The purpose of this study was to explore and to describe the experiences of nurses and HIV-positive patients regarding the antiretroviral therapy (ART) programme in primary healthcare (PHC) settings in Lesotho. A descriptive qualitative design was used to collect data which were analysed using a constant comparative analysis. Purposive sampling was used to select participants who participated in focus group discussions. Five themes and 19 sub-themes emerged from the data analysis, namely the ART programme, ART service delivery, unavailability of antiretrovirals (ARVs), staff providing ART services, and satisfaction with ART. The results showed that many HIV-positive individuals accessed ART in PHC settings. Nurses symptomatically managed patients, while patients used alternative healthcare providers owing to inadequate resources and malfunctioning equipment. Even though the nurses were proficient in ART service provision, they were few resulting in work overload and provision of inadequate services. The time taken to provide ART services was dependent on conditions of service providers, the number of patients and the availability of basic utilities such as water. Follow-up care was inadequate for HIV-positive individuals who worked in South Africa. Multiple testing was evident owing to the lack of adequate counselling and untoward incentives. ARVs purported hunger, while stigma was still evident. Conclusively, to ensure effective delivery of ART, retention in care is vital. PHC facilities must therefore be equipped adequately with sustainable equipment, and have scaled-up routine monitoring and evaluation for the effective implementation of the ART programme.
Aim An evaluative tool for the antiretroviral therapy programme was developed for use in the primary health care setting of Lesotho. Background Information on processes followed in the development of standardized and acceptable evaluative tools is not always available to practicing nurses. Methods Behaviours affecting the antiretroviral therapy (ART) programme were contextualized using the conceptual model for social programmes and Intervention Wheel framework. A convergent parallel mixed‐methods design was used to describe perceptions and explore experiences of nurses and patients. The Instrument Development Construct Validation process was used to develop an evaluative tool that was pre‐tested on 17 respondents. Results were analysed using SPSS (23), and internal consistency using Cronbach's alpha coefficient was .768. Results The tool collects information on staffing patterns, services offered, patients seen, time spent seeking services, consultation time, Antiretroviral (ARV) availability, staff adequacy, staff competency, equipment adequacy, service efficiency, activity documentation, patient satisfaction, job satisfaction, monitoring and evaluation. Conclusions The evaluative tool permits identification of factors affecting delivery of the ART programme, hence assisting nurses to improve services provided. Implications for nursing management This method can be used to develop evaluative tools to assess implementation of public health services and inform successes, challenges and recognize improvement approaches.
Background: Health care professionals at the front line of the COVID-19 pandemic require continued support to ensure not only their well-being, but enhanced care for those infected by the disease. This study aimed to assess the perceptions of health care providers regarding the COVID-19 pandemic in Lesotho. Methodology: A quantitative cross-sectional survey design was used to collect data from 190 healthcare workers who were conveniently sampled from a total of 25 health care facilities and completed structured questionnaires. Data were collected in September 2021 and analyzed using SPSS (vs23). Permission to conduct this study was granted by the relevant authorities. Informed written consent was given by the respondents in writing before they could take part in this study. Results: Respondents had positive views about the COVID-19 pandemic, and they were associated with the level of education. They understood that COVID-19 can affect anyone, including themselves and is not a disease for any particular race. They perceived that they could contract COVID-19, even despite pre-existing conditions, and there was a positive prognosis after contracting COVID-19 if necessary precautions were taken. Furthermore, they knew that the virus was affecting many people worldwide, including the elderly, who were willing to be tested. Respondents felt the testing procedure was rather painful and uncomfortable. The test providers were friendly and not rude, and respondents did not have any preferred gender for them. Respondents were also willing to discuss issues on COVID-19 with families and friends, and they lived close to health care facilities. Conclusions: This study concludes that healthcare professionals at the frontline were mostly nurses, and they had positive perceptions about the COVID-19 pandemic as they were knowledgeable and willing to test for the disease. Test providers were viewed as pleasant and healthcare facilities were
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