The impact of HIV/AIDS on the health sector: national survey of health personnel, ambulatory and hospitalised patients and health facilities, 2002

South Africa is estimated to have the largest number of people living with HIV/AIDS in the world. The Nelson Mandela/HSRC study of HIV/AIDS (2002) reported an estimated HIV prevalence of 4.5 million persons aged two years and older. The epidemic results in high morbidity and mortality. Given the overall impact of HIV/AIDS on South African society, and the need to make policies on the management of those living with the disease, it is important that studies are undertaken to provide data on the impact on the health system. Most people who were infected seven years ago are expected to become ill, and therefore the patient load is expected to increase. Given this scenario, South Africa needs data to assess the impact of HIV/AIDS on the health system to assist decision-makers and programme planners to make policies to ameliorate this impact. The HSRC and the National School of Public Health (NSPH) at the Medical University of South Africa (MEDUNSA) responded to Tender No GES 38/2000-2001 called for by the Department of Health (DoH) to achieve the following specific objectives: (a) Determine the current status and projected morbidity and mortality among South African health workers; (b) Estimate the number of persons with AIDS using public health services in South Africa and determine the demographic profile of these patients; (c) Identify the health services most severely affected by HIV/AIDS, (d) estimate and project important health service indicators such as drug utilisation, bed occupancy and length of stay in hospital; (e) Determine the impact of HIV/AIDS on human resources by focusing on training, staff morale, workload, working hours and absenteeism; (f) Estimate the total cost of administering preventive therapy to newborns and pregnant women at different levels of the health care system. To achieve these objectives, a series of studies were conducted to generate empirical data that could be used for planning and management of HIV/AIDS.