Integration of IAM and GIS technologies to support decision making in the planning and procurement of physical infrastructure for the treatment of drug-resistant tuberculosis in South Africa

Abstract

While positive progress was being made in the latter half of last century in the treatment of the Mycobacterium tuberculosis (TB) epidemic across the world, the emergence of new drug resistant forms – multi drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) threatens gains made and has raised the spectre of a resurgent and more virulent TB epidemic. Co-infection with HIV/Aids, a common phenomenon in South Africa, adds substantially to the risk of infection and numbers of patients, making control more complex and demanding. With both a high TB burden and incidence, South Africa is one of the most negatively impacted countries in the world. The real additional burden of hospitalising M(X)DR-TB patients, the urgency of the need for such accommodation, disease specific requirements for long-term acute and post-acute M(X)DR-TB care, the need to plan within an existing service strategy and limitations on available resources (budget, staff and infrastructure), requires that a new, more integrated approach to strategic planning and the provision of accommodation be developed. This paper provides an overview of new processes and a toolkit being developed in South Africa to support decision making in the planning, procurement, management and operation of physical infrastructure for the treatment of patients with M(X)DR-TB. Use is made of a new Immovable Asset Management (IAM) framework and tools being developed as well as of GIS technologies. Links are also made to facility and risk assessment tools developed for facilities benchmarking and post-occupancy evaluation. While the toolkit is being specifically developed to address the M(X)DR-TB epidemic in South Africa it is envisaged that it will have a wider application in health infrastructure planning and management. Where this paper focuses on integrated service and facility planning for M(X)DR-TB patients, the Congress paper “Hospital design to accommodate Multi- and Extensively Drug-Resistant TB patients” will focus on the design of such facilities