- Facility pick-up points not acting as a 30 minute one stop shop quick ARV collection is one among a number of challenges outlined in a new Ritshidze State of Health report for Limpopo (5th edition). The report looks at the impact of the PEPFAR disruptions in our clinics, following the U.S funding cuts and slow response of the government earlier this year.
One way to reduce the burden on already overstretched healthcare workers is ensuring that people who come to collect ARVs at facility pick-up points do just that. National ART guidelines say this should take less than 30 minutes. There is no need to go to the registry, collect files, take vitals, or see a clinician. But instead, too often facility pick-up points are doing just the opposite – creating extra work for clinic staff for absolutely no reason.
Yet while only 17% of facilities told Ritshidze that people living with HIV must go somewhere other than the pick-up point before collecting their parcel – 16% in Capricorn, 16% in Vhembe, and 20% in Mopani – many more people living with HIV reported this challenge that adds to delays.
71% of people living with HIV surveyed said they do have to go to other service points before collecting their parcel. This was particularly severe in Mopani, as reported by 88% of facility pick-up point users. This unnecessarily increases the workload for staff across the facility, at a time when staff shortages in the province are a crisis. It also comes while PEPFAR contracts were terminated in the province and the withdrawal of PEPFAR supported healthcare workers left major gaps in clinics across the Mopani and Capricorn. It is more important than ever to make life easier for the remaining staff left in place by reducing – not increasing – their workload.
It also increases the time it takes for people living with HIV to collect their pills. Only 37% of people said it took under 30 minutes to collect their parcel in Mopani. Long waits aren’t just frustrating – they drive people out of the system. Every extra hour in a line is another reason to miss a treatment collection, to skip a visit, or to stop coming back. “I wake up to go to the clinic at 6am. When I arrive, we wait outside to queue and only leave in the afternoon at around 4 to 5pm” one person living with HIV told us. These queues directly undermine the National Department of Health goal to get 1.1 million more people on, or back on, treatment.
There is one simple solution: to ensure that facility pick-up points act as a one-stop very quick ART collection only, allowing people living with HIV to easily and quickly collect their pills in under 30 minutes.
For more information or to arrange interviews contact:
Ngqabutho Mpofu | +27 72 225 9675 | ngqabutho.mpofu@tac.org.za
Lotti Rutter | +27 82 065 5842 | lotti@healthgap.org
Notes:
The Limpopo State of Health report is available here: https://ritshidze.org.za/wp-content/uploads/2025/10/Ritshidze-State-of-Health-Limpopo-2025.pdf
A summary presentation is available here: https://ritshidze.org.za/wp-content/uploads/2025/10/Ritshidze-Limpopo-State-of-Health-October-2025.pdf
What is Ritshidze?
Ritshidze is a community-led monitoring (CLM) system implemented by the Treatment Action Campaign (TAC). Through Ritshidze, community members systematically collect data at clinics and in the community that are analysed, and then used to generate solutions to problems that are put to duty bearers for action. Community-led monitoring is an indispensable strategy for improving the state of our public healthcare system, and getting more people on ARVs.
How does Ritshidze collect data?
Ritshidze collects both quantitative and qualitative data through observations, as well as through the implementation of standardised surveys and in depth interviews with healthcare users (public healthcare users, people living with HIV, members of key populations) and healthcare providers (Facility Managers, pharmacists/pharmacist assistants). All Ritshidze’s data collection tools, our data dashboard, and all raw data are available through our website.
What changes have been made in where Ritshidze collects data following the PEPFAR disruptions?
Prior to the end of January 2025, Ritshidze data was collected across sites in two PEPFAR priority districts in Limpopo: Capricorn and Mopani. While Ritshidze monitoring will continue in these districts, PEPFAR implementing partners have now had their contracts terminated in both districts – the province is no longer receiving PEPFAR support. Ritshidze data will be able to document any changes in the quality of service provision following the PEPFAR disruptions. From this reporting period, Ritshidze data will also be collected in Vhembe, a non-PEPFAR priority district. By moving beyond only monitoring PEPFAR priority districts, Ritshidze aims to understand the quality of service provision in the next layer of high demand/high burden districts.
What changes were made to data collection to determine the impact of PEPFAR funding cuts on HIV services?
A new tool was developed in this reporting period to survey patients as they exit the clinic. This was to gather evidence to the state of service provision that day – to better understand the impact of the PEPFAR disruptions on clinics. All monitoring tools are available here: https://ritshidze.org.za/category/tools/
Data collection periods and locations
- Facility level data was collected between April 2025 and June 2025 at 60 public health facilities in three districts: Capricorn (20 sites), Mopani (20 sites), and Vhembe (20 sites). Surveys were carried out with 60 Facility Managers, 3,155 public healthcare users and 1,514 people living with HIV in the Patient survey, and 3,200 public healthcare users in the Patient Exit survey.
- Key Population service data was collected in the community between July 2024 and September 2024 in three districts in Limpopo: Capricorn, Mopani, and Vhembe. A total of 1,679 surveys were carried out in the province (including 1,367 people using public health facilities). This combined 264 gay, bisexual, and other men who have sex with men (GBMSM), 603 people who use drugs, 299 sex workers, and 201 trans people.