ABSTRACT:
The burden of HIV and other increasing chronic conditions, including noncommunicable diseases (NCDs) in South Africa, is compounded by persistent treatment interruptions and poor treatment literacy(1). To address these barriers, the National Department of Health (NDOH) has developed the National Integrated Treatment Literacy Flip Chart(2), a simplified visual and interactive communication tool for healthcare workers and community cadres. This flip chart is part of the National Integrated Treatment Literacy Toolkit to support the rollout of integrated, client-centred health education for improved health outcomes. The flip chart was developed using a participatory, multidisciplinary design approach collaboratively. Content was informed by national policy, clinical guidelines, and treatment literacy best practice, and refined through structured consultations with policymakers, clinicians, PLHIV networks, health promoters, and communication specialists. An integrated, person-centred framework was applied to align treatment literacy across HIV, TB, NCDs, respiratory conditions, and mental health. Visual storytelling and simplified key messages were used to standardise delivery of health messages across facility and community-based settings, ensuring consistency, accessibility, and scalability for national implementation. The flip chart produced a unified, national treatment literacy resource that replaced multiple fragmented information, education, and communication (IEC) materials. Stakeholder validation confirmed improved clarity, consistency, and usability for frontline health workers, particularly in supporting counselling for low-literacy clients. The modular, integrated design enabled coherent messaging across HIV, TB, NCDs, respiratory conditions, and mental health. Readiness assessments indicated strong feasibility for national scale-up, with anticipated improvements in provider–patient communication, treatment understanding, and adherence-related behaviours The National Integrated Flip Chart provides a scalable, people-centred treatment literacy intervention that supports South Africa’s progress towards Universal Health Coverage. By standardising, integrating, and simplifying client education across communicable and non-communicable conditions, it strengthens frontline service delivery and continuity of care. Routine implementation will reinforce the health system's responsiveness through sustained engagement and treatement adherence