Research Articles

Factors affecting the implementation of nurse-initiated antiretroviral treatment in primary health care clinics of Limpopo Province, South Africa

T. Mabelane, G. J.O. Marincowitz, G. A. Ogunbanjo, I. Govender
South African Family Practice | Vol 58, No 1 : January/February| a4340 | DOI: https://doi.org/10.4102/safp.v58i1.4340 | ©
Submitted: 19 August 2015 | Published: 01 January 2016

About the author(s)

T. Mabelane, Department of Family Medicine, University of Limpopo, Polokwane, South Africa
G. J.O. Marincowitz, Department of Family Medicine, University of Limpopo, Polokwane, South Africa
G. A. Ogunbanjo, Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa
I. Govender, Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa

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Abstract

Introduction: The implementation of nurse-initiated antiretroviral (ARV) treatment at primary health care clinics was introduced in 2010 as a response to lower the HIV prevalence rate in the community.

Aim: The aim of the study was to identify the factors affecting the implementation of nurse-initiated ARV treatment in primary health care clinics referring patients to Dr CN Phatudi Hospital, Limpopo Province.

Methodology: A qualitative study was conducted in 2013 with a purposeful sample of nurses from 12 clinics involved in the nurse-initiated antiretroviral treatment (NIMART) programme. Two free-attitude focus groups and two individual interviews were conducted (audio- and video-recorded whilst the researcher took field notes). These interviews were transcribed verbatim and analysed using the colour-coding as well as cut-and-paste methods.

Results: Common themes that emerged from the individual and focus-group interviews were: (1) lack of resources, which included health care workers, drugs, stationery, telephones, poor training and inadequate workspace; (2) factors affecting treatment adherence, such as stigma, poverty, poor roads and the restrictions on the ‘one pill’ regime; (3) support from management and the visiting doctor and (4) nurses’ work satisfaction.

Conclusion: Two of the themes that emerged acted as barriers to the implementation of the NIMART programme, namely: (1) lack of resources and (2) factors affecting treatment adherence. The two other themes enhanced the implementation of the NIMART programme, namely: (1) support visits and (2) nurses’ work satisfaction.


Keywords

antiretroviral treatment; clinics; nurse initiated; South Africa

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