment (12-months after treatment completion) . |
| (e) | The referral letter should be accompanied by: |
| (i) | GW 20/14 referral form prescribed by the NDOH. |
| (ii) | The patient's health record (green card). |
| (iii) | MBOD guideline/COIDA (first, progress and final report) for benefit examination and compensation . |
| 11.4 | The patient should be provided with a counselling package which includes: |
| (a) | The available information on the receiving facility ; and |
| (b) | Importance of presenting to the receiving facility to his home and continuation and when they should present to the clinic/ hospital. |
NOTE:
A copy of the GW 20/14 form should be forwarded to the province/country where the patient resides to ensure continuum of treatment and care.
The acknowledgement slip on the form must be completed by the receiving facility and returned to the referring mine health facility.
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| 11.5 | Where the employer does not provide access to health services, it should refer employees to the nearest local healthcare facility for diagnosis and treatment. |
