The district and sub districts conduct weekly nerve centre meetings to closely monitor performance of HIV, TB and non-communicable diseases. Gaps are identified and corrective action plans developed which are closely monitored. The nerve centre meetings allow the district to identify facilities that require support. Nerve Centre meetings also allows for best practices to be shared.

Tuberculosis

The TB program has done the district proud, in that six TB indicator performances were ranked among the 10 best in the country, namely:

• For 2017/18 the district achieved a TB symptom child under 5 years screened in facility rate of 97.2% as compared to the South African average of 64.6%
• For 2017 the district achieved a TB Rifampicin resistance confirmed client rate of 3.1% as compared to the South African average of 6.9%
• For 2016 the district achieved a TB treatment success rate of 89% as compared to the South African average of 81.7%
• For 2016 the district achieved a TB client loss to follow up rate of 0.4% as compared to South African average of 6.9%
• For 2015 the district achieved a TB DR client loss to follow up rate of 7.3% as compared to the South African average of 17.5%
• For 2015 the district achieved a TB DR treatment success rate of 63.4% as compared to the South African average of 51.8%

TB cure rate for the District is 87.9% above the Provincial target all sub districts were all above 85% .MDR cure rate is 66.5% for 2016. Activities and campaigns are directed to taverns, soccer games, MMC camps targeting males in order to decrease TB death rate that affects more males than females. All sub districts have started implementing the plan. 12 sites have already visited by TB team and outreach teams.

Termination of Pregnancy (CTOP)

All sub-districts have fully functional CTOP sites which are run by midwife and doctor and the service is available for all who require the service.

Youth Services

Adolescent and Youth Friendly Service (AYFS) training conducted for 42 out of 53 facilities Community dialogues and awareness in conjunction with SHE Conquers project under the following topics: teenage pregnancy, family planning, substance abuse, TB, HIV, MMC, Dental and Eye Health services, HPV campaign and Integrated School Health Services and Health Promoting School.

Male Medical Circumcision (MMC)

Umzinyathi MMC performance of 57.9% is ranked amongst the 10 best in country. The South African average is 24.5% (District Health Barometer 2017/18)

• MMC is conducted at all 53 clinics, 4 Hospitals and 1 CHC by NHI contracted Doctor's
• MMC camps are conducted every Friday in different facilities within the District
• Facilities recruit for MMC in schools, ISIBAYA SAMADODA gatherings, using local media, Taxi ranks, sheebens and in workplaces
• CHALLENGES: transport for recruiting, doing reviews are not covering some sub districts, shortage of staff during MMC camps

Women and Antenatal Care

• Post-delivery Family planning on long acting reversible contraceptives (LARC)
• Reduction of teenage pregnancy.
• Promotion of ANC early booking.
• Cervical cancer screening and offering Colposcopy to deserving clients

Women and Antenatal Care

Phila Mntwana centres are the community based child health structures that are aimed at reducing morbidity and mortality from preventable conditions including HIV, Pneumonia, diarrhoea, and malnutrition. These structures are managed by local Community Care Givers (CCGs) and the following services are provided vitamin A, deworming, malnutrition screening (MUAC), TB screening and health education. For further medical attention CCGs refer them to the nearest facility to be attended to by specialised health care staff.