Challenges of primary healthcare nurses regarding the integration of HIV and AIDS services into primary healthcare in Vhembe district of Limpopo province, South Africa

Abstract

Background: Integration of human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) services into primary healthcare (PHC) is a key public health approach to achieving universal access to antiretroviral therapy (ART). Despite the government’s efforts of integrating HIV services into PHC, an insufficient number of PHC staff and inadequate infrastructure are challenging when integrating HIV and AIDS services into PHC. This study explored the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC.Objectives: The aim of the study was to explore the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC.Method: An exploratory, descriptive and contextual qualitative research design utilising face-to-face semi-structured interviews was conducted with 12 PHC nurses from selected clinics and health centres in the Vhembe district of Limpopo province.Results: Two main themes emerged from data analysis which included challenges related to healthcare recipients and challenges related to healthcare providers.Conclusion: Clear policies on the integration of HIV and AIDS services into PHC should be available and should include strategies to promote HIV testing and counselling, adherence to ART and scheduled appointments, disclosure of HIV status as well as revising the human resource policy to reduce workload.

Factors influencing patients’ choice of clinic at Inanda, KwaZulu-Natal

“…14 Previous studies in South Africa have shown that the primary healthcare clinics are insufficiently staffed. 14,16 Similar observations have been reported in Europe and Tanzania where availability of staff, services provided and reliable access to medication were significant contributors to patients' choice of healthcare facility. 5,6 In the province of Tehran in the Islamic Republic of Iran, it was reported that structural indicators contribute highly in attracting patients to a healthcare facility.…”

Level of adult client satisfaction with clinic flow time and services of an integrated non-communicable disease-HIV testing services clinic in Soweto, South Africa: a cross-sectional study

“…Government clinics already have a heavy influx of patients and long queues. A qualitative study in South Africa reported as long as nurses are expected to manage large number of patients each day in primary care, HIV and AIDS services are unlikely to be successfully integrated into PHC, as inadequate staffing and healthcare facility space will negatively impact service delivery [50]. This is especially true in countries like South Africa, which are implementing Universal Test and Treat and same-day initiation policies.…”

Registered Nurses’ Lived Experiences of HIV Counselling and Testing in Rural Primary Healthcare Clinics in Eastern Cape, South Africa

“…The impact of the AIDS epidemic in South Africa is reflected in the dramatic change in mortality rates. According to Tshililo et al (2019), RNs at clinics and health centres face challenges when they come across patients who do not accept their HIV-positive status. Some patients become frustrated after they are told of their HIV-positive status and this interferes with the process of HIV/AIDS service integration.…”

“…The client-centred nature of counselling engenders trust between the counsellor and the client so that there is an opportunity for in-depth discussion of HIV/AIDS, including how to prevent infection. The RNs who participated in the study explained that integrating HIV services into PHC increases their workload which has a negative impact on service delivery; they also indicated that the integration of HIV and AIDS services is time-consuming as they tend to spend too much time with one patient especially newly diagnosed patients (Tshililo et al 2019).…”