How far should they walk? Increasing antiretroviral therapy access in a rural community in northern KwaZulu-Natal, South Africa

J Infect Dis. 2007 Dec 1;196 Suppl 3:S469-73. doi: 10.1086/521115.


Mseleni is a rural community located in northern KwaZulu-Natal, South Africa. As in most rural regions in sub-Saharan Africa, Mseleni's health care facilities are short staffed and suffer from significant resource constraints. Although these barriers exist, Mseleni's clinic-based antiretroviral therapy (ART) program is currently estimated to be meeting the needs of 60% of individuals who require therapy within its catchment area. To increase ART coverage, close attention must be paid to staffing levels and to collection of the appropriate data to inform improvements in clinical care. A number of reviews and interventions have been undertaken to fine-tune the system. The integrated team approach is key to programmatic development and should lead to strengthening of both primary health care and the ART program. Furthermore, to meet a greater percentage of treatment needs, full use of community networks is needed to draw asymptomatic patients into voluntary counseling and testing.

Publication types

  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / virology
  • Ambulatory Care Facilities
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / economics
  • Anti-Retroviral Agents / administration & dosage*
  • Anti-Retroviral Agents / economics
  • CD4 Lymphocyte Count / methods
  • Health Services Accessibility / economics
  • Health Services Accessibility / organization & administration*
  • Health Services Accessibility / trends
  • Hospitals
  • Humans
  • Primary Health Care
  • Rural Health Services / economics
  • Rural Health Services / organization & administration*
  • Rural Health Services / trends
  • Rural Population
  • South Africa


  • Anti-HIV Agents
  • Anti-Retroviral Agents