Government-funded programmes and services for vulnerable - Unicef

Department of Health
Poor coordination between adult and child treatment programmes
A lack of coordination means that adult and child family members in the same household
affected by HIV/AIDS cannot access their treatment from the same treatment site on the
same day, resulting in duplicated travel and other costs.
Post-exposure prophylaxis
Forty per cent of child rape survivors do not qualify for PEP because they refuse testing
or present more than the prescribed 72 hours after the rape (Collings et al. 2008: 480).
Where PEP is initiated, there are often low follow-up testing rates and low drug
adherence rates.
Poor infrastructure in rural areas inhibits the availability of PEP.
Integrated management of childhood illnesses
There is a high turnover of staff trained in IMCI protocols, leaving the clinics and facilities
short of the prescribed number of staff able to implement the programme at all levels of
healthcare (DoH 2007b).
Expanded programme on immunisation
Immunisation treated as a vertical programme
Immunisation coverage in South Africa is quite good. It is currently at 84 per cent (DoH
et al. 2008). A number of challenges have prevented the vaccine coverage rate in one
year olds reaching 90 per cent. These include the treatment of the vaccine programme as
a vertical programme by health workers, rather than integrating it into all aspects of child
healthcare delivery, the non-availability of vaccines at hospitals, and lack of access to
clinics after hours and over weekends to allow working parents to vaccinate their babies
and children.
High vaccine drop-out rate
The biggest challenge to full coverage is vaccine drop-out. The drop-out rate between the
14-week and 9-month immunisations is relatively high. The drop-out rate between the
9-month and 18-month immunisations is very high (20 per cent nationally) (DoH et al. 2008).
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